The Metabolic Syndrome in Hispanics – The Role of Inflammation

We report clinical and molecular mechanisms relating the pro-inflammatory and anti-inflammatory process in the development of the components of the metabolic syndrome, emphasizing the cardiovascular problems developed in these groups of patients, especially the Hispanic population. Namely, the incidence, component characteristics and complications of the metabolic syndrome in island Puerto Ricans are described and evidence is presented supporting the fact that the metabolic syndrome may be milder in Puerto Rico than in the mainland United States because it is characterized by less aggressive coronary artery disease and a relatively normal lipid profile. Moreover, data supports the fact that increased serum cholesterol levels produce less myocardial infarctions in Puerto Rico than in mainland Hispanics and Caucasians. In addition, the incidence of ventricular tachycardia, a complication caused by remodeling and ischemia of the heart, may be lower in Puerto Rico than in the United States, although the prevalence of the metabolic syndrome is higher in the island.</p

Mitochondrial Volume Regulation and Swelling Mechanisms in Cardiomyocytes

Mitochondrion, known as the “powerhouse” of the cell, regulates ion homeostasis, redox state, cell proliferation and differentiation, and lipid synthesis. The inner mitochondrial membrane (IMM) controls mitochondrial metabolism and function. It possesses high levels of proteins that account for ~70% of the membrane mass and are involved in the electron transport chain, oxidative phosphorylation, energy transfer, and ion transport, among others. The mitochondrial matrix volume plays a crucial role in IMM remodeling. Several ion transport mechanisms, particularly K+ and Ca2+, regulate matrix volume. Small increases in matrix volume through IMM alterations can activate mitochondrial respiration, whereas excessive swelling can impair the IMM topology and initiates mitochondria-mediated cell death. The opening of mitochondrial permeability transition pores, the well-characterized phenomenon with unknown molecular identity, in low- and high-conductance modes are involved in physiological and pathological increases of matrix volume. Despite extensive studies, the precise mechanisms underlying changes in matrix volume and IMM structural remodeling in response to energy and oxidative stressors remain unknown. This review summarizes and discusses previous studies on the mechanisms involved in regulating mitochondrial matrix volume, IMM remodeling, and the crosstalk between these processes

HDL as a Biomarker of Rejection in Heart Transplant

Background: One hundred once patients underwent heart transplants due to multiple causes. These patients included 36 females and 65 males whose mean age was 51 years.&nbsp;Objective: To study metabolic and lipid changes after heart transplantation with emphasis on HDL in rejected and non rejected hearts.Methods: The metabolic changes pre and post transplant were analyzed.Results:&nbsp;1. Body mass index (BMI): 25 ± 4 - 28 ± 5 kg/ m2 (P&lt;0.05)2. Systolic blood pressure (sBP): 107 ± 17 - 131 ± 20mmHg (P&lt;0.05)3. Diastolic blood pressure (dBP): 70 ± 13 - 81 ± 10 mmHg(P&lt;0.05)4. Fasting blood sugar (FBS): 107 ± 37- 117 ± 55 mg%(0.164) (non significant)5. Cholesterol: 170 ± 55 - 189 ± 32 mg/dl(P&lt;0.05)6. High density lipoprotein (HDL): 38 ± 16 - 52 ± 17 mg/dl (P&lt;0.05)7. Low density lipoprotein (LDL): 99 ± 20- 83 ± 15 mg/dl (0.34).8. Triglycerides: 163 ± 10 -188 ± 12 mg/dl (0.144).Conclusions: The heart transplant patients developed metabolic syndrome (MetS). The elevated HDL levels observed after transplantation are indicative of role of immunologic reaction to chronic rejection processes. The patients who died of rejection (19) exhibited greater elevations in HDL that those who did not (47 ± 22 – 71 ± 40 mg/dl, P&lt;0.05). Seven autopsies were performed and revealed severe atherosclerotic changes in the aorta and coronary arteries that were likely related to dysfunctional HDL. The transplanted hearts were 21 years old. The high levels and persistent elevation of HDL observed in the rejected group can be used as a biomarker of rejection and this will help to change the anti-rejection protocol to try to avoid the rejection of the implanted heart. LDL was found to be a factor in the progressive atherosclerotic process because the level was reduced post transplant.</p