Cardiovascular Disorders In Patients Research Articles

Acacetin Protects Against High Glucose-Induced Endothelial Cells Injury by Preserving Mitochondrial Function via Activating Sirt1/Sirt3/AMPK Signals.

The strategy of decreasing atherosclerotic cardiovascular disorder is imperative for reducing premature death and improving quality of life in patients with diabetes mellitus. The aim of this study was to investigate whether the natural flavone acacetin could protect against endothelial injury induced by high glucose and attenuate diabetes-accelerated atherosclerosis in streptozotocin-(STZ) induced diabetic ApoE−/− mice model. It was found that in human umbilical vein endothelial cells (HUVECs) cultured with normal 5.5 mM or high 33 mM glucose, acacetin (0.3–3 μM) exerted strong cytoprotective effects by reversing high glucose-induced viability reduction and reducing apoptosis and excess production of intracellular reactive oxygen species (ROS) and malondialdehyde in a concentration-dependent manner. Acacetin countered high glucose-induced depolarization of mitochondrial membrane potential and reduction of ATP product and mitoBcl-2/mitoBax ratio. Silencing Sirt3 abolished the beneficial effects of acacetin. Further analysis revealed that these effects of acacetin rely on Sirt1 activation by increasing NAD+ followed by increasing Sirt3, pAMPK and PGC-1α. In STZ-diabetic mice, acacetin significantly upregulated the decreased signaling molecules (i.e. SOD, Bcl-2, PGC-1α, pAMPK, Sirt3 and Sirt1) in aorta tissue and attenuated atherosclerosis. These results indicate that vascular endothelial protection of acacetin by activating Sirt1/Sirt3/AMPK signals is likely involved in alleviating diabetes-accelerated atherosclerosis by preserving mitochondrial function, which suggests that acacetin may be a drug candidate for treating cardiovascular disorder in patients with diabetes.

Cardiovascular disorders in patients with congenital portosystemic shunts: 23 years of experience in a tertiary referral centre

Congenital portosystemic shunts are rare vascular malformations that may have an impact on the heart-lung system. Associated congenital and/or acquired heart diseases are poorly reported. To analyse cardiovascular disorders within a large congenital portosystemic shunt population, and develop a diagnostic strategy. Among the 168 consecutive fetuses and children referred for congenital portosystemic shunt (1996-2019), patients presenting with at least one cardiovascular disorder, including congenital heart disease, heart failure, portopulmonary hypertension and/or hepatopulmonary syndrome, were reviewed retrospectively. Cardiovascular disorders were detected using echocardiography and one or more of the following: right-sided heart catheterization; contrast-enhanced transthoracic echocardiography; or lung perfusion radionuclide scan. Overall, 46/168 patients with a congenital portosystemic shunt (27.4%) had one or more clinically significant cardiovascular disorders. Congenital heart disease was present in 28 patients, including six with left heterotaxy. Heart failure was present in six fetuses and 21 neonates (eight without congenital heart disease, and 13 with congenital heart disease). In neonates without congenital heart disease, heart function recovered by the age of 3years. Portopulmonary hypertension was identified in 11 patients (mean age at diagnosis: 9years); it was fatal in one patient, and remained stable in five of six patients after congenital portosystemic shunt closure. In six patients, hepatopulmonary syndrome presented as hypoxia (mean age at diagnosis: 5.3years), which reversed after congenital portosystemic shunt closure. Evaluation and monitoring of the cardiopulmonary status of patients with a congenital portosystemic shunt is mandatory to detect and prevent cardiovascular complications. Furthermore, congenital portosystemic shunts must be sought in patients with unexplained cardiovascular disorders, especially when malformations are present.

Statementtype in complex rehabilitation and secondary prevention of cardiovascular disorders in patients with coronary heart disease

The single-center randomized comparative study on revealing the clinical efficacy of the complex method of rehabilitation and secondary prevention of cardiovascular disorders in patients with ischemic heart disease with the inclusion of physical training with the use of stabilometric complex with biofeedback (stabilo-training), general iodine-bromine baths and infrared laser therapy in patients with ischemic heart disease in the remote period after surgical revascularization of myocardium. Observation was made in 60 patients with ischemic heart disease, in remote, not earlier than one year, terms after surgical revascularization of myocardium. Patients were divided into 2 groups by simple randomization method. Group 1, the main group consisted of 30 patients who received a complex rehabilitation method with the inclusion of stabilizing training, general iodine-bromine baths and infrared laser therapy; group 2, the comparison included 30 patients who received a rehabilitation course with the inclusion of general iodine-bromine baths and infrared laser therapy only. Cardiovascular disorders (CVD) were evaluated using electrocardiography (ECG) in standard leads, echocardiography (ECG), daily ECG monitoring with assessment of cardiac rhythm variability, veloergometry (VEM), stabilometry and a 6-point rating scale and psychological testing with the help of HAM and Spielberg tests. The study results were processed using the Statistica 8 for Windows application package. Preliminary calculation of sample power showed a sufficient number of patients in groups of 30 people. Calculation of statistical reliability of the results was performed by the Student-Fisher criterion. The differences between the two mean values were considered reliable at p<0.05. Under the influence of the complex with inclusion of statokinesoterapy in patients with IHD of the main group in comparison with the comparison group, more expressed antianginal and antiarrhythmic effects, increase of tolerance of physical activity, physical efficiency were noted. Positive ECG dynamics, increased cardiac output fraction, improved mood and sleep were noted. Positive dynamics of SSN in 85% of patients of the main group and in 65% of the comparison group was accompanied by increased stability in the vertical posture, decreased walking precariousness, improved coordination and equilibrium, decreased indices of the pressure center deviation (CD) in frontal and sagittal directions. The average rate of displacement of CD and the total area of the statokinesiogram decreased only in the main group of patients, in the comparison group the stated indices of stabilometry remained without dynamics. The total dynamics index of symptom severity decreased by 11±0.03 points in the main group of patients and by 6.7±0.01 points in the comparison group. The revealed positive clinical effects in patients with IHD in the distant period after surgical revascularization of myocardium, a complex method with inclusion of stabilokinesotherapy, allows to recommend this method of sensomotor physical training in complex rehabilitation programs with the purpose of SSN correction, prevention of development of acute coronary syndrome and heart insufficiency.

ST2 myocardial stress marker research in patients with obstructive sleep apnea and gastroesophageal reflux disease

Objective – To investigate the ST2 marker dynamics in the serum in patients with combined obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) and analyze its relationship with myocardial dysfunction.Materials and methods. 135 patients were examined at the Educational and Scientific Medical Center of ZSMU “University Clinic”: group I – 31 patients with GERD, group II – 32 patients with OSA, group III – 72 patients with OSA and GERD. The control group consisted of 30 healthy individuals. The patients’ average age was 48 (36; 58) years. The groups were comparable by age, gender composition. The myocardial stress marker ST2 serum level was examined in all patients. The results of dispersive ECG mapping, daily monitoring of ECG and blood pressure, and echocardioscopy were evaluated.Results. In patients with OSA and GERD combined course, 2-fold increase in the ST2 marker was detected compared with patients in the control group, with patients in group I – by 1.66 times, with patients in group II – by 1.36 times (P < 0.05). Significant correlation between ST2 level and the apnea-hypopnea index (ANI), heart rate variability parameters, the “Myocardium” index according to the dispersive ECG mapping and the left ventricular diastolic function parameters according to echocardioscopy was revealed.Conclusions. Patients with a comorbid course of obstructive sleep apnea and gastroesophageal reflux disease have higher level of the ST2 marker. Serum ST2 concentration correlates with cardiovascular disorders in patients with combined OAS and GERD.

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence.

Cardiovascular diseases (CVDs), especially those involving a systemic inflammatory process such as atherosclerosis, remain the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). CKD is a systemic condition affecting approximately 10% of the general population. The prevalence of CKD has increased over the past decades because of the aging of the population worldwide. Indeed, CVDs in patients with CKD constitute a premature form of CVD observed in the general population. Multiple studies indicate that patients with renal disease undergo accelerated aging, which precipitates the appearance of pathologies, including CVDs, usually associated with advanced age. In this review, we discuss several aspects that characterize CKD-associated CVDs, such as etiopathogenic elements that CKD patients share with the general population, changes in the cellular balance of reactive oxygen species (ROS), and the associated process of cellular senescence. Uremia-associated aging is linked with numerous changes at the cellular and molecular level. These changes are similar to those observed in the normal process of physiologic aging. We also discuss new perspectives in the study of CKD-associated CVDs and epigenetic alterations in intercellular signaling, mediated by microRNAs and/or extracellular vesicles (EVs), which promote vascular damage and subsequent development of CVD. Understanding the processes and factors involved in accelerated senescence and other abnormal intercellular signaling will identify new therapeutic targets and lead to improved methods of diagnosis and monitoring for patients with CKD-associated CVDs.

Comparative Analysis of Cardiovascular Disorders in Patients with Chronic Myeloid Leukemia on Tyrosine Kinase Inhibitor Therapy

Aim. To analyze adverse cardiovascular events in chronic myeloid leukemia (CML) patients who received various tyrosine kinase inhibitors (TKI). Materials & Methods. The trial included 97 CML patients with nilotinib, dasatinib or imatinib indications. By the time of examination the patients had undergone TKI therapy for 1-138 months. The three of them were sequentially treated with 2 drugs over the monitoring period. All CML patients were aged 22-79 years (median 53.5 years): 55 women were aged 22-71 years (median 53.5 years) and 42 men were aged 24-79 years (median 53 years). Results. The comparative analysis demonstrated significantly higher impact of nilotinib on daily maximum QTc duration compared with other TKIs. The patients who received nilotinib (n = 15) throughout 38 months had QTc of 0.47 s (interquartile range [IQR] 0.46-0.47 s), in imatinib group (n = 17) QTc was 0.43 s (IQR 0.43-0.44 s), and in dasatinib group (n = 4) QTc was 0.43 s (IQR 0.42-0.44 s) (p = 0.0008). Among all patients treated with nilotinib there were 62 % (31/50) with QTc > 0.46 s, in imatinib (6/41) and dasatinib (2/18) groups it was detected in 14.6 % and 11.1 % of patients, respectively (p = 0.0008). Five patients had QTc > 0.48 s, which is the criterion for discontinuation of treatment or dose reduction. In two patients the identified changes of QTc duration required TKI temporary suspension. After nilotinib dose reduction or discontinuation QTc duration normalized in all cases within 2 weeks. Decreased ankle-brachial index (ABI) < 0.9 without pronounced clinical symptoms was identified in two patients who received nilotinib. Afterwards they showed peripheral occlusive disease of lower extremities, and nilotinib treatment was discontinued. In patients treated with other TKIs no occlusive vascular lesions were observed. A case of chronic heart failure with reduced left ventricular ejection fraction developing on nilotinib therapy was revealed and described. Conclusion. Despite high specificity for BCR-ABL tyrosine kinase, new TKIs can, although rarely, induce cardiovascular adverse events. Prior to TKI treatment assignment CML patients should be examined with ECG and EchoCG with systolic function evaluation, and the measurement of pulmonary artery pressure as well as ABI. The examination should be repeated in the end of the 1st year TKI treatment if there is no reason for extra examinations. It is recommended to hold 24-hour ECG monitoring with QTc max measurement prior to nilotinib assignment, then once a year within 2 years of nilotinib treatment, and once in 6 months after 3 years of therapy.

Cardiovascular disorders in patients with primary hyperparathyroidism according to registry data

Cardiovascular disorders in patients with primary hyperparathyroidism according to registry data

Questionnaire-assessed risk of sleep apnea in inpatients with various endocrine disorders

Background: Sleep breathing disorders can be an additional risk factor for the development of cardiovascular disorders in patients with endocrine disorders.Aim: To assess the sleep apnea risk in patients with various endocrine disorders undergoing inpatient treatment.Materials and methods: The sleep apnea risk and the severity of daytime sleepiness were evaluated in 282 inpatients with endocrine disorders based on the following questionnaires: the Epworth Sleepiness Scale (ESS), the sleep apnea screening questionnaire (SAS), and the Berlin sleep apnea risk questionnaire (BQ). To identify the real prevalence of sleep respiratory disorders in endocrine patients we performed cardio-respiratory monitoring with Watch-PAT200 (“Itamar Medical”, Israel) device in 81 patients.Results: A high sleep apnea risk according to the BQ was detected in 59.9% (160/267) of the patients, according to the SAS in 53.53% (144/269), excessive daytime sleepiness (≥ 11 points) was found in 21.66% (60/277) of the patients with the ESS. Among the patients undergoing cardiorespiratory monitoring, sleep apnea was detected in 84% (68/81), including severe apnea in 38.2% (26/68). The highest sleep apnea risk by BQ and SAS was observed in the patients with type 2 diabetes, acromegaly and hypercortisolism. Excessive daytime sleepiness by the ESS was most noticeable in those with hypercortisolism and thyrotoxicosis.Conclusion: The high risk of sleep apnea in the inpatients with type 2 diabetes mellitus, acromegaly, hypercorticism, and hypothyroidism makes it necessary to include its active screening into the algorithm of their inpatient assessment to rule out any sleep breathing disorder.

Serum homocysteine level, vitamin B12 levels, and erythrocyte folate in psoriasis: A case-control study.

BackgroundOne of the most important organ involvements in psoriasis is atherosclerotic cardiovascular disease. Homocysteine is known to have atherogenic properties, but some inconsistency exists in the literature about its probable role as a risk factor of cardiovascular disorder in patients with psoriasis.ObjectiveBecause of some controversies, we compared homocysteine levels and related parameters of metabolic cycles in patients with psoriasis and healthy individuals.MethodsThis case-control study was conducted on 50 patients with psoriasis and 50 healthy individuals as the controls. Serum homocysteine, vitamin B12 levels, and erythrocyte folate concentrations were checked in all participants.ResultsMean serum homocysteine, erythrocyte folate, and vitamin B12 levels did not show any significant difference between the two groups (p > .05), but interestingly, in patients with psoriasis, men had a significantly higher incidence of hyperhomocysteinemia and lower levels of erythrocyte folate (p = .14). Overall, there is no significant difference in serum levels of homocysteine and metabolic-related parameters between the case and control group. There was no significant relationship between the severity of psoriasis and the body mass index of patients (p > .05).ConclusionPatients with psoriasis had a higher body mass index and higher levels of homocysteine in men. Hyperhomocysteinemia could be a predisposing factor of cardiovascular events, but more evaluations as a part of metabolic syndrome in patients with psoriasis are needed.

Cardiovascular disorders in patients with combined course of obstructive sleep apnea and gastroesophageal reflux diseaseCardiovascular disorders in patients with combined course of obstructive sleep apnea and gastroesophageal reflux disease

The aim: to investigate cardiovascular disorders in patients with combined obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) flow.Materials and methods: 165 patients aged 48 (36; 58) years were divided into four groups: I – 31 patients with GERD, II – 32 patients with OSA, III – 72 patients with comorbid OSA and GERD, control group – 30 practically healthy persons. All patients underwent: cardiorespiratory monitoring, ECG dispersion mapping (DM), daily ECG monitoring, echocardioscopy.Results: index “Myocardium” in group III according to DM ECG was by +14 % higher than in group II (p<0,05). Analysis of heart rate variability revealed in patients of group III the growth of SDNNi component by 1,6 times (p<0,05), RMSSD by 1,71 times, pNN50 – by 4,49 times compared with parameters in the control group (p<0,05 ). The HF component in group III exceeded the indicators in group I by 1.87 times, and the parameter LF was higher than in group II by +20,5 % (p<0,05). In group III, the TR component increased in 2,4 times compared with the control group (p<0,05). In patients of group III, every fourth has a daily profile of "night peaker", and every second – has a "non-dipper". The E/A ratio according to echocardioscopy in group III is less than – 18 % in group II (p<0,05). According to the results of ROC analysis, the index “Myocardium” is >18,28 % as a prognostic marker of cardiovascular disorders im patients with OSA and GERD combined flow.Conclusions: In patients with comorbid OSA and GERD revealed the most significant disorders of the cardiovascular system. In order to determine the cardiovascular disorders treatment effectiveness in patients with OSA and GERD, it is advisable to conduct dynamic monitoring of heart rate variability and echocardiography parameters

The Evaluation of Cardiovascular Parameters in Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic and multi-systemic disease with an unknown origin that is associated with inflammation and impairment of the immune system. Cardiovascular disease is the most common cause of death in patients with rheumatoid arthritis. Objectives: This study was conducted to evaluate cardiovascular parameters in patients with rheumatoid arthritis. Methods: In this descriptive study, 112 patients with rheumatoid arthritis, who had been diagnosed for at least six months, were studied. A questionnaire containing demographic data by the researcher using the interview was completed and measuring the cardiovascular parameters was done. Data were analyzed using SPSS software and appropriate statistical tests. Results: Based on the body mass index mean (27.98), the patients under study were overweight; in addition, serum levels of glucose 107.55 ± 38.47, total cholesterol 209.90 ± 37.90, LDL 129.28 ± 30.60 and systolic 145.75 ± 16.23, and diastolic 78.46 ± 11.91, blood pressure in these patients did not have normal distribution. Conclusions: The risk of cardiovascular disorders in patients with rheumatoid arthritis is considerable due to the increase in body mass index, glucose, total cholesterol, LDL, and blood pressure; therefore, screening of at-risk people is recommended.

Associated Valvular Heart Diseases among ASD Patients Undergoing Surgical Repair

Background: Congenital heart diseases (CHD) are one of the most common developmental errors in humans.Objectives: The purpose of the present study was to see the frequencies of various types of atrial septal defect (ASD) and associated cardiovascular disorders in patients undergoing surgical repair.Methodology: This cross-sectional study was conducted on patients undergoing surgical repair at the National Institute of Cardiovascular Diseases (NICVD) or the National Heart Foundation and Research Institute (NHF & RI) in Dhaka, during the period of July, 2010 to June, 2011. Patients presented with ASD at any age of both sexes were selected as study population. Diagnoses were revealed with echocardiography and confirmed preoperatively by registered cardiac surgeons.Results: The morphological types of ASD were ostium secundum type in 96% cases and sinus venosus type in 4% cases. Atrial septal defects were either small or larger defects associated with pulmonary hypertension in 38 (76%) cases, varying degree of tricuspid regurgitation was seen in 33 (66%) patients and dilated pulmonary artery was noted in 24 (48%) cases. Ventricular septal defect in 4 (8%) cases, tricuspid atresia in 2 (4%) cases and mitral valve prolapse in 6 (12%) cases were also observed.Conclusions: Ostium secundum type of ASD is found to be the commonest type of ASDJournal of Current and Advance Medical Research 2018;5(2):60-63

Stem cells rescue cardiomyopathy induced by P. gingivalis-LPS via miR-181b.

Systemic inflammation induced by bacterial infection is one of several causative agents for cardiovascular disorders in patients with periodontal disease. Experimental results indicate that miRNAs play important roles in systemic inflammation induced by endotoxins. Further evidence states that stem cell based therapy shows potential in the treatment of inflammatory responses induced by sepsis. This study investigates if stem cells show protective effects on cardiomyocyte damage induced by porphyromonas gingivalis-LPS (Pg-LPS) through regulating miRNAs. H9c2 cardiomyoblasts and neonatal rat cardiomyocytes (NRCMs) were damaged using Pg-LPS in this study. Pg-LPS damaged H9c2 or NRCMs were then rescued using adipose-derived stem cells (ADSC). The experimental results reveal that Pg-LPS treatment is capable of inducing TLR4/NFκB axis activation, cell death signaling and IGF1R/PI3 K/Akt axis suppression. miR181b was downregulated in Pg-LPS damaged H9c2/NRCMs. All markers were improved in H9c2/NRCMs cocultured with ADSC. miR181b mimic and inhibitor confirmed that miR181b plays a central role in regulating the cardio protective effect on Pg-LPS damaged H9c2/NRCMs cocultured with ADSC. miR181b acts as potential therapeutic marker in cardiomyopathy induced by Pg-LPS. Transplantation of adipose-derived stem cells show potential in the treatment of cardiomyopathy induced by porphyromonas gingivalis endotoxin via regulation of miR181b.

Heart Failure: The Most Important, Preventable, and Treatable Cardiovascular Complication of Type 2 Diabetes.

Concerns about cardiovascular disease in type 2 diabetes have traditionally focused on atherosclerotic vasculo-occlusive events, such as myocardial infarction, stroke, and limb ischemia. However, one of the earliest, most common, and most serious cardiovascular disorders in patients with diabetes is heart failure (1). Following its onset, patients experience a striking deterioration in their clinical course, which is marked by frequent hospitalizations and eventually death. Many sudden deaths in diabetes are related to underlying ventricular dysfunction rather than a new ischemic event. As effective treatments for heart failure have emerged, the risk of sudden death has declined, even in the absence of an implantable cardioverter-defibrillator (2). Heart failure and diabetes are linked pathophysiologically. Type 2 diabetes and heart failure are each characterized by insulin resistance and are accompanied by the activation of neurohormonal systems (norepinephrine, angiotensin II, aldosterone, and neprilysin) (3). The two disorders overlap; diabetes is present in 35–45% of patients with chronic heart failure, whether they have a reduced or preserved ejection fraction. A similar prevalence of diabetes in acute heart failure is reported in this issue of Diabetes Care by van den Berge et al. (4). The interplay between diabetes and heart failure is particularly striking among those with heart failure and preserved ejection fraction, who typically have features of metabolic syndrome. As noted by Sandesara et al. (5) in this issue, the presence of diabetes markedly increases the risk of morbidity and mortality of patients with heart failure and preserved ejection fraction, particularly if the microvascular complications of diabetes are also present. There exists a relationship between the severity of type 2 diabetes and the risk of heart failure, but this …

Relationship between subclinical hypothyroidism and serum osteoprotegerin level in type 2 diabetic patients

BackgroundSubclinical hypothyroidism (SCH) and osteoprotegerin (OPG) are associated with higher risks of cardiovascular disorders in patients with type 2 diabetes mellitus (T2DM). It is unknown whether diabetic patients with SCH have elevated OPG compared with those with euthyroid and, if so, whether SCH independently associated with OPG level.ObjectiveThe objective was to study the association between SCH and serum OPG level among Egyptian adults with newly diagnosed T2DM.Patients and methodsOne hundred and fifty patients with newly diagnosed T2DM and 150 healthy controls matched for sex and age were included in the study. Serum OPG, thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, blood glucose, lipid profile, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and anthropometric measurements were assessed for all participants.ResultsThe prevalence of SCH and elevated level of OPG in the diabetic patients were higher than healthy controls (17.3 vs. 4%, P<0.001; and 14 vs. 4.7%, P=0.02; respectively). Diabetics with SCH demonstrated significantly higher HOMA-IR, serum TSH, and OPG compared with diabetics without SCH. Serum TSH was significantly correlated with total cholesterol (P=0.05), fasting insulin (P=0.01), HOMA-IR (P=0.01), and OPG (P=0.005). Moreover, serum OPG was correlated with waist circumference (P=0.01), fasting insulin (P=0.05), and HOMA-IR (P=0.02). Multiple logistic regression analysis revealed that SCH was associated with serum level of OPG independently of the other significant variables (β=2.49, P=0.01).ConclusionT2DM patients with SCH demonstrate higher level and independent association with serum OPG than those with euthyroid. This result might add new information about the causal relationship between SCH and cardiovascular disorders in such a population.

The relationship of pentraxin-3 levels with IL-17, fetuin-A, insulin in patients with Behçet's disease

Abstract Background Pentraxin (PTX) 3 is synthesized by leukocytes, dendritic cells, endothelial cells and monocytes in response to IL-1 and tumor necrosis factor (TNF)-α, and it might be informative regarding local inflammation. In additionally, pentraxin (PTX)-3, produced by endothelial cells in atherosclerotic plaques, acts as a modulator of inflammatory processes and is involved in the development of atherosclerotic lesions. Objective This study aimed to identify the levels of proteins, such as PTX and fetuin-A, which are thought to play a role in the progression of atherosclerotic and cardiovascular disorders in patients with BD, and to investigate the relationship of these protein levels with BD activity, inflammatory cytokines, insulin resistance and dyslipidaemia. Patients and methods This study included 58 patients (36 females, 22 males) with BD and 20 healthy controls. Serum PTX-3, fetuin-A, interleukin (IL)-17 and insulin concentrations were determined. Homeostasis model of insulin resistance (HOMA-IR) values were calculated, and disease activity was assessed using BD Current Activity Form (BDCAF) scores. Results The levels pentraxin-3, fetuin-A, IL-17, insulin and HOMA-IR in patients with BD were found to be higher than control subjects (p 0.05). Conclusions Similar to CRP, PTX-3 is an acute-phase reactant that is considered an inflammatory and atherosclerotic biomarker. This study showed that PTX-3 levels can increase, similar to IL-17, but no relationship was detected between disease activity and coronary risk factors such as serum lipids, glucose intolerance and obesity. This was a cross-sectional study; therefore, the patients should be followed in long-term studies to determine whether higher PTX levels in BD patients are associated with a higher incidence of cardiovascular disease.

Conflicts at work are associated with a higher risk of cardiovascular disease.

Background: Only few authors have analyzed the impact of workplace conflicts and the resulting stress on the risk of developing cardiovascular disorders. The goal of this study was to analyze the association between workplace conflicts and cardiovascular disorders in patients treated by German general practitioners. Methods: Patients with an initial documentation of a workplace conflict experience between 2005 and 2014 were identified in 699 general practitioner practices (index date). We included only those who were between the ages of 18 and 65 years, had a follow-up time of at least 180 days after the index date, and had not been diagnosed with angina pectoris, myocardial infarction, coronary heart diseases, or stroke prior to the documentation of the workplace mobbing. In total, the study population consisted of 7,374 patients who experienced conflicts and 7,374 controls for analysis. The main outcome measure was the incidence of angina pectoris, myocardial infarction, and stroke correlated with workplace conflict experiences. Results: After a maximum of five years of follow-up, 2.9% of individuals who experienced workplace conflict were affected by cardiovascular diseases, while only 1.4% were affected in the control group (p-value <0.001). Workplace conflict was associated with a 1.63-fold increase in the risk of developing cardiovascular diseases. Finally, the impact of workplace conflict was higher for myocardial infarction (OR=2.03) than for angina pectoris (OR=1.79) and stroke (OR=1.56). Conclusions: Overall, we found a significant association between workplace conflicts and cardiovascular disorders.

Atrial Septal Defect (ASD) and Associated Cardiovascular Disorders in Patients Undergoing Surgical Repair

Background: Congenital heart diseases (CHD) are one of the most common developmental errors in humans.Objectives: The purpose of the present study was to see the frequencies of various types of atrial septal defect (ASD) and associated cardiovascular disorders in patients undergoing surgical repair.Methodology: This cross-sectional descriptive study was conducted on patients undergoing surgical repair at the National Institute of Cardiovascular Diseases (NICVD) and National Heart Foundation and Research Institute (NHF&amp;RI) in Dhaka during the period of July, 2010 to June, 2011. Patients presented with ASD at any age of both sexes were selected as study population. Diagnoses were revealed with echocardiography and confirmed preoperatively by registered cardiac surgeons.Results: The morphological types of ASD were Ostium secundum type in 96% cases and sinus venosus type in 4% cases. Atrial septal defects were either small or larger defects associated with pulmonary hypertension in 38(76%) cases, varying degree of tricuspid regurgitation was seen in 33(66%) patients and dilated pulmonary artery was noted in 24(48%) cases. Ventricular septal defect in 4(8%) cases, tricuspid atresia in 2(4%) cases and mitral valve prolapse in 6(12%) cases were also observed.Conclusions: Ostium secundum type of ASD is found to be the commonest type of ASD.J Shaheed Suhrawardy Med Coll, 2015; 7(1):18-21

Comparative study of extrapolative factors linked with oxidative injury and anti-inflammatory status in chronic kidney disease patients experiencing cardiovascular distress.

BackgroundChronic kidney disease (CKD) is a group of heterogeneous abnormalities affecting the function and structure of the kidney and mostly further proceeds to cardiovascular damage prior to end stage renal disease (ESRD). The oxidative insult and inflammatory mediators have some undefined role in CKD and cardiovascular complications. It is therefore, aimed at to pin point the predictive factors in the development of cardiovascular disorder in patients with chronic kidney disease.MethodsFifty patients of CKD experiencing cardiovascular distress and twenty normal individuals having same age and sex acted as control during these observations. Blood samples (Each 5 ml) were drawn and subjected to centrifugation for 10–15 minutes to separate the serum at 4000-5000rpm. The levels of MDA, GSH, SOD, CAT, VIT C, VIT E, IL-1, TNF-alpha, nitric oxide (NO) and advanced oxidation protein products (AOPPs) were estimated and analyzed.ResultsThe nitric oxide levels in the CKD patients decreased significantly (13.26±1.25 ng/ml) compared to controls (42.15±5.26 ng/ml). The serum vitamin E and C levels in these patients recorded 2.15±0.25 μg/ml and 0.97±0.09 μg/ml respectively as against their assigned controls which read 6.35±1.22 μg/ml and 3.29±0.25 μg/ml. Furthermore, a significantly higher level of Malondialdehyde (MDA) as1.25±0.07 nmol/ml was observed in CKD patients viz-a-viz relevant control. However, the serum SOD, catalase (CAT) and GSH levels in the same patients registered a significant decline as evident from respective figures 0.07±0.002 μg/dl, 1.22±0.012 μmol/mol, and 3.25±1.05 μg/dl. The control for these was observed as0.99±0.06 μg/dl, 3.19±0.05 μmol/mol, and 8.64±0.03 μg/dL. On the other hand, the IL-1 levels in the CKD patients found quite higher (402.5±18.26 pg/ml). This clearly points to substantial increase in oxidative insult and reduced NO levels leading to the renal and cardiovascular damage.ConclusionObservations support the fact that the decrease in anti-oxidative capacity accompanied by higher inflammatory mediators in CKD is indicative of oxidative stress, consequently leading to CKD progression, in all probability to cardiovascular insult. The outcome reiterates that strategies be designed afresh to contain CKD progression to cardiovascular complications and ESRD. One way could be to focus on early detection of stress related to the disease. It requires analyzing the factors related to stress, such as the one reported here. Linking these factors with the symptoms could be a crucial step forward. And further, the disease could be monitored in a more disciplined manner.

HORMONAL STATUS, STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF THE MYOCARDIUM IN PATIENTS WITH ACROMEGALY AND ARTERIAL HYPERTENSION

Objective. To assess the features of the cardiovascular system and hormonal regulation of acromegaly in patients with arterial hypertension (HTN). design and methods. The study involved 66 patients with acromegaly. We assessed the interrelations between hormonal and cardiovascular parameters in acromegaly and HTN. Results. The main cardiovascular disorders in patients with acromegaly and HTN include concentric hypertrophy and left ventricular diastolic dysfunction, dilatation of the left atrium, and abnormal daily blood pressure (BP) profile. conclusions. The increased serum levels of growth hormone and insulin-like growth factor 1, duration of acromegaly and functional activity of a pituitary-adrenal axis are associated with the abnormal daily BP variability, contractile dysfunction of the longitudinal fibers of the left ventricular myocardium, reduced velocity of active relaxation of the left atrium, and left ventricular hypertrophy.