27 research outputs found
THE IMPACT OF DIFFERENT TYPES OF AEROBIC EXERCISE ON ENDOTHELIAL FUNCTION AND ARTERIAL STIFFNESS
MicroRNAs in Cardiovascular Therapeutics
Recent research reveals the crucial role microRNAs (miRNAs) in the
pathogenesis and progression of many pathological conditions, including
cardiovascular diseases. It is widely documented that miRNAs represent
critical regulators of cardiovascular function and participate in almost
all aspects of cardiovascular biology. In particular, they are involved
in several pathophysiological pathways of various manifestations of
cardiovascular disease, such as coronary artery disease, heart failure,
stroke, diabetes mellitus, arterial hypertension and cardiac
arrhythmias. In the present article we review the available literature
regarding to the role of miRNAs in certain cardiovascular conditions.
Moreover, we discuss the therapeutic potential of miRNAs for treating
cardiovascular diseases and we attempt to highlight future directions
Atorvastatin treatment improves endothelial function through endothelial progenitor cells mobilization in ischemic heart failure patients
Objective: Endothelial function is an independent predictor of prognosis
in heart failure (HF) subjects. Statins, beyond their lipid lowering
role, exert beneficial effect in patients with atherosclerosis. In the
present study we examined the impact of low and intermediate dose
atorvastatin treatment on endothelial function, bone marrow-derived
endothelial progenitor cells (EPC) mobilization and inflammatory status
according to HF patient status. Methods: We studied the effect of 4
weeks administration of atorvastatin in 26 patients with ischemic HF.
The study was carried out on two separate arms, one with atorvastatin 40
mg/d and one with atorvastatin 10 mg/d (randomized, double-blind,
cross-over design). The number of circulating CD34(+)/CD133(+)/KDR(+)
EPCs was evaluated by flow cytometry. Endothelial function was evaluated
by flow mediated dilation (FMD) in the brachial artery. Serum levels of
tumor necrosis factor alpha (TNF-alpha) were measured by ELISA. Results:
Treatment with atorvastatin 40 mg/d significantly increased circulating
EPC (p = 0.002), FMD (p = 0.001) and reduced TNF-alpha (p = 0.01)
compared to baseline. Similarly, treatment with atorvastatin 10 mg/day
increased circulating EPC (p = 0.01), FMD (p = 0.08) and reduced
TNF-alpha (p = 0.01) compared to baseline. Interestingly, with 40 mg/day
atorvastatin treatment the increase in EPC was higher in subjects
categorized as NYHA class II compared to subjects categorized as NYHA
class III (p = 0.03). Conclusions: Our results confirmed the distinct
impact of atorvastatin treatment on the restoration of endothelial
function due to EPC mobilization in ischemic HF subjects. Moreover,
these findings provide the potential clinical significance of EPC status
monitoring to individualize treatment in HF subjects. (C) 2014 Elsevier
Ireland Ltd. All rights reserved
High platelet reactivity is associated with vascular function in patients after percutaneous coronary intervention receiving clopidogrel
Background: In the present study, we evaluated the association of
platelet reactivity with vascular function in patients after
percutaneous coronary intervention receiving clopidogrel treatment.
Methods: We enrolled 150 patients with stable CAD receiving clopidogrel
regimen (75 mg/d), 1 month after percutaneous coronary intervention.
Carotid-femoral pulse wave velocity (PWV) was measured as an index of
aortic stiffness and augmentation index (AIx) as an index of arterial
wave reflections. High on treatment platelet reactivity (HPR) was
evaluated using Verify Now Assay. Verify Now reports its results in
P2Y12 reaction units (PRU), and the diagnostic cutoff value is 230 PRU.
Patients were evaluated prospectively up to 24 months. The primary end
point was a composite of death from cardiovascular causes, nonfatal
major cardiovascular events and hospitalization for cardiovascular
causes.
Results: There was no difference in the basic clinical and demographic
characteristics between subjects with HPR and non-HPR. Subjects with
high on treatment platelet reactivity and PRU > 230 had significantly
increased PWV (8.81 +/- 2.25 m/s vs. 7.69 +/- 1.95 m/s, p = 0.001) and
AIx (25.27 +/- 8.67% vs. 20.87 +/- 10.57%, p = 0.04) compared to
subjects with PRU <= 230. PWV was also associated with PRU (r = 0.23, p
= 0.02). HPR was associated with significantly increased risk of primary
end point [HR = 5.38, 95% CI:(1.15, 26.04), p = 0.03].
Conclusions: Increased platelet reactivity is associated with impaired
arterial stiffness in patients after percutaneous coronary intervention
receiving clopidogrel treatment, highlighting another clinical factor
implicated in individual platelet response to antiplatelet therapy.
Moreover, increased platelet reactivity is associated with adverse
outcome in these patients. (C) 2014 Elsevier Ireland Ltd. All rights
reserved