Serum Endothelin-1 Correlates with Myocardial Injury and Independently Predicts Adverse Cardiac Events in Non-ST-Elevation Acute Myocardial Infarction

Effects of Physical Prehabilitation on the Dynamics of the Markers of Endothelial Function in Patients Undergoing Elective Coronary Bypass Surgery

Our aim in this study was to evaluate the effect of physical training performed before CABG on the perioperative dynamics of the serum levels of asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1) of patients with stable coronary heart disease (CHD). Patients in the preoperative period were randomized into two groups: the training group (n = 43) underwent high-intensity treadmill training; the patients in the control group (n = 35) received no training before the procedure. The serum concentrations of ADMA and ET-1 were determined in the perioperative period, and the course of the early postoperative period was analyzed. In the training group, we found a significantly lower incidence of postoperative complications during hospital stays (p = 0.013). At the end of the training program, the ADMA levels were 1.8 times higher in the controls than in the training group (p = 0.001). We found that type 2 diabetes increased the probability of complications by 12 times (OR: 12.3; 95% CI: 1.24–121.5; p = 0.03), as well as elevating the concentration of ET-1 on the eve of surgery (OR: 10.7; 95% CI: 1.4–81.3; p = 0.02). Physical prehabilitation reduced the likelihood of complications nine times (OR: 0.11; 95% CI: 0.02–0.83; p = 0.03). The AUC was 0.851 ± 0.07 (95% CI: 0.71–0.98). The obtained results indicate the benefit of physical training during the prehabilitation stage since it can help to preserve endothelial function.

Astragalus polysaccharide attenuates overexercise-induce myocardial injury via activating AMPK signaling pathway to suppress inflammation and oxidative stress

Excessive exercise leads to myocardial injury or even sudden exercise death. For the vast sports population, appropriate physiological state is a necessary condition for exercise. The present study aims to investigate the cardioprotective effects and potent mechanism of astragalus polysaccharide (APS) treatment against the exercise-induced myocardial injury via in vitro cell-based assay and in vivo model rat. Efficacies of APS incubation on the inflammatory response and oxidative stress induced by LPS were both explored in H9c2 cells by using CCK-8 and western blotting method, respectively. Normal SD rats were randomly divided into saline-treated overexercise rat group, and APS-treated overexercise rat groups with three doses. Then long-term swimming training load cycle (8 week) were performed on these rats. Finally, the changes on body weight, myocardial morphological and injury indicators, as well as the inflammation-related proteins in overexercise-induced model rats were all assessed. Three concentrations of APS all significantly increased cell viability, and decreased the apoptosis of cardiomyocytes in LPS-treated H9c2 cells. Moreover, chronic treatment of APS at all three doses also could obviously decreased myocardial injury-related indicators. Furthermore, the histopathologic examination exhibited that the APS successfully attenuated the changes of myocardial tissues, reduced the lipid accumulation and the protein levels of IL-1β, TNF-α and NF-κB. Furthermore, the APS could activate the AMPK signaling pathway, enhance the autophagy and suppress the production of ROS. On conclusions, APS exerted the protective efficacies on overexercise-induced myocardial injury by activating the AMPK signaling pathway to increase autophagy and suppress the inflammation response, oxidative stress, apoptosis of myocardial cells.

Predictive value of laboratory markers in the development of cardiac events in patients with stable coronary artery disease after elective endovascular revascularization

Aim      To reveal a relationship between preprocedural laboratory data and adverse cardiac outcomes (CO) in patients with stable ischemic heart disease (IHD) following elective endovascular revascularization (ER).Material and methods  This study included 225 patients with IHD admitted for treatment to the Research Institute of Cardiology of the Tomsk National Research Medical Center. The study included patients with documented IHD and hemodynamically significant coronary stenoses requiring elective ER. Patients were divided into groups based on the presence of complications: group 1, 98 patients with adverse CO and group 2, 127 patients without adverse CO. Besides evaluation of complaints, history, and objective status, general clinical and biochemical tests were performed for all patients. Concentration of glycated hemoglobin (НbА1с) was measured by immunoturbidimetry (DiaSys Diagnostic Systems). Serum concentrations of insulin, interleukin-6 (IL-6), endothelin 1 (ET-1), and homocysteine were measured by enzyme immunoassay. Blood lipid profile was determined by enzymatic colorimetry (DiaSys). Content of non-high-density lipoprotein (non-HDL) cholesterol (CS) was calculated as: CS - HDL CS. Insulin resistance (IR) was assessed by the HOMА-IR index. IR was diagnosed at the index of 2.77. Statistical analyses were performed with Statistica 10.0 and Medcalc 19.2.6 software.Results A one-way regression analysis identified predictors for adverse CO following ER. The most significant predictors were fibrinogen (odds ratio (OR), 1.430; 95 % confidence interval (CI), 1.027-1.990), HbA1c (OR 1.825; 95 % CI, 1.283-2.598), homocysteine (OR, 1.555; 95 % CI, 1.348-1.794), ET-1 (OR, 94.408; 95 % CI, 16.762-531.720), triglycerides (TG)/glucose ratio (OR 1.815; 95 % CI, 1.155-2.853). Based on selected factors, logistic regression models were constructed. However, not all models had a high prognostic power. Only concentrations of ET-1 and homocysteine showed a high prognostic capability in respect of the adverse outcome (88.3 and 85.7 %, respectively).Conclusion      For patients with IHD, the prognostic capability of ET-1 and homocysteine with respect of the risk for adverse CO following ER was the highest compared to other markers. The results of the study are completely consistent with data of literature and can be successfully used in clinical practice for optimizing the medical care of patients after elective ER.