The Open Cardiovascular Medicine Journal最新文献

{"title":"Electrocardiogram Changes with Acute Alcohol Intoxication: A Systematic Review.","authors":"Hitesh Raheja,&nbsp;Vinod Namana,&nbsp;Kirti Chopra,&nbsp;Ankur Sinha,&nbsp;Sushilkumar Satish Gupta,&nbsp;Stephan Kamholz,&nbsp;Norbert Moskovits,&nbsp;Jacob Shani,&nbsp;Gerald Hollander","doi":"10.2174/1874192401812010001","DOIUrl":"https://doi.org/10.2174/1874192401812010001","url":null,"abstract":"<p><strong>Background: </strong>Acute alcohol intoxication has been associated with cardiac arrhythmias but the electrocardiogram (ECG) changes associated with acute alcohol intoxication are not well defined in the literature.</p><p><strong>Objective: </strong>Highlight the best evidence regarding the ECG changes associated with acute alcohol intoxication in otherwise healthy patients and the pathophysiology of the changes.</p><p><strong>Methods: </strong>A literature search was carried out; 4 studies relating to ECG changes with acute alcohol intoxication were included in this review.</p><p><strong>Results: </strong>Of the total 141 patients included in the review, 90 (63.8%) patients had P-wave prolongation, 80 (56%) patients had QTc prolongation, 19 (13.5%) patients developed T-wave abnormalities, 10 (7%) patients had QRS complex prolongation, 3 (2.12%) patients developed ST-segment depressions.</p><p><strong>Conclusion: </strong>The most common ECG changes associated with acute alcohol intoxication are (in decreasing order of frequency) P-wave and QTc prolongation, followed by T-wave abnormalities and QRS complex prolongation. Mostly, these changes are completely reversible.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"12 ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2018-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874192401812010001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35914513","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":"Insulin Sensitivity and Insulin Resistance in Non-Diabetic Middle-Aged Patients with Obstructive Sleep Apnoea Syndrome.","authors":"K Archontogeorgis,&nbsp;N Papanas,&nbsp;E Nena,&nbsp;A Tzouvelekis,&nbsp;C Tsigalou,&nbsp;A Voulgaris,&nbsp;M Xanthoudaki,&nbsp;T Mouemin,&nbsp;M Froudarakis,&nbsp;P Steiropoulos","doi":"10.2174/1874192401711010159","DOIUrl":"https://doi.org/10.2174/1874192401711010159","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnoea syndrome <b>(</b>OSAS) has been linked with abnormal glucose metabolism, insulin resistance (IR) and development of diabetes mellitus.</p><p><strong>Methods: </strong>Non-diabetic patients (n=69) with OSAS, diagnosed by polysomnography, were prospectively recruited. To evaluate IR among OSAS patients, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Insulin sensitivity by Quantitative Insulin sensitivity Check Index (QUICKI) were used.</p><p><strong>Results: </strong>HOMA-IR was positively associated with body-mass index (BMI) (ρ=0.364, p=0.002), time with oxyhaemoglobin saturation <90% (ρ=0.291, p=0.015), arousal index (ρ=0.268, p=0.027), Epworth sleepiness scale (ESS) score (ρ=0.293, p=0.019) and negatively with average oxyhaemoglobin saturation (ρ=-0.398, p=0.001) and minimum oxyhaemoglobin saturation (ρ=-0.327, p=0.006). QUICKI was positively associated with forced vital capacity (r=0.301, p=0.014), average oxyhaemoglobin saturation (r=0.443, p<0.001), minimum oxyhaemoglobin saturation (ρ=0.318, p=0.008), and negatively associated with sleep stage transitions (r=-0.266, p=0.032), oxygen desaturation index (r=-0.404, p=0.005), time with oxyhaemoglobin saturation <90% (r=-0.311, p=0.019), arousal index (r=-0.344, p=0.004) and ESS score (r=-0.299, p=0.016). After adjustment for age and BMI, HOMA-IR was associated with sleep stage transitions, time with oxyhaemoglobin saturation <90%, average oxyhaemoglobin saturation, minimum oxyhaemoglobin saturation and arousal index. QUICKI was associated with oxygen desaturation index, sleep stage transitions, ESS score, minimum oxyhaemoglobin saturation and arousal index.</p><p><strong>Conclusions: </strong>An independent association between OSAS and IR in patients without pre-existing diabetes mellitus was observed. Recurrent hypoxia and sleep fragmentation in OSAS are associated with IR in these patients.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"159-168"},"PeriodicalIF":0.8,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35791964","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":"Pulmonary Artery Hypertension and Related Complications Associated to Left Atrial Myxoma.","authors":"Osmar Antonio Centurión,&nbsp;Laura Beatriz García","doi":"10.2174/1874192401711010156","DOIUrl":"https://doi.org/10.2174/1874192401711010156","url":null,"abstract":"Atrial Myxoma (AM) is a primary benign tumour of the heart that may behave in a not so benign manner causing serious cardiac and systemic complications [1 4]. The global annual incidence of AM is 0.5 per million people and may occur in different locations within the heart cavities but primarily affect the left atrium in 75% of the cases [5 7]. There have been reports of myxoma in the right atrium and in the left or right ventricles [8, 9]. The symptoms may widely differ depending on several factor related to the mass itself. AM tends to differ in shape, size, and texture, and originate from the vicinity of the fossa ovalis in the inter-atrial septum. AM occurs in patients between the ages of 30 and 60 years, but it can be seen at any age [7]. Sometimes, AM is discovered incidentally while investigating nonspecific symptoms on a routine echocardiography. Most AM are isolated, and they present in familial cases in less than 10%.","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"156-158"},"PeriodicalIF":0.8,"publicationDate":"2017-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35781841","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":"Khat (<i>Catha Edulis</i>) as a Risk Factor for Cardiovascular Disorders: Systematic Review and Meta-Analysis.","authors":"Teshale Ayele Mega,&nbsp;Nikodimos Eshetu Dabe","doi":"10.2174/1874192401711010146","DOIUrl":"https://doi.org/10.2174/1874192401711010146","url":null,"abstract":"<p><strong>Background: </strong>About 20 million people worldwide are believed to be using khat. Although some studies reported that khat chewing might result in cardiovascular disorders, conclusive evidence is limited.</p><p><strong>Method: </strong>The objective of this review was to synthesize the best available evidence for the effect of khat on the cardiovascular system. Databases searched were PubMed, Cochrane database of systematic reviews, CINAHL, poplin, LILACS, MedNar and Scopus. All papers included in the review were subjected to rigorous appraisal using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. Review Manager Software (Revman 5.3) was used for meta-analysis and effect size and the 95% confidence interval (CI) was calculated.</p><p><strong>Result: </strong>Data was extracted from 10 articles. Our meta-analysis included 9,207 subjects, (2123 chewers and 7084 non-chewers, respectively) to elucidate the effect of khat on heart rate, diastolic and systolic blood pressure. The mean diastolic and systolic blood pressure of khat chewers was higher than the non-chewers with a mean difference of 5.1 mmHg, 95%CI [2.7,7.5] and 7.9 mmHg, 95%CI [2.65, 13.18], respectively. Similarly, the heart rate of the chewers remained consistently higher, making the mean difference of 6.9 beats/min, 95%CI [0.5, 13.3]. In addition, khat was found to have either a causative or worsening effect on stroke, myocardial infarction and heart failure.</p><p><strong>Conclusion: </strong>We showed that khat chewing could significantly affect the cardiovascular system through its effect on heart rate and blood pressure. Therefore, health promotion should be aimed to encourage quitting khat chewing.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"146-155"},"PeriodicalIF":0.8,"publicationDate":"2017-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35781840","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 Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future Perspectives.","authors":"Michael Spartalis,&nbsp;Eleni Tzatzaki,&nbsp;Eleftherios Spartalis,&nbsp;Christos Damaskos,&nbsp;Antonios Athanasiou,&nbsp;Efthimios Livanis,&nbsp;Vassilis Voudris","doi":"10.2174/1874192401711010133","DOIUrl":"https://doi.org/10.2174/1874192401711010133","url":null,"abstract":"<p><strong>Background: </strong>Cardiac resynchronization therapy (CRT) has become a mainstay in the management of heart failure. Up to one-third of patients who received resynchronization devices do not experience the full benefits of CRT. The clinical factors influencing the likelihood to respond to the therapy are wide QRS complex, left bundle branch block, female gender, non-ischaemic cardiomyopathy (highest responders), male gender, ischaemic cardiomyopathy (moderate responders) and narrow QRS complex, non-left bundle branch block (lowest, non-responders).</p><p><strong>Objective: </strong>This review provides a conceptual description of the role of echocardiography in the optimization of CRT.</p><p><strong>Method: </strong>A literature survey was performed using PubMed database search to gather information regarding CRT and echocardiography.</p><p><strong>Results: </strong>A total of 70 studies met selection criteria for inclusion in the review. Echocardiography helps in the initial selection of the patients with dyssynchrony, which will benefit the most from optimal biventricular pacing and provides a guide to left ventricular (LV) lead placement during implantation. Different echocardiographic parameters have shown promise and can offer the possibility of patient selection, response prediction, lead placement optimization strategies and optimization of device configurations.</p><p><strong>Conclusion: </strong>LV ejection fraction along with specific electrocardiographic criteria remains the cornerstone of CRT patient selection. Echocardiography is a non-invasive, cost-effective, highly reproducible method with certain limitations and accuracy that is affected by measurement errors. Echocardiography can assist with the identification of the appropriate electromechanical substrate of CRT response and LV lead placement. The targeted approach can improve the haemodynamic response, as also the patient-specific parameters estimation.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"133-145"},"PeriodicalIF":0.8,"publicationDate":"2017-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35781839","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":"Barnidipine Real-Life Efficacy and Tolerability in Arterial Hypertension: Results from Younger and Older Patients in the BASIC-HT Study.","authors":"Robert Lins,&nbsp;Caroline De Vries","doi":"10.2174/1874192401711010120","DOIUrl":"https://doi.org/10.2174/1874192401711010120","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the efficacy and tolerability of barnidipine, a strong lipophilic calcium channel blocker, in younger (≤55 for efficacy or <65 years for adverse events) versus older (>55 or ≥65 years) patients with uncomplicated hypertension.</p><p><strong>Methods: </strong>20,275 patients received barnidipine, 10 or 20 mg/day, as monotherapy or in combination with other antihypertensive drug(s) in the observational BArnidipine real-life Safety and tolerability In Chronic HyperTension (BASIC-HT) study. Efficacy and tolerability were assessed over a 3-month period. The present paper describes results from prespecified subgroup analyses by age not reported elsewhere.</p><p><strong>Results: </strong>Both age groups showed a clinically meaningful decrease in blood pressure (BP) over time (p<0.0001). The mean systolic and diastolic BP after approximately 3 months of barnidipine therapy was well below the target value of <140/90 mmHg for individual patients, with no notable differences between age groups. The decrease in mean pulse pressure was greater in patients >55 years (-10.8 mmHg) than in patients ≤55 years (-8.7 mmHg) (p<0.0001) and the proportion of patients with pulse pressure >60 mmHg decreased from 61.1% at baseline to 24.8% at Visit 3 in patients >55 years and from 47.7% to 16.5% in patients ≤55 years (p<0.0001).The overall incidence of adverse events was low, leading to treatment discontinuation in only 3.0-3.6% of patients. Peripheral edema, a common adverse effect with calcium channel blockers in clinical practice, was reported by 2.7% of patients aged <65 years and by 4.6% of patients aged ≥65 years.</p><p><strong>Conclusion: </strong>The efficacy and tolerability profiles of barnidipine as monotherapy or in combination with other antihypertensive drugs were shown to be favorable in both younger and older patients in a real-life practice setting. Randomized double-blind controlled studies are needed to confirm these results.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"120-132"},"PeriodicalIF":0.8,"publicationDate":"2017-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35698934","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":"Trends in Stroke-Related Mortality in the ABC Region, São Paulo, Brazil: An Ecological Study Between 1997 and 2012.","authors":"Luiz Vinicius de Alcantara Sousa,&nbsp;Laércio da Silva Paiva,&nbsp;Francisco Winter Dos Santos Figueiredo,&nbsp;Tabata Cristina do Carmo Almeida,&nbsp;Fernando Rocha Oliveira,&nbsp;Fernando Adami","doi":"10.2174/1874192401711010111","DOIUrl":"https://doi.org/10.2174/1874192401711010111","url":null,"abstract":"<p><strong>Background: </strong>Stroke is the second leading cause of death and the third leading cause of physical disability in the world, with a high burden of morbidity and mortality, but it has been shown a reduction in mortality worldwide over the past two decades, especially in regions with higher income.</p><p><strong>Objective: </strong>The study analyzed the temporal trend and the factors associated with stroke-related mortality in the cities that make up the ABC region of São Paulo (Santo André, São Bernardo do Campo, São Caetano do Sul, Diadema, Mauá, Ribeirão Pires, and Rio Grande da Serra), in comparison to data from the capital city of São Paulo, in the state of São Paulo, Brazil.</p><p><strong>Method: </strong>This was an ecological study conducted in 2017 using data from 1997 to 2012. Data were collected in 2017 from the Department of Informatics of the Brazilian Unified National Health System (DATASUS), where the Mortality Information System (SIM/SUS) was accessed. Linear regression analysis was used to estimate the temporal trend of stroke-related mortality according to sex, stroke subtypes, and regions. The confidence level adopted was 95%.</p><p><strong>Results: </strong>There was a reduction in the mortality rates stratified according to sex, age groups above 15 years, and subtypes of stroke. Mortality from hemorrhagic and non-specified stroke decreased in all regions. However, a significant reduction in ischemic stroke-related mortality was observed only in the ABC region and in Brazil.</p><p><strong>Conclusion: </strong>The ABC region showed greater mortality due to stroke in males, the age group above 49 years, and non-specified stroke between 1997 and 2012.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"111-119"},"PeriodicalIF":0.8,"publicationDate":"2017-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35698933","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":"Impact of Post-Exodontia Bleeding in Cardiovascular Patients: A New Classification Proposal.","authors":"T Lillis,&nbsp;M Didagelos,&nbsp;L Lillis,&nbsp;C Theodoridis,&nbsp;H Karvounis,&nbsp;A Ziakas","doi":"10.2174/1874192401711010102","DOIUrl":"https://doi.org/10.2174/1874192401711010102","url":null,"abstract":"<p><strong>Background: </strong>Exodontia (dental extraction), being the most frequent minor surgical procedure in the general population, inevitably involves a large number of patients on antithrombotic medication. Current experience shows that there is a degree of confusion in managing these patients.</p><p><strong>Description: </strong>Post-exodontia bleeding, a natural consequence of every dental extraction with no or minor clinical significance in the vast majority of cases, often appears to be of major concern to both patients and healthcare practitioners (dentists or physicians), either because of the alarming nature of oral bleeding itself or because of the distorted perception about its importance. These concerns are enhanced by the lack of a universal standardized definition of post-exodontia bleeding and by the fact that all currently available post-exodontia bleeding definitions bear intrinsic limitations and tend to overestimate its clinical significance.</p><p><strong>Conclusion: </strong>In order to overcome the aforementioned issues, this article presents an overview of post-extraction bleeding and proposes a classification, based on the well-recognized Bleeding Academic Research Consortium (BARC) bleeding definition, aiming at reducing heterogeneity in this field.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"102-110"},"PeriodicalIF":0.8,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874192401711010102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35221915","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":"Validation of the EuroSCORE II in a Greek Cardiac Surgical Population: A Prospective Study.","authors":"G Stavridis,&nbsp;D Panaretos,&nbsp;O Kadda,&nbsp;D B Panagiotakos","doi":"10.2174/1874192401711010094","DOIUrl":"https://doi.org/10.2174/1874192401711010094","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the validity of EuroSCORE II in the Greek population.</p><p><strong>Methods: </strong>A prospective single-center study was performed during November 1, 2013 and November 5, 2016; 621 patients undergoing cardiac surgery were enrolled. The EuroSCORE II values and the actual mortality of the patients were recorded in a special database. Calibration of the model was evaluated with the Hosmer-Lemeshow goodness-of-fit test, and discrimination with the areas under the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The observed in-hospital mortality rate was 3% (<i>i.e.</i> 18/621 patients). The median EuroSCORE II value was 1.3% (1^st quartile: 0.86%, 3^rd quartile: 2.46%), which indicates a low in-hospital mortality. Area under the ROC curve for EuroSCORE II was 0.85 (95% CI: 0.75-0.94), suggesting very good correct classification of the patients.</p><p><strong>Conclusion: </strong>The findings of the present work suggest that EuroSCORE II is a very good predictor of in-hospital mortality after cardiac surgery, in our population and, therefore can safely be used for quality assurance and risk assessment.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"94-101"},"PeriodicalIF":0.8,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874192401711010094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35221913","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":"Interpreting the Mechanism of APOE (p.Leu167del) Mutation in the Incidence of Familial Hypercholesterolemia; An In-silico Approach.","authors":"Omran Mohammed Rashidi,&nbsp;Fatima Amanullah H Nazar,&nbsp;Mohamed Nabil Alama,&nbsp;Zuhier Ahmed Awan","doi":"10.2174/1874192401711010084","DOIUrl":"https://doi.org/10.2174/1874192401711010084","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein E (APOE) gene is a ligand protein in humans which mediates the metabolism of cholesterol by binding to the low-density lipoprotein receptor (LDLR). P.Leu167del mutation in APOE gene was recently connected with Familial Hypercholesterolemia, a condition associated with premature cardiovascular disease. The consequences of this mutation on the protein structure and its receptor binding capacity remain largely unknown.</p><p><strong>Objective: </strong>The current study aims to further decipher the underlying mechanism of this mutation using advanced software-based algorithms. The consequences of disrupting the leucine zipper by this mutation was studied at the structural and functional level of the APOE protein.</p><p><strong>Methods: </strong>3D protein modeling for both APOE and LDLR (wild types), along with APOE (p.Leu167del) mutant type were generated using homology modeling template-based alignment. Structural deviation analysis was performed to evaluate the spatial orientation and the stability of the mutant APOE structure. Molecular docking analysis simulating APOE-LDLR protein interaction was carried out, in order to evaluate the impact of the mutation on the binding affinity.</p><p><strong>Result: </strong>Structural deviation analysis for APOE mutated model showed low degree of deviance scoring root-mean-square deviation, (RMSD) = 0.322 Å. Whereas Docking simulation revealed an enhanced molecular interaction towards the LDLR with an estimation of +171.03 kJ/mol difference in binding free energy.</p><p><strong>Conclusion: </strong>This <i>in-silico</i> study suggests that p.Leu167del is causing the protein APOE to associate strongly with its receptor, LDLR. This gain-of-function is likely hindering the ability of LDLR to be effectively recycled back to the surface of the hepatocytes to clear cholesterol from the circulation therefore leading to FH.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"11 ","pages":"84-93"},"PeriodicalIF":0.8,"publicationDate":"2017-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35221912","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}