Serial assessment of arterial structure and function in patients with coarctation of the aorta undergoing stenting.

Stenting for CoA has become an acceptable treatment modality in the last 20 years. However little is known about arterial changes after this procedure. To assess arterial structure and function including peripheral reactivity and stiffness and intima-media thickness (IMT) pre and post stenting for coarctation of the aorta (CoA). Twenty-one patients [median age: 15 years (8-39)] were studied at baseline, 1 day, 6 months and 1 year after stenting. Twenty-one healthy subjects (1:1 matched) were used as controls. Left ventricular (LV) mass, ejection fraction, flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) of left brachial artery, common carotid (CC) and right subclavian artery (RSCA) IMT and pulse wave velocity (PWV) were assessed by echocardiography and vascular ultrasound. CoA patients had higher LV indexed mass (p < 0.0001), impaired FMD (p < 0.0001) and NMD (p < 0.0001), increased PWV (p < 0.0001), carotid and RSCA IMT (both p < 0.0001). All procedures were successful and resulted in significant gradient reduction (p < 0.001). One year after stenting there was improvement in LV function (p = 0.034) and although there was significant reduction of LV mass (103.29 ± 24.77 vs. 74.39 ± 22.07 g/m(2), p < 0.0001) values did not normalize. There was no significant change in FMD, NMD, PWV and CC or RSCA IMT. In patients with CoA, arterial reactivity is impaired and LV mass, arterial stiffness and thickness are increased. Although stenting is successful to relieve the obstruction resulting in better LV function and mass reduction, arterial structure and function remains abnormal after 1 year of follow-up.

Serial assessment of arterial structure and function in patients with coarctation of the aorta undergoing stenting

Stenting for CoA has become an acceptable treatment modality in the last 20 years. However little is known about arterial changes after this procedure. To assess arterial structure and function including peripheral reactivity and stiffness and intima-media thickness (IMT) pre and post stenting for coarctation of the aorta (CoA). Twenty-one patients [median age: 15 years (8-39)] were studied at baseline, 1 day, 6 months and 1 year after stenting. Twenty-one healthy subjects (1:1 matched) were used as controls. Left ventricular (LV) mass, ejection fraction, flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) of left brachial artery, common carotid (CC) and right subclavian artery (RSCA) IMT and pulse wave velocity (PWV) were assessed by echocardiography and vascular ultrasound. CoA patients had higher LV indexed mass (p < 0.0001), impaired FMD (p < 0.0001) and NMD (p < 0.0001), increased PWV (p < 0.0001), carotid and RSCA IMT (both p < 0.0001). All procedures were successful and resulted in significant gradient reduction (p < 0.001). One year after stenting there was improvement in LV function (p = 0.034) and although there was significant reduction of LV mass (103.29 ± 24.77 vs...

Is intake of vitamin D and calcium important for cardiovascular health in elderly obese patients?

There is compelling evidence that bariatric weight loss reduces cardiovascular complications; however, these still tend to be the most common cause of late death after surgical intervention. In a prospective cohort study, correlations of dietary nutrients with indexes of vascular health were sought, with emphasis on vitamin D and calcium. Clinically stable obese outpatient subjects (>60 years old, N = 44) were interviewed about dietary macro and micronutrients. Nutritional assessment targeted anthropometric and bioimpedance analysis (BIA), hematologic counts, lipid profile, glucose homeostasis, and inflammatory markers. Carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD), along with related vascular measurements, were documented, and results were correlated by uni- and multivariate analysis, corrected for known risk factors. IMT, FMD, and also brachial basal flow were positively influenced by vitamin D (P < 0.001). Calcium appeared beneficial for brachial basal flow only (P = 0.010). No association with IMT occurred, and a negative result for FMD was elicited. Also, vitamins A and B12 were advantageous for FMD, whereas iron was deleterious for IMT. Intake of many micronutrients including calcium and vitamin D did not meet recommendations. Vitamin D displayed a beneficial profile regarding vascular health, and more attention to this nutrient should be given, especially concerning obese patients with cardiometabolic risk. Calcium exhibited less straightforward results but deserves focus as well, along with antioxidant vitamin A as well as the B-complex which were mostly deficient in this experience.

A study on biological control of six fresh water snails of medical and veterinary importance.

This study evaluated the molluscicidal effect of Commiphora mnolmol oil extract (Myrrh), on control of six fresh water snails (Lymnaea natalensis, Bulinus truncatus, Biomphalaria alexandrina, Physa acuta, Melania tuberculata and Cleopatra bulimoides). Also, the extract effect on the egg masses of L. natalensis, B. truncatus, B. alexandrina and Ph. acuta was evaluated. Snails and egg masses were exposed at 16-20 degrees C to various concentrations (conc.). LD50 after 24 hours expo-sure were 264/132, 283/195, 230/252, 200/224, 241/246 & 241/246 ppm for young/adult of L. natalensis, B. truncatus, B. alexandrina, Ph. acuta, M. tuberculata and C. bulimnoides respectively. LDtoo after 24 hours exposure were 400/400 for L. natalensis, B. truncatus, B. alexandrina, M. tuberculata and C. bulimoides, and 300/300 for Ph. acuta. Also, complete mortality (100%) was achieved for the egg masses of L. natalensis, B. truncatus, B. alexandrina and Ph. acuta at concentrations of 300, 200, 300 & 400 ppm respectively. Lower concentrations gave the same results after longer exposure. LD100 of C. molmol oil extract (Myrrh) had a rapid lethal effect on the six snail species and their egg masses in high conc. of 300 & 400 ppm. Commiphora molmol is a promising plant to be included with the candidate plant molluscicides. The oil extract of this plant showed a remarkable molluscicidal activity against used snail species.

Helobdella nilae and Alboglossiphonia conjugata leeches as biological agents for snails control.

The efficacy of leeches, as biological agents, in control of snail intermediate hosts of schistosomiasis (Bulinus truncatus, Biomphalaria alexandrina) and fascioliasis (Lymnaea natalensis) as well as their effect on the non-target snails Physa acuta, Melanioides tuberculata and Cleopatra bulimoides was evaluated. Two glossiphoniid snail leeches, Helobdella nilae and Alboglossiphonia conjugata were used. They destroyed egg masses and young snails more rapidly than adult ones. H. nilae showed a stronger destructive effect than A. conjugata. In a descending order, it preferred L. natalensis followed by B. truncatus, B. alexandrina, Ph. acuta, M. tuberculata and lastly C. bulimoides. But, A. conjugata preferred L. natalensis followed by B. truncatus, Ph. acuta, M. tuberculata, B. alexandrina and lastly C. bulimoides. The detailed diagnostic morphology and biology of the two leeches were given.

Effects of soy germ isoflavones and hormone therapy on nitric oxide derivatives, low-density lipoprotein oxidation, and vascular reactivity in hypercholesterolemic postmenopausal women.

OBJECTIVE: To evaluate the effects of soy germ isoflavones and hormone therapy on vascular reactivity, the formation of nitric oxide derivatives, and lipid peroxidation in hypercholesterolemic postmenopausal women. DESIGN: Women were treated with soy germ, 17beta-estradiol or 17beta-estradiol + noretisterone acetate for 3 months after taking placebo for 1 month. The plasma concentrations of nitrite + nitrate and S-nitrosothiols were evaluated by gaseous phase chemiluminescence; nitrotyrosine, electronegative low-density lipoprotein, and estradiol levels were determined by enzyme-linked immunosorbent assay; cholesterol oxides and isoflavones were determined by gas chromatography and high-performance liquid chromatography, respectively. Vascular reactivity was analyzed by high-resolution ultrasonography. RESULTS: Soy germ isoflavones and hormone therapy induced a decrease in nitrite + nitrate, electronegative low-density lipoprotein, and cholesterol oxides, as well as an increase in S-nitrosothiols. Soy germ isoflavones lowered electronegative low-density lipoprotein, and cholesterol oxides more efficiently than did hormone therapy. Only soy isoflavones inhibited nitrotyrosine formation. A significant improvement of vascular reactivity was only seen in women treated with 17beta-estradiol. CONCLUSIONS: The soy germ isoflavones and 17beta-estradiol, alone or associated with noretisterone acetate, in the doses and forms used here, have similar effects on the bioavailability of nitric oxide. Soy germ treatment inhibited lipid peroxidation more effectively than hormone therapy.

Effects of soy germ isoflavones and hormone therapy on nitric oxide derivatives, low-density lipoprotein oxidation, and vascular reactivity in hypercholesterolemic postmenopausal women

Objective: To evaluate the effects of soy germ isoflavones and hormone therapy on vascular reactivity, the formation of nitric oxide derivatives, and lipid peroxidation in hypercholesterolemic postmenopausal women. Design: Women were treated with soy germ, 17A-estradiol or 17A-estradiol + noretisterone acetate for 3 months after taking placebo for 1 month. The plasma concentrations of nitrite + nitrate and S-nitrosothiols were evaluated by gaseous phase chemiluminescence; nitrotyrosine, electronegative low-density lipoprotein, and estradiol levels were determined by enzymelinked immunosorbent assay; cholesterol oxides and isoflavones were determined by gas chromatography and high-performance liquid chromatography, respectively. Vascular reactivity was analyzed by high-resolution ultrasonography. Results: Soy germ isoflavones and hormone therapy induced a decrease in nitrite + nitrate, electronegative low-density lipoprotein, and cholesterol oxides, as well as an increase in S-nitrosothiols. Soy germ isoflavones lowered electronegative low-density lipoprotein, and cholesterol oxides more efficiently than did hormone therapy. Only soy isoflavones inhibited nitrotyrosine formation. A significant improvement of vascular reactivity was only seen in women treated with 17A-estradiol. Conclusions: The soy germ isoflavones and 17A-estradiol, alone or associated with noretisterone acetate, in the doses and forms used here, have similar effects on the bioavailability of nitric oxide. Soy germ treatment inhibited lipid peroxidation more effectively than hormone therapy.

Progesterone abolishes estrogen and/or atorvastatin endothelium dependent vasodilatory effects / Progesterone abolishes estrogen and/or atorvastatin endothelium dependent vasodilatory effects

This double blind randomized placebo controlled study assessed the effects of atorvastatin, estradiol and norethisterone, isolated and in combination, on the lipid profile and on vascular reactivity, in post-menopausal women with hypercholesterolemia and arterial hypertension. Ninety-four women aged 50–65 were selected. All have received dietary counseling (4 weeks), placebo (4 weeks), and drug therapy (12 weeks): 17- estradiol 2mg/day (E) (n = 17); E + norethisterone acetate 1 mg/day (P) (n = 18); torvastatin 10 mg/day (A) (n = 20); E + A (n = 21) and E + P + A (n = 18). All treatment modalities have significantly reduced total cholesterol (TC) (E = 8.8%, E + P = 10.1%, A = 27.9%, A + E = 29.4% and E + P + A = 35.7%) and LDL-cholesterol (LDL-c) levels (E + P + A = 46.6%, E + A = 45.9%, A = 40.2%, E = 20.3%, and E + P = 12.1%). As concerns HDL-cholesterol (HDL-c), Groups E and E + A had increases of 15.5% and 13.1%, respectively. The addition of a progesterone compound reduced its concentration (Group E + P = −9.1%, and Group E + P + A = −9.5%). By random, approximately half of the patients in each group were designated to the endothelial function evaluation (brachial artery ultrasound). We observed that in Group A (n = 10), in Group E (n = 10) and with the association (Group E + A) (n = 7), there was a significant increase in the flow-mediated vasodilatation as compared to basal measurements. The addition of a progestin has annulled these benefits. Conclusions: Atorvastatin has promoted more beneficial effects on TC and LDL-c, whereas estradiol was responsible for an increase in HDL-c. The addition of a progesterone derivative abolished these benefits. Atorvastatin, estradiol or both together improved endothelial function, an effect suppressed by the addition of norethisterone.

Progesterone abolishes estrogen and/or atorvastatin endothelium dependent vasodilatory effects.

UNLABELLED: This double blind randomized placebo controlled study assessed the effects of atorvastatin, estradiol and norethisterone, isolated and in combination, on the lipid profile and on vascular reactivity, in post-menopausal women with hypercholesterolemia and arterial hypertension. Ninety-four women aged 50-65 were selected. All have received dietary counseling (4 weeks), placebo (4 weeks), and drug therapy (12 weeks): 17-beta estradiol 2mg/day (E) (n=17); E + norethisterone acetate 1mg/day (P) (n=18); Atorvastatin 10mg/day (A) (n=20); E + A (n=21) and E + P + A (n=18). All treatment modalities have significantly reduced total cholesterol (TC) (E=8.8%, E + P=10.1%, A=27.9%, A + E=29.4% and E + P + A=35.7%) and LDL-cholesterol (LDL-c) levels (E + P + A=46.6%, E + A=45.9%, A=40.2%, E=20.3%, and E + P=12.1%). As concerns HDL-cholesterol (HDL-c), Groups E and E + A had increases of 15.5% and 13.1%, respectively. The addition of a progesterone compound reduced its concentration (Group E + P=-9.1%, and Group E + P + A=-9.5%). By random, approximately half of the patients in each group were designated to the endothelial function evaluation (brachial artery ultrasound). We observed that in Group A (n=10), in Group E (n=10) and with the association (Group E + A) (n=7), there was a significant increase in the flow-mediated vasodilatation as compared to basal measurements. The addition of a progestin has annulled these benefits. CONCLUSIONS: Atorvastatin has promoted more beneficial effects on TC and LDL-c, whereas estradiol was responsible for an increase in HDL-c. The addition of a progesterone derivative abolished these benefits. Atorvastatin, estradiol or both together improved endothelial function, an effect suppressed by the addition of norethisterone.