Predictors of angiographically normal coronary arteries

Funding Acknowledgements

Type of funding sources: None.

Introduction

Coronary angiography (CAG) has been recommended for patients with well-established risk factors. However, striking rates of coronary angiograms were turning out to be normal and very little is known regarding the predictors of having normal coronary arteries.

OBJECTIVES

The primary objective of this study is to determine the predictors that increase the likelihood of having normal coronary arteries as seen in CAG.

Methods

This study analyzed 279 patients who underwent CAG from January 1, 2015 to December 31, 2019. The primary end point was to determine clinical and diagnostic predictors of having angiographically normal coronary arteries.

Results

In total, 46.9% of patients had a normal coronary angiogram. Multiple logistic regression showed that females are more likely to have normal coronary arteries (aOR- 4.6, 95% CI 2.25 – 9.53) as well as higher HDL-C (aOR- 1.027 95% CI 1.00-1.05). On the other hand, older age (aOR 0.936 95% CI 0.91-0.96) and diabetes mellitus (aOR- 0.946 95% CI 0.92-0.97) are less likely to have a normal angiogram. Overall, patients who had abnormal coronary angiograms were found to be older (63.47 years old versus 56.27 years old, p < 0.001), had greater proportions of males (71% vs 52%), with diabetes (39% vs 24%), a positive smoking history (41% vs 27%), higher Framingham score (29.7 [range 1.4–30] vs 15.9 [range 2.3–30], P <.001), higher WBC (8.1 vs 7.4, P = .018) and higher baseline creatinine (1.07 vs 0.95 mg/dl, P = .001) but noted to have lower HDL-C (40.1 vs 44.07 mg/dl, P = .003).

Conclusion

The female gender is highly predictive of having a normal angiogram while diabetes mellitus and older age are less likely to have a normal angiogram. A higher HDL-C is also associated with increased odds of a normal coronary angiogram.

Impact of a shift work-like lighting schedule on the functioning of the circadian system in the short-lived fish Nothobranchius furzeri

Adult Nothobranchius furzeri of the MZM-04/10 strain were individually kept and subjected to a "5 + 2" shifting lighting schedule (SHIFT) for 8 weeks in order to evaluate the desynchronizing effects of a simulated human-like shift-work schedule on the functioning of the circadian system (CS). With this aim, sixteen 21-week-old N. furzeri were placed into a Morning, Night and Evening schedule (lights on from 08:00 to 16:00, 00:00 to 08:00 and 16:00 to 00:00 h, respectively) and fed once a day in the middle of the corresponding photophase (12:00, 04:00 and 20:00 h, respectively). Then, in the weekends (2 days), fish were always returned to the Morning shift. As controls, 16 fish were maintained under a non-shifting LD cycle condition (CONTROL) throughout the whole experiment, with lights on from 08:00 to 16:00 h. Rest-activity rhythm (RAR) of fish subjected to SHIFT showed several symptoms of chronodisruption, such as a decrease in the percentage of diurnal activity and a reduction of the relative amplitude and the circadian function index with time. When a periodogram analysis was performed, RAR of N. furzeri under SHIFT conditions showed up to three separate circadian components: one longer than 24 h (26.5 h) that followed the weekly 8 h delays; a short-period component (~23 h) that was related to the weekend's phase advances, and finally, a 24 h component. The shifting LD schedule also affected fish CS at a molecular level, with several significant differences in the expression of core genes of the molecular clock (bmal1, clock, rorα, rev-erbα) between SHIFT and CONTROL animals. RAR impairment along with changes in clock gene expression could be associated with high stress and accelerated aging in these fish.

Circadian rhythm of wrist temperature in normal-living subjects A candidate of new index of the circadian system

Most circadian rhythms are under the control of a major pacemaker located in the hypothalamic suprachiasmatic nucleus. Some of these rhythms, called marker rhythms, serve to characterize the timing of the internal temporal order. A marker rhythm, (e.g., one used in chronotherapy) has to be periodic and easy to measure over long periods using non-invasive methods. The most frequent reference variables for human chronotherapy include salivary melatonin or cortisol, urinary 6-sulfatoximelatonin, actimetry and core body temperature (CBT). Recent evidence suggests that sleepiness may be more closely linked to increased peripheral skin temperature than to a core temperature drop, and that distal skin temperature seems to be correlated and phase-advanced with respect to CBT, suggesting that heat loss from the extremities may drive the circadian CBT rhythm. The aim of the present study was to evaluate whether the wrist skin temperature rhythm could be used as a possible index of the human circadian system. To this end, wrist skin temperature (WT1), as determined by a wireless data logger in healthy normal living subjects, was correlated with sleep-wake diaries and oral temperature (OT) recordings. WT and sleep habits were studied in 99 university students. Each subject wore a wireless iButton sensor attached to the inner side of a sport wristband. Our results show that the WT rhythm exhibits an inverse phase relationship with OT, and it is phase-advanced by 60 min with respect to OT. WT started to increase in association to bed time and dropped sharply after awakening. A secondary WT increase, independent of feeding, was observed in the early afternoon. In conclusion, WT wireless recording can be considered a reliable procedure to evaluate circadian rhythmicity, and an index to establish and follow the effects of chronotherapy in normal living subjects.

Macronutrient selection through post-ingestive signals in sharpsnout seabream fed gelatine capsules and challenged with protein dilution

Sharpsnout seabream ability for macronutrient self-selection was studied using gelatine capsules containing pure macronutrients. In particular, the existence of non-oropharyngeal chemosensory pathways involved on protein (P), fat (F) and carbohydrate (CH) selection, as well as sharpsnout seabream response to dietary protein dilution were investigated. In a sequence of experimental phases, sharpsnout seabream were fed a pelleted complete diet, an encapsulated complete diet or a combination of separately encapsulated pure macronutrients. In order to induce associative learning, capsules containing a given macronutrient were paired with a particular colour. The animals composed a diet containing 62.7% P, 21.3% CH and 16.0% F, in terms of macronutrient percentage intake, and this selection pattern was maintained throughout all experimental phases. In a second experiment, individually kept sharpsnout seabream were challenged with protein dilution. After protein capsules were diluted (from 91.9% P to 56.3% P) with cellulose, the animals increased their protein intake to compensate for dilution in such a way that their energy intake was not significantly modified (17.4 kJ/100 g BW vs. 17.6 kJ/100 g BW after dilution). These results show that sharpsnout seabream feeding on encapsulated diets are able to select and maintain a particular diet composition, as well as sustain their energy intake, without using the diet's oropharyngeal chemosensory properties. Moreover, they were also able to maintain their protein intake after dilution, which highlights the importance of this macronutrient in this omnivorous species.

Effects of intense exercise training on rainbow trout growth, body composition and metabolic responses

Cultured fish are bound to experience a variety of potentially stressful situations. In principle, stress may be reduced by adapting fish to intense exercise. This article addresses the effects of chase-induced intense exercise training on rainbow trout. Training reduced fish growth and worsened their nutritional use of food, but had no effect on food intake, biometry or body composition, indicating that a significant fraction of the diet's energy was being used for exercising rather than growth. Regarding metabolic responses, training significantly counterbalanced lactate, glucose and cortisol plasma concentration increases induced by intense exercise, while completely abolishing that of plasmatic proteins. These data suggest that this type of training adversely affects fish growth and food conversion, whereas it improves their metabolic response capacity and reduces the stress component of forced exercise.

Influence of exercise on plasma and muscle free amino acids in trained rainbow trout

Variations in the concentration of free amino acids in the muscle and plasma of trout submitted to 5 minutes of intense exercise have been studied. The responses of untrained fish and those trained performing the same type of exercise twice daily for 28 days are compared. Total amino acid concentrations in muscle tend to diminish after intense exercise. Significant decreases are observed in muscle content of alanine, beta-alanine, isoleucine and ornithine. Plasma amino acids tend to increase after exercise with significant differences in glutamate, GABA, methionine and NH4+. The small variations due to intense exercise suggest that the amino acids are mobilised. Training led to a decrease in total amino acid concentration in plasma but not in muscle, where levels of aspartate and ornithine increased. This suggests a metabolic adaptation to exercise, with amino acid level retention in the muscle.

Trout plasma metabolites, blood factors and spleen contraction: responses to exercise

Fish react to handling and capture with a burst of exercise that affects them deeply. The present study examines the effect of such severe exercise and the time course of recovery on the hematology (including spleen response) and metabolism of a population of cultured rainbow trout. Exercise was induced by continuous chasing for 5 min when the trout showed signs of exhaustion. Such exercise led to spleen contraction and an increase in haematocrit values. Carbohydrates were mobilized and anaerobic glycolysis produced lactate without significant effect on lipid metabolism. The conclusion is reached that the respiratory properties of rainbow trout blood do not change following severe exercise, while muscle anaerobic metabolism is slightly activated as deduced from the fast and short lactacidemia observed, which may have been related to a reduced stressing component, as the exercise was performed in the same environment in which the fish were reared.

Histochemical determination of muscle fiber types in locomotor muscles of anuran amphibians

1. A histochemical study using myosin ATPase, succinate dehydrogenase and alpha-glycerophosphate dehydrogenase reactions and a morphometric analysis with image analyser, was carried out in sartorius and gastrocnemius muscles of two anuran species, Rana perezi and Bufo calamita, that show different locomotor activities. 2. Four types of muscle fiber were found. There were interspecific variations in their proportions, with a predominance of oxidative muscle fibers in Bufo calamita. 3. These results agree with those obtained previously for the metabolic profile of several tissues from both species and point to a clear metabolic basis for the differences in locomotor activities between these two species.

Seasonal changes in the activities of glycolytic enzymes from liver and skeletal muscle of Rana perezi

Glycogen phosphorylase (GP), Hexokinase (HK), Phosphofructokinase (PFK), Pyruvate kinase (PK) and Lactate dehydrogenase (LDH) activities from skeletal muscle and liver were measured in Rana perezi for the four seasons of the year. Skeletal muscle showed a decrease in PFK, PK and LDH activity during winter and summer. Liver displayed an increase in GP activity in spring and in PK and LDH in autumn.

[Effect of lindane on protein nutritive utilization in trout (Salmo gairdneri) (author's transl)]

Rainbow trout weighing 100 + 10 g were fed three diets of different proteic content (67.6%, 53.2% and 36.1%) and exposed to 0.01 and 0.001 ppm of Lindane in water during 21 days. The parameters calculated were: Protein Productive Value (PPV), Conversion Index (CI) and Protein Efficiency Ratio (PER). The PPV parameter increased with a diet proteic level decrease, at control and at Lindane treated groups. Minimum protein utilization corresponds to 67.6% proteic content diet and 0.01 ppm Lindane, while maximum, to 36.1% proteic content and Lindane 0.001 ppm. The CI and PER parameters were markedly different in groups on extreme diets (67.6% and 36.1%) with higher contamination level (0.01 ppm) from all the others. The experimental parameters were not practically affected by the presence or absence of Lindane in groups on diets of medium proteic content.