Search results for: cardiovascular disease

Authors: Husham Bayazed

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A growing number of studies indicate that atherosclerotic coronary artery disease (CAD) has a complex pathogenesis that extends beyond cholesterol intimal infiltration. The atherosclerosis process may involve an immune micro-environmental condition driven by local activation of the adaptive and innate immunity arrays, resulting in the formation of atherosclerotic plaques. Therefore, despite the wide usage of lipid-lowering agents, these devastating coronary diseases are not averted either at primary or secondary prevention levels. Many trials have recently shown an interest in the immune targeting of the inflammatory process of atherosclerotic plaques, with the promised improvement in atherosclerotic cardiovascular disease outcomes. This recently includes the immune-modulatory drug “Canakinumab” as an anti-interleukin-1 beta monoclonal antibody in addition to "Colchicine,” which's established as a broad-effect drug in the management of other inflammatory conditions. Recent trials and studies highlight the importance of inflammation and immune reactions in the pathogenesis of atherosclerosis and plaque formation. This provides an insight to discuss and extend the therapies from old lipid-lowering drugs (statins) to anti-inflammatory drugs (colchicine) and new targeted immune-modulatory therapies like inhibitors of IL-1 beta (canakinumab) currently under investigation.

Keywords: atherosclerotic plagues, immune microenvironment, lipid-lowering agents, and immunomodulatory drugs

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Authors: Katherine Denise Queri

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The effects of sick workers have an impact in administration of labor. This study aims to provide knowledge on the disease that is Alzheimer’s while presenting an answer to the research question of when and how is the disease considered as a disaster inside the workplace. The study has the following as its research objectives: 1. Define Alzheimer’s disease, 2. Evaluate the effects and consequences of an employee suffering from Alzheimer’s disease, 3. Determine the concept of organizational effectiveness in the area of Human Resources, and 4. Identify common figures associated with Alzheimer’s disease. The researcher gathered important data from books, video presentations, and interviews of workers suffering from Alzheimer’s disease and from the internet. After using all the relevant data collection instruments mentioned, the following data emerged: 1. Alzheimer’s disease has certain consequences inside the workplace, 2. The occurrence of Alzheimer’s Disease in an employee’s life greatly affects the company where the worker is employed, and 3. The concept of workplace efficiency suggests that an employer must prepare for such disasters that Alzheimer’s disease may bring to the company where one is employed. Alzheimer’s disease can present disaster in any workplace.

Keywords: administration, Alzheimer's disease, conflict, disaster, employment

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Authors: Mohd Faridz Ahmad, Muhammad Amir Asyraf Rosli

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Aerobic dance has becoming a popular mode of exercise especially among women due to its fun nature. With a catchy music background and joyful dance steps, aerobic dancers would be able to have fun while sweating out. Depending on its level of aggressiveness, aerobic may also improve and maintain cardiorespiratory fitness other than being a great tool for weight loss. This study intends to prove that aerobic dance activity can bring the same, if not better impacts on health than other types of cardiovascular exercise such as jogging and cycling. The objective of this study was to evaluate and identify the effect of six weeks aerobic dance on cardiovascular fitness and weight loss among women. This study, which was held in Seremban Fit Challenge, used a quasi-experimental design. The subjects selected include a total of 14 women (n = 14) with age (32.4 years old ± 9.1), weight (65.93 kg ± 11.24) and height (165.36 ± 3.46) who joined the Seremban Fit Challenge Season 13. The subjects were asked to join an aerobic dance class with duration of one hour for six weeks in a row. As for the outcome, cardiovascular fitness was measured with a 1-mile run test while any changes on weight was measured using the weighing scale. The result showed that there was a significant difference between pre and post-test for cardiovascular fitness when p = 0.02 < 0.05 and weight loss when p = 0.00 < 0.05. In conclusion, a six-week long aerobic dance program would have a positive effect on cardiovascular fitness and weight. Therefore, aerobic dance may be used as an alternative tool for people who wish to lead a healthy lifestyle in a fun way.

Keywords: aerobic dance, cardiovascular fitness, weight loss, 1-mile run test

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Authors: A. Badran, M. Hollocks, H. Markus

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Background: Common risk factors for cardiovascular disease are associated with age-related cognitive decline. There has been much interest in treating modifiable cardiovascular risk factors in the hope of reducing cognitive decline. However, there is currently no validated neuropsychological test to assess the subclinical cognitive effects of vascular risk. The Brief Memory and Executive Test (BMET) is a clinical screening tool, which was originally designed to be sensitive and specific to Vascular Cognitive Impairment (VCI), an impairment characterised by decline in frontally-mediated cognitive functions (e.g. Executive Function and Processing Speed). Objective: To cross-sectionally assess the validity of the BMET as a measure of the subclinical effects of vascular risk on cognition, in an otherwise healthy elderly cohort. Methods: Data from 346 participants (57 ± 10 years) without major neurological or psychiatric disorders were included in this study, gathered as part of a previous multicentre validation study for the BMET. Framingham Vascular Age was used as a surrogate measure of vascular risk, incorporating several established risk factors. Principal Components Analysis of the subtests was used to produce common constructs: an index for Memory and another for Executive Function/Processing Speed. Univariate General Linear models were used to relate Vascular Age to performance on Executive Function/Processing Speed and Memory subtests of the BMET, adjusting for Age, Premorbid Intelligence and Ethnicity. Results: Adverse vascular risk was associated with poorer performance on both the Memory and Executive Function/Processing Speed indices, adjusted for Age, Premorbid Intelligence and Ethnicity (p=0.011 and p<0.001, respectively). Conclusions: Performance on the BMET reflects the subclinical effects of vascular risk on cognition, in age-related cognitive decline. Vascular risk is associated with decline in both Executive Function/Processing Speed and Memory groups of subtests. Future studies are needed to explore whether treating vascular risk factors can effectively reduce age-related cognitive decline.

Keywords: age-related cognitive decline, vascular cognitive impairment, subclinical cerebrovascular disease, cognitive aging

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Authors: Ketan Naik, P. H. Bhathawala

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The purpose of this work is to develop a mathematical model of Human Cardiovascular System using lumped parameter method. The model is divided in three parts: Systemic Circulation, Pulmonary Circulation and the Heart. The established mathematical model has been simulated by MATLAB software. The innovation of this study is in describing the system based on the vessel diameters and simulating mathematical equations with active electrical elements. Terminology of human physical body and required physical data like vessel’s radius, thickness etc., which are required to calculate circuit parameters like resistance, inductance and capacitance, are proceeds from well-known medical books. The developed model is useful to understand the anatomic of human cardiovascular system and related syndromes. The model is deal with vessel’s pressure and blood flow at certain time.

Keywords: cardiovascular system, lumped parameter method, mathematical modeling, simulation

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Authors: Md. Mizanur Rahman, Anquan Liu, Anna Frostegård, Johan Frostegård

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The role of the human immune system is essential in cardiovascular diseases and atherosclerosis. Activated cells in atherosclerosis produce abundant amounts of cytokines, but the exact mechanisms involved in the effects of these inflammatory cytokines are not clear in atherosclerosis. In a large clinical cohort, we have previously determined that antibodies against phosphorylcholine (anti-PC) are negatively and independently associated with both development of atherosclerosis and also a low risk of cardiovascular disease. Further, we reported that rheumatoid arthritis patients who were non-responders to TNF-inhibitors, where those with low anti-PC levels. Upon anti-TNF treatment, anti-PC levels increased. We, therefore, hypothesised that proinflammatory cytokines such as TNF could play a role in anti-PC regulation. Peripheral blood mononuclear cells (PBMC) were cultured with or without TNF and anti-TNF. The cell supernatants were collected after six days for ELISA measurements. In separate experiments, cells were cultured for 24 hours in both polystyrene plates and ELISPOT plates under a similar condition for ELISA and ELISPOT assays respectively. Total RNA was extracted after 6 hours of cell culture to perform RT-qPCR. Cell viability was confirmed by trypan blue staining and MTT assays. ELISA measurements detected less than 40% of anti-PC in TNF-treated cells, in comparison to control cells, whereas anti-PC production was recovered by anti-TNF treatment. ELISPOT assays showed that TNF suppresses anti-PC production by inhibiting anti-PC producing B-cells. In addition, RT-qPCR and ELISA showed that TNF also has effects also on B-cell activation as BAFF expression was inhibited by TNF treatment. Atherosclerosis is a major cause of cardiovascular diseases, but anti-PC is a protection marker for atherosclerosis development. Our findings show that TNF is a negative regulator of anti-PC production. Immune modulation and rising of anti-PC could be of major significance for the patients.

Keywords: anti-PC, Anti-TNF, atherosclerosis, cardiovascular diseases, phosphorylecholine

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Authors: Sang Hun Park, Chul Gyu Song

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Artery and vein occlusion changes observed in patients and experimental animals are unexplainable symptoms. As the fat accumulated in cardiovascular ruptures, it causes vascular blocking. Likewise, early detection of cardiovascular disease can be useful for treatment. In this study, we used the mouse femoral occlusion model to observe the arterial and venous occlusion changes without darkroom. We observed the femoral arterial flow pattern changes by proposed fluorescent imaging system using an animal model of thrombosis. We adjusted the near-infrared light source current in order to control the intensity of the fluorescent substance light. We got the clear fluorescent images and femoral artery flow pattern were measured by a 5-minute interval. The result showed that the fluorescent substance flowing in the femoral arteries were accumulated in thrombus as time passed, and the fluorescence of other vessels gradually decreased.

Keywords: thrombus, fluorescence, femoral, arteries

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Authors: Jean Marie Ntaganda, Froduald Minani, Wellars Banzi, Lydie Mpinganzima, Japhet Niyobuhungiro, Jean Bosco Gahutu, Vincent Dusabejambo, Immaculate Kambutse

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In this paper, we present a nonlinear dynamic model for the interactive mechanism of the cardiovascular and respiratory system. The model is designed and analyzed for human during physical exercises. In order to verify the adequacy of the designed model, data collected in Rwanda are used for validation. We have simulated the impact of heart rate and alveolar ventilation as controls of cardiovascular and respiratory system respectively to steady state response of the main cardiovascular hemodynamic quantities i.e., systemic arterial and venous blood pressures, arterial oxygen partial pressure and arterial carbon dioxide partial pressure, to the stabilised values of controls. We used data collected in Rwanda for both male and female during physical activities. We obtained a good agreement with physiological data in the literature. The model may represent an important tool to improve the understanding of exercise physiology.

Keywords: exercise, cardiovascular/respiratory, hemodynamic quantities, numerical simulation, physical activity, sportsmen in Rwanda, system

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Authors: Thota Sai Prakash, B. Yaswanth, Jhade Bhuvaneswar, Marreddy Divakar Reddy, Shyam Ji Gupta

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Across the globe, there are a lot of chronic diseases, and heart disease stands out as one of the most perilous. Sadly, many lives are lost to this condition, even though early intervention could prevent such tragedies. However, identifying heart disease in its initial stages is not easy. To address this challenge, we propose an automated system aimed at predicting the presence of heart disease using advanced techniques. By doing so, we hope to empower individuals with the knowledge needed to take proactive measures against this potentially fatal illness. Our approach towards this problem involves meticulous data preprocessing and the development of predictive models utilizing classification algorithms such as Support Vector Machines (SVM), Decision Tree, and Random Forest. We assess the efficiency of every model based on metrics like accuracy, ensuring that we select the most reliable option. Additionally, we conduct thorough data analysis to reveal the importance of different attributes. Among the models considered, Random Forest emerges as the standout performer with an accuracy rate of 96.04% in our study.

Keywords: support vector machines, decision tree, random forest

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Authors: Parnaz Boodagh, Danila Vella, Antonio Damore, Laura Modica De Mohac, Sang-Ho Ye, Garret Coyan, Gaetano Burriesci, William Wagner, Federica Cosentino

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The use of cardiac patches is among the main therapeutic solution for cardiovascular diseases, a leading mortality cause in the world with an increasing trend, responsible of 19 millions deaths in 2020. Several classes of biomaterials serve that purpose, both of synthetic origin and biological derivation, and many bioengineered treatment alternatives were proposed to satisfy two main requirements, providing structural support and promoting tissue remodeling. The objective of this paper is to compare the mechanical properties and the characterization of four cardiac patches: the Adeka, PhotoFix, CorPatch, and CardioCel patches. In vitro and in vivo tests included: biaxial, uniaxial, ball burst, suture retention for mechanical characterization; 2D surface topography, 3D volume and microstructure, and histology assessments for structure characterization; in vitro test to evaluate platelet deposition, calcium deposition, and macrophage polarization; rat right ventricular outflow tract (RVOT) models at 8- and 16-week time points to characterize the patch-host interaction. Lastly, the four patches were used to produce four stented aortic valve prosthesis, subjected to hydrodynamic assessment as well as durability testing to verify compliance with the standard ISO.

Keywords: cardiac patch, cardiovascular disease, cardiac repair, blood contact biomaterial

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Authors: Benu Gupta

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The purpose of the study was to assess the impact of yogic exercise on cardiovascular exercises on selected college students of high altitude. The research was conducted on college students of high altitude in Shimla for their cardiovascular function [Blood Pressure (BP), VO2 Max (TLC) and Pulse Rate (PR)] in respect to yogic exercise. Total 139 students were randomly selected from Himachal University colleges in Shimla. The study was conducted in three phases. The subjects were identified in the first phase of research program then further in next phase they were physiologically tested, and yogic exercise battery was operated in different time frame. The entire subjects were treated with three months yogic exercise. The entire lot of students were again evaluated physiologically [(Cardiovascular measurement: Blood Pressure (BP), VO2 Max (TLC) and Pulse Rate (PR)] with standard equipments. The statistical analyses of the variance (PR, BP (SBP & DBP) and TLC) were done. The result reveals that there was a significant difference in TLC; whereas there was no significant difference in PR. For BP statistical analysis suggests no significant difference were formed. Result showed that the BP of the participants were more inclined towards normal standard BP i.e. 120-80 mmHg.

Keywords: cardiovascular function, college students, high altitude, yogic exercise

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Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

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Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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Authors: Reza Safdari, Goli Arji, Robab Abdolkhani Maryam zahmatkeshan

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Background and purpose: Cardiovascular diseases are among the most common diseases in all societies. The most important step in minimizing myocardial infarction and its complications is to minimize its risk factors. The amount of medical data is increasingly growing. Medical data mining has a great potential for transforming these data into information. Using data mining techniques to generate predictive models for identifying those at risk for reducing the effects of the disease is very helpful. The present study aimed to collect data related to risk factors of heart infarction from patients’ medical record and developed predicting models using data mining algorithm. Methods: The present work was an analytical study conducted on a database containing 350 records. Data were related to patients admitted to Shahid Rajaei specialized cardiovascular hospital, Iran, in 2011. Data were collected using a four-sectioned data collection form. Data analysis was performed using SPSS and Clementine version 12. Seven predictive algorithms and one algorithm-based model for predicting association rules were applied to the data. Accuracy, precision, sensitivity, specificity, as well as positive and negative predictive values were determined and the final model was obtained. Results: five parameters, including hypertension, DLP, tobacco smoking, diabetes, and A+ blood group, were the most critical risk factors of myocardial infarction. Among the models, the neural network model was found to have the highest sensitivity, indicating its ability to successfully diagnose the disease. Conclusion: Risk prediction models have great potentials in facilitating the management of a patient with a specific disease. Therefore, health interventions or change in their life style can be conducted based on these models for improving the health conditions of the individuals at risk.

Keywords: decision trees, neural network, myocardial infarction, Data Mining

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Authors: Nadine Sammy, Mark Wilson, Samuel Vine

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The Theory of Challenge and Threat States in Athletes (TCTSA) states that self-efficacy is an antecedent of challenge and threat. These states result from conscious and unconscious evaluations of situational demands and personal resources and are represented by both cognitive and physiological markers. Challenge is considered a more adaptive stress response as it is associated with a more efficient cardiovascular profile, as well as better performance and attention effects compared with threat. Self-efficacy is proposed to influence challenge/threat because an individual’s belief that they have the skills necessary to execute the courses of action required to succeed contributes to a perception that they can cope with the demands of the situation. This study experimentally examined the effects of self-efficacy on cardiovascular responses (challenge and threat), demand and resource evaluations, performance and attention under pressurised conditions. Forty-five university students were randomly assigned to either a control (n=15), low self-efficacy (n=15) or high self-efficacy (n=15) group and completed baseline and pressurised golf putting tasks. Self-efficacy was manipulated using false feedback adapted from previous studies. Measures of self-efficacy, cardiovascular reactivity, demand and resource evaluations, task performance and attention were recorded. The high self-efficacy group displayed more favourable cardiovascular reactivity, indicative of a challenge state, compared with the low self-efficacy group. The former group also reported high resource evaluations, but no task performance or attention effects were detected. These findings demonstrate that levels of self-efficacy influence cardiovascular reactivity and perceptions of resources under pressurised conditions.

Keywords: cardiovascular, challenge, performance, threat

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Authors: Alireza Abdiardekani, Maryam Salimi, Shirin Sarejloo, Mehdi Bazrafshan, Amir Askarinejad, Amirhossein Salimi, Hanieh Bazrafshan, Salar Javanshir, Armin Attar, Shokoufeh Khanzadeh, Mohsen Esmaeili, Hamed Bazrafshan Drissi

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Background: Opium, after tobacco, is the most abused substance in the Middle East. The effects of opium use on coronary artery disease are indeed unclear. This study aimed to assess the association between opium use and angiographic findings in patients with acute coronary syndrome (ACS) diagnosis at Al-Zahra Heart Hospital, Shiraz, Iran. Methods: In this case-control study, 170 patients admitted for coronary angiography were enrolled from 2019 to 2020. They were categorized into two groups based on their history: "non-opium" and "opium." SPSS (Version 26) was used to investigate the correlation between opioid addiction and the severity of coronary artery disease. Results: The results of our study reveal that the mean age of the participants was 61.63±9.07. This study indicated that 49 (28.82%) patients were female, and 121 (71.17%) were male. Our findings revealed that three-vessel disease was more frequent in non-opium (40; 47.05%) and opium (45; 52.94%) groups. There was a significant correlation between the severity of the second diagonal artery(D2) and right coronary artery(RCA) involvement and opium consumption. There was a strong positive correlation between the location of the vascular lesion in the left circumflex artery and opium consumption. Conclusion: Opium, as an independent risk factor for cardiovascular diseases, can have specific effects on angiographic findings in patients with coronary artery disease. Public health officials and politicians should arrange several programs to increase the general population’s consciousness about opioid use and its consequences.

Keywords: acute coronary syndrome, opium, coronary artery disease, angiography

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Maryam Rafraf, Aida Ghaffari

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Objectives: Nonalcoholic fatty liver disease (NAFLD) is considered as an independent risk factor for cardiovascular disease (CVD). Dyslipidemia contributes to the enhanced risk of CVD in persons with NAFLD. This study aimed to investigate the effects of turmeric supplementation on serum lipids levels in patients with NAFLD. Methods: In this double-blind, randomized, controlled clinical trial, 46 NAFLD patients (21 males and 25 females; age range, 20 – 60 years) were randomly assigned in the two groups. The intervention and control groups received 3g of turmeric (n = 23) and placebo (n = 23), daily for 12 weeks. Fasting blood samples were collected at baseline and at the end of the trial. Results: Turmeric supplementation significantly increased serum levels of HDL-C compared with the placebo group at the end of the study (by 12.73%, P < 0.05). Serum levels of triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly reduced within turmeric group at the end of the study (P < 0.05). Conclusions: Turmeric consumption had beneficial effects on serum lipids levels of subjects and may be useful in controlling of CVD risk factors in NAFLD patients.

Keywords: nonalcoholic fatty liver, serum lipids, supplementation, turmeric

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Authors: Asim Abbasi, Amer Habib, Sajid Hussain, Muhammad Sufyan, Iqra, Hasnain Sajjad

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Except for few scattered cases, powdery mildew disease was not a big problem for watermelon in the past but with the outbreaks of its pathotypes, races 1W and 2W, this disease becomes a serious issue all around the globe. The severe outbreak of this disease also increased the rate of fungicide application for its proper management. Twelve varieties of watermelon were screened in Research Area of Department of Plant pathology, University of Agriculture, Faisalabad to check the incidence of powdery mildew disease. Disease inoculum was prepared and applied with the help of foliar spray method. Fungicides and plants extracts were also applied after the disease incidence. Percentage leaf surface area diseased was assessed visually with a modified Horsfall-Barratt scale. The results of the experiment revealed that among all varieties, WT2257 and Zcugma F1 were highly resistant showing less than 5% disease incidence while Anar Kali and Sugar baby were highly susceptible with disease incidence of more than 65%. Among botanicals neem extract gave best results with disease incidence of less than 20%. Besides neem, all other botanicals also gave significant control of powdery mildew disease than the untreated check. In case of fungicides, Gemstar showed least disease incidence i.e. < 10%, however besides control maximum disease incidence was observed in Curzate (> 30%).

Keywords: botanicals, fungicides, pathotypes, powdery mildew

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Authors: Ahmed Boujdad

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Morocco, situated in North Africa and celebrated for its diverse landscapes and vibrant cultural heritage, confronts evolving challenges in the realms of cardiovascular well-being and psychological health. In this context, this article aims to highlight distinctive findings stemming from Moroccan research concerning the effects of aerobic exercise on cardiovascular physiology and psychological states. The discourse will encompass a wide array of subjects, including adaptations in cardiac function due to exercise, management of blood pressure, and vascular well-being tailored to the Moroccan populace. A prominent focal point of the article will be the exploration of the interplay between aerobic exercise and Moroccan behavioral tendencies and socio-cultural influences. The research will delve into the correlations between consistent physical activity and its potential to mitigate stress, anxiety, and depression within the Moroccan framework. This inquiry will also extend to examining how exercise contributes to strengthening the societal tapestry of Morocco, fostering community involvement, and cultivating a sense of holistic wellness.

Keywords: kinesiology, cardiovascular, event-related potential‎, physical activity

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Authors: Fouad Chebib, Marie Hogan, Ziad El-Zoghby, Maria Irazabal, Sarah Senum, Christina Heyer, Charles Madsen, Emilie Cornec-Le Gall, Atta Behfar, Barbara Ehrlich, Peter Harris, Vicente Torres

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Background: Mutations in PKD1 and PKD2, the genes encoding the proteins polycystin-1 (PC1) and polycystin-2 (PC2) cause autosomal dominant polycystic kidney disease (ADPKD). ADPKD is a systemic disease associated with several extrarenal manifestations. Animal models have suggested an important role for the polycystins in cardiovascular function. The aim of the current study is to evaluate the association of various cardiomyopathies in a large cohort of patients with ADPKD. Methods: Clinical data was retrieved from medical records for all patients with ADPKD and cardiomyopathies (n=159). Genetic analysis was performed on available DNA by direct sequencing. Results: Among the 58 patients included in this case series, 39 patients had idiopathic dilated cardiomyopathy (IDCM), 17 had hypertrophic obstructive cardiomyopathy (HOCM), and 2 had left ventricular noncompaction (LVNC). The mean age at cardiomyopathy diagnosis was 53.3, 59.9 and 53.5 years in IDCM, HOCM and LVNC patients respectively. The median left ventricular ejection fraction at initial diagnosis of IDCM was 25%. Average basal septal thickness was 19.9 mm in patients with HOCM. Genetic data was available in 19, 8 and 2 cases of IDCM, HOCM, and LVNC respectively. PKD1 mutations were detected in 47.4%, 62.5% and 100% of IDCM, HOCM and LVNC cases. PKD2 mutations were detected only in IDCM cases and were overrepresented (36.8%) relative to the expected frequency in ADPKD (~15%). The prevalence of IDCM, HOCM, and LVNC in our ADPKD clinical cohort was 1:17, 1:39 and 1:333 respectively. When compared to the general population, IDCM and HOCM was approximately 10-fold more prevalent in patients with ADPKD. Conclusions: In summary, we suggest that PKD1 or PKD2 mutations may predispose to idiopathic dilated or hypertrophic cardiomyopathy. There is a trend for patients with PKD2 mutations to develop the former and for patients with PKD1 mutations to develop the latter. Predisposition to various cardiomyopathies may be another extrarenal manifestation of ADPKD.

Keywords: autosomal dominant polycystic kidney (ADPKD), polycystic kidney disease, cardiovascular, cardiomyopathy, idiopathic dilated cardiomyopathy, hypertrophic cardiomyopathy, left ventricular noncompaction

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Wirat Sonchan, Pratoom Moungmee, Anek Sootmongkol

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This study aimed to examine the effects of a circuit training program on muscle strength, agility, anaerobic performance and cardiovascular endurance. The study involved 24 freshmen (age 18.87+0.68 yr.) male students of the Faculty of Sport Science, Burapha University. They sample study were randomly divided into two groups: Circuit Training group (CT; n=12) and a Control group (C; n=12). Baseline data on height, weight, muscle strength (hand grip dynamometer and leg strength dynamometer), agility (agility T-Test), and anaerobic performance (Running-based Anaerobic Sprint Test) and cardiovascular endurance (20 m Endurance Shuttle Run Test) were collected. The circuit training program included one circuit of eight stations of 30/60 seconds of work/rest interval with two cycles in Week 1-4, and 60/90 seconds of work/rest interval with three cycles in Week 5-8, performed three times per week. Data were analyzed using paired t-tests and independent sample t-test. Statistically significance level was set at 0.05. The results show that after 8 weeks of a training program, muscle strength, agility, anaerobic capacity and cardiovascular endurance increased significantly in the CT Group (p < 0.05), while significant increase was not observed in the C Group (p < 0.05). The results of this study suggest that the circuit training program improved muscle strength, agility, anaerobic capacity and cardiovascular endurance of the study subjects. This program may be used as a guideline for selecting a set of exercise to improve physical fitness.

Keywords: circuit training, physical fitness, cardiovascular endurance, anaerobic performance

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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Authors: Pratima Tatke, Archana Avhad, Bhanu Duggal, Meeta Rajivlochan, Sujata Saunik, Pradip Vyas, Nidhi Pandey, Aditee Dalvi, Jyothi Subramanian

Abstract:

Background: Smoking is well established risk factor for the development and progression of coronary artery disease. It is strongly related to morbidity and mortality from cardiovascular causes. The aim of this study is to observe effect of smoking status on percutaneous coronary intervention(PCI) after 1 year. Methods: 2527 patients who underwent PCI at different hospital of Maharashtra(India) from 2012 to 2015 under the health insurance scheme which is launched by Health department, Government of Maharashtra for below poverty line(BPL) families which covers cardiology. Informed consent of patients was taken .They were followed by telephonic survey after 6months to 1year of PCI . Outcomes of interest included myocardial infarction, restenosis, cardiac rehospitalization, death, and a composite of events after PCI. Made group of two non smokers-1861 and smokers (including patients who quit at time of PCI )-659. Results: Statistical Analysis using Pearson’s chi square test revealed that there was trend seen of increasing incidence of death, Myocardial infarction and Restenosis in smokers than non smokers .Smokers had a greater death risk compared to nonsmoker; 5.7% and 5.1% respectively p=0.518. Also Repeat procedures (2.1% vs. 1.5% p=0.222), breathlessness (17.8% vs. 18.20% p=0.1) and Myocardial Infarction (7.3% vs. 10%) high in smoker than non smokers. Conclusion: Major adverse cardiovascular events (MACE) were observed even after successful PCI in smokers. Patients undergoing percutaneous coronary intervention should be encouraged to stop smoking.

Keywords: coronary artery diseases, major adverse cardiovascular events, percutaneous coronary intervention, smoking

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Authors: W. Soufi, F. Boukli Hacene, S. Ghalem

Abstract:

Alzheimer's disease (AD) is a neurodegenerative disease that leads to a progressive and permanent deterioration of nerve cells. This disease is progressively accompanied by an intellectual deterioration leading to psychological manifestations and behavioral disorders that lead to a loss of autonomy. It is the most frequent of degenerative dementia. Alzheimer's disease (AD), which affects a growing number of people, has become a major public health problem in a few years. In the context of the study of the mechanisms governing the evolution of AD disease, we have found that natural flavonoids are good acetylcholinesterase inhibitors that reduce the rate of ßA secretion in neurons. This work is to study the inhibition of acetylcholinesterase (AChE) which is an enzyme involved in Alzheimer's disease, by methods of molecular modeling. These results will probably help in the development of an effective therapeutic tool in the fight against the development of Alzheimer's disease. Our goal of the research is to study the inhibition of acetylcholinesterase (AChE) by molecular modeling methods.

Keywords: Alzheimer's disease, acetylcholinesterase, flavonoids, molecular modeling

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Authors: Aymen Laadhari

Abstract:

The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.

Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

Abstract:

Background: In both developed and underdeveloped countries, coronary artery disease (CAD) is a serious cause of death and disability. Cardiovascular disease (CVD) is becoming more prevalent in emerging countries like Pakistan due to the spread and acceptance of Western lifestyles. Material and Methods: An observational cross-sectional investigation was conducted, and data collection relied on a random cluster sampling method. The sample size for this cross-sectional study was calculated using the following factors: estimated true proportion of 17.5%, desired precision of 2%, and confidence interval of 95%. The data for this study was collected from a sample of 1387 adults. Results: The average age of those living in rural areas is 55.24 years, compared to 52.60 years for those living in urban areas. The mean fasting blood glucose of the urban participants is 105.28 mg/dL, which is higher than the mean fasting blood glucose of the rural participants, which is 102.06 mg/dL. The mean total cholesterol of the urban participants is 192.20 mg/dL, which is slightly higher than the mean total cholesterol of the rural participants, which is 191.97 mg/dL. CAD prevalence is greater in urban areas than in rural areas. ECG abnormalities prevalence is 16.1% in females compared to 12.5% in men. Conclusion: The prevalence of CAD is more common in urban areas than in rural ones for all of the measures of CAD used in the study.

Keywords: CVD prevalence, CVD risk factors, rural area, urban area

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Authors: S. Botman, D. Borchevkin, V. Petrov, E. Bogdanov, M. Patrushev, N. Shusharina

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In this paper, we report the development of the device for diagnostics of cardiovascular system state and associated automated workstation for large-scale medical measurement data collection and analysis. It was shown that optimal design for the monitoring device is wristband as it represents engineering trade-off between accuracy and usability. The monitoring device is based on the infrared reflective photoplethysmographic sensor, which allows collecting multiple physiological parameters, such as heart rate and pulsing wave characteristics. Developed device use BLE interface for medical and supplementary data transmission to the coupled mobile phone, which process it and send it to the doctor's automated workstation. Results of this experimental model approbation confirmed the applicability of the proposed approach.

Keywords: cardiovascular diseases, health monitoring systems, photoplethysmography, pulse wave, remote diagnostics

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Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

Abstract:

Background: The prevalence of cardiovascular diseases (CVD) in different triathlon sports disciplines has not been determined. Purpose: The present study aimed to determine the prevalence of CVD in world-class triathletes according to their sex, sports disciplines (aquathlon, duathlon, triathlon…), and formats (short/medium, long, and ultra-long distance). Methods: Male and female elite athletes from eleven triathlon sport disciplines, ranked in the internationally yearly top 10 between 2006 and 2019, were included. The athlete’s name was associated in a Google search with selected key terms related to heart disease and/or cardiac abnormalities. The prevalence and the hazard function of the variation were calculated, and the differences were then compared. Results: From 1329 athletes (male 639, female 690), 13 cases of CVD (0.98%, 95% CI: [0.45-1.51]) were identified, and the mean age of their occurrence was 29±6 years. Although no sex differences were found in each sport discipline/format (p > 0.05), severe outcomes (sudden cardiac arrest/death and those who had to stop their sports practice) were only observed in males. Short-distance triathlon (5.08%, 95% CI: [1.12-9.05]) was more affected than other disciplines in short/medium, long, and ultra-long formats. The prevalence of CVD in athletes who participated in multi-type of sports disciplines (4.14%, 95% CI: [1.14-7.15]) was higher than in those who participated in one type (0.52%, 95% CI: [0.10-0.93]) (p = 0.0004). Conclusion: Athletes in short-distance triathlon were more affected than other disciplines in short/medium, long and ultra-long formats. Athletes who participate in short/medium distances and those who participate in multi-type of sports disciplines should be closely monitored regardless of sex.

Keywords: cardiovascular diseases, sudden cardiac death, triathlon sport disciplines, world-class athletes

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Authors: M. M. Rahman, A. Liu, A. Frostegard, J. Frostegard

Abstract:

The human immune system plays an essential role in cardiovascular disease (CVD) and atherosclerosis. Our earlier studies showed that major immunocompetent cells including T cells are activated by phosphorylcholine epitope. Further, we have determined for the first time in a clinical cohort that antibodies against phosphorylcholine (anti-PC) are negatively and independently associated with the development of atherosclerosis and thus a low risk of cardiovascular diseases. It is still unknown whether activated T cells play a role in anti-PC production. Here we aim to clarify the role of T cells in anti-PC production. B cell alone, or with CD3 T, CD4 T or with CD8 T cells were cultured in polystyrene plates to examine anti-PC IgM production. In addition to mixed B cell with CD3 T cell culture, B cells with CD3 T cells were also cultured in transwell co-culture plates. Further, B cells alone and mixed B cell with CD3 T cell cultures with or without anti-HLA 2 antibody were cultured for 6 days. Anti-PC IgM was detected by ELISA in independent experiments. More than 8 fold higher levels of anti-PC IgM were detected by ELISA in mixed B cell with CD3 T cell cultures in comparison to B cells alone. After the co-culture of B and CD3 T cells in transwell plates, there were no increased antibody levels indicating that B and T cells need to interact to augment anti-PC IgM production. Furthermore, anti-PC IgM was abolished by anti-HLA 2 blocking antibody in mixed B and CD3 T cells culture. In addition, the lack of increased anti-PC IgM in mixed B with CD8 T cells culture and the increased levels of anti-PC in mixed B with CD4 T cells culture support the role of helper T cell for the anti-PC IgM production. Atherosclerosis is a major cause of cardiovascular diseases, but anti-PC IgM is a protection marker for atherosclerosis development. Understanding the mechanism involved in the anti-PC IgM regulation could play an important role in strategies to raise anti-PC IgM. Studies suggest that anti-PC is T-cell independent antibody, but our study shows the major role of T cell in anti-PC IgM production. Activation of helper T cells by immunization could be a possible mechanism for raising anti-PC levels.

Keywords: anti-PC, atherosclerosis, aardiovascular diseases, phosphorylcholine

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