Sex-associated effect of CETP and LPL polymorphisms on postprandial lipids in familial hypercholesterolaemia

Background: This study assessed the gender-specific influence of the cholesteryl ester transfer protein (TaqIB, I405V) and lipoprotein lipase (S447X) polymorphisms on the response to an oral fat tolerance test in heterozygotes for familial hypercholesterolaemia.Methods: We selected and genotyped 80 men and postmenopausal women heterozygous for familial hypercholesterolaemia (main group) as well as 11 healthy control subjects. Patients were subgrouped based on their response to oral fat tolerance test. The oral fat tolerance test was defined as pathological when postprandial triglyceride concentration was higher than the highest triglyceride concentration observed in healthy subjects (220 mg/dl) at any time (2, 4, 6 or 8 h).Results: In the pathological subgroup, men had significantly higher incremental area under the curve after oral fat tolerance test than postmenopausal women. Furthermore, multivariate analysis revealed a gender association of TaqIB and I405V influence on postprandial lipaemia in this subgroup.Conclusion: In conclusion, it seems that gender and TaqIB polymorphism of the cholesteryl ester transfer protein gene were both associated with the distribution of triglyceride values after oral fat tolerance test, only in subjects with a pathological response to oral fat tolerance test. Specifically, men carrying the B2 allele of the TaqIB polymorphism showed a higher postprandial triglyceride peak and a delayed return to basal values compared with women carrying B2. However, further investigations in larger populations are required to replicate and confirm these findings

The efficacy of simvoistatin of ezetimibe on tissue factor, von willebrand and c-reactive protein

Introduction: Statins have favourable effect on the lipid profile, decrease the total mortality and they also are reported as presenting many pleiotropic effects. The aim of this study was to determine and compare the pleiotropic effects of simvastatin (S) and ezetimibe (E) in dyslipidemic patients (pts). Materials and methods: Forty-four pts (20 postmenopausal women) with low-density lipoprotein cholesterol (LDL-C) > 130 mg/dl or LDL-C >100 mg/dl in pts with coronary artery disease or its equivalent, were treated with S (n=21) 10 mg daily or E (n=23) 10 mg daily. Blood sample were drawn before and three months after treatment. In both samples we measured the levels of total cholesterol, triglycerides, high-density cholesterol (HDL-C), LDL-C, apolipoprotein (apo) A, apo B, lipoprotein (a) [Lp(a)], homocysteine, tissue factor (TF), von Willebrand (vW) and C-reactive protein (CRP). The baseline lipid profile and the haematological parameters were similar in both groups. Results: S and E decreased total cholesterol (262 mg/dl to 189 mg/dl, p 130 mg/dl ή LDL > 100 mg/dl σε ασθενείς με στεφανιαία νόσο ή ανάλογο αυτής, χορηγήθηκαν 10 mg Σ (η=21) ημερησίως ή 10 mg E (η=23) ημερησίως. Ελήφθησαν δείγματα αίματος στην αρχή και τρεις μήνες μετά την έναρξη της θεραπείας. Σε όλα τα δείγματα μετρήθηκαν τα επίπεδα της ολικής χοληστερόλης, των τριγλυκεριδίων, της υψηλής σε πυκνότητα λιποπρωτεΐνης (high density lipoprotein-HDL), της LDL, της απολιποπρωτεΐνης [apolipoprotein (apo)] A, της apoB, της λιποπρωτεΐνης [Lipoprotein (lp)] (a), της ομοκυστεΐνης , του ‘tissue factor’ (TF), του παράγοντα von Willebrand (vW) και της C αντιδρώσας πρωτεΐνης (C-reactive protein, CRP). Οι αρχικές τιμές των λιπιδίων και των αιματολογικών παραμέτρων ανάμεσα στις δύο ομάδες ήταν παρόμοιες. Η Σ και η Ε μείωσαν την ολική χοληστερόλη (262 mg/dl σε 189 mg/dl, p<0,001 και 268 mg/dl σε 220 mg/dl, p=0,001, αντίστοιχα, την LDL (177 mg/dl σε 114 mg/dl, p<0,001 και 196 mg/dl σε 146 mg/dl, p<0,001, αντίστοιχα). Επίσης, η Σ ελάττωσε τα επίπεδα της apoB (125 mg/dl σε 93 mg/dl, p<0,001). Κανένα από τα φάρμακα δεν επηρέασε τις συγκεντρώσεις της lp(a), του TF, του vW και της ομοκυστεϊνης. Και τα δύο φάρμακα βελτίωσαν το λιπιδαιμικό προφίλ των ασθενών και τα επίπεδα της CRP. Παρόλ’ αυτά, δε διαπιστώθηκε καμία επίδραση στους TF και vW. Τα αποτελέσματά μας δεν υποδεικνύουν κάποια επιπρόσθετη πλειοτροπική αντιφλεγμονώδη δράση των στατινών πέραν της μείωσης της ολικής και της LDL χοληστερόλης

Left ventricular ejection fraction and Global Longitudinal Strain variability between methodology and experience

Introduction Although ejection fraction (EF) is the cornerstone of the assessment of left ventricular (LV) systolic function, its measurement faces a number of challenges related to image quality, assumptions of LV geometry, and expertise. The aim of this study was to test the inter-observer variability of EF and GLS measurement in patients with a broad spectrum of LV function, between physicians and investigators (Inv) with different levels of expertise. Methods In 122 patients, EF and GLS were measured by 4 Inv blinded to each other with different level of experience in echocardiography; EF was measured using 3 methods: visual assessment, biplane Simpson&apos;s method, and auto-EF method. GLS was measured from the 3 apical views. A significant difference for LVEF and for LVGLS was considered to be &gt;10 and &gt;2 absolute values, respectively. Results Intra-observer agreement was excellent for visually assessed EF (ICC = 0.87, P &lt; .001) and GLS (ICC = 0.82, P &lt; .001) and good for EF measured by Simpson&apos;s method (ICC = 0.70, P &lt; .001) and auto-EF (ICC = 0.72, P &lt; .001). Intra-observer and inter-observer agreements were excellent for GLS with ICCs above 0.8. GLS discordance between the 4 Inv was not significant. Discordance in EF and GLS measurements among the Inv was not related to image quality or wall motion abnormalities. Conclusion Although EF has proved its prognostic value in various cardiovascular entities, GLS seems to be more reliable for serial assessment of LV function, demonstrating lower intra- and inter-observer variability, even by different physicians with variant level of expertise

Practical Approaches to Build and Sustain a Cardio-Oncology Clinic

The therapeutical advances in recent years in the field of oncology treatment have increased survival rates and improved the quality of life of oncology patients, thus turning cancer into a chronic disease. However, most of the new cancer treatments come at the expense of serious cardiovascular adverse events threatening the success story of these patients. The establishment of multidisciplinary medical teams to prevent, monitor, and treat cardiovascular diseases in cancer-treated patients is needed now more than ever. The aim of this narrative review is to demonstrate the existing knowledge and practical approaches on how to establish and maintain a cardio-oncology program for the rising number of patients who need it