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Aims: Cardiovascular disease (CVD) is the leading cause of death in dialysis patients as well as in kidney transplant recipients (KTx). Left ventricular hypertrophy (LVH) starts early during the course of chronic kidney disease and is a strong predictor of CVD. We hypothesised that kidney transplant is significantly associated with improvement in cardiovascular reserve. We conducted a prospective study to compare changes in CV before and after kidney transplantation in patients with ESRD who received KTx to control individuals who received PD but did not receive a KTx. Study Design: A Case-Control Study. Place and Duration of Study: Clinic for nephrology Clinical Center University of Sarajevo, Bosnia and Herzegovina. Methodology: In this case-control study, we included 50 KTx from the Kidney Transplant Outpatient Clinic for nephrology Clinical Center. For each 50 KTx, PD outpatients matched for gender and age were recruited. All patients underwent transthoracic echocardiography, and LV (left ventricular) mass (LVM), LV mass index (LVMi), and indices of cardiac function were measured. In the small subgroup of 18 KTx, we retrospectively assessed and compared the LVMI measurements, during dialysis and the post-transplant period. Results: The prevalence of LVH was 24% in KTx patients and 72% in PD patients (NS). KTx had significantly lower LVM, LVMi levels, E/A ratio, FS, and LA diameter compared with the PD group, while the EF and other echocardiographic parameters did not differ. In the subgroup of 18 KTx, LVMi levels after transplantation were significantly lower than dialysis LVMi levels. Conclusion: LVH is the most frequent cardiac abnormality at the time of kidney transplantation. After KTx, the reduction of LVH and diastolic dysfunction was significant. CV remodelling after successful KTx is related to better kidney function, and can explain better outcomes for patients with kidney transplants over patients on long-term dialysis.
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ABSTRACT Various benefits of flavonoids for ameliorating cardiovascular diseases have been demonstrated. However, the lowering effects on blood pressure caused by antiproliferative potentials of flavonoids in vascular smooth muscle cells are rare. In this study, the antihypertensive effects of total flavonoids from Ampelopsis megalophylla were investigated. The dynamic pressure values and the rate of media thickness versus lumen diameter were measured by the tail-cuff system and H&E staining in vivo, respectively. The mRNA expressions of ACE, Ang II, eNOS, c-Myc, cyclin D1 and p27Kip1 in thoracic aorta or A7r5 cells were measured by qPCR, respectively. The protein expressions of c-Myc, Cyclin D1, p27Kip1 and ß-catenin in tissues or A7r5 cells were measured by Western blot assay. Total flavonoids of A. megalophylla (TFAM) reduced the expressions of ACE and Ang II, and elevated the content of eNOS in thoracic aorta cells of SHRs. Furthermore, TFAM decreased the mRNA and protein expressions of c-Myc and cyclin D1 by repressing the Wnt/ß-catenin-mediated TCF/LEF transcriptional activation both in vivo and in vitro, which is synergetic with the up-regulation of p27Kip1 expression. Our study provided evidence for developing flavonoids from A. megalophylla as herbal supplements to prevent against cardiovascular diseases by suppressing vascular remodeling
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Animals , Rats , Flavonoids/adverse effects , Ampelopsis/classification , Plants, Medicinal/classification , Rats, Inbred SHR , Antihypertensive Agents/analysisABSTRACT
Aim To determine the possibilities and mechanisms of EGFR, a receptor protein tyrosine kinase associated with many important cellular processes re-sponsible for cardiovascular remodeling in renovascular hypertensive rats. Methods 2K1C hypertensive rats were used in the present study. Blood pressure was measured with the tail-cuff method. LVMI and his-topathological changes in the cardiovascular system were analysed. EGFR expressions of aorta and myocar-dium as well as phosphorylation levels of ERK in hy-pertensive rats were detected by immunohistochemistry and Western blot analysis, respectively. Results Sys-tolic blood pressure was markedly increased 2 weeks after 2K1C surgery. Cardiovascular remodeling induced by hypertension was confirmed by elevated LVMI, pro-liferation of collagen fibers in myocardial interstitium, histopathological changes in cardiovascular system and increased IMT of thoracic aorta 6 weeks after 2 K1 C surgery. Compared with sham rats, EGFR expression in the ventricular myocardium of 2 K1 C rats was signifi-cantly increased at 6 weeks ( P<0. 05 ) , and the EG-FR/GAPDH ratio was higher in 2 K1 C rats with higher systolic blood pressure ( P < 0. 05 ) . Phosphorylation level of ERK 1/2 was upregulated correspondingly in 2 K1 C rats ( P <0. 01 ) . Increased EGFR expression was also found in aortas of 2K1C rats, particularly in tunica intima and media. Conclusion EGFR and its down-stream kinases ERK 1/2 are involved in cardio-vascular remodeling in association with the severity of hypertension in renovascular hypertensive rats.
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Objective:To observe the effect of pioglitazone on carotid artery intima-media thickness (IMT) and plaque-positive rate in patients with metabolic syndrome, and to ifnd a new way to improve arterial remodeling in patients with metabolic syndrome. Methods:Patients with metabolic syndrome were randomly divided into a control group (n=60) and a pioglitazone group (n=61). All subjects received basic therapeutic measures, i.e, appropriate medication to control blood pressure, blood sugar and cholesterol. Pioglitazone (15 mg/d) was given to patients in the pioglitazone group, and placebo (vitamin C) in the control group for 24 weeks. Color doppler ultrasound was used to measure carotid artery IMT and plaque-positive rate of patients in the 2 groups atfer the intervention. Japan’s Hitachi 7600-020 automatic biochemical analyzer was used to measure fasting serumal triglycerides, total cholesterol, high density lipoprotein cholesterol, low-density lipoprotein cholesterol, free fatty acids, fasting blood glucose, 2-hour postprandial glucose and liver and kidney function, etc. The differences between groups after the intervention were analyzed and compared in IMT, plaque-positive rate and all blood biochemical indicators. Results:Atfer the intervention, compared with the control group, carotid artery plaque-positive rate and the levels of triglyceride and free fatty acid decreased in the pioglitazone group (P0.05). Conclusion:Pioglitazone intervention can significantly improve pathologic artery remodeling, and it can more effectively inhibit the arterial plaque-formation than basic therapeutic measures in patients with metabolic syndrome.