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Mar 2020 DOI 10.14302/issn.2374-9431.jbd-20-3195
E.G SergeevaCorresponding author
FIRST St. Petersburg state medical University named after academician I. P. Pavlov
Purpose The goals of the present study were to assess the genotypic and allelic distribution of Bsm-I (rs1544410) and Apa-I (rs7975232) polymorphisms of the vitamin D receptor (VDR) gene in coronary artery disease (CAD) patients in comparison to control patients of the same age without CAD and to determine whether these gene variants are associated with dyslipidemia. Materials and Methods Based on a case-control design, 302 hospitalized patients with CAD and 194 people of comparable age without CAD were enrolled in the study. The BsmI and ApaI polymorphisms of VDR gene were studied using polymerase chain reaction followed by restriction analysis. The allele digested by the restriction enzyme was denoted by a lower letter, whereas that not digested was indicated by a capital letter. Determination of the level of vitamin D and immunoreactive insulin in the blood serum was carried out using the immuno-enzyme method. Results The bb genotype of Bsm-I VDR gene polymorphism was detected more often in patients with CAD than in the comparison group with an increased risk of CAD by 1.52 times (p=0.006, OR=1.52(1.05÷2.2). The level of HDL cholesterol was higher in CAD patients − carriers of BB genotype compared to its level in Bb genotype carriers and bb genotype carriers (1,13±0,05 mmol/l, 1,01±0,03 mmol/l, 1,02±0,03 mmol/l respectively, p<0,05). The level of vitamin D was higher in patients with BB genotype compared to its level in bb genotype carriers (45.12±3.73 nmol / l and 34.16±1.95 nmol/l respectively, p=0.008). The occurrence of a allele of Apa-I VDR gene polymorphism was higher in patients with CAD than in the control group (p=0.02, OR=1.21(0.93÷1.57). HDL cholesterol level was higher in CAD patients - AA genotype carriers compared with carriers of Aa and aa genotypes (1.18±0.08 mmol / l, 1,02±0.02 mmol / l and 1.01±0.03 mmol/l respectively, p<0,05). Immunoreactive insulin level was significantly higher in CAD patients – aa genotype carriers. No differences in LDL cholesterol and triglycerides were found. Vitamin D level was lower in CAD patients - Aa and aa genotype carriers (33,8±33,9 nmol/l ,p=0,02 and 24,7±4,9 nmol/l, p=0,05 respectively in comparison to vitamin D level = 43,3 ±4,2 nmol/l in AA genotype carriers). Conclusion The bb genotype of Bsm-I VDR gene polymorphism is associated with an increased risk of CAD. A carriage of b allele in CAD patients is associated with lower level of vitamin D and HDL cholesterol. A carriage of a allele of Apa-I VDR gene polymorphism in CAD patients is associated with lower level of vitamin D and HDL cholesterol.
Jan 2023 DOI 10.14302/issn.2329-9487.jhc-22-4362
PIO MachihudeCorresponding author
Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor.
Sep 2022 DOI 10.14302/issn.2329-9487.jhc-22-4252
Kumari Nuthalapat RamaCorresponding author
Additional Professor of Cardiology, Department of Cardiology, Nizams institute of medical sciences, Panjagutta, Hyderabad, Telangana state, India
Background Prevalence of coronary artery disease is between 7-13 percent in urban and 2-7 % in rural India1. The alarm in rise in the prevalence of coronary risk factors like diabetes, hypertension, dyslipidemia, smoking, central obesity and physical inactivity2. The correlation between these risk factors and the severity of coronary atherosclerosis, assessed by angiography which may be either single or multivessel is less consistent with studies reporting conflicting results 3,4. Therefore our study aims to understand the proper correlation between risk factors and severity of coronary artery disease in an Indian population Methods This study was conducted in the department of cardiology, NIMS hospital Hyderabad which receives patients from the urban as well as rural areas of Telangana. the patients admitted in the department of cardiology, NIMS hospital Hyderabad that presented with acute coronary syndromes and diagnosed to have coronary artery disease (single vessel/multivessel disease) on coronary angiography taken for study. Sample Size is 150 Results Among the 150 subjects, males were 111(74%) and females were 39(26%). Mean age of the study population is 55.2 ± 11.4. Among SVD group 73.65% were males &26.3% were females. Among MVD group 76.2% were males & 23.7% were females. Mean age for SVD was 53±14.4 years, while mean age foe MVD was 58.6±14.5 years. For ACS mean age of presentation for females is 60.7±11.4 and for males mean age of presentation is 55.1±12.6. MVD (57.2%) were more common among smokers than SVD. In <45 years age group SVD (69.2%) were more common than MVD (30.8%). In 45- 70 years age group and >70 years age group MVD were more common than SVD with 69.6% and 66.6% respectively, which is statistically significant. MVD (60%) were more common among hypertensives than SVD. Among non-hypertensives MVD (41.8%) was less common than SVD (58.2%) MVD was common among all age groups, which is statistically signicant. Among STEMI group SVD (58.3%) was more common than MVD (41.7%). Among NSTEMI group MVD (62%) was more common than SVD (38%).Correlation between groups was statistically significant. Among SVD study group, LVEF was commonly between 30-45% & very few with LVEF <30% MVD was associated with more severe LV dysfunction as compared to SVD in acute MI. The difference in ejection fraction between the two groups was statistically significant P value=0.0002. In hospital MACE Among SVD there was 1 MI (due to stent thrombosis) who had to TVR (primary PCI) & rest were asymptomatic and discharged in normal state MVD there were in hospital deaths (due to refractory cardiogenic shock) rest were asymptomatic and were discharged in normal state. This difference between the two groups was statistically insignificant. Conclusion Multivessel disease in ACS were seen more commonly among elderly as compared to young subjects where single vessel disease were more common. Females especially elderly more commonly have multivessel disease. Mean age for multivessel disease was higher than single vessel disease. Among <45 years age group, SVD was more prevalent among smokers, obese and physically active. Multi vessel disease is more prevalent among patients with risk factors like diabetes, hypertension, dyslipidemia and physically inactive. Subjects with family history of premature CAD presented early and correlated well with prevalence of SVD.NSTEMI presented more with multi vessel disease. In echocardiographic wall motion analysis, a depressed regional segment of infarcted area with remote hyperkinesis predicted SVD where as remote area hypokinesis predicts more multivessel disease. In hospital outcomes were seen among multi vessel disease as compared to single vessel disease although not statistically significant.
Oct 2019 DOI 10.14302/issn.2574-450X.jom-19-2852
Radwan EHCorresponding author
Department of Zoology, Faculty of Science, Damanhour University, Egypt.
Obesity can be defined as a condition of abnormal or excess fat accumulation in adipose tissue, to the extent that health may be impaired. Fennel is one of the oldest spice plants which widely grows in arid and semi-arid and due to its economic importance and pharmaceutical industry usage. This plant has anti-inflammatory and analgesic effect and is effective in gastrointestinal disorder treatment. The aim of the present study was to evaluate the phytochemical characteristics and therapeutic properties of this medicinal plant. The current study demonstrates that the alteration induced by high fat diet causing changes in blood parameters. These changes are exhibited through a decrease in RBCs, Ht, Hb and platelet and these changes could be due to oxidative stress, which lead to lipid peroxidation in RBCs membranes, auto oxidation of hemoglobin. As regards the total WBCs, lymphocytes and monocytes showed marked decrease. While a distinct increase in the percentage of neutrophils and eosinophil. The present, demonstrates that rats treated with (fennel), (ator) and (fennel with ator) exposure provided significant protection to the altered hematological variables. The effect of the treatment with fennel and ator more effect than fennel only and ator only. The finding of this study indicates that the concentration of Malondialdehyde (MDA) and Myeloperoxidase (MPO) in liver homogenates of the fennel and ator group significant decrease than group (3) and group (4) and the obese group. There is a growing awareness that obesity is a prime risk factor for the development of dyslipidemia profile and that oxidative stress may play a role in various adverse effects of obesity.
Jan 2019 DOI 10.14302/issn.2379-7835.ijn-18-2469
Kawasaki YoheiCorresponding author
Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
Background Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are categorized as omega-3 poly unsaturated fatty acids (PUFAs) that are present in fish oil, etc. DHA and EPA omega-3 PUFAs have a well-established fasting serum triglycerides (TG) lowering effect that may result in normal lipidemia in hyperlipidemic patients. In general, omega-3 PUFAs, such as DHA and EPA, can be ingested easily, and because they are highly safe, they are assumed to be suitable for controlling fasting serum TG in the serum of those who do not require drug treatment. To the best of our knowledge, however, almost all systematic reviews on the effects of omega-3 PUFAs on lowering fasting serum TG are directed at patients fulfilling the diagnostic criteria of dyslipidemia. Objectives To review and confirm the preventive effect of omega-3 PUFAs against hypertriglyceridemia or the effect on nondrug treatment in patients with a mild disease, a systematic review was conducted to determine whether there was a fasting serum TG-lowering effect in subjects without disease and those with a slightly higher triglyceride level who consumed DHA and/or EPA orally compared to those with placebo or no intake of DHA and/or EPA. Search Methods We evaluated articles from searches of PubMed (1946-February 2016), Ichushi-Web (1977-February 2016), and J Dream III (JST Plus, 1981-February 2016; JMED Plus, 1981-February 2016). The keywords were set as follows: “DHA” or “docosahexaenoic acid” or “EPA” or “eicosapentaenoic acid” and “TG” or “triglyceride” or “triglycerol” or “triacylglycerol” or “neutral lipid.”. In addition to the literature group obtained by the database search, we included participants not suffering from any disease (i.e., excluding mild hypertriglyceridemia). Eligibility Criteria Before the test selection process, the following inclusion criteria were defined. Participants were healthy men and women including those with mild hypertriglyceridemia (fasting serum TG level, 150-199 mg/dL [1.69-2.25 mmol/L)). Intervention was defined as orally ingested DHA and/or EPA. Comparison was made to placebo intake or no intake of DHA and/or EPA. Results were measured for the fasting serum TG level. The test design was RCT, and quasi-RCT. Data Abstraction Various characteristics were extracted from original reports using a standardized data extraction form, including the author of the study, research year, research design, subject characteristics (sex, age, sample size), period, dose of DHA and/or EPA (mg/day), and comparison group. Main Results We identified 37 documents for review. Among the 37 reports used to integrate literature results, 25 revealed a decrease in fasting serum TG level due to the oral ingestion of DHA and/or EPA. Sixteen studies on subjects without disease and 21 on subjects with slightly higher fasting serum TG levels were separated and stratified analysis was conducted. Ten of the 16 (normal TG participant) and 15 of the 21 studies (slightly higher TG participant) respectively, indicated that at least 133 mg/day of DHA and/or EPA intervention provided a statistically significant decrease in the fasting serum TG level between an intervention group versus a placebo group.
Nov 2016 DOI 10.14302/issn.2324-7339.jcrhap-16-1271
S. J. B. TougooumaCorresponding author
Introduction The cardiovascular complications have became the 3rd cause of death and the 4th reason for hospitalization of the patients infected by the HIV. The objective of this work was to determine the frequency of asymptomatic myocardial ischemia among patients infected by the HIV receiving antiretroviral therapy. Patients and Methods It was a descriptive cross-sectional study which was conducted in November 2015. The patients infected by HIV1 receiving antiretroviral treatment, with asymptomatic myocardial ischemia were included in the study and they were followed up in the HIV clinic of the in Infectious diseases service of the University Hospital Souro Sanou of Bobo-Dioulasso(CHUSS).. The includes patients benefited from a collection of cardiovascular risk factors, and of two measurements of the blood pressure in a sitting position after 10 minutes of rest and an electrocardiogram 12 derivations after rest. Results A total sample of 123 patients infected by HIV1 was selected, with a median age of 42 years (IQR: 36-50). It was composed of 79% of female. The cardiovascular risk factors found were distributed as follows: HTA (31.7%), obesity (33%), dyslipidemia (10.57%), active smoking (0.8%), diabetes (0.8%). All the known hypertensive cases (5.7%) were insufficiently treated. The median duration of exposure to the antiretroviral therapy was 5.3 years (IIQ: 3-7.7). The disorders of the repolarization were observed in 26 cases (21.13%). They were divided into under epicardic ischemia in 20 cases (16.26%), under endocardic lesion in 2 cases (1.63%) and after-effect of necrosis in 4 cases (3.25%). The Left ventricular hypertrophywas observed in 12 cases (9.76%) and all of them were hypertensive patients. QTc was lengthened among 7 patients (5.69%) independently of the class of antiretroviral therapy administrated. Conclusion In this study about patients infected by HIV1, it emerges that asymptomatic myocardial ischemia is frequent. It would be advisable to reinforce its tracking by using more powerful tests of ischemia, in order to better specify its gravity in this population with an increased cardiovascular risk.
Feb 2015 DOI 10.14302/issn.2379-7835.ijn-14-461
Acosta-Navarro JulioCorresponding author
Heart Institute (InCor), University of São Paulo, Medical School, Brazil
Objective: To investigate the association of meat consumption with self-reported chronic diseases (heart disease, hypertension, diabetes (type I or type II) and dyslipidemia), according to demographic, social and anthropometric variables. Methods: This was a cross sectional study, conducted at the Heart Institute, University of São Paulo, with 549 adults (≥ 18 years) who answered a questionnaire to select people for The CARVOS Study (Carotid Atherosclerosis, Aortic Stiffness and Risk Factors in Vegetarians and Omnivorous Subjects). The variables analyzed were: age, gender, education level, meat consumption, self-reported coronary heart disease, hypertension, diabetes (type I or type II) and dyslipidemia, smoking and body mass index (BMI) (kg/m2). Study subjects were classified as omnivorous (OMN=consumption of meat or fish four or more times/week) (n=228, 41.5 %), semi-vegetarians (SV=consumption of meat or fish 1-3 times/week) (n=97, 17.7%) and vegetarians (VEG=no consumption of meat or fish) (n=224, 40.8%). The differences between mean values was calculated by T-ANOVA test. To test the association between the variables, chi-square test and multiple logistic regression were used (p<0.05; CI = 95%). Results: There was a greater prevalence of smokers among OM than SV and VEG respectively 56.5%, 14% and 29.4 %, p=0.009, and a higher prevalence of overweight (41.7%) in OMN in comparison with SV (29.2%) and VEG (29.0%), p=0.008. Being OM significantly increased the risk of referring hypertension, regardless of sex and age (OR 2.19; CI 95% 1.08-4.46), and was also associated with dyslipidemia, regardless of body mass index, smoking, sex and age (OR 1.78; CI 95% 1.03-3.08). Conclusion: Higher meat consumption was associated with a greater prevalence of risk factors for hypertension and dyslipidemiachronic diseases.
Oct 2014 DOI 10.14302/issn.2471-2140.jaa-14-423
Bilbis L.S.Corresponding author
Department of Biochemistry, Usmanu Danfodiyo University, Sokoto, Nigeria
There is increasing evidence of the prevalence manifestations of metabolic syndrome worldwide. Metabolic syndrome is a cluster of abnormalities characterized by hypertension, central obesity, insulin resistance, endothelial dysfunction, dyslipidemia and oxidative stress. All these alterations predispose individuals to type 2 diabetes and cardiovascular disease that are major contributing factors to earlier mortality among people. The investigation of food nutrients that could reverse the features of metabolic syndrome is an important aspect for dietary-based therapies that may ameliorate the burden of the disorder. Antioxidant micronutrients are of great interest due to the recent described association between obesity, cardiovascular alterations and oxidative stress. These antioxidant nutrients are also being considered in the management of metabolic syndrome due to their potential benefits on hypertension, insulin resistance and hypertriglyceridemia since growing evidence has emerged that point to a causal link between oxidative stress and metabolic syndrome. Thus, dietary antioxidant supplements could have favourable effect on the attenuation and prevention of the manifestations of metabolic syndrome traits. Therefore, the present review focuses on the importance of antioxidant micronutrients in the treatment and management of metabolic syndrome.