Cardiovascular Function Research Articles

Integration of a “cardiovascular system” curriculum into an eight-year medical education program: exploration and the experience in China

Abstract Objectives The traditional, subject-based medical teaching mode has gradually transitioned to a system-based integration mode. This study aims to provide the experience of design and implementation of a pilot program to integrate a “cardiovascular system” curriculum into an eight-year medical education in Xi’an Jiaotong University in China. Methods We launched a curriculum integration project that includes study of the cardiovascular system in the eight-year medical education course. Curriculum integration was carefully designed. An integrated curriculum team was formed and the integration objectives clearly defined. The content to be integrated was identified and various tasks were assigned. The perceptions of students and teachers were evaluated using a questionnaire survey. Results We first integrated pharmacology into the new curriculum. This progressed from physiology through pathology to pathophysiology, and finally, to the principal therapeutic drugs. The “cardiovascular system” curriculum was divided into six functional parts: morphological structure; cardiac electrophysiology and relevant drugs; coronary circulation and relevant drugs; cardiovascular function, diseases, and relevant drugs; heart failure and therapeutic drugs; and other cardiovascular diseases. Conclusions An integrated curriculum centered on organ systems has been successfully established using the cardiovascular system as a pilot. Both students and teachers perceived that all cardiovascular system blocks were well-integrated.

The Impact of a Western Diet and Resistance Training in a Rat Model of Mammary Cancer

This study aimed to investigate the impact of a Western diet and resistance training on cardiac remodeling in a rat model of chemically induced mammary cancer. Fifty-six female Wistar rats were randomly assigned to one of eight experimental groups, evaluating the impact of Western and standard diets, exercise and sedentarism, and the induction of mammary cancer. Mammary cancer was induced via the intraperitoneal administration of N-methyl-N-nitrosourea (MNU) (50 mg/kg) at seven weeks of age. The resistance training protocol consisted of ladder climbing three times per week for an 18-week period, with a gradual increase in load over time. At the end of the 20-week experimental period, the animals were anesthetized and underwent echocardiography. Subsequently, the animals were euthanized, and organs and visceral adipose tissue (VAT) were collected and analyzed. A histopathological examination was performed on the mammary tumors. The Western diet increased relative VAT and contributed to cardiovascular and tumor-related changes, including an increase in interventricular septum thickness (IVS) and left ventricle posterior wall thickness (LVPW) at end-systole. Exercise reduced fat accumulation, improved cardiac performance, and helped regulate cardiovascular function, as indicated by a higher eccentricity index (EI) in the WD+EX group compared to the WD group. The WD was associated with increased VAT accumulation and initially delayed tumor initiation; however, over time, it contributed to bigger tumor aggressiveness. This diet also delayed tumor initiation but increased LVPW. Exercise, when combined with a WD, accelerated tumorigenesis, malignant transformation and invasiveness, resulted in the higher prevalence of invasive tumors. These findings underscore the complex and potentially compounding effects of diet and exercise on cancer progression.

Acute and Chronic Cardiovascular Adverse Events in Patients with Acute Myeloid Leukemia: A Systematic Review

Background/Objectives: Patients with acute myeloid leukemia (AML) have a higher propensity for adverse cardiovascular outcomes, primarily due to the toxic effects of chemotherapeutic agents. The purpose of this systematic review is to explore the association of acute myeloid leukemia treatment with adverse cardiovascular events. Methods: We systematically screened the literature for studies providing comparative data on cardiovascular toxicities in patients treated for acute myeloid leukemia. After the initial search, 3649 papers were screened and a final total number of 46 were included for the review process. Results: Common chemotherapeutic agents used in AML may cause cardiovascular (CV) toxicities. A plethora of pathophysiological mechanisms are incriminated for these effects. Drug combinations may increase the risk in a synergistic way. In addition, common mutations of AML, personal history of previous cardiovascular disease and impaired heart function carry an increased complication risk. Biomarkers, as well as multimodality imaging, may be used for the early detection of cardiovascular toxicities. Conclusions: Increased risks of CV toxicity and comorbidities are observed among AML patients. With all the available diagnostic modalities, early detection and CV prevention strategies can improve the patient’s prognosis and quality of life.

Cardiovascular function shows early impairment in asymptomatic adolescents diagnosed with type 1 diabetes mellitus: an ultrasound-derived myocardial work study

BackgroundCardiac dysfunction and endothelial damage are known complications of type 1 diabetes mellitus (T1D) mainly affecting adults. However, some studies have shown that subclinical myocardial impairment already present during adolescence. Myocardial work (MW) has emerged as an afterload-independent tool that allows early identification of subclinical damage. This study aims to provide a comprehensive non-invasive cardiovascular evaluation of T1D adolescents using both conventional and advanced echocardiography.MethodsWe enrolled 31 patients, aged between 13 and 19 years, who were diagnosed with T1D for at least 10 years and were followed up by the Paediatric Diabetology Unit of our institution. We collected data relating to anthropometry, lifestyle, blood tests, glycemic control parameters, and conventional and advanced echocardiographic measurements. A comparison of MW parameters with the data from 31 age- and sex-matched healthy volunteers from a previous study in our lab was carried out.ResultsIn our population, the glycemic control parameters showed suboptimal control. While diastolic parameters were in the normal range for all the patients, E′ velocities and left atrial diameter were significantly worse in patients with poorer glycemic controls. Global longitudinal strain (GLS), global work index (GWI), and global work efficiency (GWE) were significantly lower in the T1D population compared to those in the healthy population (p < 0.001), while global wasted work was significantly higher in the T1D population (p < 0.001). Patients with stage 1 hypertension or a pre-hypertensive state exhibited pathological pulse wave velocities with values exceeding 8 m/s (>99th percentile).ConclusionsTo the best of our knowledge, this was the first study to investigate MW in T1D adolescents. The descriptive parameters of GLS and MW showed subclinical cardiac damage already during this timeframe. Therefore, these tools should be integrated into the cardiovascular assessment of diabetic adolescents, and preventive strategies should be implemented to maximize glycemic and pressure control effectiveness.

Prognostic and Diagnostic Value of Platelet Distribution Width in COPD Patients with Pulmonary Hypertension: A Retrospective Study.

The objective of the study was to investigate the value of platelet distribution width (PDW) as a prognostic biomarker by comparing PDW between COPD patients with pulmonary hypertension (PH) (PASP 50mmHg) and those without PH (PASP < 50mmHg) and to explore its diagnostic and predictive value in this population. A retrospective study of 270 COPD patients in Liaocheng People's Hospital (July 2018 to July 2019) was done by dividing them into two groups according to pulmonary artery systolic pressure (PASP): COPD-only (PASP <50mmHg) and COPD with PH (PASP ≥50mmHg). Routine blood tests, C-reactive protein, pulmonary function tests, echocardiography, Chronic Obstructive Pulmonary Disease Assessment Questionnaire (CAT), Clinical COPD Questionnaire were performed. PDW was higher in COPD with PH group than COPD-only group. After adjusting for confounders including age, smoking history, CAT scores, white blood cell count, PDW, and NT-proBNP in COPD with PH, PDW was positively correlated with various parameters. PDW can diagnose COPD with PH, also prognostic value and cardiovascular distinction in these patients. The study concluded that PDW is a prognostic marker, reflecting pulmonary and cardiovascular physiology in COPD patients with PH. It can be used for early diagnosis, risk stratification, and individualized management for this high-risk population.

Effects of aerobic vs combined aerobic and resistance exercise training on maternal glucose metabolism, sympathetic nervous system control and cardiovascular hemodynamics in women with overweight/obesity during pregnancy.

This study aimed to identify the effects of acute aerobic exercise combined with resistance exercise on maternal glucose metabolism and sympathetic nervous system-regulated cardiovascular function in overweight or obese pregnancies. We conducted a randomized controlled trial of aerobic exercise combined with resistance training (aerobic + resistance; n = 25) compared with aerobic exercise (aerobic, n = 21) beginning at 16 wk and continuing until 36 wk of gestation in overweight or obese pregnant women. At preintervention and postintervention assessments, the glycometabolism, muscle sympathetic nervous system activity (MSNA) and cardiovascular parameters were measured and analyzed, containing fasting blood glucose (FBG), fasting blood insulin (FBI), 2 h glucose, glycosylated hemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), MSNA bursts/min, MSNA bursts/100 heartbeats, resting heart rate (HR); diastolic blood pressure (DBP), mean arterial pressure (MAP), systolic blood pressure (SBP), cardiac index (CI), cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR) and total peripheral resistance index (TPRI). Compared to aerobic group, the overweight or obese pregnant women in aerobic + resistance group showed lower FBG, FBI, 2 h glucose, HbA1c and HOMA-IR (p < 0.05). Moreover, both MSNA bursts/min and MSNA burst/100 heartbeats level were reduced in aerobic + resistance group compared to aerobic group (p < 0.0001). Finally, the resting HR, DBP, SBP, MAP, CI, CO and TPRI were significantly decreased in aerobic + resistance group compared to aerobic group (p < 0.05). In summary, aerobic exercise combined with resistance training was associated with improved glycometabolism, MSNA and cardiovascular function in overweight or obese pregnant women compared to aerobic exercise alone.

Interventional effects of different track and field sports on human cardiovascular function indicators and physiological energy metabolism

ObjectiveTo analyze the effects of different track and field events on human cardiovascular function and physiological energy metabolism.MethodThe research subjects were ordinary male students majoring in physical education at a certain university, aged between 18 and 25 years old. A total of 42 people were divided into four sub sample groups: sprint group (10 people), jump group (10 people), long-distance running group (10 people), and regular student group (12 people). The COSMED K5 portable gas metabolism analysis system was used to measure cardiopulmonary function, and key indicators such as Maximum Oxygen Uptake (VO2max) were evaluated using a Stepwise Increasing Load Test (SILT). The two factor repeated measures ANOVA method was used to analyze the effects of different load levels and groups on cardiopulmonary function and energy metabolism.ResultThe weight, systolic blood pressure, and diastolic blood pressure of different populations were not statistically significant in a quiet state (p > 0.05). The waist to hip ratios of the short-distance and long-distance running teams were 0.75 ± 0.03 and 0.76 ± 0.03, respectively, which showed significant differences compared to ordinary students (p < 0.05). There was also a significant difference in heart rate between different track and field teams and ordinary students in a quiet state (p < 0.05). The termination load of different track and field teams varied, with the long-distance running team having the highest load (p < 0.01), followed by the jumping team. Compared with ordinary students, there was a significant difference (p < 0.05) in the termination heart rate among the sprinting, long-distance, and jumping teams. However, there was p > 0.05 in the systolic blood pressure index among the four groups of subjects. There was a significant difference (p < 0.05) in diastolic blood pressure between sprinting and jumping teams and ordinary students. In a quiet state, the energy metabolism of long-distance running teams, sprinting teams, jumping teams, and ordinary students was 1.52 ± 0.64, 1.81 ± 0.91, 1.86 ± 0.87, and 2.87 ± 0.96, respectively.ConclusionIn a quiet state, there are significant differences in body shape and function between different track and field training teams and the general population. In a quantitative load state, long-distance runners have the strongest adaptability to load.

Short-Chain Fatty Acids and Their Metabolic Interactions in Heart Failure

Short-chain fatty acids (SCFAs), produced through fermentation of dietary fibers by gut bacteria, play a central role in modulating cardiovascular function and heart failure (HF) development. The progression of HF is influenced by intestinal barrier dysfunction and microbial translocation, where SCFAs serve as key mediators in the gut–heart axis. This review examines the complex metabolic interactions between SCFAs and other gut microbiota metabolites in HF, including their relationships with trimethylamine N-oxide (TMAO), aromatic amino acids (AAAs), B vitamins, and bile acids (BAs). We analyze the associations between SCFA production and clinical parameters of HF, such as left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and glomerular filtration rate (GFR). Gaining insights into metabolic networks offers new potential therapeutic targets and prognostic markers for managing heart failure, although their clinical significance needs further exploration.

Flexible Optical Fiber Sensor for Non-Invasive Continuous Monitoring of Human Physiological Signals.

With increasing health awareness, monitoring human physiological signals for health status and disease prevention has become crucial. Non-invasive flexible wearable devices address issues like invasiveness, inconvenience, size, and continuous monitoring challenges in traditional devices. Among flexible sensors, optical fiber sensors (OFSs) stand out due to their excellent biocompatibility, anti-electromagnetic interference capabilities, and ability to monitor multiple signals simultaneously. This paper reviews the application of flexible optical fiber sensing technology (OFST) in monitoring human lung function, cardiovascular function, body parameters, motor function, and various physiological signals. It emphasizes the importance of continuous monitoring in personal health management, clinical settings, sports training, and emergency response. The review discusses challenges in OFST for continuous health signal monitoring and envisions its significant potential for future development. This technology underscores the importance of constant health signal monitoring and highlights the advantages and prospects of optical fiber sensing. Innovations in OFS for non-invasive continuous monitoring of physiological signals hold profound implications for materials science, sensing technology, andbiomedicine.

Glucagon-Like Peptide-1 Links Ingestion, Homeostasis, and the Heart.

Glucagon-like peptide-1 (GLP-1), a hormone released from enteroendocrine cells in the distal small and large intestines in response to nutrients and other stimuli, not only controls eating and insulin release, but is also involved in drinking control as well as renal and cardiovascular functions. Moreover, GLP-1 functions as a central nervous system peptide transmitter, produced by preproglucagon (PPG) neurons in the hindbrain. Intestinal GLP-1 inhibits eating by activating vagal sensory neurons directly, via GLP-1 receptors (GLP-1Rs), but presumably also indirectly, by triggering the release of serotonin from enterochromaffin cells. GLP-1 enhances glucose-dependent insulin release via a vago-vagal reflex and by direct action on beta cells. Finally, intestinal GLP-1 acts on the kidneys to modulate electrolyte and water movements, and on the heart, where it provides numerous benefits, including anti-inflammatory, antiatherogenic, and vasodilatory effects, as well as protection against ischemia/reperfusion injury and arrhythmias. Hindbrain PPG neurons receive multiple inputs and project to many GLP-1R-expressing brain areas involved in reward, autonomic functions, and stress. PPG neuron-derived GLP-1 is involved in the termination of large meals and is implicated in the inhibition of water intake. This review details GLP-1's roles in these interconnected systems, highlighting recent findings and unresolved issues, and integrating them to discuss the physiological and pathological relevance of endogenous GLP-1 in coordinating these functions. As eating poses significant threats to metabolic, fluid, and immune homeostasis, the body needs mechanisms to mitigate these challenges while sustaining essential nutrient intake. Endogenous GLP-1 plays a crucial role in this "ingestive homeostasis."

Prenatal dexamethasone programs autonomic dysregulation in female rats.

Autonomic dysfunction is associated with cardiovascular and neurological diseases, including hypertension, heart failure, anxiety, and stress-related disorders. Prior studies demonstrated that late gestation exposure to dexamethasone (DEX) resulted in female-biased increases in stress-responsive mean arterial pressure (MAP) and heart rate (HR), suggesting a role for glucocorticoid-mediated programming of autonomic dysfunction. The present study investigated the influence of sympathetic (SYM) or parasympathetic (PS) blockade on cardiovascular function in male and female rat offspring of mothers injected with DEX in utero [gestation days (GD) 18-21]. At 11-12-wk of age, MAP, HR, and heart rate variability (HRV) were evaluated at baseline and in response to SYM antagonists (α1-adrenoceptor + β1-adrenoceptor), a PS (muscarinic) antagonist, or saline (SAL). To assess stress-responsive function, rats were exposed to acute restraint. Tyrosine hydroxylase was measured in the adrenals and left ventricle, and expression of the β1 adrenergic receptor, choline acetyltransferase, and acetylcholinesterase were measured in the left ventricle. Maternal DEX injection reduced basal HRV in male and female offspring. SYM blockade attenuated increases in stress-responsive HR and MAP. PS blockade elevated stress-responsive HR and MAP to a greater extent in vehicle females. SYM and PS blockade produced equivalent effects on HR and MAP responses in male offspring, regardless of maternal treatment. Based on these findings, we suggest that maternal DEX injection disrupted autonomic regulation of cardiovascular function in females, resulting in a shift toward greater SYM input and less input from PS. Future studies will investigate whether changes in autonomic function are mediated by changes in central autonomic circuitry.NEW & NOTEWORTHY Pharmacological antagonists are used to characterize the nature of the autonomic dysregulation induced in female offspring exposed to dexamethasone, in utero. The female offspring of dams injected with dexamethasone in late gestation show a reduction in vulnerability to parasympathetic blockade and an increase in responses to acute restraint stress even in the presence of sympathetic blockade. This suggests that late gestation dexamethasone disrupts the normal development of the autonomic function in females, shifting sympathovagal balance.

Abstract TP381: Alterations in Heart Rate Variability After Ischemic Stroke in Rats: Heart-Brain Connectivity

Introduction: Heart rate variability (HRV), which represents fluctuations in heart rate, provides critical insights into autonomic regulation and cardiovascular function. This study aims to evaluate how HRV metrics change before, during, and after an ischemic stroke in a rat model, with a focus on understanding the impact of stroke and subsequent reperfusion on autonomic control. Methods: We employed the standard intraluminal suture middle cerebral artery (MCA) occlusion model to induce ischemic stroke in anesthetized adult male and female Sprague Dawley rats (n=11, 2-3 months old, average body weight: 296 ± 47 g, 27% female). The procedure involved temporary occlusion of the common carotid artery (CCA) while advancing a suture into the internal carotid artery to occlude the MCA for 1 hour, followed by 3 hours of reperfusion (Fig. 1). Electrocardiogram (ECG) signals were continuously recorded throughout the procedure. Post-surgery, cerebral infarction was confirmed via the triphenyl tetrazolium chloride (TTC) staining technique. HRV metrics were analyzed from 1-minute ECG recordings taken at three time points: baseline, 1 hour post-MCA occlusion (pre-reperfusion), and 3 hours post-reperfusion. Results and Conclusions: Significant alterations in HRV metrics were observed between baseline and 3 hours after reperfusion (p&lt;0.05; Fig. 2; see figure’s caption for the metric descriptions). Specifically, high-frequency relative power percentage (HF%) and the SD1/SD2 ratio decreased significantly, while low-frequency relative power percentage (LF%) and the LF/HF ratio increased significantly. Additionally, the LF/HF power ratio showed a notable increase from baseline to 1 hour post-MCA occlusion. Our findings reveal distinct HRV metric changes associated with the ischemic stroke. The observed alterations reflect a shift of autonomic regulation towards sympathetic dominance, which intensifies after reperfusion, supporting other preclinical and clinical findings. These results suggest the potential for developing non-invasive, HRV-based techniques for real-time detection and monitoring of ischemic stroke. Further research could enhance these techniques' applicability in clinical settings.

Cardiovascular structure and function in MPS VII subjects

Cardiovascular structure and function in MPS VII subjects

Effect of home-based hot bathing on exercise-induced adaptations associated with short-term resistance exercise training in young men.

This study investigated whether home-based bathing intervention (HBBI) improve muscle strength gain and protect cardiovascular function by short-term resistance training (RT). Thirty-one healthy young men measured the maximum voluntary isometric contraction (MVC) of knee extensor, electrically evoked knee extension torque, and mean arterial pressure (MAP). Then, participants were divided into three groups with matching MVC: shower without bathing (control, n = 10), thermoneutral bathing (36°C-bathing, n = 10), and hot bathing (40°C-bathing, n = 11), and conducted 2 weeks of HBBI. Following familiarization for HBBI, participants completed 2 weeks of HBBI and acute RT (five sessions of three sets of 10 isometric knee extension at 60% MVC). Baseline neuromuscular and cardiovascular function was assessed again following completion of the 2 weeks of intervention. MVC was non-significantly increased after the RT period in 40°C-bathing with large effect size (partial η2 = 0.450). The electrically evoked knee extension torque (10/100-Hz ratio) was significantly increased after the RT period in control (p = 0.020). MAP did not alter due to bathing intervention and RT (all p > 0.05). HBBI improved muscle strength without RT-induced alteration of peripheral muscle condition. Shower without bathing reduced muscle strength gain but increased peripheral muscle condition. Short-term RT does not adversely affect the cardiovascular function, regardless of HBBI.

Effects of engineered nanomaterials on the cardiovascular system.

With the explosive development of nanotechnology, engineered nanomaterials are currently being used in various industries, including food and medicine. Concern about the health effects of nanomaterials has been raised, and available research indicates that the relative surface area of nanomaterials seems to correlate with the severity of their toxicity. With regard to engineered nanomaterials, the scope of their acute and chronic toxicities and their mechanisms are not fully understood. Studies suggest that exposure to certain nanomaterials can generate reactive oxidant species and enhance permeability of the phagolysosomal membrane, which leads to inflammasome activation, causing oxidative stress and inflammation. Since the latter two are implicated in the development of cardiovascular diseases, such as hypertension and atherosclerosis, it can be presumed that exposure to engineered nanomaterials could significantly impact cardiovascular function. In this review, I raise issues that should be considered in the assessment of the effects of engineered nanomaterials on cardiovascular function and evaluate their cardiovascular toxicity as described in various in vitro and/or in vivo toxicological studies and industrial investigations.

Differences in Biomarkers of Potential Harm After 2+ Years of Tobacco Heating System Use Compared to Cigarette Smoking: A Cross-Sectional Study

Background Growing evidence indicates that noncombustible products could be a tobacco harm reduction tool for smokers who do not quit. The Tobacco Heating System (THS) emits substantially lower levels of harmful cigarette smoke constituents, and previous randomized clinical studies showed improved levels of biomarkers of potential harm (BoPH) linked to smoking-related disease. Methods In this cross-sectional study of healthy participants (n = 982) who (i) smoked cigarettes, (ii) had voluntarily switched from smoking to THS use, or (iii) formerly smoked, blood and urine samples were assayed for nine BoPH. The co-primary endpoints were carboxyhemoglobin, total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, white blood cells, and 8-epi-prostaglandin-F2α. The key secondary endpoints were high-density lipoprotein cholesterol, soluble intercellular adhesion molecule-1, 11-dehydrothromboxane B2, central vascular augmentation index, and forced expiratory volume in 1 s (%predicted post-bronchodilator). Results THS users showed significant favorable differences in all nine BoPH compared to current smokers. Results in THS users were similar to those in former smokers. Conclusion Compared to current smokers, healthy participants who voluntarily switched from smoking to THS use for ≥2 years in the real world had favorable differences in BoPH related to oxygen delivery, genotoxicity, inflammation, oxidative stress, lipid metabolism, endothelial function, platelet activation, and cardiovascular and respiratory function. Clinical trial registration: Clinicaltrials.gov Identifier: NCT05385055. Date of registration: May 23, 2022. https://clinicaltrials.gov/study/NCT05385055

Comprehensive profiling of serum microRNAs in normal and non-alcoholic fatty liver disease (NAFLD) patients

Pediatric non-alcoholic fatty liver disease (NAFLD) is emerging as a worldwide health concern with the potential to advance to cirrhosis and liver cancer. NAFLD can also directly contribute to heart problems through inflammation and insulin resistance, even in individuals without other risk factors. The pathological mechanisms of NAFLD are linked to functional differences of miRNAs in different biological environments. The miRNA in serum exosomes may reflect the pathological state of the liver and changes in systemic metabolism, while the miRNA in serum may be associated with physiological processes other than the liver. Pediatric non-alcoholic fatty liver disease (NAFLD) is emerging as a worldwide health concern with the potential to advance to cirrhosis and liver cancer. NAFLD can also directly contribute to heart problems through inflammation and insulin resistance, even in individuals without other risk factors. The pathological mechanisms of NAFLD are linked to functional differences of miRNAs in different biological environments. The miRNA in serum exosomes may reflect the pathological state of the liver and changes in systemic metabolism, while the miRNA in serum may be associated with physiological processes other than the liver. Pediatric non-alcoholic fatty liver disease (NAFLD) is emerging as a worldwide health concern with the potential to advance to cirrhosis and liver cancer. NAFLD can also directly contribute to heart problems through inflammation and insulin resistance, even in individuals without other risk factors. The pathological mechanisms of NAFLD are linked to functional differences of miRNAs in different biological environments. The miRNA in serum exosomes may reflect the pathological state of the liver and changes in systemic metabolism, while the miRNA in serum may be associated with physiological processes other than the liver. Our study identified 36 miRNAs with differential expression in the serum of NAFLD patients compared to the control group, including 21 miRNAs with significantly increased expression and 15 with decreased expression. Consistent with our previously reported data on serum-derived exosomal miRNA profiling, this study also observed a notable upregulation of serum miR-122-5p levels in NAFLD patients. PCR validation confirmed the differential expression of miR-122-5p identified through RNA sequencing. Functional analysis using GO and KEGG pathways revealed a diverse range of biological roles associated with these differentially expressed miRNAs. Notably, NAFLD significantly impacts heart health, with miR-122-5p playing a key role in regulating cardiovascular function. Furthermore, activation of the miR-122/Sirt-6/ACE2 axis may contribute to myocardial necrosis, highlighting its potential role in NAFLD-associated cardiovascular risks. Our study suggests that miR-122 plays a key role in the progression of NAFLD and its associated metabolic disturbances, which can increase the risk of cardiovascular disease. Targeting miR-122 may offer potential therapeutic benefits for improving both liver and heart health in individuals with NAFLD.

Metabolically stable apelin analogs: development and functional role in water balance and cardiovascular function.

Apelin, a (neuro) vasoactive peptide, plays a prominent role in controlling water balance and cardiovascular functions. Apelin and its receptor co-localize with vasopressin in magnocellular vasopressinergic neurons. Apelin receptors (Apelin-Rs) are also expressed in the collecting ducts of the kidney, where vasopressin type 2 receptors are also present. Apelin and vasopressin interact at the brain and renal levels to maintain body fluid homeostasis by regulating diuresis in opposite directions. Apelin and angiotensin II have opposite effects on the regulation of blood pressure (BP). Angiotensin II, by binding to AT1 receptors present in VSMCs, induces intracellular calcium mobilization and vasoconstriction, while apelin, by binding to Apelin-R present on vascular endothelium, increases nitric oxide production and induces vasodilation. Apelin also plays a crucial role in the regulation of cardiac function. Apelin-deficient and Apelin-R-deficient mice develop progressive myocardial dysfunction with ageing and are susceptible to heart failure in response to pressure overload. Since the half-life of apelin is very short in vivo (in the minute range), several metabolically stable apelin analogs and non-peptidic Apelin-R agonists have been developed, with potential applications in diverse diseases. In this review, we highlight the interaction between apelin and vasopressin in the regulation of water balance and that between apelin and angiotensin II in the regulation of BP. Additionally, we underline the protective effects of apelin in cardiac function. Lastly, we discuss the beneficial effects of Apelin-R activation in different pathological states such as hyponatremia, hypertension, and heart failure.

Prebiotics Beyond the Gut: Omics Insights, Artificial Intelligence, and Clinical Trials in Organ-Specific Applications.

Prebiotics, traditionally linked to gut health, are increasingly recognized for their systemic benefits, influencing multiple organ systems through interactions with the gut microbiota. Compounds like inulin, fructooligosaccharides (FOS), and galactooligosaccharides (GOS) enhance short-chain fatty acid (SCFA) production, benefiting neurocognitive health, cardiovascular function, immune modulation, and skin integrity. Advances in biotechnology, including deep eutectic solvents (DES) for extraction and machine learning (ML) for personalized formulations, have expanded prebiotic applications. Integrating these innovations with "omics" technologies enables precise microbial modulation, fostering personalized nutrition and precision therapies. This review examines organ-specific effects of prebiotics, highlights findings from clinical trials, and explores biotechnological innovations that enhance prebiotic efficacy, laying the groundwork for future personalized therapeutic strategies.

The Significance of Renal Impairment in Children with Eating Disorders

Background: Eating disorders have previously been associated with renal impairment. Low muscle mass reduces serum creatinine used for the calculation of the estimated glomerular filtration rate (eGFR), leading to overestimation of renal function. To solve this problem, the development of a tool to detect renal impairment in individual patients with a specific muscle mass is required to individualize risk assessment for further management. The objectives of our study were as follows: To investigate the percentage drop in creatinine (pdCr) during rehydration as a new indicator of renal dysfunction not dependent on muscle mass and to investigate a correlation between cardiovascular function and fluid management with renal function. Methods: In a 5-year retrospective cohort study of all consecutive children admitted because of an eating disorder, renal function expressed as eGFR on admission and as pdCr between admission and the lowest creatinine level was analysed in relation to cardiovascular parameters and fluid management. Results: We included 29 patients. The mean age was 13.4 years. A pdCr after admission was noted in 26/29 (89.7%). The eGFR was &lt;90 in 15 (65%) and improved to &gt;90 in 13/15 (86.6%). In patients with a fluid management plan, there was a median of 18.6% for those with pdCr and 6.4% (p = 0.02) for those without. Renal dysfunction was not related to cardiovascular parameters. Conclusions: The majority of patients with an eating disorder had renal impairment. PdCr was more sensitive in the detection of renal impairment in individual patients compared to eGFR.