Interplay of Oxidative Stress and Nitric Oxide Synthase Gene Expression on Cardiovascular Responses in Preeclampsia / Interação do estresse oxidativo e da expressão dos genes das óxido nítrico sintases nas respostas cardiovasculares na pré-eclâmpsia

Abstract Objective To assess the influence of oxidative stress on the gene expression of nitric oxide synthases (NOS 3 and NOS 2) and, hence, the cardiovascular responses in preeclampsia. Methods This was a case control study in which patients with preeclampsia (PE group) and normal pregnancy controls (NP group) were included according to the guidelines of the American College of Obstetricians and Gynecologists (ACOG). The serum levels of malondialdehyde (MDA), total antioxidant capacity, and nitric oxide (NO) were estimated, and the heart rate andmean arterial pressure were recorded. The gene profiling of NOS3 and NOS2 was performed through real-time polymerase chain reaction (RT-PCR). The statistical analysis was performed using the Student t-test, and values of p<0.05 were considered statistically significant. Results The serum levels of malondialdehyde were increased (p<0.0001), and the total antioxidant capacity was reduced in the PE group (p=0.034), indicating oxidative stress. In the PE group, themean arterial pressure was significantly higher (p<0.0001), but the serum levels of NO did not show a statistically significant reduction (p=0.20). The gene expression profiling of NOS3 and NOS2 revealed a down regulation in the PE group by 8.49 and 51.05 times respectively. Conclusion Oxidative stress may lead to endothelial dysfunction, which could result in increased mean arterial pressure. Nitric oxide may play a role in this mechanism, but interactions with other vasoactive /biological substances cannot be overlooked, as the gene expression of NOS3 and NOS2 has been reduced.

Resumo Objetivo Avaliar a influência do estresse oxidativo na expressão genética das óxido nítrico sintases (nitric oxide synthases, NOS, em inglês; NOS 3 e NOS 2) e, consequentemente, nas respostas cardiovasculares na pré-eclâmpsia. Métodos Este foi um estudo caso-controle no qual pacientes com pré-eclâmpsia (grupo PE) e controles comgravidez normal (grupo GN) foramincluídos de acordo com as diretrizes do American College of Obstetricians and Gynecologists (ACOG). Foram estimados os níveis séricos de malondialdeído (MDA) da capacidade antioxidante total, e de óxido nítrico (nitric oxide, NO, em inglês). A frequência cardíaca e a pressão arterial média foram registradas. O perfil genético da NOS3 e da NOS2 foi feito por reação em cadeia de polimerase em tempo real (real-time polymerase chain reaction, RT-PCR, em inglês). A análise estatística foi feita utilizando-se o teste t de Student, e valores de p<0,05 foram considerados estatisticamente significativos. Resultados Os níveis séricos de malondialdeído sérico estavam aumentados (p<0,0001), e a capacidade antioxidante total, reduzida no grupo PE (p=0,034), o que indicava estresse oxidativo. No grupo PE, a pressão arterial média era significativamente maior (p<0,0001), mas os níveis séricos de NO não demostraram redução estatisticamente significativa (p=0,20). O perfil de expressão genética da NOS3 e da NOS2 revelou uma regulação negativa no grupo PE de 8,49 e 51,05 vezes, respectivamente. Conclusão O estresse oxidativo pode levar à disfunção endotelial, o que pode resultar em aumento da pressão arterialmédia. O NO pode desempenhar umpapel neste mecanismo, mas as interações com outras substâncias vasoativas/biológicas não podem ser negligenciadas, uma vez que a expressão genética da NOS3 e da NOS2 foi reduzida.

Different anthropometric adiposity measures and their association with cardiovascular disease risk factors in middle aged women.

A cross sectional study of 136 women age group40-55 years was conducted to study which anthropometric measure had the strongest association with cardiovascular disease risk factors in middle aged women. In accordance with their BMI measurement subjects were divided into three groups namely:Normal weight (Group1) BMI 18.5-24.9 kg/m2, Overweight (Group2) – 25 kg/m2 – 29.9 kg/m2, Obese (Group3) – BMI > 30 kg/ m2. Each group was further divided into premenopausal and postmenopausal women BMI, WHR, WHtR, SBP, DBP were recorded. TG, TC, HDL and FBS values were estimated. Results showed that both pre and post menopausal middle aged obese women with higher BMI, WHR and WHtR have more chances of having cardiovascular diseases. BMI, WHR and WHtR are theeasy and practical methods to diagnose obesity and together can be used as simple measures to predict cardiovascular risk factors in middle aged women.

Evaluation of arterial stiffness in elderly with prehypertension.

Arterial stiffness is an independent marker of cardiovascular (CV) risk that increases with age. Hypertension is known to augment the age-related arterial stiffness. The influence of prehypertension on arterial stiffness in elderly is least studied. The present study was aimed to assess the age-associated arterial stiffness in the elderly subjects with prehypertension. A cross sectional study was conducted on elderly subjects aged 60-80 years with prehypertension (n=25) and age-matched normotensives (n=20). The arterial stiffness was assessed by measuring: (1) Pulse wave velocity between carotid-femoral (c-f PWV) and brachial-ankle (baPWV) (2) Augmentation index (AIx) and (3) Arterial stiffness index (ASI) at brachial (bASI) and tibial artery (aASI). We found a significant increase in c-f PWV (p<0.001), baPWV (p<0.001) and AIx@75 (p<0.001) in prehypertensives than normotensive elderly individuals. There was no significant difference in the ASI at brachial and tibial arteries. The significant predictor of c-f PWV and AIx@75 was SBP (β=0.584, p=0.04; β=0.700, p=0.019 respectively), and aASI was PP (β=0.493, p=0.049). These findings show an augmentation of age-related arterial stiffness in elderly with prehypertension.

Alterations in minute ventilation, maximum voluntary ventilation and dyspneic index in different trimesters of pregnancy.

Respiratory function in pregnancy is of special importance since the life of fetus depends primarily upon its oxygen supply. Thus this study was designed to evaluate the Minute ventilation (MV), Maximum Voluntary Ventilation (MVV) & Dyspneic Index (DI) in different trimesters of pregnancy & compare the results with nonpregnant control group. A cross-sectional study was carried out in 200 healthy women in the age range of 19-35 years with 50 subjects each in 1st, 2nd, 3rd trimesters of pregnancy and non-pregnant control group. We recorded respiratory parameters in study and control groups. Statistical analysis was done by ANOVA and Tukey Krammer post Hoc tests. It was observed that there was a significant decrease in MVV and dyspneic index in all trimesters of pregnancy and an insignificant variation in MV when compared to the control group. The changes in pulmonary function are influenced by the mechanical pressure of enlarging gravid uterus, elevating the diaphragm and restricting the movements of lungs thus hampering forceful expiration. The decrease seen in MVV in 1st trimester might be due to bronchoconstriction effect of decreased alveolar Pco2 on the bronchial smooth muscles.

Role of yoga in modifying anxiety level in women.

Anxiety leads to derangement in physical and mental health. Anxiety levels are more in full time housewives than working women. There is a need for simple, easy treatment for anxiety to alleviate the burden on health caused by anxiety. Yoga is among the top ten complementary and alternative medicine therapies. Our study aimed to determine the anxiety levels in apparently healthy full time housewives and to study the effects of Yoga on anxiety levels among them. Present study is a comparative interventional study. Study was conducted on 50 apparently healthy full time housewives (20-50 years) who attended one month Yoga camp. Hamilton Anxiety (HAMA) Scale was used to evaluate anxiety levels before and at the end of the yoga camp. Statistical analysis was done by Paired t test using SPSS 9.0. The baseline pulse rate, SBP, DBP were 82.90±4.25 bpm, 124.84±11.022 mm Hg, 85.20±10.81 mm Hg respectively. After four weeks yoga camp there was statistically significant lowering of pulse rate (77.58±3.86 bpm), SBP (117.92±6.76 mm Hg), DBP (78.68±6.62 mm Hg). Before yoga training, percentage distributions of subjects with mild, moderate and severe anxiety were 6%, 18% and 76% respectively. At the end of four week yoga training, percentage distributions of subjects with mild, moderate and severe anxiety were 44.23%, 19.23% and 36.53% respectively. There was highly significant (p=0.000) difference in the mean values of total score before (33.71±4.90) and after (26.93±4.53) yoga. These results indicate that there was a reduction in the severity of anxiety from severe to moderate and mild indicating decrease in anxiety following yoga. Based on the results of our study, we conclude that regular yogic practices and adapting and implementing the principals and philosophy of yoga in day to day life may decrease the anxiety level.

Effect of Yoga on Short Term Heart Rate Variability Measure as a Stress Index in Subjunior Cyclists : A Pilot Study。

Subjunior athletes experience mental stress due to pressure from the coach, teachers and parents for better performance. Stress, if remains for longer period and not managed appropriately can leads to negative physical, mental and cognitive impact on children. The present study was aimed to evaluate the effect of integrated yoga module on heart rate variability (HRV) measure as a stress index in subjunior cyclists. Fast furrier transform technique of frequency domain method was used for the analysis of HRV. We have found a significant increase in high frequency (HF) component by 14.64% (P<0.05) and decrease in the low frequency component (LF) of HRV spectrum by 5.52% (P<0.05) and a decrease in LF/ HF ratio by 19.63% (P<0.01) in yoga group. In the control group, there was decrease in the HF component and, no significant difference in the LF component of HRV spectrum and LF/HF ratio. The results show that yoga practice decreases sympathetic activity and causes a shift in the autonomic balance towards parasympathetic dominance indicating a reduction in stress. In conclusion, yoga practice helps to reduce stress by optimizing the autonomic functions. So, it is suggested to incorporate yoga module as a regular feature to keep subjunior athletes both mentally and physically fit.

Role of exercise and nutrition on cardiopulmonary fitness and pulmonary functions on residential and non-residential school children.

Physical fitness is the prime criterion for survival and to lead a healthy life. Our aim is to find out effect of exercise and nutrition on physical fitness on growing children with scientific records. The present study was designed on healthy school children of a Residential-Sainik (100) and Non-Residential (100) school children (12-16 yrs) of Bijapur. To evaluate cardiopulmonary fitness parameters included are VO2 Max (ml/kg/min) and Physical Fitness Index (PFI %). Harvard Step Test determined VO2 Max and PFI. Also recorded pulmonary function parameters like Forced Expiratory Volume in 1 sec (FEV1 in %) by recording spirometry. Peak Expiratory Flow Rate (PEFR in L/Min) by Peak flow meter and Maximal Expiratory Pressure (MEP in mmHg) by modified Black’s apparatus. We found statistically significant higher values (p=0.000) of VO2 Max, PFI, FEV1, PEFR and MEP in residential school children compared to nonresidential school children higher. So, our study shows that regular exercise and nutritious food increase the cardiopulmonary fitness values and pulmonary functions in Residential school children.

Role of Exercise and Nutrition on Cardiopulmonary Fitness.

Physical fitness is the prime criterion for survival, to achieve any goal and to lead a healthy life. Effect of exercise to have a good physical fitness is well known since ancient Vedas. Our aim is to find out the effect of exercise and nutrition on growing children with scientific records. So, we have selected Residential and Non-residential school children with age between 12 and 16 years. Obviously, Residential school children will get recommended nutritious food and they are undergoing regular physical exercise training. Subjects were divided into two groups. Group I is residential and group II is non-residential, each of having 100 students and they were subjected for cardiopulmonary fitness tests. Physical fitness can be assessed by suitable cardiopulmonary fitness parameters like Physical Fitness Index (PFI in %) and maximal oxygen consumption that is VO2max (ml/kg/min) by using Harvard step test. Results were compared and subjected to statistical analysis for Z test. VO2 max (Mean ± SD) in residential was 66.03 ± 7.06 and in non-residential school children was 55.24 ± 7.53. PFI (Mean ± SD) in residential was 54.96 ± 8.38 and in non-residential school children was 44.75 ± 5.05. So, VO2 max (p=0.000) and PFI (p=0.000) were significantly higher in residential as compared to that of non-residential school children. So, from above data analysis it is observed that regular exercise and nutritious food increase the cardiopulmonary fitness values in residential school children.