The effects of Atorvastatin Therapy on rheological characteristics of erythrocyte Membrane, serum lipid profile and oxidative status in patients with dyslipidemia

WOS: 000310473600005PubMed: 22706680The statins, most commonly used in the treatment of hyperlipidemia, have certain beneficial effects including improved endothelial function, plaque stability and decreased oxidative stress and inflammation, beyond their lipid-lowering effect in plasma. We evaluated the pleiotropic impact of atorvastatin on erythrocyte structural/mechanical properties and lipid peroxidation in dyslipidemics. the study group included 44 patients with dyslipidemia and was divided into subgroups according to triglyceride and cholesterol levels as hypercholesterolemic (n = 29) and mixed-type hyperlipidemic (n = 15). Subjects were given 10 mg atorvastatin per day for 12 weeks. Changes in serum lipid composition, lipid contents, Na+/K+-ATPase activity and osmotic fragility in erythrocytes and oxidative stress parameters of erythrocytes and plasma were studied. Atorvastatin therapy improved the serum lipid profile of both subgroups. This alteration was accompanied by a decreased level of cholesterol in erythrocyte membranes. Moreover, enhanced activity of Na+/K+-ATPase in erythrocytes reflected the improvements in membrane lipids of both subgroups. However, a significant change was observed in osmotic fragility values of the mixed-typed dyslipidemic group. This treatment lowered the lipid peroxidation in plasma and erythrocytes and increased plasma total antioxidant capacity in all groups. the present study shows that the use of atorvastatin reversed the structural and functional features of erythrocyte membranes in dyslipidemic subjects. Also, hypolipidemic therapy had a beneficial impact on a balance between oxidant and antioxidant systems.Karadeniz Technical University Research FoundationThis work was supported by Grants from the Karadeniz Technical University Research Foundation

Endothelial Progenitor Cell Levels and Extent of Post-prandial Lipemic Response

BACKGROUND AND OBJECTIVE: Due to the frequency of meal ingestion, individuals spend the majority of the day, ~18 h, in a status of post-prandial (PP) stress. Remnant-like lipoprotein particles (RLPs) are predominant in PP phase playing an important role in the development of atherosclerosis. Endothelial progenitor cells (EPCs) have been suggested to play a role in vessel wall homeostasis and in reducing atherosclerosis. However, there is no information about peripheral blood EPCs number following PP stress. We investigated the association between circulating EPCs levels and extent of PP lipemia in healthy subjects following a high-fat meal. MATERIALS AND METHODS: A total of 84 healthy subjects (42 men, 42 women) aged 17–55 years were included in the study. PP lipemic response of subjects was determined by Oral Fat-Loading Test (OFLT). All the subjects were classified on the basis of their plasma TG levels after PP lipemic stressors in categories 1 (low), 2 (moderate), and 3 (high). Circulating EPCs numbers were measured by the flow cytometry method. RESULTS: There was a significant difference in terms of lipid parameters between men and women: high-density lipoprotein cholesterol (HDL-C) was significantly lower in men than in women (p < 0.001). Total cholesterol (TC) (p = 0.004), low-density lipoprotein cholesterol (LDL-C) (p < 0.001), triglyceride (TG) (p < 0.001), and TG-AUC (p < 0.001) were significantly higher in men than in women. There was no significant difference between the genders in terms of CD34(+)KDR(+) and CD34(+)KDR(+)CD133(+)cell number and MMP-9 levels. Vascular endothelial growth factor (VEGF) levels were significantly higher in men than women (p = 0.004). TC, LDL-C, and TG were significantly higher in the 3rd category than 1st and 2nd categories (p < 0.001) in women. Age, body mass index (BMI), fat rate, TG, TC, and LDL-C were significantly higher in the 3rd category than 1st category (p < 0.001, p = 0.002, p = 0.002, p = 0.01, p = 0.007, p = 0.004; respectively), in men. Circulating numbers of EPCs in men were significantly higher in the PP hyperlipidemia group than in the low TG levels category, independently from age (p < 0.05). Circulating EPC levels showed a positive correlation with OFLT response in men (r = 0.414, p < 0.05). Also, OFLT response showed a strong positive correlation with fasting TG levels (r = 0.930, p < 0.001). EPC levels in categories of women were not different. CONCLUSION: Increased EPCs levels in subjects with different PP hyperlipidemia may be associated with a response to endothelial injury, related to increased atherogenic remnant particles at the PP phase

Evaluation of 32 Episodes of Infective Endocarditis

In spite of developments in the diagnosis and management of infective endocarditis, this disease still carries high rates of morbidity and mortality. Between 1997-2001, 32 episodes of endocarditis in 30 patients were treated in our department. Twenty-two patients were male and eight female; their ages ranged from 21-84 (mean years). Of these episodes 78% associated with native valve and 21% with prosthetic valve. Fever, fatigue, chills, dyspnea were the most common clinical findings. Blood cultures were positive in 78.1% (25/32) of the episodes, revealing Staphylococcus spp. (12), Streptococcus spp. (6), Enterococcus spp. (3), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Listeria spp. (1). During follow-up 34.3% of the episodes were complicated by emboli and the overall mortality rate was 40.6%. The presence of congestive heart failure was found as the major risk factor affecting the prognosis of the disease. In view of this grave outcome of this disease, prompt diagnosis and medical therapy and when indicated early surgical intervention is essential

Correction of right to left shunt by transcatheter treatment of pulmonary stenosis and atrial septal defect: a case report

Co-occurrence of atrial septal defect and pulmonary valve stenosis is a rare entity for adult population. It is possible to correct both the pulmonary stenosis and the defect in the atrial septum by transcatheter methods. We present a case of right to left shant due to severe pulmonary stenosis and atrial defect which was successfully corrected by transcatheter pulmonary valvuloplasty and closure of the atrial septal defect

Preliminary results from a nationwide adult cardiology perspective for pulmonary hypertension: RegiStry on clInical outcoMe and sUrvival in pulmonaRy hypertension Groups (SIMURG)

Objective: The present study was designed to evaluate the characteristics of pulmonary hypertension (PH) and adult cardiology practice patterns for PH in our country

Preliminary Results From a Nationwide Adult Cardiology Perspective for Pulmonary Hypertension: Registry on Clinical Outcome and Survival in Pulmonary Hypertension Groups (Simurg)

Objective: The present study was designed to evaluate the characteristics of pulmonary hypertension (PH) and adult cardiology practice patterns for PH in our country. Methods: We evaluated preliminary survey data of 1501 patients with PH (females, 69%; age, 44.8±5.45) from 20 adult cardiology centers (AdCCs). Results: The average experience of AdCCs in diagnosing and treating patients with PH was 8.5±3.7 years. Pulmonary arterial hypertension (PAH) was the most frequent group (69%) followed by group 4 PH (19%), group 3 PH (8%), and combined pre- and post-capillary PH (4%). PAH associated with congenital heart disease (APAH-CHD) was the most frequent subgroup (47%) of PAH. Most of the patients’ functional class (FC) at the time of diagnosis was III. The right heart catheterization (RHC) rate was 11.9±11.6 per month. Most frequently used vasoreactivity agent was intravenous adenosine (60%). All patients under targeted treatments were periodically for FC, six-minute walking test, and echo measures at 3-month intervals. AdCCs repeated RHC in case of clinical worsening (CW). The annual rate of hospitalization was 14.9±19.5. In-hospital use of intravenous iloprost reported from 16 AdCCs in CWs. Bosentan and ambrisentan, as monotreatment or combination treatment (CT), were noted in 845 and 28 patients, respectively, and inhaled iloprost, subcutaneous treprostinil, and intravenous epoprostenol were noted in 283, 30, and four patients, respectively. Bosentan was the first agent used for CT in all AdCCs and iloprost was the second. Routine use of antiaggregant, anticoagulant, and pneumococcal and influenza prophylaxis were restricted in only two AdCCs. Conclusion: Our nationwide data illustrate the current status of PH regarding clinical characteristics and practice patterns.PubMedWoSScopu

33 Questions about Triglycerides and Cardiovascular Effects: Expert Answers

Education professionals are concerned about the dropping levels of motivation and engagement students experience as they go through schooling. Sustained low motivation across the student population leads to increased dropout rates, which in turn leads to many detrimental consequences. The literature shows clear correlations between low self-efficacy and low motivation, alongside a lack of tools to address the problem. This thesis tested a student-centered intervention composed of a goal setting instrument, an expressive writing instrument, and several coping mechanisms. Self-efficacy was tested in eight 16-year-old Finnish students before and after the intervention using a validated self-efficacy scale. A thematic analysis was conducted to assess the importance and effects of each of the components of the intervention, and to account for external variables. All the participants showed an increase in self-efficacy after the intervention, which was attributed to be the main cause. The goal setting instrument was reported to have the strongest effect on self-efficacy, followed by the expressive writing instrument. The coping mechanisms showed null effects. The results suggest that the goal setting instrument causes new appraisals of the most influential source of self-efficacy: performance attainments. Additionally, expressive writing serves as a foundational previous step to goal setting. However, further research is required to confirm the validity of these findings. The small sample size, the strong localization, and the fact that self-efficacy is not directly observable, severely limit the results of the study. In addition, a longer study should be conducted to observe the durability of the effects of the intervention