Pub Date : 2018-01-01DOI: 10.17554/j.issn.2309-6861.2018.05.160
A. Kinsara
Arrhythmogenic right ventricular dysplasia is a cardiomyopathy of the young that presents with a sudden cardiac death. It has unique features that prompted a different classification, based on a combination of right ventricular imaging by echocardiography and cardiac magnetic resonance imaging, histology, repolarization abnormalities, depolarization and conduction abnormalities, arrhythmias and family history (including genetic testing). Hence the usual investigative pathway requires a multimodality approach. Treatment is complex and starts with exercise restriction in this young active population and ends up with insertion of an Automated ORIGINAL ARTICLE Arrhythmogenic Right Ventricular Dysplasia, Did We Know Everything Abdulhalim Jamal Kinsara, FRCP 747 Journal of Cardiol Ther 2018 October; 5(1): 747-750 ISSN 2309-6861(print), ISSN 2312-122X(online) Online Submissions: http: //www.ghrnet.org/index./jct/ doi: 10.17554/j.issn.2309-6861.2018.05.160 Journal of Cardiology and Therapy truncation. However, the presence of desmosomal mutations did not affect the prognosis[9].
{"title":"Arrhythmogenic Right Ventricular Dysplasia, Did We KnowEverything: Kinsara AJ et al. ARVD update","authors":"A. Kinsara","doi":"10.17554/j.issn.2309-6861.2018.05.160","DOIUrl":"https://doi.org/10.17554/j.issn.2309-6861.2018.05.160","url":null,"abstract":"Arrhythmogenic right ventricular dysplasia is a cardiomyopathy of the young that presents with a sudden cardiac death. It has unique features that prompted a different classification, based on a combination of right ventricular imaging by echocardiography and cardiac magnetic resonance imaging, histology, repolarization abnormalities, depolarization and conduction abnormalities, arrhythmias and family history (including genetic testing). Hence the usual investigative pathway requires a multimodality approach. Treatment is complex and starts with exercise restriction in this young active population and ends up with insertion of an Automated ORIGINAL ARTICLE Arrhythmogenic Right Ventricular Dysplasia, Did We Know Everything Abdulhalim Jamal Kinsara, FRCP 747 Journal of Cardiol Ther 2018 October; 5(1): 747-750 ISSN 2309-6861(print), ISSN 2312-122X(online) Online Submissions: http: //www.ghrnet.org/index./jct/ doi: 10.17554/j.issn.2309-6861.2018.05.160 Journal of Cardiology and Therapy truncation. However, the presence of desmosomal mutations did not affect the prognosis[9].","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"23 1","pages":"747-750"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91007589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-23DOI: 10.17554/J.ISSN.2309-6861.2017.04.137
F. Cacciapuoti
Stable coronary artery disease (SCAD), is caused by an imbalance between myocardial blood supply and oxygen demand. It occurs when the heart muscle doesn’t get as much blood as it needs. Specifically, it isn’t acute coronary angina, but suggests that a heart attack is more likely to happen in the future. Sometimes, conventional anti-ischemic drugs can be insufficient to improve the symptoms in the presence of SCAD. But, their association with some agents having different mechanisms from traditional anti-ischemic compounds, such as Trimetazidine, Ranolazine or Ivabradine (second line of treatment) may be effective. These (especially when given in association with nitrates, beta-blockers or calcium-antagonists) obtained significant results in numerous SCAD-studies when conventional drugs alone were ineffective. In addition, Ranolazine shown interesting anti-arrhythmic effects both in supra-and-ventricular arrhythmias and, given alone or in association with other anti-arrhythmics (as Cordarone or Dronedarone) obtained promising results in these rhythm disturbances.
{"title":"Trimetazidine, Ranolazine, Ivabradine Antagonize Stable Coronary Artery Disease Otherwise from Conventional Anti-Ischemic Drugs","authors":"F. Cacciapuoti","doi":"10.17554/J.ISSN.2309-6861.2017.04.137","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.137","url":null,"abstract":"Stable coronary artery disease (SCAD), is caused by an imbalance between myocardial blood supply and oxygen demand. It occurs when the heart muscle doesn’t get as much blood as it needs. Specifically, it isn’t acute coronary angina, but suggests that a heart attack is more likely to happen in the future. Sometimes, conventional anti-ischemic drugs can be insufficient to improve the symptoms in the presence of SCAD. But, their association with some agents having different mechanisms from traditional anti-ischemic compounds, such as Trimetazidine, Ranolazine or Ivabradine (second line of treatment) may be effective. These (especially when given in association with nitrates, beta-blockers or calcium-antagonists) obtained significant results in numerous SCAD-studies when conventional drugs alone were ineffective. In addition, Ranolazine shown interesting anti-arrhythmic effects both in supra-and-ventricular arrhythmias and, given alone or in association with other anti-arrhythmics (as Cordarone or Dronedarone) obtained promising results in these rhythm disturbances.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"3 1","pages":"688-692"},"PeriodicalIF":0.0,"publicationDate":"2017-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88623058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-23DOI: 10.17554/j.issn.2309-6861.2017.04.133
Ram B. Singh
INTRODUCTION: Coronary risk factors (CRF) and acute coronary syndromes have become a major health problem in most middle income countries, although they are decreasing in developed countries. The increased risk of ACS in South Asians is not explained by conventional CRF, hence this study examines the coronary protective factors(CPF) to explain the cause of remaining of the risk. SUBJECTS AND METHODS: Case control study including 435 patients with ACS who were compared with 495 age and sex matched control subjects. Clinical, electrocardiographic, radiological and laboratory data were obtained in all the patients for confirmation of diagnosis by WHO and AHA criteria. Multivariate logistic regression analysis was conducted after adjustment of age, and body mass index(BMI) to determine the association of CPF with ACS, RESULTS : Coronary protective factors; healthy diet (Fruit, vegetable legume, and nuts(>400g/day)(31.0 vs 52.7%) moderate physical activity(23.4 vs 68.0%), meditation and yoga (>5days/week ) 5.7 vs 25.2 %), moderate alcohol(<10drinks/week)(2.7 vs 24.6%), lean body weight (BMI<25 Kg/M2) (7.8 vs 51.5%) and never tobacco intake (48.9 vs 68.0%) were significantly lower among ACS patients compared to control subjects. Multivariate logistic regression analysis revealed that after adjustment of age, and BMI, the association of odds ratio (99% confidence interval) for healthy diet (male 0.57 (0.45-0.69)**female 0.59 (0.48-0.68)**, moderate physical activity (male 0.62(0.51-0.69**, female 0.67(0.55-0.75)**), meditation and yoga ( male 0.46 (0.35-0.56)* female 0.48 (0.40-0.59)*, lean body weight (male 0.61 (0.53-0.72)* female 0.62(0.52-0.71)* and never tobacco intake (male 0.48 (0.43-0.55)** female0.51 (0.45-0.67)* as well as moderate alcohol intake (male 0.42 (0.34-0.54)* were inversely associated with ACS. No such association of moderate alcohol was noted among females due to less numbers. Conclusions : This study shows that decreased adherence to healthy diet and moderate physical activity were highly significant CPF of ACS. Lean body weight, meditation and yoga were also significantly less CPF but had weak association. Never tobacco and moderate alcohol intake(males) were also significant CPF but with only weak association among females with ACS. Moderate alcohol intake was not a protective factor of ACS among females.
{"title":"Association of Coronary Protective Factors among Patients with Acute Coronary Syndromes","authors":"Ram B. Singh","doi":"10.17554/j.issn.2309-6861.2017.04.133","DOIUrl":"https://doi.org/10.17554/j.issn.2309-6861.2017.04.133","url":null,"abstract":"INTRODUCTION: Coronary risk factors (CRF) and acute coronary syndromes have become a major health problem in most middle income countries, although they are decreasing in developed countries. The increased risk of ACS in South Asians is not explained by conventional CRF, hence this study examines the coronary protective factors(CPF) to explain the cause of remaining of the risk. SUBJECTS AND METHODS: Case control study including 435 patients with ACS who were compared with 495 age and sex matched control subjects. Clinical, electrocardiographic, radiological and laboratory data were obtained in all the patients for confirmation of diagnosis by WHO and AHA criteria. Multivariate logistic regression analysis was conducted after adjustment of age, and body mass index(BMI) to determine the association of CPF with ACS, RESULTS : Coronary protective factors; healthy diet (Fruit, vegetable legume, and nuts(>400g/day)(31.0 vs 52.7%) moderate physical activity(23.4 vs 68.0%), meditation and yoga (>5days/week ) 5.7 vs 25.2 %), moderate alcohol(<10drinks/week)(2.7 vs 24.6%), lean body weight (BMI<25 Kg/M2) (7.8 vs 51.5%) and never tobacco intake (48.9 vs 68.0%) were significantly lower among ACS patients compared to control subjects. Multivariate logistic regression analysis revealed that after adjustment of age, and BMI, the association of odds ratio (99% confidence interval) for healthy diet (male 0.57 (0.45-0.69)**female 0.59 (0.48-0.68)**, moderate physical activity (male 0.62(0.51-0.69**, female 0.67(0.55-0.75)**), meditation and yoga ( male 0.46 (0.35-0.56)* female 0.48 (0.40-0.59)*, lean body weight (male 0.61 (0.53-0.72)* female 0.62(0.52-0.71)* and never tobacco intake (male 0.48 (0.43-0.55)** female0.51 (0.45-0.67)* as well as moderate alcohol intake (male 0.42 (0.34-0.54)* were inversely associated with ACS. No such association of moderate alcohol was noted among females due to less numbers. Conclusions : This study shows that decreased adherence to healthy diet and moderate physical activity were highly significant CPF of ACS. Lean body weight, meditation and yoga were also significantly less CPF but had weak association. Never tobacco and moderate alcohol intake(males) were also significant CPF but with only weak association among females with ACS. Moderate alcohol intake was not a protective factor of ACS among females.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"4 1","pages":"693-699"},"PeriodicalIF":0.0,"publicationDate":"2017-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74464547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-23DOI: 10.17554/J.ISSN.2309-6861.2017.04.134
A. S. Zago, H. Monteiro, B. C. Turi, Anderson Bernardino da Silva, R. F. D. Silva, A. Jacomini, S. Amaral
The purpose of this study was to analyze the effect of aging and the estimated training status (TS) on the blood pressure (BP) and antihypertensive medicine consumption (AMC) which are supposed to be high in older people compared with adults. Participants (n=396) performed the following tests: Functional fitness battery test proposed by AAHPERD, blood pressure measurement and a questionnaire about habits of physical exercise and medicine consumptions. In summary, older group present high level of blood pressure and medicine consumptions compared with adults groups (BP - 125±5/77±9 vs 119±12/78±9 mmHg and AMC - 1.8±0.1 vs 1.4±0.1 respectively). However, when participants were divided according to TS, good level of TS was associated with low level of blood pressure. These results were not observed in adults group. Thus, the current study contributes to establish the good level of TS as a marker of good level of blood pressure, especially in older group.
本研究的目的是分析年龄和预估训练状态(TS)对老年人血压(BP)和降压药消耗量(AMC)的影响，老年人的血压(BP)和降压药消耗量(AMC)应高于成年人。参与者(n=396)进行了以下测试:AAHPERD建议的功能健身电池测试，血压测量和体育锻炼习惯和药物消耗问卷。综上所述，与成年人相比，老年组血压和药物消耗水平较高(BP - 125±5/77±9 vs 119±12/78±9 mmHg, AMC - 1.8±0.1 vs 1.4±0.1)。然而，当参与者根据TS进行分组时，良好的TS水平与较低的血压水平相关。这些结果在成人组中没有观察到。因此，本研究有助于建立良好的TS水平作为血压水平良好的标志，特别是在老年人中。
{"title":"The impact of aging and estimated training status on blood pressure and antihypertensive medicine consumption","authors":"A. S. Zago, H. Monteiro, B. C. Turi, Anderson Bernardino da Silva, R. F. D. Silva, A. Jacomini, S. Amaral","doi":"10.17554/J.ISSN.2309-6861.2017.04.134","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.134","url":null,"abstract":"The purpose of this study was to analyze the effect of aging and the estimated training status (TS) on the blood pressure (BP) and antihypertensive medicine consumption (AMC) which are supposed to be high in older people compared with adults. Participants (n=396) performed the following tests: Functional fitness battery test proposed by AAHPERD, blood pressure measurement and a questionnaire about habits of physical exercise and medicine consumptions. In summary, older group present high level of blood pressure and medicine consumptions compared with adults groups (BP - 125±5/77±9 vs 119±12/78±9 mmHg and AMC - 1.8±0.1 vs 1.4±0.1 respectively). However, when participants were divided according to TS, good level of TS was associated with low level of blood pressure. These results were not observed in adults group. Thus, the current study contributes to establish the good level of TS as a marker of good level of blood pressure, especially in older group.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"106 1","pages":"681-687"},"PeriodicalIF":0.0,"publicationDate":"2017-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86970517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-03DOI: 10.17554/J.ISSN.2309-6861.2017.04.131
G. Caminiti, Filomena Cacciapuoti, C. Fossati, D. Battaglia, N. Punzo, M. Volterrani
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with poor quality of life and high rate of hospitalization in elderly frail patients. In patients with non-paroxysmal AF, optimizing heart rate is often the main goal but available drugs fail to reach heart rate control in about 30% of cases and this often happens because their doses can not be implemented due to side effects. Ivabradine is a pure heart rate lowering agent acting through the inhibition of If current in the sinus atrial cells, and it is widely used for patients with stable angina and chronic heart failure in sinus rhythm. According to very preliminary data, ivabradine shows heart rate lowering proprieties in non-paroxysmal AF when used alone or in association to other heart rate lowering drugs. Interestingly, studies suggest that this seems to translate into clinical benefits such as improvement of exercise tolerance and ejection fraction. However, new trials are needed to confirm the effectiveness and safety of ivabradine in non-paroxysmal AF.
{"title":"Heart Rate Control in Non-Paroxysmal Atrial Fibrillation. A New Indication for Ivabradine?","authors":"G. Caminiti, Filomena Cacciapuoti, C. Fossati, D. Battaglia, N. Punzo, M. Volterrani","doi":"10.17554/J.ISSN.2309-6861.2017.04.131","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.131","url":null,"abstract":"Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with poor quality of life and high rate of hospitalization in elderly frail patients. In patients with non-paroxysmal AF, optimizing heart rate is often the main goal but available drugs fail to reach heart rate control in about 30% of cases and this often happens because their doses can not be implemented due to side effects. Ivabradine is a pure heart rate lowering agent acting through the inhibition of If current in the sinus atrial cells, and it is widely used for patients with stable angina and chronic heart failure in sinus rhythm. According to very preliminary data, ivabradine shows heart rate lowering proprieties in non-paroxysmal AF when used alone or in association to other heart rate lowering drugs. Interestingly, studies suggest that this seems to translate into clinical benefits such as improvement of exercise tolerance and ejection fraction. However, new trials are needed to confirm the effectiveness and safety of ivabradine in non-paroxysmal AF.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"29 1","pages":"671-675"},"PeriodicalIF":0.0,"publicationDate":"2017-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77959717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-03DOI: 10.17554/J.ISSN.2309-6861.2017.04.129
A. Berezin
Obesity remains a leading cause of cardiovascular (CV) events and diabetes worldwide. Although there are at least two main body-size phenotypes (metabolically healthy and metabolically non-healthy) of individuals with established obesity, the cardiometabolic risk amongst these patients’ populations extremely distinguishes. The editorial is discussed the controversies regarding obese paradox and the probabilities to stratify the patients with established obesity in cardiometabolic risk. It is suggested that the biomarkers could predict CV events in patients depending on obese phenotypes. The role of metabolic biomarkers, progenitor cells, natriuretic peptides, inflammatory cytokines and galectin-3 are discussed.
{"title":"Novel Biomarkers for Cardiovascular Risk in Obese Patients","authors":"A. Berezin","doi":"10.17554/J.ISSN.2309-6861.2017.04.129","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.129","url":null,"abstract":"Obesity remains a leading cause of cardiovascular (CV) events and diabetes worldwide. Although there are at least two main body-size phenotypes (metabolically healthy and metabolically non-healthy) of individuals with established obesity, the cardiometabolic risk amongst these patients’ populations extremely distinguishes. The editorial is discussed the controversies regarding obese paradox and the probabilities to stratify the patients with established obesity in cardiometabolic risk. It is suggested that the biomarkers could predict CV events in patients depending on obese phenotypes. The role of metabolic biomarkers, progenitor cells, natriuretic peptides, inflammatory cytokines and galectin-3 are discussed.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"10 1","pages":"676-680"},"PeriodicalIF":0.0,"publicationDate":"2017-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87235388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-03DOI: 10.17554/J.ISSN.2309-6861.2017.04.127
Xiyang Peng, Junwei Zhou, X. Wu
Myocardial infarction is due to lasting and serious myocardial ischemic that leads to myocardial necrosis and cardiac remodeling, and can consequently results in heart failure. Traditional treatment for myocardial infarction includes drug therapy, thrombolytic therapy, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Although these treatments can to some extent relieve the symptom of myocardial ischemia, they fail to repair the necrotic heart tissues. Myocardial regeneration is undoubtedly the best solution to the clinical problems of myocardial infarction treatment. The review briefly illustrated the pros and cons of the traditional treatments of myocardial infarction, and focused on the application of new strategies for myocardial infarction treatment using myocardial regeneration.
{"title":"New Strategies for Myocardial Infarction Treatment","authors":"Xiyang Peng, Junwei Zhou, X. Wu","doi":"10.17554/J.ISSN.2309-6861.2017.04.127","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.127","url":null,"abstract":"Myocardial infarction is due to lasting and serious myocardial ischemic that leads to myocardial necrosis and cardiac remodeling, and can consequently results in heart failure. Traditional treatment for myocardial infarction includes drug therapy, thrombolytic therapy, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Although these treatments can to some extent relieve the symptom of myocardial ischemia, they fail to repair the necrotic heart tissues. Myocardial regeneration is undoubtedly the best solution to the clinical problems of myocardial infarction treatment. The review briefly illustrated the pros and cons of the traditional treatments of myocardial infarction, and focused on the application of new strategies for myocardial infarction treatment using myocardial regeneration.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"1 1","pages":"664-670"},"PeriodicalIF":0.0,"publicationDate":"2017-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88292044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-17DOI: 10.17554/J.ISSN.2309-6861.2017.04.130
J. Prandota
Cardiovascular diseases such as atherosclerosis, atherothrombosis, coronary artery disease and stroke are the main causes of death worldwide . Atherosclerosis is a chronic, progressive immunoinflammatory and fibroproliferative disease of medium and large sized arteries with increased blood lipoprotein/cholesterol and their disposition in the arterial wall, important T H 1 type proinflammatory reaction, and thrombogenic status. Elevated plasma levels of proinflammatory cytokines have been demonstrated in patients with established atherosclerotic disease, and therefore it is believed that cytokines are key players in all stages of disease and have a profound influence on the pathogenesis of the disease. Several authors suggested that the number of different pathogens, including T. gondii , may promote synergistic inflammatory responses that are capable of triggering and exacerbating atherosclerotic process. Latent chronic T. gondii infection may be a frequent cause of vascular endothelial cell dysfunction because this pathogen attacks all nucleated cells, and endothelium cells have enhanced susceptibility to infection with T. gondii tachyzoites. Oxidative stress characteristic for atherosclerosis may be caused by the host infection with the parasite. T. gondii is unable to synthesize sterol and acquires cholesterol from the host LDL receptor pathway. The accumulation of foamy transformed macrophages in the aortic intima characteristic for atherosclerotic lesion is due to acyl-CoA:cholesterol acyltransferase 1 and 2 (ACAT1 and ACAT2) increased expression in macrophages and other cells infected with T. gondii . ACAT2 is crucial in foam cell formation and development of atherosclerosis. The parasite also expresses two cholesteryl ester(CE)-synthesizing enzymes Tg ACAT1 and Tg ACAT2 that contribute to the CEs formation for storage in lipid bodies, but at the same time ACAT and CEs play a crucial role in replication of the pathogen. It must be emphasized that the increased expression of ACAT1 and ACAT2 normally present in macrophages may thus be further enhanced by the superimposing Tg ACAT1 and Tg ACA2 activities available in the host cells infected with T. gondii . In addition, p roinflammatory cytokines increase foam cell formation and latent chronic T. gondii infection persistently generates these biomediators and thus play an important role in foam cell biogenesis. P atients with atherosclerosis had increased plasma levels of TGF- b and this cytokine increased T. gondii replication in the host cells, and participated in development of fibrotic changes in atherosclerotic lesions. Atherogenesis involved platelets activation with subsequent serotonin release. Hyperserotoninemia was also reported in autistic and mentally retarded children, and recently, a significantly higher seroprevalence of chronic toxoplasmosis was found in autistic children as compared with controls. T. gondii infection caused also increased leptin levels, and a marked association
{"title":"Possible Pivotal Role of T. gondii infection in the Pathogenesis of Atherosclerosis","authors":"J. Prandota","doi":"10.17554/J.ISSN.2309-6861.2017.04.130","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.130","url":null,"abstract":"Cardiovascular diseases such as atherosclerosis, atherothrombosis, coronary artery disease and stroke are the main causes of death worldwide . Atherosclerosis is a chronic, progressive immunoinflammatory and fibroproliferative disease of medium and large sized arteries with increased blood lipoprotein/cholesterol and their disposition in the arterial wall, important T H 1 type proinflammatory reaction, and thrombogenic status. Elevated plasma levels of proinflammatory cytokines have been demonstrated in patients with established atherosclerotic disease, and therefore it is believed that cytokines are key players in all stages of disease and have a profound influence on the pathogenesis of the disease. Several authors suggested that the number of different pathogens, including T. gondii , may promote synergistic inflammatory responses that are capable of triggering and exacerbating atherosclerotic process. Latent chronic T. gondii infection may be a frequent cause of vascular endothelial cell dysfunction because this pathogen attacks all nucleated cells, and endothelium cells have enhanced susceptibility to infection with T. gondii tachyzoites. Oxidative stress characteristic for atherosclerosis may be caused by the host infection with the parasite. T. gondii is unable to synthesize sterol and acquires cholesterol from the host LDL receptor pathway. The accumulation of foamy transformed macrophages in the aortic intima characteristic for atherosclerotic lesion is due to acyl-CoA:cholesterol acyltransferase 1 and 2 (ACAT1 and ACAT2) increased expression in macrophages and other cells infected with T. gondii . ACAT2 is crucial in foam cell formation and development of atherosclerosis. The parasite also expresses two cholesteryl ester(CE)-synthesizing enzymes Tg ACAT1 and Tg ACAT2 that contribute to the CEs formation for storage in lipid bodies, but at the same time ACAT and CEs play a crucial role in replication of the pathogen. It must be emphasized that the increased expression of ACAT1 and ACAT2 normally present in macrophages may thus be further enhanced by the superimposing Tg ACAT1 and Tg ACA2 activities available in the host cells infected with T. gondii . In addition, p roinflammatory cytokines increase foam cell formation and latent chronic T. gondii infection persistently generates these biomediators and thus play an important role in foam cell biogenesis. P atients with atherosclerosis had increased plasma levels of TGF- b and this cytokine increased T. gondii replication in the host cells, and participated in development of fibrotic changes in atherosclerotic lesions. Atherogenesis involved platelets activation with subsequent serotonin release. Hyperserotoninemia was also reported in autistic and mentally retarded children, and recently, a significantly higher seroprevalence of chronic toxoplasmosis was found in autistic children as compared with controls. T. gondii infection caused also increased leptin levels, and a marked association","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"12 1","pages":"611-663"},"PeriodicalIF":0.0,"publicationDate":"2017-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85608144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-24DOI: 10.17554/J.ISSN.2309-6861.2017.04.123-3
T. Giacon, F. Vanderlei, Natália Turri da Silva, Thais Cabral Almeida, Ana Laura Ricci Vitor, V. Valenti, L. Vanderlei
Diabetes mellitus remains a serious problem of public health and also have the autonomic neuropathy as one of the most frequent complications. In this sense, it is important early identify and prevent changes induced by diabetes mellitus. Physical exercise is known by their positive influences on autonomic modulation so, in order to provide an update of published findings on the topic over the past thirteen years related to this issue the objective of this study was gather information about the influence of physical exercise on autonomic nervous system in individuals with diabetes mellitus, using heart rate variability as a tool of measurement. The search for studies was conducted in the following electronic databases: MedLine/Pubmed, PEDro, SciELO, Lilacs and Cochrane using diabetes mellitus, physical exercise, exercise therapy, autonomic nervous system, sympathetic nervous system, parasympathetic nervous system and heart rate as standard descriptors. Additionally, heart rate variability and diabetic autonomic neuropathy were included due to the wide use as keyword. The results included 10 articles which, in general, showed the physical training promotes positive influence on autonomic nervous system of patients with diabetes mellitus; exercise has different responses on autonomic nervous system in diabetes mellitus when associated with other variables as cardiac autonomic neuropathy, hypertension, obesity and ventricular dysfunction; the positive influence of exercise could be observed through hear rate variability and depends on the characteristics of the exercise as frequency, intensity and type of training.
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Pub Date : 2017-02-24DOI: 10.17554/J.ISSN.2309-6861.2017.04.123
V. Valenti
Cardiovascular rehabilitation through exercise is of great interest since cardiovascular disease is one of the main cause of mortality worldwide. Exercise presents benefic effects on the reduction of cardiovascular disorders development. Previous studies analyzed the influence of aerobic exercise in improving cardiovascular function through physiological mechanism[. In this special number of the Journal of Cardiology and Therapy we discuss the acute and chronic effects of exercise on cardiovascular system.
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