Adrian H Heald, John Warner-Levy, Lleyton Belston, Hellena Habete-Asres, Linda Horne, Ann Metters, Martin Whyte, Martin Gibson
{"title":"Success story of GLP-1 agonist (Liraglutide) treatment in someone with type 1 diabetes: a life transformed.","authors":"Adrian H Heald, John Warner-Levy, Lleyton Belston, Hellena Habete-Asres, Linda Horne, Ann Metters, Martin Whyte, Martin Gibson","doi":"10.1097/XCE.0000000000000293","DOIUrl":"10.1097/XCE.0000000000000293","url":null,"abstract":"","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 4","pages":"e293"},"PeriodicalIF":1.3,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151973","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}
Shahab Fatemi, Stefan Acosta, Moncef Zarrouk, Peter M Nilsson, Anders Gottsäter
{"title":"A population-based study on hyperinsulinaemia and arterial stiffness in men with and without abdominal aortic aneurysm.","authors":"Shahab Fatemi, Stefan Acosta, Moncef Zarrouk, Peter M Nilsson, Anders Gottsäter","doi":"10.1097/XCE.0000000000000290","DOIUrl":"10.1097/XCE.0000000000000290","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with type 2 diabetes mellitus (DM) run lower risk for abdominal aortic aneurysm (AAA, aortic diameter ≥ 30 mm) and its complications. We aimed to evaluate associations between disturbances in glucose metabolism and arterial stiffness, AAA, and abdominal aortic diameter in 65-year-old men.</p><p><strong>Methods: </strong>Forty-eight 65-year-old men with screening-detected AAA and 115 men with normal abdominal aortic diameter underwent examination of glucose metabolism and arterial stiffness.</p><p><strong>Results: </strong>Men with AAA had higher BMI, waist-hip ratio (WHR), frequency of DM, haemoglobin A<sub>1c</sub>, smoking exposure, and plasma insulin levels at 0, 60 and 120 min during OGTT compared to those without. The increase in p-insulin (<i>P</i> < 0.001) after OGTT was also higher in men with AAA, adjusted for smoking, WHR, and nadir value of p-insulin. In analyses adjusted for smoking, use of lipid-lowering agents, and WHR, the increase in p-insulin at 2-hours (<i>P</i> = 0.006) after OGTT and p-homocysteine were associated with abdominal aortic diameter. There were no differences between groups in aortic stiffness or skin autofluorescence Advanced Glycation End products.</p><p><strong>Conclusion: </strong>In this population-based study hyperinsulinaemia as a marker of insulin resistance, but not hyperglycaemia or aortic stiffness, was associated with AAA and abdominal aortic diameter in 65-year-old men.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 4","pages":"e0290"},"PeriodicalIF":1.3,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10508446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137147","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}
Małgorzata Niemiec, Nicola Dyrek, Klaudia Żądecka, Bartosz Gruchlik, Adrianna Berger-Kucza, Katarzyna Mizia-Stec
{"title":"Takotsubo syndrome with several hypertensive crises: an unexpected diagnosis.","authors":"Małgorzata Niemiec, Nicola Dyrek, Klaudia Żądecka, Bartosz Gruchlik, Adrianna Berger-Kucza, Katarzyna Mizia-Stec","doi":"10.1097/XCE.0000000000000291","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000291","url":null,"abstract":"<p><p>We present an unusual clinical case of a 39-year-old woman admitted to the Department of Cardiology due to stenocardial pain accompanied by hypertensive crisis. The patient presented with severe chest pain and high blood pressure, along with a history of type 2 diabetes, hyperlipidemia, smoking, and hypertension. Initial tests showed elevated troponin T, glucose, CRP, and D-dimer levels, and electrocardiography and transthoracic echocardiography showed abnormalities suggesting acute myocardial infarction, but angiography did not reveal any significant coronary artery blockages. Further tests and imaging led to a diagnosis of takotsubo syndrome (TTS) and suspicion of pheochromocytoma, which was confirmed later biopsy. The presented case is very rare because the coexistence of TTS and pheochromocytoma is not common due to the rarity of the tumor. It is very important to make a quick and accurate diagnosis, because improperly treated cases can lead to death.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 3","pages":"e0291"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225339","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}
Adrian H Heald, Mike Stedman, Chris Daly, John Julian Warner-Levy, Mark Livingston, Lamiece Hussain, Simon Anderson
{"title":"First episode psychosis and weight gain a longitudinal perspective in Cheshire UK: a comparison between individuals with nonaffective versus affective psychosis.","authors":"Adrian H Heald, Mike Stedman, Chris Daly, John Julian Warner-Levy, Mark Livingston, Lamiece Hussain, Simon Anderson","doi":"10.1097/XCE.0000000000000286","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000286","url":null,"abstract":"<p><p>Early weight gain following initiation of antipsychotic treatment predicts longer-term weight gain, with attendant long-term consequences including premature cardiovascular events/death. An important question is whether there is a difference in weight change over time between people with affective versus nonaffective psychosis. Here we describe the results of a real-world analysis of the BMI change in the months postdiagnosis with affective versus nonaffective psychosis.</p><p><strong>Methods: </strong>We undertook an anonymised search across one Primary Care Network in Cheshire, UK with a total population of 32 301 individuals. We reviewed the health records of anyone who had been diagnosed over a 10-year period between June 2012 and June 2022 for the first time with first episode nonaffective psychosis versus psychosis associated with depression or bipolar affective disorder (affective psychosis).</p><p><strong>Results: </strong>The overall % change in BMI was +8% in nonaffective psychosis individuals and +4% in those with a diagnosis of affective psychosis - however, the distribution was markedly skewed for nonaffective psychosis patients. Using caseness as >30% increase in BMI; affective = 4% cases and nonaffective = 13% cases, there was a three-fold difference in terms of increase in BMI. In regression analysis, the <i>r</i><sup>2</sup> linking the initial BMI to % change in BMI was 0.13 for nonaffective psychosis and 0.14 for affective psychosis.</p><p><strong>Conclusion: </strong>The differences observed here in the distribution of weight change over time between individuals with affective versus nonaffective psychosis may relate to underlying constitutional differences. The phenotypic and genetic factors underlying this difference remain to be defined.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 3","pages":"e0286"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/73/xce-12-e0286.PMC10289689.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9714033","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":"Mineralocorticoid receptor antagonists in cardiovascular translational biology.","authors":"Robert J Chilton, José Silva-Cardoso","doi":"10.1097/XCE.0000000000000289","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000289","url":null,"abstract":"<p><p>This review examines the role of mineralocorticoid receptor antagonists (MRAs) in cardiovascular biology and the molecular mechanisms involved in mineralocorticoid receptor antagonism. The data discussed suggest that MRAs can play an important role in decreasing the impact of inflammation and fibrosis on cardiorenal outcomes. Evidence derived from major randomized clinical trials demonstrates that steroidal MRAs reduce mortality in patients with heart failure and reduced ejection fraction. Initial positive findings observed in patients with chronic kidney disease and type 2 diabetes (T2D) indicate the possible mechanisms of action of nonsteroidal MRAs, and the clinical benefits for patients with cardiorenal disease and T2D. This article supports the application of basic science concepts to expand our understanding of the molecular mechanisms of action involved in pathophysiology. This approach encourages the development of treatment options before diseases clinically manifest. Video Abstract: http://links.lww.com/CAEN/A42.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 3","pages":"e0289"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10056207","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}
Desire Nzomessi, Emmanuelle Massie, Karim Gariani, Raphael Giraud, Philippe Meyer
{"title":"Combined lactic acidosis and ketoacidosis in a female diabetic patient with severe heart failure.","authors":"Desire Nzomessi, Emmanuelle Massie, Karim Gariani, Raphael Giraud, Philippe Meyer","doi":"10.1097/XCE.0000000000000287","DOIUrl":"10.1097/XCE.0000000000000287","url":null,"abstract":"<p><p>SGLT2i are now recommended in a wide spectrum of indications including type 2 diabetes (T2DM), heart failure, and chronic kidney disease. This medication class is now available in combination with metformin, which is still a fundamental treatment in patients with T2DM. Despite excellent proven safety profile for both drugs, the expanding use of these agents in clinical practice may lead to an increased incidence of rare side effects, like metformin-associated lactic acidosis (MALA) and euglycemic diabetic ketoacidosis (EDKA), which can be life-threatening. A 58-year-old woman with T2DM and severe heart failure treated by metformin and empagliflozin developed progressive EDKA triggered by fasting that was also complicated by severe acute renal failure and MALA. She was successfully treated with intermittent hemodialysis. This case report highlights the importance of the recognition of rare, but very serious adverse effects due to combined metformin and SGLT2i therapy.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 3","pages":"e0287"},"PeriodicalIF":1.3,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812492","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}
Gaspar Del Rio-Pertuz, Cristina Morataya, Kanak Parmar, Zeyad Elharabi, Daniel Davis, Mostafa Abohelwa, Ozman Ochoa, Alison Tran, Kenneth Nugent, David Paniagua, Erwin Argueta-Sosa
{"title":"Association between right heart catheterization hemodynamics and glycosylated hemoglobin levels in adults with heart failure with reduced ejection fraction.","authors":"Gaspar Del Rio-Pertuz, Cristina Morataya, Kanak Parmar, Zeyad Elharabi, Daniel Davis, Mostafa Abohelwa, Ozman Ochoa, Alison Tran, Kenneth Nugent, David Paniagua, Erwin Argueta-Sosa","doi":"10.1097/XCE.0000000000000285","DOIUrl":"10.1097/XCE.0000000000000285","url":null,"abstract":"<p><p>This study hypothesized that elevated glycosylated hemoglobin (HbA1c) levels are associated with abnormal right heart catheterization (RHC) hemodynamic parameters in patients with heart failure with reduced ejection fraction (HFrEF) and no prior diagnosis of diabetes.</p><p><strong>Methods: </strong>Retrospective cohort study of adult patients with HFrEF and no prior diagnosis of diabetes who underwent RHC and had HbA1c levels measured 30 days before or after the RHC. This study excluded patients who had received blood transfusions within 90 days prior to HbA1c measurement and patients with known diabetes. Univariate and multivariate regression analyses adjusted for age, sex, and BMI were used to test for an association between RHC hemodynamic parameters and HbA1c levels.</p><p><strong>Results: </strong>A total of 136 patients were included with a mean age of 55 ± 15 years and mean HbA1c was 5.99 ± 0.64%. Unadjusted univariate models showed that HbA1c is significantly associated with cardiac index (CI) by the Fick method and thermodilution, right atrial pressure (RAP), and mean pulmonary arterial pressure (MPAP). After multivariate analysis, for every one unit increase in HbA1c, there was a 0.19 and 0.26 L/min/m<sup>2</sup> decrease in expected CI by thermodilution and by the Fick method (<i>P</i> = 0.03 and <i>P</i> < 0.01), respectively. For every one unit increase in HbA1c, there was a 2.39 mmHg increase in expected RAP (<i>P</i> = 0.01).</p><p><strong>Conclusion: </strong>Elevated HbA1c levels measured within 30 days before or after the index RHC in patients with a left ventricular ejection fraction <40% were associated with congestive hemodynamic parameters.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 3","pages":"e0285"},"PeriodicalIF":1.3,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10287124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9714037","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}
Adrian H Heald, Sarah Roberts, Lucia Albeda Gimeno, John Martin Gibson, Anuj Saboo, Jonathan Abraham
{"title":"Enhancing type 2 diabetes treatment through digital plans of care. Patterns of access to a care-planning app over the first 3 months of a digital health intervention.","authors":"Adrian H Heald, Sarah Roberts, Lucia Albeda Gimeno, John Martin Gibson, Anuj Saboo, Jonathan Abraham","doi":"10.1097/XCE.0000000000000283","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000283","url":null,"abstract":"Enhancing type 2 diabetes treatment through digital plans of care. Patterns of access to a care-planning app over the first 3 months of a digital health intervention Adrian H. Heald, Sarah Roberts, Lucia Albeda Gimeno, John Martin Gibson, Anuj Saboo and Jonathan Abraham Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester and Healum, London, UK5April20235April2023122","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 2","pages":"e0283"},"PeriodicalIF":2.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/5c/xce-12-e0283.PMC10082235.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284035","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}
Radhika Deshpande, Raj Patel, Manjari R Regmi, Mohsin Salih, Robert Kropp, Basma Al-Bast, Muhammad A Sheikh, Andrew Sagalov, Abhishek Kulkarni, Momin Siddique, Shruti Hegde, Mukul Bhattarai
{"title":"Safety outcomes of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes and other risk factors for cardiovascular disease: a systematic review and meta-analysis.","authors":"Radhika Deshpande, Raj Patel, Manjari R Regmi, Mohsin Salih, Robert Kropp, Basma Al-Bast, Muhammad A Sheikh, Andrew Sagalov, Abhishek Kulkarni, Momin Siddique, Shruti Hegde, Mukul Bhattarai","doi":"10.1097/XCE.0000000000000284","DOIUrl":"10.1097/XCE.0000000000000284","url":null,"abstract":"<p><p>Sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) have emerged as standard therapy for heart failure. We aim to assess the safety of SGLT2-Is in patients with a high risk of cardiovascular disease.</p><p><strong>Areas covered: </strong>An electronic database search was conducted for randomized control trials comparing SGLT2-Is to placebo in patients with a high risk of cardiac disease or heart failure. Data were pooled for outcomes using random-effect models. The odds ratio (OR) and 95% confidence interval (CI) were used to compare eight safety outcomes between the two groups. The analysis included ten studies with 71 553 participants, among whom 39 053 received SGLT2-Is; 28 809 were male and 15 655 were female (mean age, 65.2 years). The mean follow-up period was 2.3 years with the range being 0.8-4.2 years. The SGLT2-Is group had a significant reduction in AKI (OR = 0.8;95% CI 0.74-0.90) and serious adverse effects (OR = 0.9; 95% CI 0.83-0.96) as compared to placebo. No difference was found in fracture (OR = 1.1; 95% CI 0.91-1.24), amputation (OR = 1.1; 95% CI 1.00-1.29), hypoglycemia (OR 0.98;95% CI 0.83-1.15), and UTI (OR = 1.1; 95% CI 1.00-1.22). In contrast, DKA (OR = 2.4; 95% CI 1.65-3.60) and volume depletion (OR = 1.2; 95% CI 1.07-1.41) were higher in SGLT2-Is group.</p><p><strong>Expert opinion/commentary: </strong>The benefits of SLGT2-Is outweigh the risk of adverse events. They may reduce the risk of AKI but are associated with an increased risk of DKA and volume depletion. Further studies are warranted to monitor a wider range of safety outcomes of SGLT2-Is.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"12 2","pages":"e0284"},"PeriodicalIF":1.3,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467679","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}
G. Del Rio-Pertuz, C. Morataya, K. Parmar, Z. Elharabi, Daniel Davis, Mostafa M Abohelwa, Ozman Ochoa, Alison Tran, K. Nugent, D. Paniagua, Erwin E Argueta-Sosa
{"title":"Association between right heart catheterization hemodynamics and glycosylated hemoglobin levels in adults with heart failure with reduced ejection fraction","authors":"G. Del Rio-Pertuz, C. Morataya, K. Parmar, Z. Elharabi, Daniel Davis, Mostafa M Abohelwa, Ozman Ochoa, Alison Tran, K. Nugent, D. Paniagua, Erwin E Argueta-Sosa","doi":"10.1016/j.cardfail.2022.10.263","DOIUrl":"https://doi.org/10.1016/j.cardfail.2022.10.263","url":null,"abstract":"","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49465754","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}