Epicardial, paracardial, and perivascular fat quantity, gene expressions, and serum cytokines in patients with coronary artery disease and diabetes

INTRODUCTION Obesity and diabetes mellitus (DM) are common disorders that increase cardiovascular risk and lead to coronary artery disease (CAD). OBJECTIVES The aim of our study was to assess the link between epicardial fat (EF) volume and paracardial fat (PF) volume, relative expressions of several genes in epicardial, paracardial, and perivascular fat and corresponding serum cytokines in patients with CAD in relation to DM. PATIENTS AND METHODS A total of 66 consecutive patients (33 with DM) with multivessel CAD were included. We obtained cardiac magnetic resonance, serum cytokines levels, and their relative mRNA expressions in EF, PF, and perivascular fat samples of the following: adrenomedullin (ADM), fibroblast growth factor 21 (FGF21), transforming growth factor β (TGFβ), phospholipid transfer protein (PLTP), receptor for advanced glycation endproducts (RAGE), thrombospondin 1 (THSB1), and uncoupling protein 1 (UCP1). RESULTS There were no differences in the anthropometric parameters or fat depots, except for higher epicardial fat volume in patients with DM (mean [SD], 105.6 [38.5] ml vs 84 [29.2] ml; P = 0.02). Patients with DM exhibited a significantly increased RAGE expression in EF (median [Q1–Q3], 0.17 [0.06–1.48] AU vs 0.08 [0.02–0.24] AU, P = 0.03). Diabetes was also associated with increased expression of ADM in EF and PF and decreased expression of FGF21 compared with patients without DM. CONCLUSIONS Patients with multivessel CAD and DM revealed increased volume and more dysfunctional profile of gene expressions in EF and significantly decreased expression of cardioprotective FGF21

Functional magnetic resonance imaging for assessment of the autonomic dysfunction in patients with ANCA-associated vasculitides

Introduction: Nervous system involvement is common in ANCA-associated vasculitides (AAV). While peripheral and central nervous system involvement are well described, it is still unclear how and to what extent the autonomic nervous system (ANS) is involved. Functional magnetic resonance imaging (fMRI) can provide information on both – structure and potential damage of the brain as well as the function of the selected brain centers. Objectives: The aim of this study was to investigate the ANS dysfunction in AAV patients and its correlation with fMRI results during the Valsalva maneuver. Patients and methods: 31 patients with AAV and 30 healthy controls were enrolled in the study. Each participant completed the COMPASS-31 questionnaire. Magnetic resonance imaging (MRI) was performed using a 3T scanner. Participants were asked to perform the Valsalva maneuver according to the fixed protocol using the device measuring the pressure value in the subjects’ airways. During the maneuver fMRI data were collected. The generalized least squares time series analysis and the region-of-interest (ROI) analysis were performed. Results: AAV patients had higher COMPASS-31 questionnaire median score (12.86 vs. 2.99; p<0.01), as compared to the control group. Structural MRI investigation did not reveal any significant differences between the groups. The brain centers involved in ANS function were detected during fMRI, however the analysis of ROI in patients and controls showed no differences. Conclusions: Patients with AAV have symptoms related to the ANS, but no differences in the functioning of the ANS brain centers have been demonstrated in fMRI study during the Valsalva maneuver

Asymmetric and symmetric dimethylarginines and mortality in patients with hematological malignancies—A prospective study

<div><p>The study was designed to determine the associations of asymmetric (ADMA) and symmetric (SDMA) dimethylarginines plasma concentrations with all-cause mortality in patients with hematological malignancies. 33 patients with acute myeloid leukemia (AML), 31 patients with non-Hodgkin’s lymphoma (nHL), 32 patients with chronic lymphocytic leukemia (CLL) and 48 patients without malignancy were enrolled into the study. Each patient was followed until death or for at least 14.5 months (range: 14.5–53). Median ADMA and SDMA were significantly elevated in AML, nHL and CLL compared to controls (ADMA: 1.36, 1.24, 1.03, 0.55 μmol/l respectively, p<0.0001; SDMA: 0.86, 0.76, 0.71, 0.52 μmol/l respectively, p<0.0001). High ADMA and SDMA were associated with increased risk for all-cause mortality in CLL group (Hazard ratio (HR) for ADMA: 3.05, 95% CI:1.58–5.88, p = 0.001; HR for SDMA: 4.71, 95% CI:1.91–11.58, p = 0.001). Our study suggests that ADMA and SDMA could be novel prognostic factors for all-cause mortality in CLL patients.</p></div