Intra and inter-day repeatability of peripheral arterial function: suitability and potential limitations

The present study aimed to investigate the inter- and intraday repeatability of reactive hyperemia index (RHI) measured by Endo-PAT in healthy volunteers. Interday RHI repeatability was tested in two consecutive days in a group of thirty-one male subjects. Intraday repeatability was investigated at baseline and after 2 and 4 h in a group of sixteen volunteers. Data were evaluated by analysis of variance. Bland-Altman plot, coefficient of variation (CV), coefficient of repeatability (CR) and intraclass correlation coefficient (ICC) were measured. While interday RHI repeatability was found to be reliable (CV: 6.0%; CR: 0.51; ICC: 0.77), multiple evaluations within the same day significantly (p<0.001) affected RHI (repeatability of the measurement - CV: 18.8%; CR: 1.26; ICC: 0.48). In particular, a significant increase in RHI occurred at 4 h compared to 2 h (+16.8%; p<0.05) and to baseline (+30.1%; p<0.05). In conclusion, RHI showed good interday but poor intraday repeatability. Multiple evaluations increased RHI especially in subjects with endothelial dysfunction who improved or reversed their impairment. These results show the potential limitations of multiple Endo-PAT measurements within the same day and the importance of standardizing the protocols before RHI evaluations

Effect of acute cigarette smoking on blood pressure and peripheral endothelial function in young healthy male smokers: preliminary data

Smoking is one of the major risk factors for atherosclerosis associated with premature coronary and artery diseases. Endothelial dysfunction is an early event in atherosclerosis, and seems mainly related to the decreased production or availability of nitric oxide in smokers. The objective of the study is to investigate the effect of a single cigarette on blood pressure and peripheral arterial function in young moderate smokers (approximately 15 cigarettes/day)

Exploring efficient seamless handover in VANET systems using network dwell time

Vehicular ad hoc networks are a long-term solution contributing significantly towards intelligent transport systems (ITS) in providing access to critical life-safety applications and services. Although vehicular ad hoc networks are attracting greater commercial interest, current research has not adequately captured the real-world constraints in vehicular ad hoc network handover techniques. Therefore, in order to have the best practice for vehicular ad hoc network services, it is necessary to have seamless connectivity for optimal coverage and ideal channel utilisation. Due to the high velocity of vehicles and smaller coverage distances, there are serious challenges in providing seamless handover from one roadside unit (RSU) to another. Though other research efforts have looked at many issues in vehicular ad hoc networks (VANETs), very few research work have looked at handover issues. Most literature assume that handover does not take a significant time and does not affect the overall VANET operation. In our previous work, we started to investigate these issues. This journal provides a more comprehensive analysis involving the beacon frequency, the size of beacon and the velocity of the vehicle. We used some of the concepts of Y-Comm architecture such as network dwell time (NDT), time before handover (TBH) and exit time (ET) to provide a framework to investigate handover issues. Further simulation studies were used to investigate the relation between beaconing, velocity and the network dwell time. Our results show that there is a need to understand the cumulative effect of beaconing in addition to the probability of successful reception as well as how these probability distributions are affected by the velocity of the vehicle. This provides more insight into how to support life critical applications using proactive handover techniques

Different gene expression modulation is the major effect fue to shear stress and stent application in huvecs model: preliminary results

Although it is known that disturbed shear stress may cause endothelial damage, the mechanism by which a stent procedure may affect the endothelium is not yet fully clarify. We present the preliminary data on gene expression analysis of human endothelial cells in a laminar flow bioreactor (LFB) system submitted to different physical (flow changes) and/or mechanical (stent application) stimuli. Our preliminary results show that low shear stress together with stent procedure are the experimental conditions that mainly modulate the highest number of genes in human endothelial model. Those genes belong to pathways specifically involved in the endothelial dysfunctio

A serving of blueberry (V. corymbosum) acutely improves peripheral arterial dysfunction in young smokers and non-smokers : two randomized, controlled, crossover pilot studies

Several studies have documented the important role of polyphenol-rich foods in the modulation of vascular remodelling and function. This study aimed to evaluate the capacity of a single portion of blueberry (V. corymbosum) to acutely improve peripheral arterial dysfunction in a group of young volunteers. Twenty-four healthy males (12 non-smokers and 12 smokers) were recruited for two different randomized, controlled, crossover pilot acute studies. In the first study, non-smokers were exposed to a control treatment (C; 300 mL of water with sugar) and a blueberry treatment (BB; 300 g of blueberry). In the second study, smokers underwent 3 different protocols: (1) - smoking treatment (S); (2) - control treatment (CS; 300 mL of water with sugar + smoking); (3) - blueberry treatment (BS; 300 g of blueberry + smoking). Each treatment (1 day long) was separated by a one week washout period. Blood pressure, peripheral arterial function (reactive hyperemia index, RHI, a marker of endothelial function) and arterial stiffness (digital augmentation index, dAix and dAix normalized by considering a heart rate of 75 bpm, dAix@75) were measured before and after each treatment. In the first study, the consumption of blueberry and control treatment acutely increased peripheral arterial function in the group of non-smokers. The improvement in RHI was higher and significantly different after blueberry treatment compared to the control treatment (54.8 \ub1 8.4% BB vs. 28.2 \ub1 8.3% C; p = 0.01). No effects were observed for markers of arterial stiffness, blood pressure and heart rate. Acute cigarette smoke significantly increased blood pressure and heart rate, while no significant effect was registered in peripheral arterial function and stiffness. The intake of blueberry and control treatment before a cigarette did not counteract the increase in blood pressure and heart rate, while it significantly improved peripheral arterial function. In particular, a significant increase was observed following BS (35.2 \ub1 7.5% RHI; p = 0.02) and CS treatments (34.6 \ub1 11.9% RHI; p = 0.02) when compared to only smoking treatment. No difference between BS and CS was detected. In conclusion, the intake of blueberry and control treatments acutely improved peripheral arterial dysfunction both in smoker and in non-smoker subjects. Further studies should be performed to confirm the results obtained and reveal the potential mechanisms of blueberry in the improvement of endothelial function

Severity of oxidative stress and inflammatory activation in end-stage heart failure patients are unaltered after 1 month of left ventricular mechanical assistance

This study investigates the impact of early left ventricular (LV)-mechanical unloading on systemic oxidative stress and inflammation in terminal heart failure patients and their impact both on multi organ failure and on intensive care unit (ICU) stay. Circulating levels of urinary 15-isoprostane-F2t (8-epi-PGF2a) and pro-inflammatory markers [plasma interleukin (IL)-6, IL-8, and urinary neopterin, a monocyte activation index] were analyzed in 20 healthy subjects, 22 stable end-stage heart failure (ESHF) patients and in 23 LV assist device (LVAD) recipients at pre-implant and during first post-LVAD (PL) month. Multiorgan function was evaluated by total Sequential Organ Failure Assessment (tSOFA) score. In LVAD recipients the levels of oxidative-inflammatory markers and tSOFA score were higher compared to other groups. After device implantation 8-epi-PGF2a levels were unchanged, while IL-6, and IL-8 levels increased during first week, and at 1 month returned to pre-implant values, while neopterin levels increased progressively during LVAD support. The tSOFA score worsened at 1 PL-week with respect to pre-implant value, but improved at 1 PL-month. The tSOFA score related with IL-6 and IL-8 levels, while length of ICU stay related with pre-implant IL-6 levels. These data suggest that hemodynamic instability in terminal HF is associated to worsening of systemic inflammatory and oxidative milieu that do not improve in the early phase of hemodynamic recovery and LV-unloading by LVAD, affecting multi-organ function and length of ICU stay. This data stimulate to evaluate the impact of inflammatory signals on long-term outcome of mechanical circulatory support

Effect of a wild blueberry (Vaccinium angustifolium) drink intervention on markers of oxidative stress, inflammation and endothelial function in humans with cardiovascular risk factors

Purpose Wild blueberries (WB) (Vaccinium angustifolium) are rich sources of polyphenols, such as flavonols, phenolic acids and anthocyanins (ACNs), reported to decrease the risk of cardiovascular and degenerative diseases. This study investigated the effect of regular consumption of a WB or a placebo (PL) drink on markers of oxidative stress, inflammation and endothelial function in subjects with risk factors for cardiovascular disease. Methods Eighteen male volunteers (ages 47.8 ? 9.7 years; body mass index 24.8 ? 2.6 kg/m2) received according to a cross-over design, a WB (25 g freeze-dried powder, providing 375 mg of ACNs) or a PL drink for 6 weeks, spaced by a 6-week wash-out. Endogenous and oxidatively induced DNA damage in blood mononuclear cells, serum interleukin levels, reactive hyperemia index, nitric oxide, soluble vascular adhesion molecule concentration and other variables were analyzed. In conclusion, the consumption of the WB drink for 6 weeks significantly reduced the levels of oxidized DNA bases and increased the resistance to oxidatively induced DNA damage. Future studies should address in greater detail the role of WB in endothelial functio

Genetic Variants of the Renin-Angiotensin-Aldosterone System and Reverse Remodeling After Cardiac Resynchronization Therapy

Background: Reverse remodeling (RR) after cardiac resynchronization therapy (CRT) is associated with favorable clinical outcomes in heart failure (HF). The renin-angiotensin-aldosterone system (RAAS) is involved in the remodeling process. Methods and Results: We assessed the association between RR and 8 common RAAS gene variants, which were determined by TaqMan assays, in 156 outpatients with chronic HF. RR was defined as a O15% decrease in left ventricular end systolic volume (LVESV) at 9 (interquartile range 7e12) months after CRT. We matched 76 patients who did not show RR (RR) to 80 RR? control subjects by age, sex, HF etiology, New York Heart Association (NYHA) functional class and left ventricular ejection fraction (LVEF). The frequency of the minor allele of the NR3C2 gene (rs5522 C/T), encoding the mineralocorticoid receptor, was higher in RR than in RR (24/126 vs 10/150; P value after false discovery rate correction: <.0193). Conversely, LVESV decreased significantly less after CRT in carriers of the NR3C2 minor C allele (P 5 .02). After adjustment for age, sex, NYHA functional class, previous myocardial infarction, atrial fibrillation, and LVEF, RR remained independently associated with NR3C2 C allele carriage (odds ratio 3.093, 95% confidence interval 1.253e7.632). Conclusions: The association of RR after CRT with a common polymorphism in the mineralocorticoid receptor gene involved in aldosterone signaling suggests a possible role for variants in RAAS genes in progressive LV function decline, despite apparently effective CRT

"Nutrizione e Rischio Cardiovascolare"

Wild blueberries are rich sources of polyphenols such as anthocyanins capable of counteracting oxidative stress, influencing vasomotor tone and modulating gene expression associated with disease processes such as cardiovascular disease