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myocardial ischemic disease

Cosmo Godino, Antonio Colombo, Alberto Margonato
Heart rate is an established prognostic marker for longevity and is an important contributor in the pathophysiology of various cardiovascular diseases, including ischemic heart disease and heart failure. Most ischemic episodes are triggered by an increase in heart rate, which causes an imbalance between myocardial oxygen delivery and consumption. In addition, increased heart rate is a modifiable risk factor for chronic heart failure. Ivabradine, an inhibitor of If ion channels, is an approved second-line anti-ischemic drug for the treatment of angina...
October 21, 2016: Clinical Drug Investigation
Dongkyu Kim, Sook Hee Ku, Hyosuk Kim, Ji Hoon Jeong, Minhyung Lee, Ick Chan Kwon, Donghoon Choi, Sun Hwa Kim
Gene therapy is aimed at selectively knocking up or knocking down the target genes involved in the development of diseases. In many human diseases, dysregulation of disease-associated genes is occurred concurrently: some genes are abnormally turned up and some are turned down. In the field of non-viral gene therapy, plasmid DNA (pDNA) and small interfering RNA (siRNA) are suggested as representative regulation tools for activating and silencing the expression of genes of interest, representatively. Herein, we simultaneously loaded both siRNA (Src homology region 2 domain-containing tyrosine phosphatase-1 siRNA, siSHP-1) for anti-apoptosis and pDNA (hypoxia-inducible vascular endothelial growth factor expression vector, pHI-VEGF) for angiogenesis in a single polymeric nanocarrier and used to synergistically attenuate ischemia-reperfusion (IR)-induced myocardial infarction, which is mainly caused by dysregulating of cardiac apoptosis and angiogenesis...
October 17, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Marc P Bonaca, Mark A Creager, Jeffrey Olin, Benjamin M Scirica, Ian C Gilchrist, Sabina A Murphy, Erica L Goodrich, Eugene Braunwald, David A Morrow
OBJECTIVES: The aim of this study was to determine whether the reduction in peripheral revascularization with vorapaxar in patients with peripheral artery disease (PAD) is directionally consistent across indications, including acute limb ischemia, progressively disabling symptoms, or both. BACKGROUND: The protease-activated receptor-1 antagonist vorapaxar reduces peripheral revascularization in patients with PAD. METHODS: The TRA 2°P-TIMI 50 (Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-Thrombolysis in Myocardial Infarction 50) trial randomized 26,449 patients with histories of myocardial infarction, stroke, or symptomatic PAD to vorapaxar or placebo on a background of standard therapy...
October 24, 2016: JACC. Cardiovascular Interventions
Kongkiat Chaikriangkrai, Ghanshyam Palamaner Subash Shantha, Hye Yeon Jhun, Patompong Ungprasert, Gardar Sigurdsson, Faisal Nabi, John J Mahmarian, Su Min Chang
STUDY OBJECTIVE: Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients. Recent studies also indicate that CACS may accurately risk stratify stable patients presenting to the emergency department (ED) with acute chest pain; however, many were underpowered. The purpose of this systematic review and meta-analysis is to evaluate the prognostic value and accuracy of a zero (normal) CACS for identifying patients at acceptable low risk for future cardiovascular events who might be safely discharged home from the ED...
October 10, 2016: Annals of Emergency Medicine
Wojciech Kosmala, Aleksandra Rojek, Monika Przewlocka-Kosmala, Leah Wright, Andrzej Mysiak, Thomas H Marwick
BACKGROUND: Impaired functional capacity is a hallmark of patients with heart failure with preserved ejection fraction (HFpEF). Despite the association of HFpEF with reduced myocardial compliance attributed to fibrosis, spironolactone has not been shown to alter outcomes-perhaps reflecting the heterogeneity of underlying pathological mechanisms. OBJECTIVES: The authors sought to identify improvement in exercise capacity with spironolactone in the subset of patients with HFpEF with exercise-induced increase in ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e') reflecting elevation of left ventricular (LV) filling pressure...
October 25, 2016: Journal of the American College of Cardiology
Yang Li, Jian Li, Zhiwen Hou, Yang Yu, Bo Yu
The primary physiological function of Krüppel-like zinc-finger transcription factor (KLF5) is the regulation of cardiovascular remodeling. Vascular remodeling is closely related to the amelioration of various ischemic diseases. However, the underlying correlation of KLF5 and ischemia is not clear. In this study, we aim to investigate the role of KLF5 in myocardial ischemia reperfusion (IR) injury and the potential mechanisms involved. Cultured H9C2 cells were subjected to oxygen-glucose deprivation/reperfusion (OGD/Rep) to mimic myocardial IR injury in vivo...
October 17, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Anastasia Mihailidou, Anthony Ashton
OBJECTIVE: Myocardial infarction (MI) continues to be a major burden of disease, despite rapid reperfusion interventions. Reperfusion of ischemic hearts (reperfusion injury) induces free radical generation, activation of early stress responses and apoptosis, which contributes to ventricular remodeling and dysfunction, which may lead to developing heart failure. Mineralocorticoid receptor (MR) antagonists have been shown clinically to reduce blood pressure, particularly in resistant hypertension, and substantially increase survival in heart failure...
September 2016: Journal of Hypertension
Michael Olsen, Sara Greve, Marie Blicher, Ruan Kruger, Thomas Sehestedt, Susanne Rasmussen, Julie Vishram, Pierre Boutouyrie, Stephane Laurent
OBJECTIVE: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular (CV) risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pressure and previously published equations. The aim of this study was to investigate whether ePWV could predict CV events independently of traditional cardiovascular risk factors and/or cfPWV...
September 2016: Journal of Hypertension
Juhwan Noh, Jungwoo Sohn, Jaelim Cho, Changsoo Kim, Dong Chun Shin
OBJECTIVE: Epidemiological studies have been published acute or chronic adverse association between ambient particulate matter and cardiovascular/respiratory diseases. Recently, there has been increased interest in investigating the role of fine particulate matter on major adverse cardiovascular event (MACE). For the long-term effects, the external validity of studies has rarely been satisfied due to the representativeness of cohorts. The aim of this study was to investigate the potential impact of fine particulate matter long-term exposure on MACE, defined as time to incidence of acute myocardial infarction, ischemic stroke, hemorrhagic stroke, or death due to cardiovascular cause...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
Craig Anderson, Doug McEvoy, Jiguang Wang
OBJECTIVE: There is uncertainty over whether treatment of obstructive sleep apnea (OSA) can prevent serious cardiovascular (CV) events. DESIGN AND METHOD: SAVE (NCT00738179; ACTRN12608000409370) was designed to determine whether treatment of OSA with CPAP reduces the risk of serious CV events in patients with established CV disease. Participants were centrally randomised to CPAP treatment or usual care between 2008 and 2013,with follow-up completed late 2015 and the results will be announced in August 2016...
September 2016: Journal of Hypertension
Madhumita Chatterjee, Meinrad Gawaz
Platelet membrane bedecked with a wide array of receptors offers a platform to regulate platelet responsiveness, thrombotic propensity, inflammatory disposition, and immune reactivity under diverse pathophysiological conditions. Ectopic proteolytic cleavage of such receptors irreversibly inactivates receptor-mediated intracellular signaling governing cellular functions, further releases soluble fragments into circulation which might modulate functions of target cells. Glycoprotein VI-(GPVI) is a membrane glycoprotein expressed in platelets and megakaryocytes...
October 18, 2016: Platelets
Liming Yu, Chongxi Fan, Zhi Li, Jian Zhang, Xiaodong Xue, Yinli Xu, Guolong Zhao, Yang Yang, Huishan Wang
Stress hyperglycemia is commonly observed in patients suffering from ischemic heart disease. It not only worsens cardiovascular prognosis but also attenuates the efficacies of various cardioprotective agents. This study aimed to investigate the protective effect of melatonin against myocardial ischemia-reperfusion (MI/R) injury in acute hyperglycemic state with a focus on Notch1/Hes1/Akt signaling and intracellular thioredoxin (Trx) system. Sprague-Dawley rats were subjected to MI/R surgery and high glucose (HG, 500 g/L) infusion (4 ml/kg/h) to induce temporary hyperglycemia...
October 18, 2016: Journal of Pineal Research
Cheng Sun, Heng Zhang, Zhe Zheng
PURPOSE OF REVIEW: The efficacy and safety of β-blockers in the treatment of cardiovascular diseases, such as ischemic heart disease, cardiac arrhythmias, and heart failure, have been well established for decades. In this article, we review the current opinions on the application of β-blockers for secondary prevention in patients undergoing coronary artery bypass grafting (CABG) surgery. RECENT FINDINGS: As the average age of patients treated surgically for coronary artery disease (CAD) is increasing, it is not uncommon to have candidates for CABG presenting with concomitant atrial fibrillation, heart failure or hypertension, most of which were caused by excessive activation of the adrenergic nervous system...
November 2016: Current Opinion in Cardiology
E D'Elia, P Ferrero, C Vittori, A Calabrese, V Duino, S Perlini, M Senni
Athletes may have electrocardiogram (ECG) repolarization abnormalities during stress test suggestive for ischemia in the absence of ischemic coronary artery disease, often in a setting of myocardial septum hypertrophy. Global longitudinal strain (GLS) might be altered in these athletes compared to hypertensive patients with the same degree of septal thickness. About 735 consecutive athletes were screened for mandatory assessment of fitness to participate in competitive sports. At the stress test, 23 (19 M, 4 F) were found to have ECG repolarization abnormalities suggestive for ischemia in the presence of normal coronary vessels...
October 17, 2016: Scandinavian Journal of Medicine & Science in Sports
Jennifer Gile, Tobias Eckle
Cardiovascular disease is the number one cause of death worldwide. A powerful strategy for cardioprotection would be to identify specific molecules or targets that mimic ischemic preconditioning (IP), where short non-lethal episodes of ischemia and reperfusion prior to myocardial infarction result in dramatic reduction of infarct sizes. Since 1960 researchers believed that adenosine has a strong cardio-protective potential. In fact, with the discovery of cardiac IP in 1986 by Murry et al., adenosine was the first identified molecule that was used in studying the underlying mechanism of IP...
2016: Journal of Nature and Science
Omer Akyol, Sumeyya Akyol, Chu-Huang Chen
Endothelial cells (EC) respond to injury by releasing numerous factors, including von Willebrand factor (VWF). High circulating levels of unusually large VWF multimers (UL-VWFM) have strong procoagulant activity and facilitate platelet adhesion and aggregation by interacting with platelets after an acute event superimposed on peripheral arterial disease and coronary artery disease. ADAMTS13-a disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13-regulates a key physiological process of coagulation in the circulation by cleaving VWF multimers into small, inactive fragments...
October 13, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Laura Policardo, Giuseppe Seghieri, Paolo Francesconi, Roberto Anichini, Flavia Franconi, Stefano Del Prato
OBJECTIVE: Women with diabetes have a greater excess risk for cardiovascular diseases (CVD) than men. This study was aimed at clarifying whether this effect is lifelong or more evident in some life-periods. METHODS: The effect of diabetes and gender on the risk of first ever hospitalization for acute myocardial infarction (AMI), ischemic stroke (IS), congestive heart failure (CHF), lower extremity amputations (LEA) or any of these major cardiovascular events (MACE) have been evaluated by a Cox-hazard model, over years 2008-2012 querying administrative databases of a cohort living in Tuscany, Italy...
September 30, 2016: Journal of Diabetes and its Complications
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