Cardiovascular Endocrinology & Metabolism最新文献

{"title":"Cardiometabolic medicine: a review of the current proposed approaches to revamped training in the United States.","authors":"Garshasb P Soroosh,&nbsp;Omar Dzaye,&nbsp;Cara Reiter-Brennan,&nbsp;Michael J Blaha","doi":"10.1097/XCE.0000000000000243","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000243","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading cause of mortality in the United States, and the population of patients with cardiometabolic conditions, including obesity, metabolic syndrome and diabetes mellitus, continues to grow. There is a need for physicians with specific training in cardiometabolic medicine to provide a 'medical home' for patients with cardiometabolic disease, rather than the fractured care that currently exists in the United States. Cardiometabolic specialists will head multidisciplinary clinics, develop practice guidelines, and lead through research. Proposals for US training in cardiometabolic medicine include: maintain the current training model, a dedicated 2-3 year fellowship following internal medicine residency, a 1-year fellowship following either internal medicine residency or fellowship in cardiology or endocrinology, and certification available to any interested clinician. This review discusses the pros and cons of these approaches. The authors believe that a dedicated cardiometabolic training fellowship has significant advantages over the other options.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"168-174"},"PeriodicalIF":2.3,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/12/xce-10-168.PMC8352603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307012","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":"Salivary markers and coronavirus disease 2019: insights from cross-talk between the oral microbiome and pulmonary and systemic low-grade inflammation and implications for vascular complications.","authors":"Antoine AbdelMassih,&nbsp;Alaa A Hassan,&nbsp;Aya S Abou-Zeid,&nbsp;Aya Hassan,&nbsp;Engy Hussein,&nbsp;Mahenar Gadalla,&nbsp;Mahinour Hussein,&nbsp;Maryam A Eid,&nbsp;Maryam Elahmady,&nbsp;Nadine El Nahhas,&nbsp;Nadine Emad,&nbsp;Nihal Zahra,&nbsp;Nour Aboushadi,&nbsp;Nourhan Ibrahim,&nbsp;Sherouk Mokhtar,&nbsp;Habiba-Allah Ismail,&nbsp;Nadine El-Husseiny,&nbsp;Reham Khaled Moharam,&nbsp;Esraa Menshawey,&nbsp;Rahma Menshawey","doi":"10.1097/XCE.0000000000000242","DOIUrl":"10.1097/XCE.0000000000000242","url":null,"abstract":"<p><p>To date, coronavirus disease 2019 (COVID-19) has affected over 6.2 million individuals worldwide, including 1.46 million deaths. COVID-19 complications are mainly induced by low-grade inflammation-causing vascular degeneration. There is an increasing body of evidence that suggests that oral dysbiotic taxa are associated with worse prognosis in COVID-19 patients, especially the Prevotella genus, which was retrieved from nasopharyngeal and bronchoalveolar lavage samples in affected patients. Oral dysbiosis may act by increasing the likelihood of vascular complications through low-grade inflammation, as well as impairing respiratory mucosal barrier mechanisms against SARS-CoV-2. Salivary markers can be used to reflect this oral dysbiosis and its subsequent damaging effects on and the lungs and vasculature. Salivary sampling can be self-collected, and is less costly and less invasive, and thus may be a superior option to serum markers in risk stratification of COVID-19 patients. Prospective studies are needed to confirm such hypothesis. Video Abstract: http://links.lww.com/CAEN/A28.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"162-167"},"PeriodicalIF":2.3,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/59/xce-10-162.PMC8352626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39306626","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":"Speckle tracking echocardiographic assessment of left ventricular longitudinal strain in female patients with subclinical hyperthyroidism.","authors":"Randa R Abdelrazk,&nbsp;Amr A El-Sehrawy,&nbsp;Mohamed G M Ghoniem,&nbsp;Maged Z Amer","doi":"10.1097/XCE.0000000000000241","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000241","url":null,"abstract":"<p><strong>Background: </strong>Patients with subclinical hypothyroidism (SCH) are subjected to many cardiac changes. However, these changes are of gradual onset and cannot be usually detected using conventional diagnostic methods. Speckle tracking echocardiography (STE) is capable to detect cardiac function alterations usually unidentified by conventional echocardiography. The present study aimed to evaluate the role of STE in the detection of early cardiac changes in female patients with SCH.</p><p><strong>Methods: </strong>The study included 33 female patients with SCH and 30 matched healthy volunteer women with normal thyroid functions who served as controls. Upon recruitment, all participants were subjected to careful history taking, thorough clinical examination and routine laboratory investigations, including thyroid-stimulating hormone and Free T4. The echocardiographic examination included conventional, color Doppler and two-dimensional STE.</p><p><strong>Results: </strong>Analysis of conventional echocardiographic data revealed that patients had significantly higher end-systolic volume when compared with controls. In addition, it was noted that SCH patients had significantly lower mitral E/A ratio, isovolumetric relaxation time and significantly higher left atrium volume index in comparison to controls. In respect to STE data, we noted that patients had significantly lower values of mid-anteroseptal, apical lateral, apical septal, apical apex, AP4L strain and global strain % when compared with controls.</p><p><strong>Conclusions: </strong>Patients with SCH have deteriorated global strain in comparison to healthy controls.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"182-185"},"PeriodicalIF":2.3,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/06/xce-10-182.PMC8352628.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307015","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":"Novel biomarkers for subtle myocardial involvement in type I diabetes mellitus.","authors":"Sonia A El-Saiedi,&nbsp;Mona H Hafez,&nbsp;Yasser M Sedky,&nbsp;Sahar A Sharaf,&nbsp;Mona S Kamel,&nbsp;Antoine F AbdelMassih","doi":"10.1097/XCE.0000000000000240","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000240","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy.</p><p><strong>Methodology: </strong>This study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements.</p><p><strong>Results: </strong>Diabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both).</p><p><strong>Conclusion: </strong>CT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"175-181"},"PeriodicalIF":2.3,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307014","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 diastolic function in newly diagnosed hyperthyroid patients with preserved left ventricular systolic function.","authors":"Maryam Shojaeifard,&nbsp;Zahra Davoudi,&nbsp;Azam Erfanifar,&nbsp;Hamed Fattahi Neisiani,&nbsp;Sajad Erami,&nbsp;Hooman Bakhshandeh,&nbsp;Khadije Mohammadi","doi":"10.1097/XCE.0000000000000238","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000238","url":null,"abstract":"<p><strong>Background: </strong>Diastolic dysfunction has been reported as a cardiovascular effect of hyperthyroidism, and is also supposed to be a cause of heart failure manifestations in the patients with preserved ejection fraction (EF).</p><p><strong>Methods: </strong>For evaluation of diastolic function in hyperthyroid patients and also diastolic function during performing exercise stress echocardiography, we conducted this study on 25 newly diagnosed hyperthyroid patients compared to 26 healthy subjects as control group. Diastolic function of the patients at rest was assessed using these parameters as follows: left atrium volume index, tricuspid regurgitation (TR) velocity, mitral inflow early diastolic flow (E wave), tissue Doppler of mitral annular velocity (e'), E/e' ratio, and isovolumic relaxation time (IVRT); and during exercise stress echocardiography, we judged diastolic response by measuring E/e' ratio and TR velocity at the peak of stress.</p><p><strong>Results: </strong>The mean age of the patients was 39.64 ± 12.23 years old and 52% of them were female. History of exertional dyspnea was found in 64% of patients. All the patients had normal diastolic function at the time of resting and there was no significant difference in diastolic parameters between the two groups except for IVRT, which was lower in hyperthyroid patients. Interestingly, no patients developed diastolic dysfunction during exercise stress echocardiography.</p><p><strong>Conclusion: </strong>Our finding did not show diastolic dysfunction in hyperthyroid patients neither at rest nor during exercise echocardiography and did not support the hypothesis that diastolic dysfunction can be a cause of exertional intolerance and dyspnea in the patients with preserved EF.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"186-190"},"PeriodicalIF":2.3,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307016","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":"The acute vs. chronic effect of exercise on insulin sensitivity: nothing lasts forever.","authors":"Fred J DiMenna,&nbsp;Avigdor D Arad","doi":"10.1097/XCE.0000000000000239","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000239","url":null,"abstract":"<p><p>Regular exercise causes chronic adaptations in anatomy/physiology that provide first-line defense for disease prevention/treatment ('exercise is medicine'). However, transient changes in function that occur following each exercise bout (acute effect) are also important to consider. For example, in contrast to chronic adaptations, the effect of exercise on insulin sensitivity is predominantly rooted in a prolonged acute effect (PAE) that can last up to 72 h. Untrained individuals and individuals with lower insulin sensitivity benefit more from this effect and even trained individuals with high insulin sensitivity restore most of a detraining-induced loss following one session of resumed training. Consequently, exercise to combat insulin resistance that begins the pathological journey to cardiometabolic diseases including type 2 diabetes (T2D) should be prescribed with precision to elicit a PAE on insulin sensitivity to serve as a first-line defense prior to pharmaceutical intervention or, when such intervention is necessary, a potential adjunct to it. Video Abstract: http://links.lww.com/CAEN/A27.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"149-161"},"PeriodicalIF":2.3,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307013","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":"JAK out of the Box; The Rationale behind Janus Kinase Inhibitors in the COVID-19 setting, and their potential in obese and diabetic populations.","authors":"Rahma Menshawey,&nbsp;Esraa Menshawey,&nbsp;Ayman H K Alserr,&nbsp;Antoine Fakhry Abdelmassih","doi":"10.1097/XCE.0000000000000237","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000237","url":null,"abstract":"<p><p>The adaptive use of Janus kinase (JAK)-inhibitors has been suggested by rheumatology experts in the management of COVID-19. We recount the rationale behind their use in this setting, and the current evidence for and against their use in this review. JAK-inhibitors role in COVID-19 infection appears to be multifaceted, including preventing viral endocytosis and dampening the effect of excessive chemokines. This drug class may be able to achieve these effects at already preapproved dosages. Concerns arise regarding reactivation of latent viral infections and the feasibility of their use in those with severe disease. Most interestingly, JAK-Inhibitors may also have an additional advantage for diabetic and obese populations, where the dysregulation of JAK-signal transducer and activator of transcription pathway may be responsible for their increased risk of poor outcomes. Targeting this pathway may provide a therapeutic advantage for these patient groups.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"80-88"},"PeriodicalIF":2.3,"publicationDate":"2020-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39011669","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":"Testosterone, HIV, and cardiovascular disease risk.","authors":"Jelani K Grant,&nbsp;Quentin Loyd,&nbsp;Claudia Martinez","doi":"10.1097/XCE.0000000000000236","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000236","url":null,"abstract":"<p><p>There has been a recent increase in the use of testosterone supplementation among young adults in the United States, despite the controversy of testosterone replacement therapy (TRT) and cardiovascular safety. The lower testosterone levels and earlier age of TRT use in persons living with HIV (PLHIV) is of particular relevance for this population because cardiovascular disease (CVD) comorbidities are known to be increased among PLHIV. There is very limited data on TRT in PLHIV, as such, in this article, we sought to compile current evidence regarding the diagnosis and management of testosterone deficiency and its link to CVD risk including among PLHIV.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"72-79"},"PeriodicalIF":2.3,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/d9/xce-10-072.PMC8189608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092931","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":"The relationship between plasma vitamin D level and heart valves calcification in acute coronary syndrome and non acute coronary syndrome patients.","authors":"Viktor Feldman,&nbsp;Avishag Laish-Farkash,&nbsp;Chaim Yosefy","doi":"10.1097/XCE.0000000000000235","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000235","url":null,"abstract":"<p><strong>Background: </strong>There is conflicting data regarding the association between low levels of plasma vitamin D and ischemic heart disease. We aimed to investigate the relationship between plasma vitamin D levels and heart valve calcification in hospitalized patients with ischemic heart disease versus non-ischemic heart disease controls.</p><p><strong>Methods: </strong>A prospective case-control study comprising two age and gender-matched groups. The study group included consecutive patients hospitalized due to acute coronary syndrome; the control group included consecutive non-ischemic heart disease patients hospitalized for noncardiac causes. Blood samples for 25-hydroxyvitamin D level were drawn. An echocardiogram was performed during the first 3 days of hospitalization and reviewed for presence and degree of valvular calcification.</p><p><strong>Results: </strong>Forty patients with acute coronary syndrome and 40 controls (age 58 ± 11 years, 64% male in both groups) were included. Mean plasma 25-hydroxyvitamin D vitamin level in the entire cohort was 24.5 ± 8 ng/ml. Valve calcification rates were similar in acute coronary syndrome versus non-acute coronary syndrome group (28 vs. 21 had valvular calcification; 18 vs. 12 had aortic valve calcification; 21 vs. 14 had mitral valve calcification, respectively; <i>P</i> = NS for all). We found no significant relationship between vitamin D level and valvular calcification, aortic valve calcification, or mitral valve calcification rate or degree in the entire cohort and in each group alone (<i>P</i> = NS for all). There was a negative correlation between 25-hydroxyvitamin D levels and age in the acute coronary syndrome group (<i>r</i> = -0.399, <i>P</i> = 0.012).</p><p><strong>Conclusions: </strong>We did not find a significant relationship between plasma vitamin D levels and the rate or degree of calcification of either aortic/mitral/both valves in hospitalized patients with or without ischemic heart disease.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"113-119"},"PeriodicalIF":2.3,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186514/pdf/xce-10-113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100977","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":"Hyperthyroidism in severe mitral regurgitation post mechanical mitral valve replacement: the effect on warfarin anticoagulation.","authors":"Gracia Lilihata,&nbsp;Charles Saputra,&nbsp;Dian Yaniarti,&nbsp;Rarsari Soerarso","doi":"10.1097/XCE.0000000000000233","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000233","url":null,"abstract":"<p><p>A 24-year-old male patient came to the emergency room with melena, gum bleeding and nosebleeds. This patient has a history of mechanical prosthetic mitral valve replacement for severe mitral regurgitation (MR) and consumed warfarin irregularly, but did not come back for regular check-up. Investigations showed greatly increased thyroid function and international normalised ratio (INR) was 15.8. Patients were diagnosed with thyroid storm and bleeding due to prolongation of INR. His hyperthyroid state might have caused increased rate of degradation of vitamin K-dependent clotting factor thereby increased sensitivity to warfarin. Concomitant acute decompensated heart failure, thrombocytopenia and hypoalbuminemia also contributed to his risk of bleeding. Treatment included anti-thyroid therapy as well as warfarin reversal therapy by stopping warfarin, low-dose intravenous vitamin K due to his mechanical prosthetic valve and fresh frozen plasma. In conclusion, hyperthyroidism could increase the response to warfarin so close monitoring is needed to balance the risk of bleeding and thromboembolism.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"146-148"},"PeriodicalIF":2.3,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186518/pdf/xce-10-146.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39083655","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}