Amira El Tantawy, Ghada Anwar, Reem Esmail, Hanan Zekri, Samar Mahmoud, Nancy Samir, Amr Fathalla, Mary Maher, Antoine F AbdelMassih
{"title":"Cardiac autonomic neuropathy linked to left ventricular dysfunction in type 1 diabetic patients.","authors":"Amira El Tantawy, Ghada Anwar, Reem Esmail, Hanan Zekri, Samar Mahmoud, Nancy Samir, Amr Fathalla, Mary Maher, Antoine F AbdelMassih","doi":"10.1097/XCE.0000000000000272","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000272","url":null,"abstract":"Introduction Type 1 diabetes is a major cause of cardiovascular death; diabetic cardiomyopathy (DCM) is the most important cause of mortality among diabetic patients. There is an increasing body of evidence that the most important inducer of DCM is microvascular injury. The aim of this study is to establish a potential relationship between low frequency/high frequency (LF/HF) ratio and DCM and to set a possible predictive cutoff of LF:HF ratio for early detection of DCM. Methods 75 type 1 diabetic patients together with 75 controls were assessed using tissue Doppler imaging for left ventricular (LV) and right ventricular (RV) diastolic function, and heart rate variability (HRV) indices including LF/HF ratio. Type 1 diabetic patients were also assessed for parameters of glycemic and lipid profile control. Results Cases showed a statistically significant increase in LF/HF ratio compared to controls reflecting reduced HRV. Also, LV and RV diastolic function were reduced in cases compared to controls, there was a significant correlation between LV E/E’ ratio (ratio of early transmitral velocity and average early mitral annular and basal septal velocities) and LF/HF ratio. LF/HF ratio was able to predict LV diastolic dysfunction as expressed by the LV E/E’ ratio with a sensitivity of 96%. Conclusion HRV indices notably LF/HF ratio seem to be an early and sensitive predictor of DCM, the latter finding not only underlines the role of microvascular injury in the induction of DCM but might help also for the early detection and reversal of it.","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"e0272"},"PeriodicalIF":2.3,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/4b/xce-11-e0272.PMC9509180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40376663","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":"Treatment of acute upper gastrointestinal bleeding occurred after percutaneous coronary intervention for acute myocardial infarction in patients with acute renal impairment: a case report.","authors":"Rong Wu, Jinhua Li, Yuhuang Guo","doi":"10.1097/XCE.0000000000000269","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000269","url":null,"abstract":"<p><p>Upper gastrointestinal (UGI) bleeding after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in ordinary patients is a common complication and poses a dilemma for clinical doctors to treat. In patients with renal impairment, that is more difficult and has rarely been reported. This case report involves an 82-year-old man who received regular hemodialysis and underwent PCI for acute inferior wall ST-segment elevation myocardial infarction. On the third day after PCI, the patient developed acute UGI bleeding, and gastroscopy confirmed that he had developed compound gastroduodenal ulcers (active stage) with hyperemia of the surrounding mucosa. After fasting, blood transfusion, acid inhibition, gastric protection and symptomatic support treatment, the patient's UGI bleeding remained uncontrolled. Finally, upper gastrointestinal bleeding was stopped by empiric transcatheter arterial embolization (TAE). The patient's condition was controlled through active treatment, and he was eventually discharged from the hospital. Bleeding complications after coronary stenting often present a dilemma, particularly in patients with renal impairment. Therefore, patients such as this should be thoroughly evaluated before any treatment. In the case of no obvious hemorrhagic spots found on endoscopic examination and failure of conservative medical treatment, empiric transcatheter arterial embolization TAE is a well-tolerated and effective treatment for UGI bleeding.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"e0269"},"PeriodicalIF":2.3,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/5a/xce-11-e0269.PMC9377679.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40426419","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, Lucia Albeda Gimeno, Erin Gilingham, Lynne Hudson, Lisa Price, Anuj Saboo, Laura Beresford, Sally Seviour, Alison White, Sarah Roberts, Jonathan Abraham
{"title":"Enhancing type 2 diabetes treatment through digital plans of care. First results from the East Cheshire Study of an App to support people in the management of type 2 diabetes.","authors":"Adrian H Heald, Lucia Albeda Gimeno, Erin Gilingham, Lynne Hudson, Lisa Price, Anuj Saboo, Laura Beresford, Sally Seviour, Alison White, Sarah Roberts, Jonathan Abraham","doi":"10.1097/XCE.0000000000000268","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000268","url":null,"abstract":"<p><strong>Introduction: </strong>The use of personalised care planning has been effective at improving health outcomes for people with long-term health conditions.</p><p><strong>Methods: </strong>We analysed data in relation to changes in BMI/HbA1c. The sample was made up of (<i>n</i> = 36) participants randomised to either the active intervention group (App+usual care) or the control group (usual care).</p><p><strong>Results: </strong>The average HbA1c percentage change for the treatment group was 9.5%, but just -2% for the control (usual care) group (<i>P</i> = 0.015 for the difference). The average percentage change in BMI for the treatment group was -0.4%, but 0.1% for the control group (<i>P</i> = 0.03 for the difference).</p><p><strong>Conclusion: </strong>These preliminary findings point to how the provision of personalised plans of care, support and education linked to a mobile app, can result in HbA1c and BMI reduction over a 6-month period. While the results are preliminary, they portend the potential for digital plans of care to enhance T2DM management.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"e0268"},"PeriodicalIF":2.3,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/0d/xce-11-e0268.PMC9298469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40598913","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}
Alain Putot, Antoine Monin, Alban Belkouche, Frédéric Chagué, Marianne Zeller, Yves Cottin
{"title":"Preexisting atrial fibrillation and myocardial infarction: only 10% of infarcts directly linked to atrial fibrillation.","authors":"Alain Putot, Antoine Monin, Alban Belkouche, Frédéric Chagué, Marianne Zeller, Yves Cottin","doi":"10.1097/XCE.0000000000000267","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000267","url":null,"abstract":"<p><p>The aim of the study was to evaluate the incidence and prognosis of type 1 myocardial infarction (T1MI) and type 2 MI (T2MI) in patients with acute MI and known atrial fibrillation (AF) to identify MI directly linked to AF. Among the 669 patients, four patients with hyperthyroidism were excluded, and among the remaining 665 patients, about two-thirds were diagnosed with T1MI, and the remaining third were diagnosed with T2MI. AF was the direct cause of MI in 9.8% of our overall population [1.8% of T1MI type C (coronary embolism), 4.9% of T2MI type A and 3.1% of T2MI type B]. Among patients with T2MI, 30-day mortality was lower when the trigger was AF than for the other triggers, for both type 2A (6% vs. 11%) and type 2B (0% vs. 13%). Most cases of AF-related MI are, thus, T2MI, for which therapeutic guidelines are lacking. Given the diverse triggers in T2MI, a specific approach using etiological patterns is needed to properly determine the optimal therapeutic.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"e0267"},"PeriodicalIF":2.3,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9242400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581661","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}
Preetha Balakrishnan, Elizabeth Owen, Markus Eberl, Benjamin Friedrich, Tobias Etter
{"title":"A retrospective real-world observational pilot analysis of Waya: a self-monitoring fitness app in Germany.","authors":"Preetha Balakrishnan, Elizabeth Owen, Markus Eberl, Benjamin Friedrich, Tobias Etter","doi":"10.1097/XCE.0000000000000266","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000266","url":null,"abstract":"<p><p>The increasing prevalence of lifestyle-driven metabolic disorders poses a heavy burden on the healthcare system. Several low-cost, easily accessible, and effective weight loss interventions are being developed to improve this situation. Waya is one such German digital application that guides users to reach their desired weight in a healthy manner, by monitoring their eating habits and physical activity levels. In this retrospective real-world observational pilot study, we aimed to identify if the use of Waya helps in reducing weight as intended and the underlying factors associated with it.</p><p><strong>Methods: </strong>Data from healthy overweight or obese participants who provided their weight information and answered the short form of the Weight Efficacy Lifestyle Questionnaire and the International Physical Activity Questionnaire activity questionnaires once before the completion of the first module (baseline) were compared with data provided after the beginning of the last module. Age and sex-based distribution were studied and the correlation between nutrition, physical activity, and weight was analyzed.</p><p><strong>Results: </strong>Waya participants showed an improvement in nutritional behavior, physical activity levels, and weight reduction compared with baseline. These changes were independent of age and sex. Weight loss mainly correlated with improvements in nutritional behavior but not physical activity.</p><p><strong>Conclusion: </strong>The results from our pilot study showed that Waya is beneficial in bringing about short-term weight loss mainly through behavioral changes in nutrition. Although physical activity levels improved, its influence on weight loss was not apparent.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"e0266"},"PeriodicalIF":2.3,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/90/xce-11-e0266.PMC9213173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40399969","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}
S. Thotamgari, U. Grewal, A. Sheth, Akhilesh Babbili, Paari Dominic
{"title":"Can glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors help in mitigating the risk of atrial fibrillation in patients with diabetes?","authors":"S. Thotamgari, U. Grewal, A. Sheth, Akhilesh Babbili, Paari Dominic","doi":"10.1097/XCE.0000000000000265","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000265","url":null,"abstract":"The role of glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i) in mitigating the risk of atrial fibrillation (AF) remains unknown. We interrogated the Food and Drug Administration’s Adverse Event Reporting System (FAERS) database to study the association between AF-related adverse events and the use of GLP-1 RA and DPP-4i. A signal of disproportionate reporting of AF was detected with the DPP-4i group compared with all the other drugs in the FAERS database [ROR, 2.56; 95% confidence interval (CI), 2.10–3.12], whereas there was no disproportionality signal detected with the GLP-1 RA group (ROR, 0.90; 95% CI, 0.78–1.03) although liraglutide showed a significant disproportionality signal (ROR, 2.51; 95% CI, 2.00–3.15). Our analysis supports the existing body of literature demonstrating the cardiac safety of GLP-1 RA but raises concerns about the apparent increase in the risk of AF associated with DPP-4i. Further clinical and translational studies are needed to validate these findings.","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45104890","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}
G. Piccirillo, F. Moscucci, M. Carnovale, A. Corrao, I. Di Diego, I. Lospinuso, S. Sciomer, P. Rossi, D. Magrí
{"title":"Glucose dysregulation and repolarization variability markers are short-term mortality predictors in decompensated heart failure","authors":"G. Piccirillo, F. Moscucci, M. Carnovale, A. Corrao, I. Di Diego, I. Lospinuso, S. Sciomer, P. Rossi, D. Magrí","doi":"10.1097/XCE.0000000000000264","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000264","url":null,"abstract":"Objective As recently reported, elevated fasting glucose plasma level constitutes a risk factor for 30-day total mortality in acutely decompensated chronic heart failure (CHF). Aim of this study was to evaluate the 30-day mortality risk in decompensated CHF patients by fasting glucose plasma level and some repolarization ECG markers. Method A total of 164 decompensated CHF patients (M/F: 94/71; mean age, 83 ± 10 years) were studied; Tend (Te), QT interval (QT) and 5 min of ECG recordings were obtained, studying mean, SD and normalized index of the abovementioned ECG intervals. These repolarization variables and fasting glucose were analyzed to assess the 30-day mortality risk among these patients. Results Thirty-day mortality rate was 21%, deceased subjects showed a significant increase in N terminal-pro-brain natriuretic peptide (P < 0.001), higher sensitivity cardiac troponin, fasting glucose, creatinine clearance, QTSD, QTVN, Te mean, TeSD and TeVN than the survivals. Multivariable regression analysis reported that fasting glucose (hazard ratio, 1.59; 95% confidence interval, 1.09–2.10; P < 0.01), Te mean (hazard ratio, 1.03; 95% confidence interval, 1.01–1.05; P < 0.01) and QTSD (hazard ratio, 1.17; 95% confidence interval, 1.01–1.36; P < 0.05) were significantly related to higher mortality risk, whereas only fasting glucose (hazard ratio, 1.84; 95% confidence interval, 1.12–3.02; P < 0.05) and Te mean (hazard ratio, 1.07; 95% confidence interval, 1.02–1.11; P < 0.01) were associated to cardiovascular mortality. Conclusion Data suggest that two simple, inexpensive, noninvasive markers, as fasting glucose and Te, were capable to stratify the short-term total and cardiovascular mortality risk in acutely decompensated CHF.","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44535102","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}
C. Longoria, Qudratullah S. Qadiri, E. Matthews, S. Campbell, J. Guers
{"title":"Naltrexone alters cardiovascular function following acute forced swimming in mice","authors":"C. Longoria, Qudratullah S. Qadiri, E. Matthews, S. Campbell, J. Guers","doi":"10.1097/XCE.0000000000000263","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000263","url":null,"abstract":"Purpose Naltrexone (NTX) is an opioid antagonist that can reverse the physiological effects of opioid receptors when bound. Opioid receptors have been found to play a role in cardiovascular (CV) function, and thus, binding of NTX may alter CV activity at rest and in response to acute and chronic exercise (EX). We hypothesized that opioid receptor blockade will alter the typical CV responses following acute EX. Methods We assessed the effects of opioid receptor blockade on CV function via echocardiography in mice following an acute bout of forced swimming (FSw), a model of rodent EX. We administered opioid receptor antagonist, NTX, or saline in mice before FSw and in the absence of an FSw perturbation. Furthermore, we assessed how NTX can influence maximal EX capacity on a rodent treadmill. Results Our data shows that NTX administration does not decrease maximal EX capacity in mice (P > 0.05). However, NTX attenuated cardiac output following FSw (FSw = 52.5 ± 2.5 ml/min vs. FSw + NTX = 32.7 ± 5.2 ml/min; P < 0.05) when compared with saline control (33.5 ± 3.8 ml/min). Further, the administration of NTX in the non-EX condition significantly (P < 0.05) reduced ejection fraction. Conclusion These data suggest that normal opioid receptor activation is necessary for typical CV function following FSw.","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48375480","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}