Interrelated modulation of endothelial function in Behcet's disease by clinical activity and corticosteroid treatment

Corticosteroids are commonly used in empirical treatment of Behçet's disease (BD), a systemic inflammatory condition associated with reversible endothelial dysfunction. In the present study we aimed to dissect the effects of clinical disease activity and chronic or short-term corticosteroid treatment on endothelial function in patients with BD. In a case-control, cross-sectional study, we assessed endothelial function by endothelium dependent flow mediated dilatation (FMD) at the brachial artery of 87 patients, who either were or were not receiving chronic corticosteroid treatment, and exhibiting variable clinical disease activity. Healthy individuals matched for age and sex served as controls. Endothelial function was also assessed in a prospective study of 11 patients before and after 7 days of treatment with prednisolone given at disease relapse (20 mg/day). In the cross-sectional component of the study, FMD was lower in patients than in control individuals (mean ± standard error: 4.1 ± 0.4% versus 5.7 ± 0.2%, P = 0.003), whereas there was a significant interaction between the effects of corticosteroids and disease activity on endothelial function (P = 0.014, two-factor analysis of variance). Among patients with inactive BD, those who were not treated with corticosteroids (n = 33) had FMD comparable to that in healthy control individuals, whereas those treated with corticosteroids (n = 15) had impaired endothelial function (P = 0.023 versus the respective control subgroup). In contrast, among patients with active BD, those who were not treated with corticosteroids (n = 20) had lower FMD than control individuals (P = 0.007), but in those who were receiving corticosteroids (n = 19) the FMD values were comparable to those in control individuals. Moreover, FMD was significantly improved after 7 days of prednisolone administration (3.7 ± 0.9% versus 7.6 ± 1.4%, P = 0.027). Taken together, these results imply that although corticosteroid treatment may impair endothelial function per se during the remission phase of the inflammatory process, it restores endothelial dysfunction during active BD by counteracting the harmful effects of relapsing inflammation

The relationship between maximal exercise-induced increases in serum IL-6, MPO and MMP-9 concentrations

The aim of this study was to test the hypothesis that exercise would induce inflammatory response characterized by increased pro-inflammatory cytokines - interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α), adhesion molecule, matrix metalloprotease-9 (MMP-9) and myeloperoxidase (MPO) levels. Additional aim was to elucidate the possible source of maximal exercise-induced increase in MMP-9 concentration. To examine our hypothesis, 26 professional male ice hockey players [age 25±1 (mean±SEM) years; BMI 25.8± 0.4kg/m 2] performed an incremental bicycle test until exhaustion, when maximal oxygen consumption was recorded. Venous blood samples were collected 30min before and 2min after exercise. There was an increase in the count of leucocytes (8.7±1.8 versus 5.7±1.3×10 9 cells per l) and IL-6 (1.24±0.17 versus 0.69±0.13pg/ml), MPO (72±7 versus 50±4ng/ml) and MPP-9 (139±9 versus 110±6ng/ml) concentrations (P<0.05) comparing post- and pre-exercise levels. Maximal exercise-induced increase in MPO correlated with the increases in IL-6 (P<0.05, R=0.54) and MMP-9 (P<0.01, R=0.62) concentrations. Furthermore, increase in IL-6 correlated with the increase in MMP-9 concentrations (P<0.05, R=0.60). Maximal exercise induces an inflammatory response characterized by leucocytosis and increased IL-6, MPO and MMP-9 concentrations. Correlations between increased MPO (marker of neutrophils degranulation) and both increased IL-6 and MMP-9 concentrations may suggest that neutrophils could be the main source of these inflammatory biomarkers during maximal exercise. Furthermore, correlation between increases in serum IL-6 and MMP-9 concentrations may suggest that IL-6 could exert modulatory effects on MMP-9 release during maximal exercise.publishersversionPeer reviewe

Clinical Utility of Cardiovascular Magnetic Resonance Imaging for Diagnosis of Acute Myocarditis

A 49 year-old patient with past medical history significant for arterial hypertension (treated with telmisartan 80 mg daily), presented to the emergency department with 18-hour gastric discomfort and fatigue. Five days prior to this presentation the patient had an episode of febrile gastroenteritis. The evening prior to presentation the patient had blood chemistries performed at an outside institution, where an increase of myocardial enzymes (troponin and CPK-MB) were noted. On presentation the patient was uncomfortable due to abdominal pain, but the clinical examination was almost normal. Blood pressure was 150/80 mmHg and heart rate was 60 beats/min. Cardiac S1 and S2 sounds where audible, without additional cardiac tones, murmurs, pericardial or pleural friction. There was no jugular venous distention, rales or peripheral edema present. Admission 12-lead electrocardiogram (ECG) demonstrated normal sinus rhythm with a rate of 60 beats/min, and early repolarization pattern with a slight J-point elevation in the lateral leads (I, aVL, V5, V6)

Clinical Utility of Cardiovascular Magnetic Resonance Imaging for Diagnosis of Acute Myocarditis

Cardiac magnetic resonance imaging (CMR) is a novel imaging technique that may help differentiate between myocarditis and acute coronary syndrome and compares favorably to other imaging techniques because it also provides information on tissue consistency and characteristics. We herein present a case, whereby CMR was most useful in providing such a differential diagnosis

Health Risk and Biological Effects of Cardiac Ionising Imaging: From Epidemiology to Genes

Cardiac diagnostic or therapeutic testing is an essential tool for diagnosis and treatment of cardiovascular disease, but it also involves considerable exposure to ionizing radiation. Every exposure produces a corresponding increase in cancer risk, and risks are highest for radiation exposure during infancy and adolescence. Recent studies on chromosomal biomarkers corroborate the current radioprotection assumption showing that even modest radiation load due to cardiac catheter-based fluoroscopic procedures can damage the DNA of the cell. In this article, we review the biological and clinical risks of cardiac imaging employing ionizing radiation. We also discuss the perspectives offered by the use of molecular biomarkers in order to better assess the long-term development of health effects

Classification des potentiels évoqués par corrélation de Pearson dans une interface cerveau-ordinateur

National audienceDans cette communication, nous décrivons et évaluons les performances d'une technique d'apprentissage des coefficients d'un classifieur linéaire utilisé dans une interface cerveau-ordinateur. Les signaux de l'électroencéphalogramme d'un individu sont analysés au moyen de cette technique afin de mettre en évidence les réponses de ce dernier à des stimuli visuels. Le traitement et la classification des signaux sont utilisés afin d'implanter un système de communication palliative permettant à l'individu d'épeler des mots. Les performances de la méthode de classification ont été évaluées par une expérimentation sur huit personnes

Tea Consumption Enhances Endothelial-Dependent Vasodilation; a Meta-Analysis

Background: Tea consumption is associated with a lower risk of cardiovascular disease including stroke. Direct effects of tea components on the vasculature, particularly the endothelium, may partly explain this association. Objective: We performed a meta-analysis of controlled human intervention studies on the effect of tea on flow-mediated dilation (FMD) of the brachial artery, a measurement of endothelial function, which is suggested to be associated with cardiovascular risk. Methods: Human intervention studies were identified by systematic search of the databases Medline, Embase, Chemical Abstracts and Biosis through March 2009 and by hand-searching related articles. Studies were selected based on predefined criteria: intervention with tea as the sole experimental variable, placebo-controlled design, and no missing data on FMD outcome or its variability. A random effects model was used to calculate the pooled overall effect on FMD due to the intake of tea. The impact of various subject and treatment characteristics was investigated in the presence of heterogeneity. Results: In total, 9 studies from different research groups were included with 15 relevant study arms. The overall absolute increase in FMD of tea vs. placebo was 2.6 % of the arterial diameter (95 % CI: 1.8-3.3%; P-value,0.001) for a median daily dose of 500 mL of tea (2–3 cups). This is a relative increase of approximately 40 % compared to the average FMD of 6.3% measured under placebo or baseline conditions. There was significant heterogeneity between studies (P-value,0.001) tha