Oxydative status and atrial fibrillations

According to the recent epidemiological reports atrial fibrillation (AF) affects about 6 million people in Europe and the number is expected to double in the next 50 years (1). Because of the growing incidence, AF is considered as `the new epidemic` (2). Despite being recognized as far back as ancient Greece and China, nowadays AF is a real challenge for cardiologists. The numerous antiarrhythmic drugs, namely blockers of !-adrenergic receptors and cardiac ion channels, as well as catheter ablation have inadequate efficacy on AF recurrences and progressive clinical course. Main limitation for these results is the poor understanding of arrhythmia pathogenesis (3). Thus, in the last years, the efforts of scientists are increasingly focused on the underlying mechanisms concerning AF initiation and recurrences

Subxiphoid echocardiographic evaluation of right heart function in patients with chronic obstructive pulmonary disease

PURPOSE: The purpose of this study is to evaluate by subxiphoid echocardiography the sensitivity and specificity of various echocardiographic parameters for early diagnosis and survival of patients with chronic obstructive pulmonary disease (COPD).MATERIAL AND METHODS: Subxiphoid echocardiography was performed in 75 COPD patients to evaluate inferior vena cava dimension (IVCD), its collapsibility index (CI), end-diastolic right ventricular dimension (EDRVD), end-diastolic right ventricular thickness (EDRVT) (M-mode), right atrial area (RAA), right ventricular areas and right ventricular area shortening fraction. Results were compared to those of 30 healthy controls. Patients in sinus rhythm were divided in two according to there NYHA class (I+II and III+IV) an in three according to there acid-base blood gases status.RESULTS: All the indexes were equally and significantly changed in the patients with RVH/PH and those with COPD and atrial fibrillation (AF) when compared to controls. COPD patients with neither ECG criteria for RV hypertrophy (RVH), nor x-ray evidence of pulmonary hypertension (PH) presented with significantly greater EDRVA and RAA and normal IVC/CI. In both cases, according to cardiac and respiratory severity status subdivision, significant changes in any indexes with worsening of cardiac and respiratory failure were observed. Best sensitivity, specificity and predictive accuracy for early diagnosis were established for IVCD/CI and EDRVT. During the two-year study period, seven (9%) patients died in end stage respiratory and heart failure because of considerably reduced right heart performance.CONCLUSION: Subxiphoid echocardiography may be used for early detection of cor pulmonale, evaluation of right heart dysfunction and prognosis in COPD patients.Scripta Scientifica Medica 2013; 45(2): 55-60

Information and use of rapid diagnostic tests

New technologies and methods for analyzing laboratory performance are rapidly entering the everyday life. Screening with rapid diagnostic tests is already increasing the opportunities, reducing the cost of laboratory tests and facilitating the diagnosis of the disease at an early stage. Globally, diagnosis through rapid tests plays an important role in protecting public health. In Bulgaria, there is still a lack of extensive use of these types of tests, which is why we examined the opinion of 580 people in the Varna region to determine their level of awareness and frequency of use of rapid tests

A case of non-compaction cardiomyopathy

The aim of this case report was to present a rare myocardial disease, the so-called isolated non-compaction cardiomyopathy (NCCM). This disorder, a primary genetic cardiomyopathy, attracts increasing attention. A woman with a sudden onset of shortness of breath and isolated NCCM is described. Criteria for diagnosis as well as echocardiographic findings and magnetic resonance imaging of the heart are presented. Although rare, a new option of myocardial disease with various modes of clinical presentation but, most commonly, with acute or chronic heart failure should be taken into consideration. Multiple imaging modalities are available and should be used for proper diagnosis.Scripta Scientifica Medica 2013; 45(3): 86-89

Adipobiology of inflammation

Besides its importance for glucose, lipid and energy metabolism, the present paradigm defines adipose tissue as thebody's largest endocrine and paracrine organ. Accumulating evidence demonstrates that adipose tissue cells synthesize and release a large number of signaling proteins collectively termed adipokines. Adipokines regulate a broad spectrum of biological processes, with inflammation being a key example. This defines a new field of study: adipobiology of inflammation. Herewe shalldance round it, supposing that the pathogenesis of inflammation-related diseases such as atherosclerosis, thyroid-associated ophthalmopathy, inflammatory bowel diseases, and breast cancer may be influenced by competing stimulatory and inhibitory effects mediated by adipokines. This concept may reveal new tools for the development of adipopharmacology of inflammatory disease.Biomedical Reviews 2005; 16: 83-88

Dynamic change of NT- PROBNP in patients with ST-elevation myocardial infarction treated with primary coronary intervention

In the recent years important biomarkers have  emerged as  tools for diagnosis and risk stratification in cardiovascular diseases. Such markers are B- type natriuretic peptide ( BNP) and N- terminal B- type  natriuretic peptide (NT-proBNP).Peripheral blood for the serum levels of  NT-proBNP was taken from patients with STEMI before PCI and 24-48hours after the onset of the symptoms of myocardial infarction. Three of the samples  from all 53 turned out to be positive to NT - proBNP  concentration on Day 0. On day 1 there was   a significant  elevation of the positive samples 11 from 53 patients ( 20,7%) ( p = 0,01). All  patients with STEMI and elevated serum levels of NT- proBNP  have left ventricular ejection fraction <50%.  Our results imply that  NT -proBNP level and its increase in the serum  may be used as a biomarker for the severity of the ischemic heart disease

Nutrigenomics: DNA-based individualized nutrition

In the past decade, nutrition research has undergone an important shift from epidemiology and physiology to molecular biology, adipobiology and genetics, thus launching the science of nutrigenomics. To at molecular level study effects of nutrition on health and disease. The completion of several large genome projects has markedly altered the research agenda by drawing attention to the importance of genes in human nutrition. There has been a growing recognition that micronutrients and macronutrients can be potent dietary signals that influencethemetabolic pathways of cells and have an important role in the control of energy, vascular and neuronal homeostasis. Accordingly, nutrition researchers have increasingly started to recognize that gene-environment interactions can be implicated in the pathogenesis of lifestyle-related diseases, particularly cardiometabolic diseases, fatty liver diseases, cancers, and Alzheimer's disease. An adiponutrigenomic insight into life expectancy is also outlined. Overall, the present Dance Round focuses on a mater of nationwide importance for Bulgaria, a country at the epicenter of today's global healthquake, the obesity and related diseases.Biomedical Reviews 2006; 17: 117-122

Effect of preductal in patients with cor anaemicum: assessment of myocardial perfusion

Nowadays anaemia affects a great part of the population worldwide. This problem is particularly significant because of its medical, social and economic aspects. The aim of this study was to establish the changes in myocardial perfusion after treatment with preductal in patients with chronic anaemia. The study covered 45 female patients at a mean age of 39.95±4.25 years. Echocardiographic and single-photon emission computer tomographic examinations were performed. Left ventricular size and volume and cardiac output were increased but ejection fractions and fractions of shortening were decreased prior to preductal treatment. Scintigraphy revealed an increase of the left ventricular size and thinning of the myocardium in 26.66% of the cases. There were hypo perfusion areas in 62.22% of the cases. After a 3-month preductal treatment, any changes were completely reversed and any echocardiographic parameters normalized. Hyper dynamic heart regimen increased left ventricular volume and myocardial hypo perfusion under the conditions of chronic anaemic hypoxia in patients with severe anaemia of different types. Three-month-long preductal treatment caused a complete recovery of myocardial alterations.Scripta Scientifica Medica 2012; 44(2): 69-72

Cognitive changes in previously untreated hypertensive patients after six months of treatment with lercanidipine

The relationship between arterial hypertension and cognitive disturbances is well established. Elevated blood pressure in middle age is known to predict cognitive impairment in advanced age. Early and aggressive control of blood pressure should therefore reduce the risk of later cognitive decline. We performed a study assessing the efficacy of lercanidipine, a vasoselective dihydropyridine calcium antagonist, on blood pressure and cognitive functions in previously untreated hypertensive patients. Good control of blood pressure as well as improvement of memory and attention was achieved after 6 months of treatment.Scripta Scientifica Medica 2010;42(2):109-11

Heavy metal stress response of microalgal strains Arthronema africanum and Coelastrella sp. BGV

The present study compared the stress response of two microalgal strains – Arthronema africanum (Cyanoprokaryota) and Coelastrella sp. BGV (Chlorophyta), after heavy metals’ treatment. Changes of algal growth, pigment and protein content were analyzed after adding Cu, Cd and Pb (50 µM and 100 µM) to the nutrition medium. It was found that Cd and Pb significantly inhibited growth and protein biosynthesis of microalgae, but the effect of Cu remained less pronounced. In both strains, a decrease of chlorophyll content was observed, while carotenoid content markedly increased, especially in Coelastrella sp. BGV biomass. The addition of 100 µM Cd and 100 µM Pb to the medium caused a strong enhancement of malondialdehyde in both microalgal strains, which corresponded to the significant increase of superoxide dismutase and catalase activity. The antioxidant enzymes appeared to be differently altered by heavy metals’ exposure. The activity of SOD in the Arthronema africanum cells was most strongly affected by Cd, in contrast to Coelastrella sp. BGV that was highly increased by 100 µM Pb. The application of 100 µM Cd and 100 µM Pb increased in a similar manner catalase activity in both microalgae. The strains that were studied showed a high absorption capacity for metal ions, especially for Pb, which was absorbed largely than Cd and Cu. For that reason, we assumed that both microalga and, in particular, Coelastrella sp. BGV, could be successfully used for treatment of contaminated water bodies