Immunometabolic and Vascular Health Responses among High Endurance Trained Subjects.

In this study, we aimed to examine the impact of high endurance training on vascular health parameters and immune-endocrine responses against modified low-density lipoprotein (LDL) particles. This observational, cross-sectional study included high endurance-trained and healthy non-trained subjects. Vascular ultrasound was used to assess vascular health parameters based on carotid intima-media thickness and endothelial function (flow-mediated dilation). Enzyme-linked immunosorbent assays were used to measure interleukin (IL)-8 and IL-10, autoantibody isotypes anti-oxidized LDL (oxLDL) and anti-apolipoprotein B (ApoB-D) peptide. Plasma levels of the corticosterone and 17 α-hydroxyprogesterone hormones were analyzed by mass spectrometry. This study enrolled 96 subjects, of whom 44 were high endurance trained and 52 were healthy non-trained individuals. Smaller carotid intima-media thickness values were observed in the high-endurance trained than in the healthy non-trained males, while no differences were observed between female groups. Flow-mediated dilation measurements did not differ by training or sex. The humoral immune responses to IgG anti-oxLDL and IgM anti-ApoB-D autoantibodies showed an isotype imbalance between the high-endurance trained and the non-trained groups. Immunoendocrine parameters showed inverse correlations between 17 α-hydroxyprogesterone concentrations and carotid intima-media thickness measurements. Direct correlations were found between IL-10 concentrations and flow-mediated dilation measurements. Chronic high-endurance exercise modulates immune-endocrine and vascular health parameters, in a sex-dependent manner.

Cardiovascular Safety of Azithromycin in Patients Hospitalized With COVID-19: A Prespecified Pooled Analysis of the COALITION I and COALITION II Randomized Clinical Trials.

The cardiovascular safety from azithromycin in the treatment of several infectious diseases has been challenged. In this prespecified pooled analysis of 2 multicenter randomized clinical trials, we aimed to assess whether the use of azithromycin might lead to corrected QT (QTc) interval prolongation or clinically relevant ventricular arrhythmias. In the COALITION COVID Brazil I trial, 667 patients admitted with moderate COVID-19 were randomly allocated to hydroxychloroquine, hydroxychloroquine plus azithromycin, or standard of care. In the COALITION COVID Brazil II trial, 447 patients with severe COVID-19 were randomly allocated to hydroxychloroquine alone versus hydroxychloroquine plus azithromycin. The principal end point for the present analysis was the composite of death, resuscitated cardiac arrest, or ventricular arrhythmias. The addition of azithromycin to hydroxychloroquine did not result in any prolongation of the QTc interval (425.8 ± 3.6 ms vs 427.9 ± 3.9 ms, respectively, mean difference -2.1 ms, 95% confidence interval -12.5 to 8.4 ms, p = 0.70). The combination of azithromycin plus hydroxychloroquine compared with hydroxychloroquine alone did not result in increased risk of the primary end point (proportion of patients with events at 15 days 17.2% vs 16.0%, respectively, hazard ratio 1.08, 95% confidence interval 0.78 to 1.49, p = 0.65). In conclusion, in patients hospitalized with COVID-19 already receiving standard-of-care management (including hydroxychloroquine), the addition of azithromycin did not result in the prolongation of the QTc interval or increase in cardiovascular adverse events. Because azithromycin is among the most commonly prescribed antimicrobial agents, our results may inform clinical practice. Clinical Trial Registration: NCT04322123, NCT04321278.

Stent composition and immune response after long-term coronary angioplasty.

Background: There are limited data about the influence of stent composition on immune responses after percutaneous coronary intervention (PCI). Objective: The aim was to compare the effects of PCI with conventional cobalt-chromium bare metal stent (BMS) and drug-eluting stent (DES) implantation on the modulation of humoral and cellular immune responses. Methods: A randomised, single-centre, open pilot study involving patients with stable coronary artery disease eligible for PCI was performed. Blood samples were collected from the peripheral artery (PA) and the coronary sinus (CS) at baseline and 40 weeks following PCI. IgM and IgG autoantibodies (Abs), anti-oxLDL and anti-ApoB-D, as well as cytokine levels were evaluated by enzyme-linked immunosorbent assay. Results: A total of 30 patients of 60 years mean age were included, 68% of whom were men. At the nine-month follow-up, a modulation in the levels of cytokines and autoantibodies was observed in both stent type groups. However, no difference was observed in the modulation of these markers between stents. Conclusion: The stent type promotes modulations in cellular and humoral immune responses in the long-term, with differences in the magnitude of effects in specific immune responses.

Phytosterol consumption and markers of subclinical atherosclerosis: Cross-sectional results from ELSA-Brasil.

BACKGROUND AND AIMS: Phytosterol (PS) consumption is associated with lower total and LDL-cholesterol (LDL-c) concentrations, but its impact on cardiovascular risk is unclear. This study assessed the effect of usual intake of PS on markers of subclinical atherosclerosis in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS AND RESULTS: This cross-sectional study included 2560 participants of ELSA-Brasil, aged 48 (43-54) years, with available food frequency questionnaires (FFQ), coronary artery calcium (CAC) scores, carotid intima media thickness (cIMT), and carotid-femoral pulse wave velocity (cf-PWV), at baseline. Several logistic and linear regression models were used, and significance level was set at a P < 0.05. Mean values (SD) for PS consumption were 256 (198) mg/day, CAC 22.78 (110.54) Agatston Units, cf-PWV 9.07 (1.60) m/s and cIMT 0.57 (0.12) mm. PS consumption in Q4 was associated with lower total- and LDL-c levels, and with higher percentiles of cf-PWV (P < 0.001). Proportion of subjects in Q4 of PS consumption was 1.5 times higher among individuals in cf-PWV Q4, than in Q1 (P = 0.002, for comparisons among quartiles). There was a trend (P = 0.003) for higher cf-PWV with higher PS intake. In crude logistic and linear regressions, PS intake was associated with cf-PWV. In the adjusted models, these associations disappeared. No associations were found between PS and cIMT or CAC. CONCLUSIONS: In this large and apparently healthy cross-sectional sample from ELSA-Brasil, usual PS consumption was associated with lower total- and LDL-cholesterol, but not with markers of subclinical atherosclerosis.

Beneficial effects of green banana biomass consumption in patients with pre-diabetes and type 2 diabetes: a randomised controlled trial.

Diabetes mellitus is a global epidemic, characterised as a heterogeneous group of metabolic disorders associated with high risk of CVD. Green banana biomass, which is composed of resistant starches (RS) and cannot be hydrolysed by amylases, delays gastric emptying and modulates insulin sensitivity, thus contributing to improve metabolic disorders. The aim of the present study was to investigate the effects of consumption of RS from green banana biomass on body composition, fasting plasma glucose, glycated Hb (HbA1c) and homeostasis model assessment of insulin resistance in subjects with pre-diabetes or type 2 diabetes on top of treatment. Middle-aged subjects (n 113) of both sexes with pre-diabetes (HbA1c: 5·7-6·4 %) or diabetes (HbA1c ≥ 6·5 %) were randomised to receive nutritional support plus green banana biomass (40 g) (RS: approximately 4·5 g, G1, n 62) or diet alone (G2, n 51) for 24 weeks. Body composition, biochemical analyses and dietary intake were evaluated at the beginning and end of the study. In the experimental group (G1), consumption of RS was associated with reduction in HbA1c (P = 0·0001), fasting glucose (P = 0·021), diastolic blood pressure (P = 0·010), body weight (P = 0·002), BMI (P = 0·006), waist and hip circumferences (P < 0·01), fat mass percentage (P = 0·001) and increase in lean mass percentage (P = 0·011). In controls (G2), reductions were observed in waist and hip circumferences (P < 0·01), HbA1c (P = 0·002) and high-density lipoprotein-cholesterol (P = 0·020). In pre-diabetes or diabetes, non-significant differences were observed in the percentage reduction in HbA1c and fasting glucose in exploratory analyses. Our results indicate that the consumption of bioactive starches is a good dietary strategy to improve metabolic control and body composition.

Fatores de risco cardiovascular em mulheres da associação de obesos do município de Ponta Grossa-PR / Analysis of cardiovascular risk factors in women from the obese association from Ponta Grossa-PR

Introdução: O excesso de peso e o acúmulo de gordura corporal na região abdominal estão entre os mais importantes fatores de risco para doença cardiovascular, pois aumentam diretamente ou indiretamente o fator de doença arterial cardiovascular e dislipidemia. Objetivo: O presente estudo tem como objetivo investigar os fatores de risco cardiovascular em mulheres obesas integrantes de uma Associação de Obesos do município Ponta Grossa, Paraná. Métodos: A amostra foi composta de 16 mulheres obesas com idade média 46,4±8,9 anos. Variáveis antropométrica, como massa corporal e estatura para verificação do índice de massa corporal (IMC), juntamente com a circunferência abdominal (CA) foram mensuradas. As variáveis bioquímicas plasmáticas analisadas foram low density protein (LDL), high density lipoprotein (HDL), triglicerídeos totais (TRIG), colesterol total e glicemia de jejum. Resultados: A avaliação antropométrica apresentou osvalores médios à estatura de 153,7 ± 11,5 cm, massa corporal 97,2 ± 17,3 kg, IMC 41,39 ± 8,4 Kg/m2, CA 114 ±11,3cm; os resultados bioquímicos apresentaram níveis plasmáticos médios de LDL 100,3 ± 25,5mg/dl, HDL54,7 ± 11,1mg/dl, TRIG 156,3 ± 91,9mg/dl, colesterol total 191,3 ± 41,9mg/dl, GLI 159,1 ± 59,9mg/dl. Analisando as médias das variáveis TRIG, GLI e CA, verifica-se que o grupo apresenta valores médios acima dos recomendados, e destes valores observa-se seis indivíduos apresentando hipertrigliceridemia, cinco apresentando síndrome metabólica, cinco apresentando HDL abaixo do recomendado, todos os indivíduos apresentando CA superiores ao sugerido e em cinco indivíduos a concomitância de valores alterados em mais de um parâmetro. Conclusão: Deste modo, conclui-se que a obesidade andrógena pode trazer alterações no metabolismo de lipides revela-se necessário uma intervenção terapêutica a fim de reduzir estes fatores de risco, de modo a proporcionar uma melhor qualidade de vida a estes indivíduos...

Introduction: Overweight and excess of fat accumulation in the abdominal region is among the most important risk factors for cardiovascular disease, increasing directly or indirectly the coronary artery disease factor and dyslipidemia. Objective: The present study aims at investigating the cardiovascular risk factors in obese women assisted by an Obese Association from Ponta Grossa, Paraná. Methodology: The sample consisted of 16 obese women. Their mean age was 46.4 + 8.9 years. Anthropometric variables such as body mass and body height for body mass index (BMI), along with the abdominal circumference (AC) were analysed. Plasma biochemical variables such as low density protein (LDL), high density lipoprotein (HDL), total triglycerides(total-TG), total cholesterol (total-TC), and fasting glucose were also analysed. Results: The anthropometric evaluation showed the following: height 153,7 + 11,5 cm, weight 97,2 + 17,3 Kg, body mass index (BMI) 41,39 + 8,4 Kg/m2, abdominal circumference (AC) 114 + 11,3 cm. Biochemical results showed the following mean serum levels: LDL 100,3 + 25,5 mg/dl; HDL 54,7 + 11,1 mg/dl; total triglycerides (total-TG) 156,3 + 91,9 mg/dl; total cholesterol 191,3 + 41,9 mg/dl; and fasting glucose (GLI) 159,1 + 59,9 mg/dl. Analyzing the mean of the following variables total-TG, GLI, and AC, we noticed that the group presents mean values above therecommended parameters; of these values, six patients had hypertriglyceridemia five had metabolic syndrome; and in five HDL was lower than the normal levels; all the individual had AC above the suggested parameter, and five individuals had altered values in more than one parameter concomitantly. Conclusion: Thus, it was concluded that the androgenic obesity might cause modifications in lipid metabolism and reveal the need of a therapeutic intervention to reduce or to stabilize these risk factors, providing a better quality of life to these patients with physical activity programs or use of medicine...

Enhanced interictal responsiveness of the migraineous visual cortex to incongruent bar stimulation: a functional MRI visual activation study.

Since visual aura is usually described as expanding zigzag lines, neurones involved with the perception of line orientation may initiate this phenomenon. A visual incongruent line stimulation protocol was developed to obtain functional magnetic resonance images (fMRI) interictally in 5 female migraine patients with typical fortification spectra and in 5 normal matched controls. Activation in the visual cortex was present contralateral to the side of stimulation in 4 of 5 patients, notably in the extrastriate visual cortex. In 4 of 5 controls activation was observed in the medial and anterior orbitofrontal cortex. In one of them additional activation at the right nucleus accumbens/ventral striatum and right ventral pallidum was present. In the remaining control subject activation was present in the left primary visual cortex. The enhanced interictal reactivity of the visual cortex in migraineurs supports the hypothesis of abnormal cortical excitability as an important pathophysiological mechanism in migraine aura, though the role of specific regions of the visual cortex remains to be explored.