PulsePub Date : 2018-10-19DOI: 10.3329/pulse.v10i1.38605
MM Rahman, R Rahim, AH Rasel, AS Murad
{"title":"Simultaneous Detection and Differentiation of Chikungunya Virus and Dengue Virus in Blood at Clinical Presentation by Real Time RT-PCR","authors":"MM Rahman, R Rahim, AH Rasel, AS Murad","doi":"10.3329/pulse.v10i1.38605","DOIUrl":"https://doi.org/10.3329/pulse.v10i1.38605","url":null,"abstract":"Background: Chikungunya viral infection in Bangladesh has marked 2017 summer with unprecedented magnitude for the first time. Chikungunya virus (CHIKV) and Dengue virus (DENV) are arboviruses that share the same Aedes mosquito vectors and thus overlap in their endemic areas.These two viruses cause similar clinical presentations, especially in the initial stages of infection. Because the outcomes and management strategies for these two viruses are different, early and accurate diagnosis is imperative. Early diagnosis is also important for surveillance and outbreak control. Objective: As virus isolation is not undergoing in the country and antigen based commercial detection assay is not available for CHIKV we used one step real time reverse transcriptase polymerase chain reaction (RT-PCR) method to detect and discriminate CHIKV and DENV in blood during suspicious clinical symptoms. Results: By this RT-PCR method we have detected 603 cases of CHIKV and 233 cases of DENV and thus facilitated rapid diagnosis and clinical management in the recent CHIKV outbreaks in the country. Conclusion: This is the first report about molecular detection and differentiation of CHIKV and DENV at time of clinical presentation and further show evidence of simultaneous outbreaks of both the viral infections in the country. Pulse Vol.10 January-December 2017 p.6-11","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"122 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2018-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-07-01Epub Date: 2018-04-12DOI: 10.1159/000485659
Ok Sang Lee, Jinlong Zhang, Sun-Hoi Jung, Hyang-Sook Kim, Myung-Koo Lee, Hae-Young Lee
{"title":"High-Intensity Statin Therapy Is \"Too Much,\" Thus Not Indicated for Very Elderly Patients.","authors":"Ok Sang Lee, Jinlong Zhang, Sun-Hoi Jung, Hyang-Sook Kim, Myung-Koo Lee, Hae-Young Lee","doi":"10.1159/000485659","DOIUrl":"https://doi.org/10.1159/000485659","url":null,"abstract":"<p><strong>Purpose: </strong>Although moderate- to high-intensity statin therapy is increasingly recommended in cardiovascular disease patients, the efficacy and safety in elderly patients have not been proven clearly. Here, we compare the effect of various-intensity statins between elderly and very elderly patients.</p><p><strong>Methods: </strong>43,870 patients over 65 years old who were treated with statins were screened using electronic medical record data.</p><p><strong>Results: </strong>We evaluated 451 patients in the elderly group aged 65-74 years and 159 patients in the very elderly group over 75 years old. Baseline cholesterol profiles were similar between the 2 groups, but the 10-year atherosclerotic cardiovascular disease (ASCVD) risk was significantly higher in the very elderly (20.9 ± 11.5$ vs. 37.2 ± 13.6$, <i>p <</i> 0.001). The reduction rate of low-density lipoprotein (LDL) (-40.2 ± 21.3$ vs. -39.3 ± 21.0$, <i>p</i> = 0.634) and the ratio of target LDL attainment (74.2 vs. 79.2$, <i>p</i> = 0.252) were similar between the 2 groups. Low-intensity statins showed comparable LDL cholesterol reduction with moderate-intensity statins both in the elderly and the very elderly groups. The 10-year ASCVD risk reduction was similar between the 2 groups (-3.5 ± 4.9$ vs. -3.0 ± 8.4$, <i>p</i> = 0.480), but in the very elderly group, no different ASCVD reduction rate was shown in low- to high-intensity statins (<i>p</i> = 0.784). Only the elderly group showed a significant correlation (<i>r</i> = 0.112, <i>p</i> = 0.017) with LDL reduction and 10-year ASCVD risk. Interestingly, the incidence of adverse drug reaction (ADR) was higher in the very elderly group (4.4$) than in the elderly group (2.7$) and was more frequent in high-intensity statin therapy.</p><p><strong>Conclusion: </strong>The efficacy of statins in LDL reduction was similar between the elderly and very elderly population. However, the benefit of moderate- to high-intensity statins is limited considering potential ADR. Therefore, the stepwise intensification of statin therapy might be necessary for the very elderly in spite of the higher cardiovascular risk.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"19-31"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000485659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-07-01Epub Date: 2018-07-18DOI: 10.1159/000489855
Yi Chen, Lei Lei, Ji-Guang Wang
{"title":"Methods of Blood Pressure Assessment Used in Milestone Hypertension Trials.","authors":"Yi Chen, Lei Lei, Ji-Guang Wang","doi":"10.1159/000489855","DOIUrl":"https://doi.org/10.1159/000489855","url":null,"abstract":"<p><p>In the present review, we summarized the blood pressure (BP) measurement protocols of contemporary outcome trials in hypertension. In all these trials, clinic BP was used for the diagnosis and therapeutic monitoring of hypertension. In most trials, BP was measured in the sitting position with mercury sphygmomanometers or automated electronic BP monitors by trained observers. BP readings were taken on each occasion at least twice with a 30-to-60-s interval after 5 min of rest. Details regarding the arm side, cuff size, and the timing of BP measurement were infrequently reported. If clinic BP continues being used in future hypertension trials, the measurement should strictly follow current guidelines. The observers must be trained and experienced, and the device should be validated by automated electronic BP monitors. On each occasion, BP readings should be taken 2-3 times. The time interval between successive measurements has to be 30-60 s, and the resting period before the measurement should be at least 5 min in the supine or seated position and 1-3 min standing. BP should usually be measured in the seated position. The higher arm side and an appropriate size cuff should be chosen and noted. BP should be measured at defined trough hours. Automated office BP measurement has recently been used and seems to have less white-coat effect. The out-of-office BP measurement, either ambulatory or home BP monitoring, was only used in a subset of study participants of few hypertension trials. Future trials should consider these novel office or out-of-office BP measurements in guiding the therapy and preventing cardiovascular events.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"112-123"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489855","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Central Blood Pressure in an Asian Population: Comparison between Brachial Oscillometry and Radial Tonometry Methods.","authors":"Satoshi Hoshide, Takahiro Komori, Yukiyo Ogata, Kazuo Eguchi, Kazuomi Kario","doi":"10.1159/000484442","DOIUrl":"https://doi.org/10.1159/000484442","url":null,"abstract":"<p><strong>Background: </strong>New devices have recently been developed using various features of the waveform derived from a brachial cuff for noninvasive estimation of central systolic blood pressure (SBP). Central SBP estimated from brachial oscillometry has never been compared with that estimated from radial tonometry in a Japanese population.</p><p><strong>Subjects and methods: </strong>We recruited 155 Japanese volunteers (mean age 58 ± 16 years, range 18-99 years; 66.5$ women) and estimated their central SBP using brachial oscillometry (Mobil-O-Graph) or radial tonometry (SphygmoCor).</p><p><strong>Results: </strong>The mean (standard deviation) peripheral SBP and central SBP measured with brachial oscillometry was 128 ± 18 mm Hg and 118 ± 16 mm Hg, respectively, while the central SBP estimated using radial tonometry was 119 ± 18 mm Hg. The mean (standard deviation) difference in estimated central SBP between brachial oscillometry and radial tonometry was 0.36 ± 5.9 mm Hg, and the central SBPs estimated using these devices were strongly correlated (<i>r</i> = 0.946, intraclass correlation coefficient = 0.940, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Central SBP estimated using brachial oscillometry was similar to that estimated from radial tonometry in a Japanese population.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"98-102"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000484442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-07-01Epub Date: 2018-07-18DOI: 10.1159/000489854
Chan Joo Lee, Tae-Hoon Kim, Sungha Park, Hui-Nam Pak
{"title":"Obstructive Sleep Apnea Is Closely Related to Cardiovascular Risk Factors, but Not to Clinical Recurrence of Atrial Fibrillation after Catheter Ablation: An Analysis of Atrial Fibrillation Patients.","authors":"Chan Joo Lee, Tae-Hoon Kim, Sungha Park, Hui-Nam Pak","doi":"10.1159/000489854","DOIUrl":"https://doi.org/10.1159/000489854","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a well-known predictor of atrial fibrillation (AF). However, OSA usually accompanies other risk factors of AF. We tried to investigate whether OSA is related to AF recurrence after catheter ablation.</p><p><strong>Methods: </strong>A total of 378 patients (mean age 59.9 ± 10.7 years, 72.5$ male) who underwent catheter ablation of AF were enrolled and underwent overnight ambulatory polysomnography before the ablation procedure. These patients were examined once every 3 months at the outpatient clinic to determine AF recurrence.</p><p><strong>Results: </strong>Based on the apnea-hypopnea index (AHI), we divided the study subjects into 3 groups defined as mild (AHI < 10), moderate (10 <AHI < 30), or severe (AHI > 30) OSA. Patients with severe OSA had a higher prevalence of hypertension, diabetes mellitus, and coronary artery disease (CAD). However, AF recurrence was not different between the three groups. The Kaplan-Meier analysis also showed no significant difference in AF recurrence according to the degree of severity of OSA. Multivariate logistic regression analysis revealed that OSA might be a predictor of CAD; however, Cox regression analysis showed that only early recurrence is closely related to AF recurrence after catheter ablation, rather than the severity of OSA.</p><p><strong>Conclusion: </strong>This study shows that the severity of OSA is not associated with the recurrence of AF after catheter ablation in Korean patients. Treatment of OSA for the sole indication of lowering AF recurrence may need to be reconsidered.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"103-111"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-07-01Epub Date: 2018-07-18DOI: 10.1159/000490573
Lei Lei, Ji-Guang Wang
{"title":"Dietary Sodium Intake and Serum Uric Acid: A Mini-Review.","authors":"Lei Lei, Ji-Guang Wang","doi":"10.1159/000490573","DOIUrl":"https://doi.org/10.1159/000490573","url":null,"abstract":"<p><p>The aim of the present review is to summarize recent studies on the relationship between dietary sodium intake and serum uric acid concentration. In short-term dietary sodium intervention studies, including a recent further analysis of a previously published trial, high dietary sodium intake (200 mmol/day), compared with a low sodium diet (20-60 mmol/day), resulted in a significant reduction in serum uric acid, being approximately 20-60 μmol/L. This finding, though consistent across short-term studies, is in contradiction to the long-term observational evidence on the relationship between dietary sodium intake and serum uric acid. Indeed, in a population-based prospective study, high dietary sodium intake was associated with a higher serum uric acid concentration. If serum uric acid would be followed up, several currently ongoing long-term randomized dietary sodium intervention studies may shed some light on how dietary sodium intake interacts with serum uric acid in the development of hypertension.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"124-129"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000490573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-07-01Epub Date: 2018-02-09DOI: 10.1159/000485660
Mizuri Taki, Satoshi Hoshide, Ken Kono, Kazuomi Kario
{"title":"Correlation between B-Type Natriuretic Peptide and N-Terminal pro-B-Type Natriuretic Peptide in a Large Japanese Population at Risk of Stage A Heart Failure.","authors":"Mizuri Taki, Satoshi Hoshide, Ken Kono, Kazuomi Kario","doi":"10.1159/000485660","DOIUrl":"https://doi.org/10.1159/000485660","url":null,"abstract":"<p><strong>Background: </strong>The measurements of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are useful for ruling out heart failure and as prognostic markers in not only heart failure populations but also general populations. It is not clear whether these two biomarkers are elevated in parallel or associated with demographic characteristics in large populations at risk of stage A heart failure. Here we investigated the relationship between BNP and NT-proBNP and extended the evaluation of this association to known demographic disparities in stage A heart failure.</p><p><strong>Methods: </strong>Of 4,310 ambulatory patients, we analyzed the cases of the 3,643 (mean age 65 ± 11 years, 46$ male, and 79$ on antihypertensive medication) patients whose serum BNP and NT-proBNP levels were both measured and who had a history of and/or risk factors for cardiovascular disease from the Japan Morning Surge-Home Blood Pressure (J-HOP) Study dataset.</p><p><strong>Results: </strong>The median (25th-75th percentiles) BNP and NT-proBNP values were 18.7 (9.3-38.5) pg/mL and 50.3 (25.5-97.4) pg/mL. There was a significant association between log-transformed BNP and log-transformed NT-proBNP (<i>r</i> = 818, <i>p</i> < 0.001). A multiple linear regression analysis showed that log-transformed NT-proBNP was significantly associated with log-transformed BNP (beta coefficient = 0.774, <i>p</i> < 0.001). When stratified by demographic characteristics, these associations remained (all <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In a large Japanese population at risk of stage A heart failure, there was a significant association between BNP and NT-proBNP after adjustment and stratification by demographics.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"6 1-2","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000485660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36555562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-03-01Epub Date: 2017-09-07DOI: 10.1159/000479701
Nicola Di Daniele, Manfredi Tesauro, Alberto Mascali, Valentina Rovella, Angelo Scuteri
{"title":"Lower Heart Rate Variability Is Associated with Lower Pulse Pressure Amplification: Role of Obesity.","authors":"Nicola Di Daniele, Manfredi Tesauro, Alberto Mascali, Valentina Rovella, Angelo Scuteri","doi":"10.1159/000479701","DOIUrl":"https://doi.org/10.1159/000479701","url":null,"abstract":"<p><strong>Background: </strong>Heart rate variability (HRV), pulse pressure amplification, and obesity represent risk factors for cardiovascular events. The aims of the present study are (1) to explore the impact of HRV on pulse pressure amplification and (2) to investigate whether the association between HRV and pulse pressure amplification differs in obese and lean subjects.</p><p><strong>Methods: </strong>A total of 342 patients (age 61 ± 11 years) were enrolled. HRV was analyzed concerning both the frequency and time domain as well as concerning the HRV triangular index. Pulse pressure amplification was estimated as the ratio between brachial and carotid pulse pressure, the latter measured with SphygmoCor.</p><p><strong>Results: </strong>Time domain HRV indices were directly correlated with pulse pressure amplification (the lower the HRV indices, the lower the pulse pressure amplification). This association was stronger in obese than in lean subjects after controlling for age and sex.</p><p><strong>Conclusion: </strong>Larger controlled studies are needed to provide a more detailed insight into the relation between HRV and pulse pressure amplification and to determine which pathways are differentially activated in lean and obese subjects.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"5 1-4","pages":"99-105"},"PeriodicalIF":2.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000479701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36099730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PulsePub Date : 2018-03-01Epub Date: 2017-04-07DOI: 10.1159/000461594
Hirofumi Tanaka
{"title":"Various Indices of Arterial Stiffness: Are They Closely Related or Distinctly Different?","authors":"Hirofumi Tanaka","doi":"10.1159/000461594","DOIUrl":"https://doi.org/10.1159/000461594","url":null,"abstract":"<p><p>Arterial stiffness is an independent risk factor for cardiovascular disease. There are a number of techniques and devices that have been developed and utilized to capture the information pertaining to the elasticity of the blood vessel. Almost all the available indices of arterial stiffness are known to increase with advancing age and are elevated in the presence of hypertension and coronary heart disease. It is not known how closely these different measures of arterial stiffness are related to each other. Available evidence indicates that arterial stiffness indices that share a homogeneous methodology appear to demonstrate good correlations. However, there are no significant associations between some measures. These overall results may be surprising considering that all the indices are supposed to reflect the same property of the arterial wall (i.e., arterial elasticity). Interestingly, no or weak correlations between indices of vascular function are not confined only to arterial stiffness and can be extended to endothelial function and vascular reactivity measures.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"5 1-4","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000461594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36099726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}