Non-invasive Oscillometrically Measured Aortic Pulse Wave Velocity in Healthy Individuals and COPD Patients

A kardiovaszkuláris (CV) rizikóbecslés részeként a szubklinikus célszervkárosodás fontosságát számos tanulmány bizonyítja. Az aorta rugalmatlansága (aortic stiffness) különösen az aorta pulzushullám terjedési sebessége (PWVao) egyre inkább elismert biomarkerré vált a CV rizikóbecslésben. A korai célszervkárosodás, a szubklinikus ateroszklerózis egészséges populáción történő vizsgálata nagy jelentőséggel bír a prevenció szempontjából, hiszen a tünetmentes szubklinikus ateroszklerózis már fiatal korban is gyakori jelenség, melyre mind a koreai mind a vietnámi háborúban meghalt fiatal katonákon végzett tanulmányok is rámutattak. Ismert, hogy a szívroham és a stroke szempontjából veszélyeztetett, tünetmentes betegek felismerésében igen nagy szerepe van a carotis ultrahang vizsgálatnak, hiszen direkt módon képes kimutatni a tünetmentes carotis ateroszklerózis jelenlétét és mértékét. A krónikus, légúti obstrukcióval járó tüdő betegség (COPD) világszerte a vezető halálokok közé tartozik. Jellemzője a kislégúti obstrukció, a krónikus gyulladás, az exacerbációk és a progresszív kimenetel. A COPD-s betegek jelentős része szív és érrendszeri betegségben hal meg, így ezen betegcsoportban is nagy jelentősége van a szubklinikus ateroszklerózis kimutatásának. Az artériás stiffness, az érfali rugalmatlanság az elmúlt évtizedben került a szív-érrendszeri prevencióval foglalkozó szakemberek érdeklődésének középpontjába. Az érelmeszesedés legkorábbi stádiumában, amikor az artériák falán morfológiai eltérés még nem igazolható, funkcionális vizsgálómódszerekkel már kimutatható az érfalak csökkent tágulékonysága. Egyik legjellemzőbb paramétere, a PWVao , mely a hagyományos rizikófaktoroktól független, erős prediktora a későbbi szív-érrendszeri eseményeknek, köztük a halálozásnak. Alkalmazása, mérésének beillesztése a rutin kardiovaszkuláris kockázatbecslés módszerei közé segíti a kockázat pontosítását, a tünetmentes egyének rizikójának reklasszifikálását. COPD-ben további előnyt nyújt az artériás stiffness vizsgálata, hiszen segíthet igazolni a kardiovaszkuláris komorbiditások fennállását, már igen korai, akár szubklinikus stádiumban is, ezáltal beazonosítani a nagy kockázatú egyéneket

Circulating survivin levels in healthy and asthmatic pregnancy.

BACKGROUND: Asthma is one of the most common conditions which complicate pregnancy. Pro- and anti-apoptotic mechanisms can be modulated by asthma accompanying pregnancy. Survivin, an anti-apoptotic protein has been implicated in the pathomechanism of asthma and also in the development of pathological pregnancies; however survivin has not been studied in pregnant asthmatics. METHODS: Twenty-eight asthmatic pregnant (AP), 25 asthmatic non-pregnant (ANP), 21 healthy pregnant (HP) and 29 healthy non-pregnant (HNP) women were enrolled in this cross-sectional study. Plasma survivin concentration was determined by ELISA. RESULTS: Plasma survivin was significantly lower in HP (1.64 /0-74.9/ pg/ml) than in HNP (24.6 /0-333.3/ pg/ml, p = 0.01). However, this difference was not observed between the asthmatic groups (p = 0.64). Similarly, there was no difference either between HNP and ANP (10.5 /0-215.4/ pg/ml, p = 0.23) or between HP and AP (13.9 /0-364.1/ pg/ml, p = 0.30) groups. CONCLUSIONS: Decreased plasma survivin levels in physiological but not in asthmatic pregnancy may suggest that the normal apoptotic mechanisms are compromised in asthmatic gestation

Miscellanea. Levelek a szerkesztőhöz. Folyóirat-referátumok

Levelek a szerkesztőhöz. | Folyóirat-referátumok. Gerontológia A földre leülés és felállás képessége a bármely okú halálozás előrejelzője (Ability to sit and rise from the floor as a predictor of all-cause mortality) de Brito, L. B., Ricardo, D. R., de Araújo, D. S. et al. (Levelező szerző: Claudio Gil Soares de Araújo, Clinimex Rua Siqueira Campos, 93/101, 22031-070, Rio de Janeiro, Brazília; e-mail: [email protected].): Eur. J. Prev. Cardiol., 2014, 21 (7), 892–898. | Kardiológia A nem szteroid gyulladáscsökkentők (NSAID-ok) cardiovascularis hatásai: okozhatnak-e jelentős vérnyomás- emelkedést az NSAID-ok? [Cardiovascular effects of NSAIDs: Do nonsteroidal anti-inflammattory drugs (NSAIDs) cause a clinically significant increase in blood pressure?] Sherve, K., Gerard, C. J., Neher, J. O., et al. (Valley Family Medicine Residency, Renton, WA, Amerikai Egyesült Államok; e-mail: [email protected]): Am. Fam. Physician, 2014, 90 (4), online | Szülészet-nőgyógyászat Ultrahang a 3. trimeszterben (Ultraschall im 3. trimenon) Schmitz, R. (Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, e-mail: [email protected]): Geburtsch. Frauenheilk., 2013, 73 (1), 42–45

Soluble Urokinase-Type Plasminogen Activator Receptor and Arterial Stiffness in Patients with COPD

Soluble urokinase-type plasminogen activator receptor (suPAR) is upregulated by inflammation and plays a role in the pathogenesis of atherosclerosis. Chronic obstructive pulmonary disease (COPD) is associated with enhanced systemic inflammation and increased risk for atherosclerosis, however, studies analysing the circulating suPAR levels in COPD are contradictory. The aim of the study was to investigate plasma suPAR concentrations together with markers of arterial stiffness in COPD.Twenty-four patients with COPD and 18 non-COPD, control subjects participated in the study. Plasma suPAR was measured, together with lung volumes, symptom burden, exacerbation history, markers of arterial stiffness and soluble inflammatory biomarkers, such as endothelin-1, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6).Plasma suPAR levels were higher in COPD (2.84 ± 0.67 ng/ml vs. 2.41 ± 0.57 ng/ml, p = 0.03) and were related to lung function measured with FEV1 (r = - 0.65, p < 0.01) and symptom burden determined with the modified Medical Research Council questionnaire (r = 0.55, p < 0.05). Plasma suPAR concentrations correlated with various measures of arterial stiffness in all subjects, but only with ejection duration in COPD (r = - 0.44, p = 0.03).Plasma suPAR levels are elevated in COPD and relate to arterial stiffness. Our results suggest that suPAR may be a potential link between COPD and atherosclerosis

Circulating soluble urokinase-type plasminogen activator receptor in obstructive sleep apnoea

Background and Objectives: Obstructive sleep apnoea (OSA) is associated with heightened systemic inflammation and a hypercoagulation state. Soluble urokinase-type plasminogen activator receptor (suPAR) plays a role in fibrinolysis and systemic inflammation. However, suPAR has not been investigated in OSA. Materials and Methods: A total of 53 patients with OSA and 15 control volunteers participated in the study. Medical history was taken and in-hospital sleep studies were performed. Plasma suPAR levels were determined by ELISA. Results: There was no difference in plasma suPAR values between patients with OSA (2.198 ± 0.675 ng/mL) and control subjects (2.088 ± 0.976 ng/mL, p = 0.62). Neither was there any difference when patients with OSA were divided into mild (2.134 ± 0.799 ng/mL), moderate (2.274 ± 0.597 ng/mL) and severe groups (2.128 ± 0.744 ng/mL, p = 0.84). There was no significant correlation between plasma suPAR and indices of OSA severity, blood results or comorbidities, such as hypertension, diabetes, dyslipidaemia or cardiovascular disease. Plasma suPAR levels were higher in women when all subjects were analysed together (2.487 ± 0.683 vs. 1.895 ± 0.692 ng/mL, p < 0.01), and also separately in controls (2.539 ± 0.956 vs. 1.411 ± 0.534 ng/mL, p = 0.02) and patients (2.467 ± 0.568 vs. 1.991 ± 0.686 ng/mL, p < 0.01). Conclusions: Our results suggest that suPAR does not play a significant role in the pathophysiology of OSA. The significant gender difference needs to be considered when conducting studies on circulating suPAR. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma

BACKGROUND: Asthma often complicates pregnancy and represents a risk of serious pregnancy complications. The complement system contributes to asthma pathogenesis and is up-regulated in healthy gestation as well. The anaphylatoxin C5a has a major pro-inflammatory role, and the complement factor H is a main soluble regulator protein both in asthma and during pregnancy; however, peripheral levels of these complement factors and their relationship to disease control have not yet been evaluated in pregnant subjects with asthma. METHODS: The present study aimed to investigate circulating C5a and complement factor H levels in asthma (non-pregnant subjects with asthma; n = 19) and in pregnancy with asthma (pregnant subjects with asthma; n = 22), compared with healthy non-pregnant (n = 21) and healthy pregnant women (n = 13) and to test their relationship to clinical parameters of asthma (lung function, airway inflammation, and symptoms). RESULTS: Circulating C5a levels were higher in the pregnant asthma subject group compared with the healthy non-pregnant, healthy pregnant, and non-pregnant asthma groups: median 2.629 (interquartile range [IQR] 2.257-3.052) ng/mL versus 1.84 (IQR 1.576-2.563), 1.783 (IQR 0.6064-2.786), and 2.024 (IQR 1.232-2.615) ng/mL, respectively (P = .02 in all cases). C5a correlated negatively with FEV1 (r = -0.44, P = .039) and FVC values (r = -0.64, P = .001) in the pregnant asthma group and positively with fraction of exhaled nitric oxide levels in the non-pregnant asthma group (n = 12, r = 0.78, P = .004). Complement factor H levels were elevated in both the healthy pregnant and pregnant asthma subject groups compared with the healthy non-pregnant group (median 1,082 [IQR 734.9-1,224] and 910.7 [IQR 614.5-1076] mug/mL vs 559.7 [IQR 388.7-783.1] mug/mL, P = .002 and P = .004, respectively) but not in the pregnant asthma group compared with the non-pregnant asthma group (median 687.4 [IQR 441.6-947.6] mug/mL, P = .10). CONCLUSIONS: Asthma during pregnancy increases the circulating level of pro-inflammatory C5a, which is accompanied by impaired lung function and partly counteracted by the gestation-specific elevation of regulatory complement factor H level (detected in pregnancy both in healthy and subjects with asthma)

Oscillometrically Measured Aortic Pulse Wave Velocity Reveals Asymptomatic Carotid Atherosclerosis in a Middle-Aged, Apparently Healthy Population

Background. Asymptomatic atherosclerosis is a common entity even at young age. Studies have suggested a strong relationship between increased arterial stiffness and asymptomatic carotid atherosclerosis (ACA) in general population, particularly in those with high cardiovascular risk, but no data exist from a younger population free from recognized cardiovascular disease. Hypothesis. We hypothesized there is an association between ACA and aortic pulse wave velocity (PWVao) in middle-aged, apparently healthy, normotensive population to reveal increased cardiovascular risk. Methods. We examined the relationship between ACA and PWVao in 236 apparently healthy, asymptomatic, normotensive, middle-aged subjects (age 47 ± 8 years; 52% women). PWVao was measured with the oscillometric method (Arteriograph). ACA was assessed by carotid artery ultrasonography. Results. ACA was present in 51 subjects. Subjects with ACA were older (p8.3 m/s identified ACA with a 71% sensitivity, 65% specificity, 36% positive and 89% negative predictive value, 2.04 relative risk, and 4.54 odds ratio, respectively. Conclusions. PWVao measured by the Arteriograph proved to be an independent marker of ACA. Our study may reveal high CV risk, detected as increased PWVao, which according to our study is related in a very high probability to asymptomatic carotid atherosclerosis in apparently healthy, young, and middle-aged subjects