Impact of an endurance training program on exercise-induced cardiac biomarker release

We evaluated the influence of a 14-wk endurance running program on the exercise-induced release of high-sensitivity cardiac troponin T (hs-cTnT) and NH2-terminal pro-brain natriuretic peptide (NT-proBNP). Fifty-eight untrained participants were randomized to supervised endurance exercise (14 wk, 3–4 days/wk, 120–240 min/wk, 65–85% of maximum heart rate) or a control group. At baseline and after the training program, hs-cTnT and NT-proBNP were assessed before and 5 min, 1 h, 3 h, 6 h, 12 h, and 24 h after a 60-min maximal running test. Before training, hs-cTnT was significantly elevated in both groups with acute exercise (P < 0.0001) with no between-group differences. There was considerable heterogeneity in peak hs-cTnT concentration with the upper reference limit exceeded in 71% of the exercise tests. After training, both baseline and postexercise hs-cTnT were significantly higher compared with pretraining and the response of the control group (P = 0.008). Acute exercise led to a small but significant increase in NT-proBNP, but this was not mediated by training (P = 0.121). In summary, a controlled endurance training intervention resulted in higher pre- and postexercise values of hs-cTnT with no changes in NT-proBNP

MRI Discriminates Thrombus Composition and ST Resolution after Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction

Histological composition of material obtained by thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST-segment elevation acute myocardial infarction (STEMI) is highly variable. We aimed to characterize this material using magnetic resonance imaging (MRI) and to correlate MRI findings with the success of PCI in terms of ST-segment resolution. Thrombus aspiration during primary or rescue PCI was attempted in 100 consecutive STEMI patients, of whom enough material for MRI was obtained in 59. MR images were obtained at 9.4T and T1 and T2 values were measured. Patients with (n = 31) and without (n = 28) adequate ST resolution 120 min after PCI (≥70% of pre-PCI value) had similar baseline characteristics except for a higher prevalence of diabetes mellitus in the latter (10 vs. 43%, p = 0.003). T1 values were similar in both groups (1248±112 vs. 1307±85 ms, respectively, p = 0.7). T2 values averaged 31.2±10.3 and 36.6±12.2 ms; in thrombus from patients with and without adequate ST resolution (p = 0.09). After adjusting for diabetes and other baseline characteristics, lower T2 values were significantly associated with inadequate ST resolution (odds ratio for 1 ms increase 1.08, CI 95% 1.01–1.16, p = 0.027). Histology classified thrombus in 3 groups: coagulated blood (n = 38), fibrin rich (n = 9) and lipid-rich (n = 3). Thrombi composed mostly of coagulated blood were characterized as being of short (n = 10), intermediate (n = 15) or long evolution (n = 13), T2 values being 34.0±13.2, 31.9±8.3 and 31.5±7.9 ms respectively (p = NS). In this subgroup, T2 was significantly higher in specimens from patients with inadequate perfusion (35.9±10.3 versus 28.6±6.7 ms, p = 0.02). This can be of clinical interest as it provides information on the probability of adequate ST resolution, a surrogate for effective myocardial reperfusion

Doppler ultrasound in the measurement of pulse wave velocity: agreement with the Complior method

Aortic stiffness is an independent predictor factor for cardiovascular risk. Different methods for determining pulse wave velocity (PWV) are used, among which the most common are mechanical methods such as SphygmoCor or Complior, which require specific devices and are limited by technical difficulty in obtaining measurements. Doppler guided by 2D ultrasound is a good alternative to these methods. We studied 40 patients (29 male, aged 21 to 82 years) comparing the Complior method with Doppler. Agreement of both devices was high (R = 0.91, 0.84-0.95, 95% CI). The reproducibility analysis revealed no intra-nor interobserver differences. Based on these results, we conclude that Doppler ultrasound is a reliable and reproducible alternative to other established methods for the measurement of aortic PWV

In silico transcriptional regulation and functional analysis of dengue shock syndrome associated SNPs in PLCE1 and MICB genes

YesSingle nucleotide polymorphisms (SNPs) in PLCE1 and MICB genes increase risk for the development of dengue shock syndrome (DSS). We used Bioinformatics tools to predict alterations at the transcriptional and posttranslational levels driven by PLCE1 and MICB SNPs associated with DSS. Functional and phenotypic analysis conducted to determine deleterious SNPs and impact of amino acid substitution on the structure and function of proteins identified rs2274223 (H1619R) as deleterious to protein coding as it induces structural change in the C2 domain of PLCε, with the mutant residue more positively charged than the wild-type residue (RMSD score, 1.75 Å).Moreover, rs2274223 condenses the chromatinrepressing PLCε expression in DSS. Briefly, this study presents the impact of a single nucleotide transition at SNPs associated with DSS on differential protein binding patterns with PLCE1 and MICB genes and on protein structure modification and their possible role in the pathogenesis of DSS

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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CLINICAL CHARACTERISTICS AND PLASMA LIPIDS IN SUBJECTS WITH FAMILIAL COMBINED HYPOLIPIDEMIA: A POOLED ANALYSIS

Background. Angiopoietin-like 3 (ANGPTL3) regulates lipoprotein metabolism by modulating extracellular lipases. Loss-of function mutations in ANGPTL3 gene cause familial combined hypolipidemia (FHBL2). The mode of inheritance and hepatic and vascular consequences of FHBL2 have not been fully elucidated. To get further insights on these aspects, we re-evaluated the clinical and the biochemical characteristics of all reported cases of FHBL2. Methods and Results. One hundred fteen FHBL2 individuals carrying 13 different mutations in the ANGPTL3 gene (14 homozygotes, 8 compound heterozygotes and 93 heterozygotes) and 402 controls were considered. Carriers of 2 mutant alleles had undetectable plasma levels of ANGPTL3 protein whereas heterozygotes showed a reduction ranging from 34% to 88%, according to genotype. Compared to controls, homozygotes as well as heterozygotes showed a signi cant reduction of all plasma lipoproteins, while no difference in Lp(a) levels was detected between groups. The prevalence of fatty liver was not different in FHBL2 subjects compared to controls. Notably diabetes mellitus and cardiovascular disease were absent among homozygotes. Conclusions. FHBL2 trait is inherited in a co-dominant manner and the lipid-lowering effect of 2 ANGPTL3 mutant alleles was more than 4 times larger than that of one mutant allele. No changes in Lp(a) were detected in FHBL2. Furthermore, our analysis con rmed that FHBL2 is not associated with adverse clinical sequelae. The possibility that FHBL2 confers lower risk of diabetes and cardiovascular disease warrant more detailed investigations

Morphometric, anatomic and radiographic study of the scapula in the white‐footed tamarin (Saguinus leucopus): report of scapular cartilage and one variation in cranial (superior) transverse scapular ligament

The white-footed tamarin (Saguinus leucopus) is an endangered endemic primate of Colombia, mainly due to the deforestation of its habitat and illegal trade, which generates a high incidence of these animals in wildlife care centres. Musculoskeletal system disorders in S. leucopus are one of the most common diseases and therefore the aim of this study was to contribute to the morphologic studies with a morphometric, anatomic and radiographic description of the scapula in this species to provide a basis for medical interventions, surgical approaches, radiologic diagnoses and comparative functions of this bone. Gross dissections of each scapular region were made in eight specimens without a diagnosis of osteomuscular disease. These specimens died from natural cases in the wildlife care centres of the Corporación Autónoma Regional de Caldas (CORPORCALDAS); after necropsy their carcasses were fixed with 10% formaldehyde, 5% mineral oil and 1% phenic acid in these centres over the course of at least 1 week. X-rays of the scapula were taken in the small animal clinic of the Universidad del Tolima, and morphometric data of the scapulae were obtained with a digital calliper. The scapula of the white-footed tamarin was a flat triangular bone with a deep scapular notch in its cranial margin, where there was a cranial transverse scapular ligament that was absent in two specimens. The coracoid process was highly developed, medially covering the humeral joint. The dorsal margin was covered by the scapular cartilage, which was highly developed in the caudal angle. In the dorsal fourth of the caudal margin, there was a surface from which the m. teres major originated. The lateral surface had a scapular spine with a long hamatus process of the acromion until the lateral part of the humeral joint. The infraspinatus fossa was wider than the supraspinous fossa. On the costal surface, the subscapular fossa was formed by three subscapular lines and one subscapular ridge, the latter helping to form the surface for the m. teres major. In the two radiographic views, caudocranial to the scapula and dorsoventral to the thorax, the scapular spine, acromion, coracoid process, scapular incisura, supraglenoid tubercle, caudal margin, subscapular ridge, and the joints with the clavicle and the humerus could be observed. The scapula of the white-footed tamarin presented bony reliefs that share characteristics with other primates but also with domestic mammals due to its quadrupedal locomotion, which allowed us to correlate its morphologic adaptation with its quadrupedal arboreal displacement