Pre-heart failure at 2D- and 3D-speckle tracking echocardiography: A comprehensive review.

Chronic heart failure (CHF) has different stages and includes pre-HF (PHF), a state of high risk of developing myocardial dysfunction and advanced CHF. Some major behavioral risk factors of PHF might predispose to biological risk factors such as obesity, diabetes mellitus, dyslipidemia, hypertension, myocardial infarction, and cardiomyopathy. These risk factors damage the myocytes leading to fibrosis, apoptosis, cardiac hypertrophy, along with alterations in cardiomyocyte' size and shape. A condition of physiological subcellular remodeling resulting into a pathological state might be developed, conducting to PHF. Both PHF and heart failure (HF) are associated with the activation of phospholipases and protease, mitochondrial dysfunction, oxidative stress and development of intra-cellular free Ca2+  [Ca2+ ]i overloading to an elevation in diastolic [Ca2+ ]i . Simultaneously, cardiac gene expression is activated leading to further molecular, structural and biochemical changes of the myocardium. The sub-cellular remodeling may be intimately involved in the transition of cardiac hypertrophy to heart failure. 2D- and 3D-speckle tracking echocardiography (STE) have been used to quantify regional alterations of longitudinal strain and area strain, through their polar projection, which permits a further assessment of both sites and degrees of myocardial damage. The examination of strain can identify sub-clinical cardiac dysfunction or cardiomyocyte remodeling. During remodeling of the myocardium cardiac strain is attenuated, therefore it is an indicator of disease assessment.

Effects of empagliflozin on proinflammatory cytokines and other coronary risk factors in patients with type 2 diabetes mellitus: A single-arm real-world observation.

OBJECTIVE: This single-arm real-world observation aims to examine the effects of empagliflozin (EMPA) on coronary risk factors among subjects with known diabetes. MATERIALS AND METHODS: Records of 63 subjects with type 2 diabetes mellitus, receiving EMPA were drawn for this study. Of 63 patients with diabetes, 6 were excluded, and the remaining 57 received EMPA (25 mg/day) for 24 weeks. Clinical data, dietary intakes, and physical activity were assessed by validated questionnaires. RESULTS: Treatment with EMPA was associated with significant decline in fasting and 2-hour post-prandial blood glucose and Hb1c indicating that this agent has potential antidiabetic effects. Pro-inflammatory cytokines; C-reactive protein, TNF-α, and interleukin-6 showed significant reduction after treatment with EMPA, compared to baseline levels. Apart from these changes, parameters of oxidative stress, thiobarbituric acid reactive substances, malondialdehyde, and diene conjugates as well as uric acid, showed a significant decline with an increase in antioxidant vitamins A, E, and C and beta-carotene as well as nitrite. There was a significant decline in serum uric acid, systolic and diastolic blood pressures, and angiotensin-converting enzyme (ACE), with a non-significant reduction in body weight and body mass index as well as in waist circumference of modest significance, after intervention of 12 weeks compared to baseline levels. Total cholesterol, VLDL cholesterol and triglycerides showed non-significant decline compared to baseline levels. CONCLUSION: It is possible that EMPA administration can cause a significant decline in pro-inflammatory cytokines along with blood glucose, Hb1c, oxidative stress, uric acid, blood pressures, and ACE with an increase in antioxidant vitamins and nitrite. Randomized, controlled intervention trials would be necessary to confirm our findings.

Effect of the consumption of a food based on fruits and natural additives in patients with cardiovascular risk / Efecto del consumo de un alimento con base de frutas y aditivos naturales en pacientes con riesgo cardiovascular

Background: cardiovascular diseases (CVD), a group of disorders of the heart and blood vessels are the main cause of morbidity and mortality worldwide. Strategies for its prevention have been proposed, such as modifying life habits, including increasing the consumption of fruits and vegetables associated with the decrease in the probability of suffering CVD. Objective: to evaluate the effects of a base compote of guava (Psidium guajava) and passion fruit (Passiflora ligularis) on blood pressure and metabolic and inflammatory biomarkers in hypertensive type two diabetic patients. Methods: food characterization test (microbiological, proximal, sensorial, antioxidant activity and total phenols). The compote was administered for 21 days to 8 adults (30 to 65 years old); glycaemia, blood pressure, inflammatory markers, and BMI and waist circumference before and after the intervention were measured. Results: the sensory test showed: 66% acceptance and all attributes a value >3, indicating that it was well evaluated. The microbiological aspects comply with the safety for human consumption and nutritionally it stands out that the contribution of carbohydrates (12.3%) is adequate for these patients. The hydrophilic ORAC value was 98.570 µmol ET/g sample. In the patients at the end of the study, a statistically significant decrease in systolic blood pressure was observed (127 mmHg, p 0.041) and the pro-inflammatory markers TNFα, IL-1ß and IL6 (31.9 pg/mL, p 0.012, 31.9 pg/mL, p 0.012, and 3.5 pg/mL, p 0.017 respectively) and glycaemia increase (157.5 mg/dL, p 0.036). Conclusions: the medium-term consumption of a compote based on guava, passion fruit, cinnamon and flaxseed oil improves systolic blood pressure and the proinflammatory markers TNFα, IL-1ß and IL6 in diabetic and hypertensive patients

Antecedentes: las enfermedades cardiovasculares (ECV), conjunto de trastornos del corazón y los vasos sanguíneos son la principal causa de morbilidad y mortalidad en todo el mundo. Se han propuesto estrategias para su prevención como modificar los hábitos de vida, incluyendo aumentar el consumo de frutas y verduras asociadas con la disminución en la probabilidad de sufrir ECV. Objetivo: evaluar los efectos de una compota base de guayaba (Psidium guajava) y granadilla (Passiflora ligularis) en la presión arterial y biomarcadores metabólicos e inflamatorios en pacientes diabéticos tipo 2 hipertensos. Métodos: caracterización del alimento prueba (análisis microbiológico, proximal, sensorial, actividad antioxidante y fenoles totales). Se suministró la compota durante 21 días a 8 adultos (30 a 65 años), se midió glicemia, presión arterial, marcadores inflamatorios, IMC y perímetro de cintura antes y después de la intervención. Resultados: la prueba sensorial mostró: 66% de aceptación, y todos los atributos un valor >3, indicando que fue bien evaluado. Los aspectos microbiológicos cumplen con la inocuidad para consumo humano y nutricionalmente se destaca que el aporte de carbohidratos (12,3%) es adecuado para estos pacientes. El valor ORAC hidrofílico fue 98,570 µmol ET/g muestra. En los pacientes al final del estudio se observó disminución estadísticamente significativa de la presión arterial sistólica (127 mm Hg; p 0,041) y los marcadores proinflamatorios TNFα, IL-1ß e IL6 (31,9 pg/mL, p 0,012; 31,9 pg/mL, p 0,012; y 3,5 pg/mL, p 0,017, respectivamente) e incremento de la glicemia (157,5 mg/dL, p 0,036). Conclusión: el consumo a mediano plazo de una compota a base de guayaba, granadilla, canela y aceite de linaza mejora la presión arterial sistólica y los marcadores pro inflamatorios TNFα, IL-1ß e IL6 en pacientes diabéticos e hipertensos.