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1.
Sci Rep ; 13(1): 19340, 2023 11 07.
Article in English | MEDLINE | ID: mdl-37935741

ABSTRACT

Purified diets (PD) increase standardization and repeatability in rodent studies but lead to differences in the phenotype of animals compared to grain-based "chow" diets. PD contain less fiber and are often devoid of soluble fiber, which can impact gut health. Thus, the aim of the present study was to modify the PD AIN93G by addition of soluble fiber, to promote more natural gut development as seen with chow diets. One hundred twenty male C57BL/6J mice were fed over 12 weeks either a chow diet, AIN93G or one of three modified AIN93G with increased fiber content and different ratios of soluble fiber to cellulose. Gut health was assessed through histological and immunohistochemical parameters and gut barrier gene expression. Gut microbiota composition was analyzed and its activity characterized through short chain fatty acid (SCFA) quantification. Feeding AIN93G led to tissue atrophy, a less diverse microbiota and a lower production of SCFA compared to chow diet. The addition of soluble fiber mitigated these effects, leading to intermediate colon and caecum crypt lengths and microbiota composition compared to both control diets. In conclusion, the addition of soluble fibers in PDs seems essential for gut morphology as well as a diverse and functional gut microbiome.


Subject(s)
Colon , Dietary Fiber , Mice , Male , Animals , Dietary Fiber/metabolism , Mice, Inbred C57BL , Colon/metabolism , Cecum/metabolism , Diet , Fatty Acids, Volatile/metabolism
2.
Nutrients ; 11(10)2019 Oct 02.
Article in English | MEDLINE | ID: mdl-31581733

ABSTRACT

Low whole grain consumption is a risk factor for the development of non-communicable diseases such as type 2 diabetes. Dietary fiber and phytochemicals are bioactive grain compounds, which could be involved in mediating these beneficial effects. These compounds are not equally distributed in the wheat grain, but are enriched in the bran and aleurone fractions. As little is known on physiological effects of different wheat fractions, the aim of this study was to investigate this aspect in an obesity model. For twelve weeks, C57BL/6J mice were fed high-fat diets (HFD), supplemented with one of four wheat fractions: whole grain flour, refined white flour, bran, or aleurone. The different diets did not affect body weight, however bran and aleurone decreased liver triglyceride content, and increased hepatic n-3 polyunsaturated fatty acid (PUFA) concentrations. Furthermore, lipidomics analysis revealed increased PUFA concentration in the lipid classes of phosphatidylcholine (PC), PC-ether, and phosphatidylinositol in the plasma of mice fed whole grain, bran, and aleurone supplemented diets, compared to refined white flour. Furthermore, bran, aleurone, and whole grain supplemented diets increased microbial α-diversity, but only bran and aleurone increased the cecal concentrations of short-chain fatty acids. The effects on hepatic lipid metabolism might thus at least partially be mediated by microbiota-dependent mechanisms.


Subject(s)
Diet, High-Fat , Dietary Supplements , Edible Grain , Lipids/blood , Liver/metabolism , Obesity/diet therapy , Triticum , Animal Feed , Animals , Bacteria/genetics , Bacteria/metabolism , Biomarkers/blood , Dietary Fiber , Disease Models, Animal , Flour , Gastrointestinal Microbiome , Male , Mice, Inbred C57BL , Nutritive Value , Obesity/etiology , Obesity/metabolism , Plant Proteins
3.
Nutrients ; 11(8)2019 Aug 09.
Article in English | MEDLINE | ID: mdl-31405019

ABSTRACT

Dietary pulses, including lentils, are protein-rich plant foods that are enriched in intestinal health-promoting bioactives, such as non-digestible carbohydrates and phenolic compounds. The aim of this study was to investigate the effect of diets supplemented with cooked red lentils on the colonic microenvironment (microbiota composition and activity and epithelial barrier integrity and function). C57Bl/6 male mice were fed one of five diets: a control basal diet (BD), a BD-supplemented diet with 5, 10 or 20% cooked red lentils (by weight), or a BD-supplemented diet with 0.7% pectin (equivalent soluble fiber level as found in the 20% lentil diet). Red lentil supplementation resulted in increased: (1) fecal microbiota α-diversity; (2) abundance of short-chain fatty acid (SCFA)-producing bacteria (e.g., Prevotella, Roseburia and Dorea spp.); (3) concentrations of fecal SCFAs; (4) mRNA expression of SCFA receptors (G-protein-coupled receptors (GPR 41 and 43) and tight/adherens junction proteins (Zona Occulden-1 (ZO-1), Claudin-2, E-cadherin). Overall, 20% lentil had the greatest impact on colon health outcomes, which were in part explained by a change in the soluble and insoluble fiber profile of the diet. These results support recent public health recommendations to increase consumption of plant-based protein foods for improved health, in particular intestinal health.


Subject(s)
Bacteria/metabolism , Colon/microbiology , Cooking , Dietary Fiber/metabolism , Gastrointestinal Microbiome , Lens Plant/metabolism , Seeds/metabolism , Animals , Bacteria/genetics , Cadherins/genetics , Cadherins/metabolism , Colon/metabolism , Diet , Dietary Fiber/administration & dosage , Fatty Acids/metabolism , Feces/microbiology , Hot Temperature , Male , Mice, Inbred C57BL , Mucins/genetics , Mucins/metabolism , Nutritive Value , Permeability , Receptors, G-Protein-Coupled/genetics , Receptors, G-Protein-Coupled/metabolism , Tight Junction Proteins/genetics , Tight Junction Proteins/metabolism
4.
J Nutr Biochem ; 70: 91-104, 2019 08.
Article in English | MEDLINE | ID: mdl-31195365

ABSTRACT

Obesity is associated with impaired intestinal epithelial barrier function and an altered microbiota community structure, which contribute to host systemic inflammation and metabolic dysfunction. Fiber-rich common beans (Phaseolus vulgaris) promote intestinal health (microbiota and host epithelial barrier integrity) in lean mice. The objective was to assess the intestinal health promoting effects of navy bean supplementation during high-fat (HF)diet-induced obesity. Male C57BL/6 mice were fed either a high-fat (HF) diet (60% of kcal from fat) or an isocaloric HF diet supplemented with 15.7% (by weight) cooked navy bean powder (HF+B) for 12 weeks. Compared to HF, the HF+B diet altered the fecal microbiota community structure (16S rRNA gene sequencing), most notably increasing abundance of Akkermansia muciniphila (+19-fold), whose abundance typically decreases in obese humans and rodents. Additionally, HF+B fecal abundance of carbohydrate fermenting, short chain fatty acid (SCFA) producing Prevotella (+332-fold) and S24-7 (+1.6-fold) and fecal SCFA levels were increased. HF+B improved intestinal health and epithelial barrier integrity versus HF, evidenced by reduced serum fluorescein isothiocyanate (FITC)-dextran concentration in an in vivo gut permeability test, and increased intestinal mRNA expression of tight junction components (ZO-1, occludin), anti-microbial defenses (Reg3γ, IgA, Defα5, Defß2) and mucins (Muc2). Additionally, HF+B improved the systemic obese phenotype via reduced serum HOMA-IR and leptin:adiponectin ratio, and locally via attenuation of epididymal adipose tissue crown-like structure formation, adipocyte size, and inflammatory transcription factor (NFκBp65 and STAT3) activation. Therefore, navy bean supplementation improved obese intestinal health (microbiota and epithelial barrier integrity) and attenuated the severity of the obese phenotype.


Subject(s)
Diet, High-Fat , Inflammation/physiopathology , Intestinal Mucosa/physiopathology , Phaseolus , Adipokines/metabolism , Adipose Tissue/metabolism , Akkermansia , Animal Feed , Animals , Body Weight , Carbohydrate Metabolism , Dietary Fiber , Dietary Supplements , Epithelial Cells/metabolism , Epithelial Cells/pathology , Feces , Fermentation , Fluorescein-5-isothiocyanate , Gastrointestinal Microbiome , Intestinal Mucosa/metabolism , Male , Mice , Mice, Inbred C57BL , Obesity/metabolism , Permeability , Phenotype , Prevotella , RNA, Ribosomal, 16S/metabolism , Verrucomicrobia
5.
Metabolites ; 9(3)2019 Mar 21.
Article in English | MEDLINE | ID: mdl-30901936

ABSTRACT

Nuclear magnetic resonance (NMR) spectroscopy is one of the most promising methods for use in metabolomics studies as it is able to perform non targeted measurement of metabolites in a quantitative and non-destructive way. Sample preparation of liquid samples like urine or blood serum is comparatively easy in NMR metabolomics, because mainly buffer and chemical shift reference substance are added. For solid samples like feces suitable extraction protocols need to be defined as initial step, where the exact protocol depends on sample type and features. Focusing on short chain fatty acids (SCFAs) in mice feces, we describe here a set of extraction protocols developed with the aim to suppress changes in metabolite composition within 24 h after extraction. Feces are obtained from mice fed on either standard rodent diet or high fat diet. The protocols presented in this manuscript are straightforward for application, and successfully minimize residual bacterial and enzymatic activities. Additionally, they are able to minimize the lipid background originating from the high fat diet.

6.
Hum Mol Genet ; 28(6): 961-971, 2019 03 15.
Article in English | MEDLINE | ID: mdl-30476097

ABSTRACT

Spastic paraplegia gene 11(SPG11)-linked hereditary spastic paraplegia is a complex monogenic neurodegenerative disease that in addition to spastic paraplegia is characterized by childhood onset cognitive impairment, thin corpus callosum and enlarged ventricles. We have previously shown impaired proliferation of SPG11 neural progenitor cells (NPCs). For the delineation of potential defect in SPG11 brain development we employ 2D culture systems and 3D human brain organoids derived from SPG11 patients' iPSC and controls. We reveal that an increased rate of asymmetric divisions of NPCs leads to proliferation defect, causing premature neurogenesis. Correspondingly, SPG11 organoids appeared smaller than controls and had larger ventricles as well as thinner germinal wall. Premature neurogenesis and organoid size were rescued by GSK3 inhibititors including the Food and Drug Administration-approved tideglusib. These findings shed light on the neurodevelopmental mechanisms underlying disease pathology.


Subject(s)
Cerebral Cortex/embryology , Cerebral Cortex/metabolism , Neurogenesis/genetics , Proteins/genetics , Alleles , Biomarkers , Cerebral Cortex/physiopathology , Cognition Disorders/genetics , Cognition Disorders/physiopathology , Disease Susceptibility , Fluorescent Antibody Technique , Genotype , Glycogen Synthase Kinase 3/metabolism , Humans , Mutation , Organoids , Phenotype , beta Catenin
7.
Appl Physiol Nutr Metab ; 43(9): 893-901, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29522694

ABSTRACT

The potential for a chickpea-supplemented diet (rich in fermentable nondigestible carbohydrates and phenolic compounds) to modify the colonic microenvironment and attenuate the severity of acute colonic inflammation was investigated. C57Bl/6 male mice were fed a control basal diet or basal diet supplemented with 20% cooked chickpea flour for 3 weeks prior to acute colitis onset induced by 7-day exposure to dextran sodium sulfate (DSS; 2% w/v in drinking water) and colon and serum levels of inflammatory mediators were assessed. Despite an equal degree of DSS-induced epithelial barrier histological damage and clinical symptoms between dietary groups, biomarkers of the ensuing inflammatory response were attenuated by chickpea pre-feeding, including reduced colon tissue activation of nuclear factor kappa B and inflammatory cytokine production (tumor necrosis factor alpha and interleukin (IL)-18). Additionally, colon protein expression of anti-inflammatory (IL-10) and epithelial repair (IL-22 and IL-27) cytokines were increased by chickpea pre-feeding. Furthermore, during acute colitis, chickpea pre-feeding increased markers of enhanced colonic function, including Relmß and IgA gene expression. Collectively, chickpea pre-feeding modulated the baseline function of the colonic microenvironment, whereby upon induction of acute colitis, the severity of the inflammatory response was attenuated.


Subject(s)
Cicer , Colitis/diet therapy , Inflammation/diet therapy , Animals , Biomarkers/metabolism , Colitis/chemically induced , Dextran Sulfate , Diet , Disease Models, Animal , Flour , Inflammation/chemically induced , Interleukin-18/metabolism , Interleukins/metabolism , Intestinal Mucosa/metabolism , Male , Mice, Inbred C57BL , NF-kappa B/metabolism , Tumor Necrosis Factor-alpha/metabolism , Interleukin-22
8.
Mol Nutr Food Res ; 60(9): 2008-19, 2016 09.
Article in English | MEDLINE | ID: mdl-27004411

ABSTRACT

SCOPE: Isoflavones are discussed to improve serum lipoproteins and body composition and to reduce cardiovascular disease risk in postmenopausal women (PMW). LDL receptors (LDLR) and scavenger receptor CD36 (CD36) play a pivotal role in the regulation of plasma LDL-cholesterol concentrations (LDL-chol). We investigated the impact of isoflavones on the receptor expression of both receptors in leukocytes of PMW. METHODS AND RESULTS: A randomized, double-blind, placebo-controlled trial in parallel design was conducted to assess the effects of an isoflavone-enriched soy extract (117.4 mg/day isoflavone aglycone equivalents) for 12 weeks on serum LDL-chol, LDLR, and CD36 expression on leukocytes in 170 healthy PMW. Baseline and after 12 weeks, blood lipid concentrations, anthropometric data and body composition were determined. Receptor expression on leukocytes was measured by means of flow cytometry. After the intervention, no significant differences were found for LDLR and CD36 expression on leukocytes. A significant increase of serum LDL-chol was shown for the isoflavone group (p = 0.03) after 12 weeks. Body fat content and VAT were not affected. CONCLUSION: Isoflavone supplementation for 12 weeks did not change LDLR and CD36 expression on leukocytes of PMW and did not affect body fat content and visceral adipose tissue (VAT), but slightly increased serum LDL-chol.


Subject(s)
CD36 Antigens/blood , Isoflavones/pharmacology , Postmenopause , Receptors, LDL/blood , Aged , Body Composition/drug effects , Dietary Supplements , Double-Blind Method , Female , Humans , Leukocytes/drug effects , Leukocytes/metabolism , Lipids/blood , Lymphocytes/drug effects , Lymphocytes/metabolism , Middle Aged , Monocytes/drug effects , Monocytes/metabolism , Postmenopause/drug effects , Glycine max/chemistry
9.
Microb Ecol Health Dis ; 26: 26164, 2015.
Article in English | MEDLINE | ID: mdl-25656825

ABSTRACT

In the human gut, millions of bacteria contribute to the microbiota, whose composition is specific for every individual. Although we are just at the very beginning of understanding the microbiota concept, we already know that the composition of the microbiota has a profound impact on human health. A key factor in determining gut microbiota composition is diet. Preliminary evidence suggests that dietary patterns are associated with distinct combinations of bacteria in the intestine, also called enterotypes. Western diets result in significantly different microbiota compositions than traditional diets. It is currently unknown which food constituents specifically promote growth and functionality of beneficial bacteria in the intestine. The aim of this review is to summarize the recently published evidence from human in vivo studies on the gut microbiota-modulating effects of diet. It includes sections on dietary patterns (e.g. Western diet), whole foods, food constituents, as wells as food-associated microbes and their influence on the composition of human gut microbiota. The conclusions highlight the problems faced by scientists in this fast-developing field of research, and the need for high-quality, large-scale human dietary intervention studies.

10.
Eur J Nutr ; 53(1): 211-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-23558350

ABSTRACT

PURPOSE: Adipose tissue-associated chronic inflammation is involved in the pathogenesis of obesity-related diseases. Dietary fatty acids are known to influence inflammatory processes. The aim of this study was to investigate, whether diets with regular fat contents but variable fat qualities affect adipose tissue-associated inflammation through the fatty acid composition of mesenteric adipose tissue (MAT). METHODS: Obese Zucker rats were fed diets containing 7 % wt:wt rapeseed oil, corn oil, or lard for 10 weeks. Fatty acid composition and endocrine function regarding adipokines and cytokines of MAT, number of total CD3(+) T cells, and cytokine secretion of mesenteric lymph node (MLN)-derived lymphocytes were determined. Local effects in MAT and MLN were compared to systemic effects assessed in serum and peripheral blood mononuclear cells. RESULTS: Fatty acid composition of MAT reflected dietary fatty acid intake, without affecting endocrine function. Feeding the lard diet for 10 weeks increased the serum adiponectin and TNF-α secretion of blood lymphocytes, whereas CD3(+) T cells in blood were decreased. No effects were seen for the secretion of adipokines and cytokines from MAT, the amount of T cells in MLN, and cytokine secretion of MLN lymphocytes. CONCLUSIONS: In conclusion, feeding obese rats a diet with regular fat content but variable fat sources for 10 weeks, changed the fatty acid composition of MAT but not its secretory properties or MLN functions. Although the local immune system was not influenced, lard-feeding induced minor changes in systemic immune function.


Subject(s)
Biomarkers/blood , Dietary Fats/administration & dosage , Inflammation/blood , Obesity/blood , Adipokines/blood , Adipokines/metabolism , Adipose Tissue/physiology , Animals , Blood Glucose/metabolism , Chemokine CCL2/blood , Cholesterol/blood , Corn Oil/administration & dosage , Fatty Acids, Monounsaturated , Female , Insulin/blood , Leukocytes, Mononuclear/metabolism , Lymph Nodes/metabolism , Plant Oils/administration & dosage , Rapeseed Oil , Rats , Rats, Zucker , Tumor Necrosis Factor-alpha/blood , Tumor Necrosis Factor-alpha/metabolism
11.
J Rheumatol ; 40(10): 1683-96, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24037549

ABSTRACT

OBJECTIVE: An increased incidence of apoptotic cells and an increased activation of dendritic cells (DC) may be involved in the pathogenesis of systemic lupus erythematosus (SLE). We investigated the characteristics of apoptotic neutrophils and monocyte-derived DC of patients with SLE, their interaction, and the influence of autoantibodies and inflammatory cytokines on this interaction. METHODS: Kinetics of neutrophil apoptosis and DC activation were studied by flow cytometry. To analyze the interaction of apoptotic cells with phagocytes, crossover coculture experiments were performed with DC from patients with SLE and apoptotic Jurkat T cells as well as with apoptotic neutrophils from patients with SLE and the monocytic cell line U937. SLE serum and cytokines were added to this coculture, and activation and suppression of DC were quantified by levels of inflammatory cytokine secretion. RESULTS: Apoptotic neutrophils and DC from patients with SLE showed no inherent defects compared to healthy controls, and the suppressive nature of their interaction was not affected. Autoantibodies as well as the inflammatory cytokines interleukin 17 (IL-17) and IL-1ß had no influence on the interaction in this setup. Interferon (IFN)-α, however, substantially reduced the suppressive effect of apoptotic cells on DC. CONCLUSION: The data suggest that aberrant immune reactivity in SLE is not generally due to an intrinsic defect in apoptotic cells, their processing, or their interaction with DC, but likely arises from the milieu in which this interaction takes place. Our study highlights the importance of IFN-α during early stages of SLE and its potential as a therapeutic target.


Subject(s)
Apoptosis/drug effects , Dendritic Cells/drug effects , Interferon-alpha/pharmacology , Lupus Erythematosus, Systemic/immunology , Adolescent , Adult , Aged , Apoptosis/immunology , Autoantibodies/pharmacology , Dendritic Cells/immunology , Female , Humans , Interleukin-17/pharmacology , Interleukin-1beta/pharmacology , Jurkat Cells , Lupus Erythematosus, Systemic/etiology , Male , Middle Aged , U937 Cells
12.
PLoS One ; 8(6): e66690, 2013.
Article in English | MEDLINE | ID: mdl-23825152

ABSTRACT

Obesity and obesity-associated diseases e.g. cardiovascular diseases and type 2 diabetes are spread worldwide. Anthocyanins are supposed to have health-promoting properties, although convincing evidence is lacking. The aim of the present study was to investigate the effect of anthocyanins on several risk factors for obesity-associated diseases. Therefore, Fischer rats were fed anthocyanin-rich grape-bilberry juice or an anthocyanin-depleted control juice for 10 weeks. Intervention with anthocyanin-rich grape-bilberry juice reduced serum cholesterol and tended to decrease serum triglycerides. No effects were seen for serum non-esterified fatty acids, glucose, and insulin. Anthocyanin-rich grape-bilberry juice intervention reduced serum leptin and resistin, but showed no influence on serum adiponectin and secretion of adipokines from mesenteric adipose tissue. Furthermore, anthocyanin-rich grape-bilberry juice increased the proportion of polyunsaturated fatty acids and decreased the amount of saturated fatty acids in plasma. These results indicate that anthocyanins possess a preventive potential for obesity-associated diseases.


Subject(s)
Anthocyanins/analysis , Beverages , Cholesterol/blood , Fatty Acids, Nonesterified/blood , Leptin/blood , Resistin/blood , Adipokines/blood , Animals , Blood Glucose/analysis , Body Weight , Feeding Behavior , Insulin/blood , Male , Rats , Rats, Inbred F344 , Triglycerides/blood
13.
Mol Nutr Food Res ; 57(10): 1753-61, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23729013

ABSTRACT

SCOPE: Most studies on immunomodulatory effects of anthocyanins are concentrated on their anti-inflammatory potential. In vitro studies suggest that anthocyanins possess anti-inflammatory potential, but results from in vivo studies are rare and inconclusive. Sparse information is available about the immune tissues that are affected by anthocyanins. As systemic bioavailability of anthocyanins is rather low, predominantly luminal anthocyanins could influence the gut-associated lymphoid tissue (GALT). Therefore, the present study investigated the immunomodulatory effects of an anthocyanin-rich grape-bilberry juice (ARJ) on the systemic immune system, GALT, and mesenteric adipose tissue (MAT). METHODS AND RESULTS: Fischer rats (n = 24/group) received ARJ or anthocyanin-depleted grape-bilberry juice (control) for 10 wk. Lymphocytes were isolated from blood, spleen, Peyer's Patches, and mesenteric lymph nodes. Anthocyanin intake was 15 mg/day and concentrations were determined in plasma and intestinal tract. Number of T and natural killer cells, natural killer cell activity, cytokine secretion from lymphocytes (IL-10, IFN-γ, and TNF-α) and MAT (IL-6, IL-10, and MCP-1), inflammation markers in serum (sICAM, IFN-γ, and MCP-1), and activation status of NF-κB were not influenced by ARJ. CONCLUSION: This in vivo study suggests that anthocyanins at physiological doses affect neither the systemic immune system, nor GALT, or MAT in healthy, unchallenged rats.


Subject(s)
Anthocyanins/pharmacology , Anti-Inflammatory Agents/pharmacology , Beverages , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/immunology , Adipose Tissue/drug effects , Animals , Cytokines/metabolism , Immunomodulation , Intestinal Mucosa/drug effects , Lymph Nodes/drug effects , Lymphocytes/drug effects , Male , NF-kappa B/metabolism , Peyer's Patches/drug effects , Rats , Rats, Inbred F344 , Spleen/drug effects , Vaccinium myrtillus/chemistry , Vitis/chemistry
14.
J Heart Valve Dis ; 17(3): 335-42, 2008 May.
Article in English | MEDLINE | ID: mdl-18592932

ABSTRACT

BACKGROUND AND AIM OF THE STUDY: Following mechanical heart valve replacement, patients may require a form of 'bridging' anticoagulation to prevent valve-associated thromboembolism until oral vitamin K antagonists take effect. In 2000, the present authors changed their bridging protocol to a fixed dose of 40 mg enoxaparin twice daily (b.i.d., subcutaneous), regardless of the patient's body weight and renal function. The study aim was to evaluate the feasibility of this protocol with regards to thromboembolism, hemorrhage and other valve-associated adverse effects. METHODS: Between April 2000 and December 2004, a total of 256 consecutive patients who had undergone mechanical heart valve replacement were enrolled into this retrospective study. All patients received 40 mg enoxaparin b.i.d., subcutaneously, as bridging anticoagulation for a mean of 6.7 days, commencing at a mean of 3.8 days (range: 2-42 days) after surgery. This was approximately 55% (range: 32-95%) of the recommended dose considered to be safe in this setting. RESULTS: A total of 18 (7%) minor bleeding events and two (0.7%) arterial thromboses were seen to arise from previously existing high-grade (>90%) stenosis of the affected vessels. At discharge, all prosthetic valves showed regular, echocardiographically confirmed, function. The mean follow up was 38.6 days (range: 8-106 days). Mitral valve replacement (p = 0.005) was shown to be a significant risk factor for minor bleeding, but not for thromboembolism. None of the other risk factors reached significance when testing for minor bleeding or major thromboembolic events. CONCLUSION: Within the special setting of postoperative cardiac surgery, this modified anticoagulation protocol appears feasible and safe, with efficacy equivalent to that of full-dose protocols reported elsewhere using either low-molecular-weight or unfractionated heparin. By using this protocol, the effort required to bridge patients to effective oral anticoagulation was greatly reduced as there was no requirement for repeated laboratory measurements and dose adjustments. A prospective multi-center study should be conducted to confirm the hypothesis that the first bridging period after prosthetic heart valve replacement with extracorporeal circulation is different, and permits the use of a bridging protocol with a lower anticoagulation dose.


Subject(s)
Anticoagulants/therapeutic use , Aortic Valve/surgery , Cardiovascular Surgical Procedures , Heart Valve Prosthesis , Mitral Valve/surgery , Thromboembolism/prevention & control , Aged , Anticoagulants/adverse effects , Dose-Response Relationship, Drug , Enoxaparin/adverse effects , Enoxaparin/therapeutic use , Female , Heparin, Low-Molecular-Weight/adverse effects , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Male , Outcome Assessment, Health Care , Postoperative Care , Retrospective Studies , Thromboembolism/physiopathology , Vitamin K/antagonists & inhibitors
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