Influence of alcohol consumption and smoking habits on cardiovascular risk factors and antioxidant status in healthy men

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Mitral stenosis with left atrial thrombi

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The associations between serum leptin, adiponectin and intercellular adhesion molecule-1 in hypercholesterolemic patients

We examined the associations between adiponectin or leptin and serum ICAM-1 levels in seventy-six hypercholesterolemic patients (mean age 59 yrs, 25 males and 51 females, LDL-cholesterol>=130mg/dL at screening). Blood lipid profiles and HOMA-IR derived from fasting glucose and insulin concentrations were determined. Serum levels of adiponectin, leptin and ICAM-1 were analyzed using ELISA. The results showed that serum levels of leptin were positively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =0.392, p<0.001). Serum levels of adiponectin were negatively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =-0.343, p<0.005). Stepwise multiple linear regression analysis showed that serum leptin was an independent factor to be associated with serum ICAM-1 levels after adjusting for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.001). With respect to adiponectin, its association with serum ICAM-1 was attenuated but still significant when further adjustments were made for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.005). In conclusion, this study suggests that adiponectin and leptin are associated with endothelial derived inflammation.ope

The Effect of Hypoxic-Preconditioning on the Reperfusion-Induced Arrhythmias in the Cat Hearts

Background Ischemic preconditioning(a prior short period of coronary artery occlusion) has been known to have protective effects on ischemia-induced myocardial injury. The purpose of this study was to investigate the effects of hypoxic preconditioning or ischemic preconditioning on the ventricular arrhythmias after a prolonged period of coronary artery occlusion in the cat hearts. Method Thirty-six cats were anesthetized with a-chloralose(60mg/kg, I.P.) and prepared for left anterior descending coronary artery(LAD) occlusion after thoracotomy. A 10 minute occlusion of LAD was used with a subsequent 3 minute reperfusion period as ischemic-preconditioning before a 20 minute occlusion of LAD and subsequent reperfusion in 10 cats. Hypoxic-preconditioning was done according to the identical procedure as ischemic-preconditioning but using hypoventilation and normal ventilation instead of occlusion and reperfusion, respectively, in 12cats. The remaining 14 were used as controls following occlusion of LAD for 20 minutes and subsequent reperfusion. Results Two preconditionings significantly reduced the severity of ventricular arrhythmias during the reperfusion period following a 20 minutes occlusion of LAD compared with controls. Ischemic-proeconditioning reduced the frequency of ventricular premature beats(VPBs) during a 20 minute occlusion of LAD with absence of significant fatal ventricular arrhythmias such as ventricular thachycardia or fibrillation compared with controls. Hypoxic-preconditioning failed to reduced the frequency of VPBs during a 20 minute occlusion of LAD where as ventricular fibrillation was totally suppressed and ventricular tachycardia occurred in one cat. Conclusion These data suggest that 1) not only ischemic-preconditioning but also hypoxic-preconditioning alleviates the reperfusion-induced arrhythmias : 2) the mecnanism of the reperfusion-induced arrhythmias is different from that of the ischemia-induced arrhythmias : 3) hypoxic-preconditioning allows one to perform further studies regarding the mechanisms of preconditioning.ope

Clinical Utility of Harmonic Imaging in the Detection of Right to Left Shunt through Patent Foramen Ovale by Transthoracic Contrast Echocardiography

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.ope

Cardiac hemangioma

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Differences in body fat distribution and antioxidant status in Korean men with cardiovascular disease with or without diabetes

Background: Abnormal body fat distribution and reduced antioxidant status have been shown to be effective markers of risk of cardiovascular disease (CVD). Objective: The objective of this study was to determine the differences in body fat distribution and antioxidant status in healthy men (control subjects) and in men with CVD with or without diabetes. Design: An oral-glucose-tolerance test was performed and CVD patients were subdivided into groups according to the presence or absence of diabetes. Adipose tissue areas were calculated from computed tomography scans made at the L1 and L4 vertebrae. Fasting serum concentrations of lipids, testosterone, insulin-like growth factor I, antioxidants, and plasma homocysteine were determined. Results: There were no significant differences in mean age, body mass index (in kg/m2), or blood pressure between the groups. The visceral fat area at the L1 vertebra was nonsignificantly greater in CVD patients without diabetes than in control subjects, whereas it was significantly greater in CVD patients with diabetes than in control subjects at both the L1 and L4 vertebrae. Both groups of CVD patients had higher plasma concentrations of homocysteine and lower serum insulin-like growth factor I concentrations and superoxide dismutase activities than did control subjects. Serum β-carotene and lycopene concentrations were lowest in the CVD patients with diabetes. Conclusion: The concurrent presence of CVD and diabetes is associated with a greater negative effect on the risk factors typically associated with significant declines in health status.ope

Change in Body Fat Distribution and Antioxidant System in Patients with Coronary Heart Disease

BACKGROUND: Changes in body fat distribution and antioxidant status can be shown in patients with coronary heart disease (CHD) and these changes may be more pronounced in CHD patients with than those without diabetes. This study was undertaken to determine the discrimination of body fat distribution, hormones and antioxidants among healthy male and CHD male patients with and without diabetes. METHODS: An oral glucose tolerance test was performed in 64 healthy males and 56 CHD male patients. CHD group was subdivided into patients with and without diabetes. Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, L1, L4 and mid portion of thigh and calf. Fasting serum levels of lipids, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: 28% of healthy males, 33% of CHD patients without diabetes and 15% of CHD patients with diabetes were current smokers. 56% of healthy males, 30% of CHD patients without diabetes and 46% of CHD patients with diabetes supplemented their diet with synthetic vitamin preparation. There were no differences among groups in means of age, body mass index and blood pressure. While CHD patients without diabetes showed an increase in visceral fat area at only L1 level, CHD patients with diabetes showed an increase at both L1 and L4 levels, compared with healthy males. CHD patients with diabetes showed the lowest mean value of HDL-cholesterol and testosterone. The mean response areaof insulin and C-peptide during OGTT was higher in CHD patients without diabetes than healthy males. CHD patients with and without diabetes showed higher plasma level of homocysteine and lower serum levels of IGF-1, superoxide dismutase (SOD) and beta-carotene, compared with healthy males. Serum levels of cryptoxanthin and lycopene were lower in CHD patients with diabetes than healthy males. CONCLUSION: Visceral fat accumulation, an increase in insuline and homocysteine levels and a decrease in IGF-1, SOD and beta-carotene levels in CHD patients indicate a difference in body fat distribution, hormones and antioxidant systems between CHD patients and healthy males. In addition, a further increase in visceral fat and a decrease in the serum levels of HDL-cholesterol, testosterone and carotenoids in CHD patients with diabetes show the increased risk in the simultaneous presence of CHD and diabetes. Thus, the lifestyle modification of these CHD patients such as quitting smoking, reducing abdominal fat and taking antioxidant-rich foods is recommended.ope

Analysis of the Left Ventricular Contractile Reserve Using End-systolic Pressure-Volume Relation (ESPVR) in Idiopathic Dilated Cardiomyopathy: Its Correlation with Pathologic Findings

Background Left ventricular (LV) end-systolic pressure volume relation (ESPVR) is considered as a load independent contractile index. However, its application in human beings has been limited by the difficulty in the accurate real time measurement of the LV volume changes. With introduction of the echocardiographic automatated edge detection method, on-line generation of multiple LV pressure volume-loops has become possible to assess ESPVR. This study was performed to investigate the correlation of the degree of myocardial damages with myocardial contractility and contractile reserve assessed by ESPVR as a surrogate of contractility index. Methods Studies were attempted in ten patients with idiopathic dilated cardiomyopathy. Baseline two-dimensional and Doppler echocardiography, cardiac catheterization for hemodynamic assessment and endomyocardial biopsy were performed. Generation of multiple LV pressure-volume loops during occlusion and release of the inferior vena cava by a balloon catheter was performed using the volume signals from the echocardiographic automatated edge detection method and the pressure signals from a 5F fluid-filled lumen catheter. ESPVR was measured at the baseline and after 3 minutes of dobutamin infusion (10 microgram/Kg/min). Results No correlation was observed between the degree of myocyte hypertrophy change or interstitial fibrosis and the two-dimensional echocardiographic or hemodynamic data. However, restrictive LV filling pattern was more common in the patients with severe degree of myocyte hypertrophy change. Myocardial contractility and contractile reserve were also significantly reduced in this patient group. The degree of interstitial fibrosis did not affect myocardial contractility or contractile reserve in this particular patient group. Conclusion Assessment of ESPVR using the echocardiographic automatated edge detection method was feasible in the patients with idiopathic dilated cardiomyopathy. The degree of myocardial hypertrophy change was prominent in the patients with reduced contractility and contractile reserve.ope

Direct myocardial depressant effect of methylmethacrylate monomer

BACKGROUND: The present study explored the mechanism of direct myocardial depression by methylmethacrylate monomer (MMA). METHODS: Isometric contraction of isolated guinea pig right ventricular papillary muscle was measured in modified normal and 26 mm K+ Tyrode solutions at various stimulation rates. Normal and slow action potentials were evaluated by conventional microelectrode technique. MMA effects on various aspects of sarcoplasmic reticulum function were evaluated by its effect on rapid-cooling contractures, rested-state contraction in rat papillary muscle in modified normal Tyrode solution, and in guinea pig papillary muscle under low Na+ (25 mm) Tyrode solution. Whole cell patch clamp techniques were applied to measure the inward Ca2+ currents (I(Ca)). RESULTS: MMA (0.5, 1.5, and 4.7 mm) caused concentration-dependent depression of peak force and maximal rate of force development to approximately 70, 50, and 20% of baseline from rested state to 3 Hz stimulation rates, respectively. Depression of peak force and maximal rate of force development by MMA was dependent on stimulation frequency, with less depression at higher stimulation rates. In low Na+ Tyrode solution, 1.5 mm MMA depressed peak force of rat and guinea pig myocardium by 20-30%. In 26 mm K+ Tyrode solution, 0.5 and 1.5 mm MMA caused selective and marked concentration-dependent depression of late force development (0.5 mm: approximately 60% of baseline, 1.5 mm: approximately 30% of baseline) with no alteration in early force development. MMA (1.5 mm) depressed rapid-cooling contracture to 53 +/- 10% of baseline, accompanied by approximately 63% prolongation of time to peak contracture. In patch clamp studies, MMA reduced I(Ca) in a concentration-dependent manner. CONCLUSIONS: The direct myocardial depressant effect of MMA seems to be caused in part by depression of Ca2+ influx through cardiac membrane, while depolarization-activated sarcoplasmic reticulum Ca2+ release appears modestly depressed.ope