139 research outputs found

    The EPATH trial

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    Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the “Eplerenone in Primary Hyperparathyroidism” (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e’, diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone- specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e’ (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e’. CTX showed no correlations with LVEF or e’. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies

    Geographical distribution and morphometry of Heimyscus fumosus (Brosset et al., 1965)

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    More than 35 years after its original description, our knowledge of the De Balsac's mouse (Heimyscus fumosus) remains poor, and few specimens are deposited in museums. We collected 239 specimens of this species in ten central African localities. We therefore had the opportunity to confirm its geographical distribution, which covers lowland forests between the Sanaga and the Oubangui-Congo rivers. Moreover, based upon specimens collected from a single locality, we analysed intra-populational morphological variations of the De Balsac's mouse. We showed that most external and cranial measurements increased with age; while sexual dimorphism was lowPlus de 35 ans après sa description, le Muridé africain Heimyscus fumosus reste mal connu et peu de spécimens sont déposés dans les musées. Depuis 1992 nous avons collecté 239 spécimens dans dix localités d'Afrique centrale, nous permettant de confirmer sa distribution géographique. Cette espèce est présente dans les forêts de plaine situées entre les rivières Sanaga et Oubangui-Congo. De plus, l'étude d'une population du sud-ouest du Gabon nous a permis d'analyser les variations morphologiques intra-populationnelles chez cette espèce. Nos résultats mettent en évidence une augmentation avec l'âge de la plupart des mesures externes et crâniennes; en revanche, le dimorphisme sexuel est faible

    Population structure and reproduction of Heimyscus fumosus (Brosset et al., 1965) in south-western Gabon

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    Population structure and annual reproduction cycle of the De B alsac's mouse (Heimyscus fumosus) were studied in a wild population of south-western Gabon. The reproductive status of the mice was investigated at autopsy, and age of each animal was estimated by tooth wear patterns and body weight. Sex-ratio was equilibrated whatever the season and the ageclass. Females tended to reach sexual maturity more slowly than males. However, the average age at puberty differed between individuals of the same sex. A wide range of tooth-wearclasses and weight-classes were present in most months of the year, and sexually active individuals of both sexes were captured in most months. However pregnant or lactating females were only captured from August to March, while very young individuals were only captured from October to March. Thus, the reproduction of H. fumosus would be partly seasonal with an interruption from April to July (end of the short wet season, and beginning of the long dry season). We discussed the potential role of food availability on this seasonalityLa reproduction et la structure de population du Muridé africain Heimyscus fumosus ont été étudiées dans une population sauvage du sud-ouest du Gabon. Pour chaque animal, nous avons noté, lors de l'autopsie, s'il était sexuellement actif et, pour les femelles, si elles étaient prégnantes ou allaitantes. De plus, l'âge des animaux a été estimé en fonction de leur usure dentaire et de leur poids. Le sexe-ratio obtenu était équilibré quels que soient l'âge ou la saison. Bien que l'âge de la puberté diffère entre individus de même sexe, les femelles atteindraient leur maturité sexuelle plus tardivement que les mâles. La plupart des mois, de larges gammes de classes de poids et de classes d'âge dentaires étaient présentes. Bien que des individus sexuellement actifs aient été capturés tout au long de l'année, les femelles allaitantes et prégnantes ne l'ont été que d'août à mars, tandis que les très jeunes individus l'ont été d'octobre à mars. Ainsi, la reproduction de H. fumosus serait partiellement saisonnière, avec une interruption d'avril à juillet (fin de la petite saison des pluies et début de la grande saison sèche). Nous discutons du rôle potentiel de la disponibilité des ressources sur cette saisonnalité de la reproduction

    Vitamin D Supplementation and Hemoglobin Levels in Hypertensive Patients

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    Epidemiological evidence suggests that circulating 25-hydroxyvitamin D (25OHD) levels are inversely associated with hemoglobin (Hb) levels and anemia risk. We evaluated whether vitamin D supplementation improves Hb levels and reduces anemia risk in hypertensive patients. Two hundred patients with 25OHD levels <75 nmol/L who attended the Styrian Vitamin D Hypertension Trial were included, of whom 188 completed the trial. Patients randomly received 2800 IU vitamin D3 daily or a matching placebo for eight weeks. Initially, the prevalence of anemic status (Hb levels <12.5 g/dL) and deficient 25OHD levels (<30 nmol/L) was 6.5% and 7.5%, respectively. All anemic patients had 25OHD levels >50 nmol/L. The mean (95% confidence interval) vitamin D effect on Hb levels was 0.04 (−0.14 to 0.22) g/dL (). Moreover, vitamin D treatment did not influence anemic status significantly (). Likewise, vitamin D had no significant effect on Hb levels in the subgroups of anemic patients or in patients with initial 25OHD levels <30 nmol/L. In conclusion, a daily vitamin D supplement of 2800 IU for eight weeks did not improve Hb levels or anemic status in hypertensive patients. Future trials should focus on anemic patients with deficient 25OHD levels (e.g., <30 nmol/L). This trial is registered with clinicaltrials.gov [NCT02136771]

    Thermic sealing in femoral catheterization: First experience with the Secure Device

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    Background: Devices currently used to achieve hemostasis of the femoral artery following percutaneous cardiac catheterization are associated with vascular complications and remnants of artificial materials are retained at the puncture site. The Secure arterial closure Device induces hemostasis by utilizing thermal energy, which causes collagen shrinking and swelling. In comparison to established devices, it has the advantage of leaving no foreign material in the body following closing. This study was designed to evaluate the efficacy and safety of the Secure Device to close the puncture site following percutaneous cardiac catheterization. Methods: The Secure Device was evaluated in a prospective non-randomized single-center trial with patients undergoing 6 F invasive cardiac procedures. A total of 67 patients were enrolled and the device was utilized in 63 patients. Fifty diagnostic and 13 interventional cases were evaluated. Femoral artery puncture closure was performed immediately after completion of the procedure. Time to hemostasis (TTH), time to ambulation (TTA) and data regarding short-term and 30-day clinical follow-up were recorded. Results: Mean TTH was 4:30 ± 2:15 min in the overall observational group. A subpopulation of patients receiving anticoagulants had a TTH of 4:53 ± 1:43 min. There were two access site complications (hematoma &gt; 5 cm). No major adverse events were identified during hospitalization or at the 30 day follow-up. Conclusions: The new Secure Device demonstrates that it is feasible in diagnostic and interventional cardiac catheterization. With respect to safety, the Secure Device was non-inferior to other closure devices as tested in the ISAR closure trial

    The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review

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    Vitamins D and K are both fat-soluble vitamins and play a central role in calcium metabolism. Vitamin D promotes the production of vitamin K-dependent proteins, which require vitamin K for carboxylation in order to function properly. The purpose of this review is to summarize available evidence of the synergistic interplay between vitamins D and K on bone and cardiovascular health. Animal and human studies suggest that optimal concentrations of both vitamin D and vitamin K are beneficial for bone and cardiovascular health as supported by genetic, molecular, cellular, and human studies. Most clinical trials studied vitamin D and K supplementation with bone health in postmenopausal women. Few intervention trials studied vitamin D and K supplementation with cardiovascular-related outcomes. These limited studies indicate that joint supplementation might be beneficial for cardiovascular health. Current evidence supports the notion that joint supplementation of vitamins D and K might be more effective than the consumption of either alone for bone and cardiovascular health. As more is discovered about the powerful combination of vitamins D and K, it gives a renewed reason to eat a healthy diet including a variety of foods such as vegetables and fermented dairy for bone and cardiovascular health

    Left ventricular ejection fraction and cardiac biomarkers for dynamic prediction of cardiotoxicity in early breast cancer

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    BACKGROUND/PURPOSE: This study aims to quantify the utility of monitoring LVEF, hs-cTnT, and NT-proBNP for dynamic cardiotoxicity risk assessment in women with HER2+ early breast cancer undergoing neoadjuvant/adjuvant trastuzumab-based therapy. MATERIALS AND METHODS: We used joint models of longitudinal and time-to-event data to analyze 1,136 echocardiography reports and 326 hs-cTnT and NT-proBNP measurements from 185 women. Cardiotoxicity was defined as a 10% decline in LVEF below 50% and/or clinically overt heart failure. RESULTS: Median pre-treatment LVEF was 64%, and 19 patients (10%) experienced cardiotoxicity (asymptomatic n = 12, during treatment n = 19). The pre-treatment LVEF strongly predicted for cardiotoxicity (subdistribution hazard ratio per 5% increase in pre-treatment LVEF = 0.68, 95%CI: 0.48–0.95, p = 0.026). In contrast, pre-treatment hs-cTnT and NT-proBNP were not consistently associated with cardiotoxicity. During treatment, the longitudinal LVEF trajectory dynamically identified women at high risk of developing cardiotoxicity (hazard ratio per 5% LVEF increase at any time of follow-up = 0.36, 95% CI: 0.2–0.65, p = 0.005). Thirty-four patients (18%) developed an LVEF decline ≥ 5% from pre-treatment to first follow-up (“early LVEF decline”). One-year cardiotoxicity risk was 6.8% in those without early LVEF decline and pre-treatment LVEF ≥ 60% (n = 117), 15.9% in those with early LVEF decline or pre-treatment LVEF 5% during trastuzumab-based therapy. The longitudinal LVEF trajectory but not hs-cTnT or NT-proBNP allows for a dynamic assessment of cardiotoxicity risk in this setting

    Effect of Galectin 3 on Aldosterone-Associated Risk of Cardiovascular Mortality in Patients Undergoing Coronary Angiography

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    Recent experimental studies have suggested that galectin-3 has an interaction with aldosterone, and modifies its adverse effects. We therefore aimed to elucidate whether the relationship between plasma aldosterone concentrations (PACs) and long-term fatal cardiovascular (CV) events would depend on plasma galectin-3 levels. A total of 2,457 patients (median age: 63.5 [interquartile range (IQR) = 56.3 to 70.6] years, 30.1% women) from the LUdwigshafen RIsk and Cardiovascular Health study, with a median follow-up of 9.9 (IQR = 8.5 to 10.7) years, were included. We tested the interaction between aldosterone and galectin-3 for CV-mortality using a multivariate Cox proportional hazard model, reporting hazard ratios (HRs) with 95% confidence intervals (95%CIs). Adjustments for multiple CV risk factors as well as medication use were included. Mean PAC was 79.0 (IQR = 48.0 to 124.0) pg/ml and there were 558 (16.8%) CV deaths. There was a significant interaction between PAC and galectin-3 (p = 0.021). When stratifying patients by the median galectin-3, there was a significant association between aldosterone and CV-mortality for those above (HR per 1 standard deviation = 1.14; 95%CI [1.01 to 1.30], p = 0.023), but not below the cut-off value (HR per 1 standard deviation = 1.00; 95%CI [0.87 to 1.15], p = 0.185). In conclusion, the current study demonstrates for the first time a modifying effect of galectin-3 on the association between aldosterone and CV-mortality risk in humans. These findings indicate that galectin-3 is an intermediate between aldosterone and adverse outcomes
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