Cardiovascular & hematological disorders drug targets最新文献

Introduction: Atrial Fibrillation (AF) is the most common cardiac arrhythmia in the world, with a lifetime risk of 26% for men and 23% for women. AF is a prevalent cardiac arrhythmia that is more common with increasing age. Globally, around 33.5 million people are estimated to have AF, which is anticipated to rise as the population ages. Although effective therapeutic methods exist, they are costly for the healthcare system.

Methods: The search was conducted across multiple databases, including Medline, PubMed, and Google Scholar, as well as through manual searches of recognized publications and their bibliographies. Identifying modifiable risk factors for AF and implementing appropriate preventative measures may significantly improve public health and reduce healthcare costs. The development of AF has been reported to be associated with various causes, including electrical and structural changes in the atrial tissue.

Results: This article has reviewed how environmental factors, occupational hazards, and seasonal variability can affect AF. The incidence and prevalence of AF have been increasing, leading to a high lifetime risk for individuals. The available evidence indicates that seasonal variation, environmental factors, such as noise and air pollution, type of job, and altitude are all associated with an increased risk of developing AF. Although the exact mechanisms underlying these associations remain unclear, it is likely that a combination of factors, including changes in autonomic tone, inflammation, and oxidative stress, play a role.

Conclusion: This review has highlighted the significance of assuming the role of environmental and occupational factors in the development of AF.

Background: Thymus atlanticus (Ball) Roussine (T. atlanticus) is traditionally used in the Moroccan high Atlas Mountains to treat several disorders, including cardiovascular disease. In the present study, the lipid-lowering and anti-atherosclerotic activities of the traditionally used aqueous extract of T. atlanticus were evaluated on guinea pigs subjected to chronic hyperlipidemia.

Methods: Animals were given a diet containing 2% cholesterol and 20% lard for 12 weeks. Moreover, thyme extract was given daily at 400 mg/kg. At the end of the experiment, lipid levels and paraoxonase arylesterase activity were measured, and aorta histology was studied.

Results: Our findings revealed that there was an important elevation of blood lipids in the HFD group along with a significant decrease in paraoxonase arylesterase activity (-40.06%). Moreover, the consumption of fat altered the histology of aorta by thickening the intima media and forming atherosclerotic lesions and foam cells in these tissues. However, the administration of thyme extract attenuated HFD-caused alterations by decreasing blood lipids, elevating paraoxonase activity (+24.04%), and limiting the progression of atherosclerotic lesions.

Conclusion: We conclude that the supplementation with the aqueous extract of T. atlanticus could potentially protect against hyperlipidemia and consequently, the development of atherosclerosis.

Objective: To investigate the effectiveness of the decentralization and virtualization of anticoagulation clinics just before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: We conducted a cohort study investigation at Prince Sultan Cardiac Clinics PSCC Qassim region, Saudi Arabia. To evaluate the effectiveness of the virtual coagulation clinic, we calculated the time in therapeutic range (TTR), Morisky score for adherence, and satisfaction. Demographics of the patients were analyzed to group patients based on their regions or districts to facilitate the visits. Thirteen different PHCs/Hospitals were allocated for decentralization based on patient density in that region. Intensive courses were provided for all general practitioners (GPs) regarding warfarin anticoagulation and point of care testing (POCT) using iSTAT. All appointments were scheduled by WhatsApp, with no more actual visits to the main center.

Results: Among the included participants (n = 5616), 61.1% were females, 38.9% were males, and the mean age was 60.5 (18-85) years. The total number of clinic visits was 7303 per month, with an average of 1.3 visits per patient. Approximately 95% of the participants had a valvular indication to receive anticoagulation; of them, 55% underwent mitral valve replacement. Moreover, after the virtualization of the INR clinic, keeping INR levels within a therapeutic range was reported in 80% of patients. Regarding patient satisfaction, 90% of the total population was satisfied by the new experience.

Conclusion: Decentralization and virtualization of the INR clinic have similar TTR results if conducted properly.

Background: The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health crisis with significant morbidity and mortality.

Objective: The aim of this study was to investigate the incidence of COVID-19 in patients undergoing primary percutaneous coronary intervention (PCI) for myocardial infarction and identify associated demographic and clinical characteristics.

Methods: In this study, a retrospective and descriptive cross-sectional design was used to examine all patients (a total of 85) who experienced acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI). The study measured various parameters, such as COVID-19 status, age, sex, ethnicity, diabetes, and hypertension. Data analysis was conducted using SPSS version 25 software.

Results: Out of the 85 patients who underwent primary percutaneous coronary intervention (PCI) for myocardial infarction (MI), 14 patients (16.5%) were found to have COVID-19. COVID-19 diagnosis was confirmed through RT-PCR testing for 2 patients, while the remaining 12 patients were diagnosed using lung CT scans. Among the COVID-19 patients, 21.4% (n = 3) had background diabetes, and 7.1% (n = 1) had background hypertension. MI recurrence was observed in 14.3% of COVID-19 patients (2 cases). Unfortunately, 1 COVID-19 patient, a 70- year-old Persian woman with diabetes and hypertension, passed away. No significant differences were found in terms of age, sex, ethnicity, underlying diabetes, or underlying hypertension between the COVID-19 and non-COVID-19 groups.

Conclusion: The high occurrence of COVID-19 among myocardial infarction (MI) patients undergoing primary percutaneous coronary intervention (PCI) is worth noting. Further investigation is recommended to explore the impact of demographic and contextual factors on the severity and outcomes of primary PCI in MI patients with COVID-19, as well as the underlying mechanisms involved.

Introduction: Gaucher's disease (GD) is a rare lysosomal storage disease. It is characterized by the deposition of glucocerebroside in cells of the macrophage-monocyte system. GD presents a broad clinical expression, including hematologic abnormalities (such as pancytopenia), massive hepatosplenomegaly, diffuse infiltrative pulmonary disease, renal involvement in the form of nephropathy and glomerulonephritis, skeletal involvement in the form of bone pain, bony infarct, osteopenia, and pathological fracture. Based on the presence or absence of neurologic involvement, it is differentiated into type 1, type 2, and type 3. Gaucher's disease type 1 is the most common form, having the nonneuropathic form and carrying autosomal recessive traits. Gaucher's disease affects all racial and ethnic groups, while type 1 GD is most prevalent among Ashkenazi Jews.

Case presentation: A 20-year-old female was admitted to the medicine department with complaints of generalized weakness and easy fatigability, menorrhagia, and a dragging sensation in the abdomen. On clinical evaluation, she had bone marrow failure syndrome features along with massive splenomegaly. Later, she was confirmed with Gaucher disease type 1 disease by clinical and investigation (low β-glucosidase level) evaluation.

Conclusion: This case emphasizes keeping a differential diagnosis of glycogen storage disorder while evaluating a case of unexplained pancytopenia with massive splenomegaly in adulthood for an extended period. Currently, enzyme replacement therapy and substrate reduction therapy are the mainstay therapeutic options for GD.

Background: This study aims to examine the clinical characteristics and prognosis of patients with chest trauma who were infected with COVID-19 and underwent emergency surgery.

Objective: In light of the COVID-19 pandemic, this research investigates the impact of COVID-19 on patients with chest trauma who underwent emergency surgery.

Methods: This retrospective cohort study was conducted on 56 patients with chest trauma in two groups with COVID-19, and no covid who underwent surgery in Shahid Madani Hospital.

Results: Among the trauma patients, 21 were infected with COVID-19, and 35 were not. The predominant causes of trauma were car and motorcycle accidents. Among COVID-19 patients, 3.3% exhibited symptoms of fever, chills, cough, shortness of breath, and gastrointestinal symptoms, while 5.9% had severe lung involvement confirmed by CT scan. Following surgery, 1.57% (12 individuals) of COVID-19 patients were transferred to the ICU, with an average hospitalization duration of 1.11 days. In contrast, the average hospitalization duration for non-COVID-19 chest trauma patients was 1.9 days (p =0.015).

Conclusion: Patients with chest trauma who underwent surgery and were infected with COVID-19 demonstrated significant differences in average length of stay, ICU admissions, and pneumonia incidence. However, there was no significant distinction in the mortality rate between the two groups.

Aims: This work aimed to investigate the antihypertensive activity of Ammi visnaga.

Background: The aqueous extract of Ammi visnaga has traditionally been used to treat hypertension in Morocco.

Objective: The objective of this investigation was to evaluate the effect of Ammi visnaga aqueous extract (AVAE) on arterial blood pressure, systolic blood pressure (SBP), mean blood pressure (MBP), diastolic blood pressure (DBP), and heart rate (HR) in normotensive and hypertensive rats. In addition, the effect of the aqueous extract of Ammi visnaga on vasodilatation was assessed in isolated rat aortic rings with functional endothelium pre-contracted with epinephrine EP or KCl.

Methods: AVAE was obtained, and its antihypertensive ability was pharmacologically investigated in L-NAME hypertensive and normotensive rats. The rats received oral AVAE at two selected doses of 70 and 140 mg/kg for six hours (acute experiment) and seven days (sub-chronic). Thereafter, systolic, diastolic, mean arterial blood pressure and heart rate were evaluated. Moreover, the vasorelaxant activity of AESA was performed in thoracic aortic ring rats. In addition, the mechanisms of action involved in the vasorelaxant effect were studied.

Results: AVAE lowered blood pressure only in L-Name-induced hypertensive rats. Furthermore, AVAE (0.375-1.375 mg/ml) showed a vasodilator effect in isolated aortic rats. In addition, not all of the medications used in our study were responsible for the signaling pathway. As a result, additional pharmaceuticals are required to confirm the mechanism of this signaling pathway.

Conclusion: The aqueous extract of Ammi visnaga exerts an interesting antihypertensive activity, which could be mediated through its vasorelaxant activity. The study supports its use as a medicinal plant against hypertension in Morocco.

Background: The association of obesity with left ventricular (LV) diastolic dysfunction is fully understood, but there are few investigations regarding its effect on LV systolic function in the absence of other risk factors. This study aimed to identify the global longitudinal strain (GLS) changes in isolated overweight and obese people in the absence of other risk factors.

Methods: A total of 120 individuals, including 60 obese, 30 overweight, and 30 healthy controls with no underlying disease and no history of hypertension, diabetes, CAD, or CKD were included in the study. Echocardiographic findings were measured, including apical 2-, 3- and 4-chamber GLS, GLS total, LV diameter, interventricular septum thickness, and PAP. These findings were then compared between the three groups (obese, overweight, and normal controls).

Results: Analyses showed that LV diameter in healthy controls was significantly lower compared to overweight (p = 0.02) and obese (p < 0.0001) participants. Also, the interventricular septal thickness was significantly increased in overweight (p = 0.007) and obese (p < 0.0001) individuals compared to healthy controls. The mean and standard deviation (Mean ± SD) of total GLS values were - 22.29% ± 1.89% for normal weight, -22.09% ± 1.91% for overweight, and -19.88% ± 2.34% for obese individuals. The total GLS of obese participants was significantly lower than overweight and normal controls (p < 0.0001). It was observed that the GLS values were significantly lower in people with BMI higher than 40. The mean ± SD of total GLS values were -20.68% (1.84%) for BMI ≤ 40 patients and -18.51% (2.52%) for BMI > 40 patients.

Conclusion: Data revealed that all GLS values had a moderately strong correlation with BMI values. Also, subclinical LV dysfunction was detected in overweight and obese subjects.

Aim: The research intended to explore the possible nephroprotective potential of the ethyl acetate fraction derived from Acacia catechu leaves against nephrotoxicity brought about by 5-fluorouracil (5-FU) in Wistar rats.

Background: While possessing strong anticancer properties, 5-FU is hindered in its therapeutic application due to significant organ toxicity linked to elevated oxidative stress and inflammation.

Objective: The study is undertaken to conduct an analysis of the ethyl acetate fraction of A. catechu leaves both in terms of quality and quantity, examining its impact on different biochemical and histopathological parameters within the context of 5-FU-induced renal damage in rats and elucidation of the mechanism behind the observed outcomes.

Methodology: Intraperitoneal injection of 5-FU at a dosage of 20 mg/kg/day over 5 days was given to induce nephrotoxicity in rats. The evaluation of nephrotoxicity involved quantifying serum creatinine, urea, uric acid, and electrolyte concentrations. Furthermore, superoxide dismutase, catalase antioxidant enzymes, and TNF-α concentration in serum were also measured.

Results: 5-FU injection led to the initiation of oxidative stress within the kidneys, leading to modifications in renal biomarkers (including serum creatinine, urea, uric acid, and Na⁺, K⁺ levels), and a reduction in antioxidant enzymes namely superoxide dismutase and catalase. Notably, the presence of the inflammatory cytokine TNF-α was significantly elevated due to 5-FU. Microscopic examination of renal tissue revealed tubular degeneration and congestion. However, treatment involving the ethyl acetate fraction derived from A. catechu leaves effectively and dose-dependently reversed the changes observed in renal biomarkers, renal antioxidant enzymes, inflammatory mediators, and histopathological features, bringing them closer to normal conditions. The observed recuperative impact was mainly attributed to the antioxidant and antiinflammatory properties of the fraction.

Conclusion: The ethyl acetate fraction of A. catechu leaves exhibited a mitigating influence on the renal impairment caused by 5-FU, showcasing its potential as a nephroprotective agent capable of preventing and ameliorating 5-FU-induced nephrotoxicity.

Raised blood pressure is the most common complication worldwide that may lead to atherosclerosis and ischemic heart disease. Unhealthy lifestyles, smoking, alcohol consumption, junk food, and genetic disorders are some of the causes of hypertension. To treat this condition, numerous antihypertensive medications are available, either alone or in combination, that work via various mechanisms of action. Combinational therapy provides a certain advantage over monotherapy in the sense that it acts in multi mechanism mode and minimal drug amount is required to elicit the desired therapeutic effect. Such therapy is given to patients with systolic blood pressure greater than 20 mmHg and/or diastolic blood pressure exceeding 10 mmHg beyond the normal range, as well as those suffering from severe cardiovascular disease. The selection of antihypertensive medications, such as calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and low-dose diuretics, hinges on their ability to manage blood pressure effectively and reduce cardiovascular disease risks. This review provides insights into the diverse monotherapy and combination therapy approaches used for elevated blood pressure management. In addition, it offers an analysis of combination therapy versus monotherapy and discusses the current status of these therapies, from researchbased findings to clinical trials.