bluuebunny/crossref_metadata_2025_split huggingface dataset:
ET-1 Plasma Levels During Cold Stress Test in Sclerodermic Patients
Authors: Danese Chiara , Parlapiano Claudio , Zavattaro Emilia , Di Prima MariaAnna , Campana Elisabetta , Rota Cinzia , Tonnarini Gianfranco , Di Siena GianLuca , Borgia M.C. 
Published: July 2008

Endothelial cell injury in blood vessels of small arteries and capillaries is considered the primary event in the pathogenesis of systemic sclerosis (SSc). Because endothelin-1 (ET-1) is mainly released in the site of endothelial cell damage, thereby inducing a potent vasoconstriction, it was our intention to study ET-1 release in a group of SSc patients during a cold pressor test (CPT). Twelve SSc patients and a control group of 10 healthy subjects underwent CPT. Blood samples for ET-1 assay were collected at 90 and 180 seconds of exposure to cold stress. Heart rate and blood pressure were recorded at the same intervals. A capillaroscopic examination was performed in both groups before and after CPT. We observed significantly higher levels of plasma ET-1 in SSc patients compared with those of the control group at baseline (P=0.007) and at 90 (P=0.006) and 180 seconds (P=0.03) of CPT. During the test, the capillaroscopic examination showed a dramatic worsening of the vascular picture that was parallel to the increase in ET-1 plasma levels. This suggests that higher ET-1 plasma levels can have a part in the acute vascular reac tivity of SSc patients undergoing CPT.
The Coronary Angiogenetic Effect of Heparin: Experimental Basis and Clinical Evidence
Authors: Bombardini Tonino , Picano Eugenio , Bombardini Tonino 
Published: July 2008

Heparin is a highly sulfated polysaccharide consisting of a repeating disaccharide structure as found in other glycosaminoglycanes. The intravenous and subcutaneous formulation of the drug is routinely used for its well-known, time-honored antithrombotic effect. However, available evidences linking heparin to angiogenesis raise the possibility of a therapeutically relevant antiischemic effect of the drug. Molecular biology data show that in a hypoxic milieu heparin could facilitate angiogenesis through interactions with a family of polypeptide growth factor mitogens that stimulate endothelial cell prolifera tion. Experimental data suggest that heparin can augment collateral circulation when combined with other potentially angiogenetic factors, such as repeated ischemia, coronary occlusion, or physical exercise. Clinical data, although very initial, encompassing a total of only 41 heparin-treated patients with coronary artery disease, suggest that heparin facilitates collateral development stimulated by exercise-induced myocardial ischemia in humans. According to the heparin-collateral hypothesis, the mechanism of action of heparin as an antiischemic medication would be independent of its anticoagulant action. The molecular targets of heparin are Factor Xa and IIa for antithrombotic action, heparin- binding growth factors (including fibroblast growth factor and vascular endothelial growth factor) for angiogenesis. The antithrombotic effect is not linked to a cellular target, whereas the angiogenetic effect directly stimulates endothelial cells. The molecular cofactor required for effect is antithrombin III for antithrombosis, and possibly endogenous adenosine for angiogenesis. The therapeutic effect is achieved within minutes or hours for antithrombosis, and within weeks or months for angiogenesis.
Vasoconstriction During Acute Hypervolemic Hemodilution in Hypertensive Patients is Not Prevented by Calcium Blockade
Authors: Wysocki Marian , Andersson Ove K. , Persson Bengt , Bagge Ulf 
Published: July 2008

The reduction of blood viscosity by moderate acute hypervolemic hemodilution in untreated hypertensives can be associated with a secondary vasoconstriction. The aim of this study was to examine whether a vasodilating therapy prevents this hemodynamic reaction. Twelve hypertensive patients (WHO stage II) were treated with the vasoselective calcium channel blocker isradipine in a placebo-controlled, double-blind, crossover study. Acute hypervolemic hemodilution was performed twice: at the end of the placebo period and after two months of treatment. Hemodilution was achieved by the intravenous infusion of 1000 mL saline over a 10- to 15-minute period. Arterial blood pressure, heart rate, cardiac output (dye dilution), renal blood flow, glomerular filtration, natriuresis, hemat ocrit, whole blood, and plasma viscosity were assessed before and after infusion. Flow resis tance and vascular hindrance in the central and renal circulation were calculated. Acute hemodilution associated with a significant reduction of blood (P<0.01) and plasma (P<0.01) viscosity did not influence the mean arterial pressure and cardiac output. Consequently, the total flow resistance remained unchanged. However, as a result of hemodilution, the calculated vascular hindrance index in the systemic circulation increased, indicating a vasoconstrictive reaction, both with placebo (from 5.22 to 6.07 U x mPa-1 x s-1, P < 0.05) and during chronic treatment with calcium blockade (from 3.75 to 4.22 U x mPa-1 x s-1, P<0.02). Vasoconstriction was not observed in the renal circula tion, either during the placebo or active treatments. The results of this study indicate that the systemic vasoconstriction evoked by the acute moderate hypervolemic hemodilution in hypertensive patients was not prevented by a calcium channel blockade.
Plasma Leukocyte Elastase Concentration and Coronary Artery Disease
Authors: Koşar Feridun , Varol Ercan , Ayaz Selime , Kütük Emine , Oguzhan Abdurrahman , Diker Erdem 
Published: July 2008

It has previously been shown that leukocyte elastase is involved in the pathogenesis of atherosclerosis. Few studies have addressed the relation between leukocyte elastase concentrations and coronary artery disease (CAD). The authors investigated (1) the clinical significance of leukocyte elastase determi nation in the diagnosis of CAD and (2) the relation between plasma leukocyte elastase concentration and lesion morphology. The study included 185 subjects (140 men, 45 women) who underwent coronary angiography during investigation of chest pain; 135 had coronary stenosis (Group I) and 50 had nonstenotic coronaries (Group II). Among Group I patients, those with simple atheromatous plaques were distinguished from those with complex plaques. Elastase concentrations in Group I were greater than in Group II (57.1 ± 1.16 μg I-1 vs 27.6 ± 1.0 μg I-1, P < 0.001), and greater in complex plaque patients than in those with simple plaques (64.5 ± 1.24 μg I- 1 vs 45.9 ±1.01 μg I-1, P < 0.001 ) . Logistic regression analysis showed (1) that elastase concentration, age, and sex had independent value for prediction of CAD and (2) that among Group I patients, the risk of complex plaques was greatest for those with high elastase concentration. These results suggest that plasma leukocyte elastase concentration is a sensitive diag nostic marker of CAD and that high values of elastase may indicate the presence of complex atheromatous plaques.
Evaluation of Polarographic Measurements of Basal Muscle Oxygen Tension in Type I Diabetic Patients
Authors: Maisch Christine , Hofmann Valerie , Benda Norbert , Luft Dieter 
Published: July 2008

Microcirculatory changes occur early in insulin-dependent diabetes mellitus (IDDM) and are believed to be an early feature of late diabetic complications, leading to reduced oxygen pressure and hypoxia in the skin and other tissues. Whether muscle oxygen supply is also altered is unknown. Therefore, the authors analyzed polarographic measurements of muscle oxygen tension in 44 healthy type I diabetic patients (mean age 28 years; mean diabetes duration 7 years) and in 57 healthy controls, matched for age, sex, and body mass index, and the corresponding influencing factors. Two measurements were taken at rest 60 minutes apart in the anterior tibial muscle. Muscle oxygen tensions did not differ between IDDM patients and controls (23.0 ±8.6 vs 25.3 ±9.0 mmHg) and were reproducible on repeated measurements (25.3 ±9.7 vs 25.5 ± 7.4 mmHg). Coefficients of variation were 13.5 ±10.8% in IDDM patients and 13.1 ±9.3% in controls. Compared with controls, in IDDM patients hemoglobin A1c (HbA1c) and blood glucose concentrations were elevated, and arterial oxygen pressure was significantly lower. Muscle oxygen tensions were positively correlated with blood glucose concentrations in IDDM patients (Rho=0.48, P=0.002) but not with HbA1c or with insulin concentrations. The authors conclude that the polarographic measurement of muscle oxygen tension is a reliable method with good reproducibility. Hypoxia in the anterior tibial muscle of type I diabetic patients can be excluded. In IDDM patients the level of muscle oxygen tension is correlated with the level of blood glucose concentration.
Use of Nuclear Magnetic Resonance Imaging Angiography to Follow-Up Arterial Remodeling in an Animal Model
Authors: Nikol Sigrid , Esin Serap , Nekolla Stephan , Huehns Tanya Y. , Schirmer Johannes , Schwaiger Markus , Höfling Berthold 
Published: July 2008

Appropriately sized arteries in small animals may be possible models for studying the remodeling process as occurs after arterial balloon injury in humans. Magnetic resonance imaging (MRI) is able to noninvasively image tissue in vivo. To date, small animal angiog raphy models have mostly used research-dedicated instruments and resolution, which are not universally available. Experiments were carried out on a rat aorta model of remodeling in vivo (n=40). Arteries were injured by oversized balloon dilation; control arteries were uninjured. Angiography imaging was performed immediately before sacrifice with an unmodified clinical MRI unit, a 1.5 Tesla MR tomograph with a 20-cm-diameter coil. Longitudinal MRI pictures of the aorta and morphometry of tissue sections to measure luminal and arterial wall areas were analyzed with use of computer-assisted techniques. Comparison of dimensions demonstrated correlation between MRI and histology measurements of the lumen. MRI and morphometry showed a gradual increase in mean luminal area over 6 weeks following injury. The lumen increase correlated with total arterial area and thickness. In this rat aorta model, remodeling documented at histology was followed-up in vivo. The use of such clinical MRI scanners has potential to reduce animal numbers needed to follow-up the remodeling process after therapeutic intervention.
Tortuosity, Kinking, and Coiling of the Carotid Artery: Expression of Atherosclerosis or Aging?
Authors: Del Corso Laura , Moruzzo Daniela , Conte Biagio , Agelli Maria , Romanelli Anna Maria , Pastine Fabrizio , Protti Mariangela , Pentimone Ferdinando , Baggiani Giovanni 
Published: July 2008

The etiology of carotid abnormalities is both congenital than acquired. The aim of this study was to clarify the role of aging and atherosclerosis in the acquired cases, and the role of these abnormalities in hemodynamic alterations and neurologic symptoms. Over a 1-year period the authors studied all the subjects undergoing carotid exami nation by continuous-wave and color-coded Doppler sonography at an Angiology Unit. They evaluated neurologic symptoms; risk factors for atherosclerosis; number, sites, and kinds of carotid abnormalities; atherosclerotic lesions; stenosis; hemodynamic alterations of the carotid; and other localizations of atherosclerotic diseases. There were 469 subjects: 272 (58%) with abnormalities (group 1) and 197 (42%) without abnormalities (group 2). The total number of abnormalities was 479 (104 tortu osities, 262 kinkings, and 113 coilings). The abnormalities were more prevalent in the elderly (P<0.001) and in women (P< 0.001). In group 1 they found significant preva lences of hyperlipemia (P<0.001), hypertension (P<0.01), chronic cigarette smoking (P<0.01), and ischemic heart disease (P<0.05). (continued on next page) Carotid atherosclerotic lesions were more prevalent in group 1 than in group 2 (P<0.001); among the patients with atherosclerotic carotid lesions, those in group 1 were older than those in group 2 (P<0.001). Tortuosity seemed to be associated with fewer hemodynamic alterations. The authors conclude that atherosclerosis, hypertension, and aging may play an important role in producing carotid abnormalities. The aging seemed more important than atherosclerosis. Only a prospective study of patients with carotid abnormalities and no atherosclerotic lesion will clarify the role of hemodynamics and neurologic symptomatology.
Comparison of the Three Different Formulas for Doppler Estimation of Pulmonary Artery Systolic Pressure
Authors: Abaci Adnan , Kabukcu Mehmet , Övünç Kenan , Tokgözoğglu Lale , Tarrach Münir , Batur Mustafa Kemal , Aksöyek Serdar 
Published: July 2008

Noninvasive pulmonary artery systolic pressure (PASP) is calculated by summing the right ventricular systolic pressure obtained from Doppler velocity of regurgitant flow through the tricuspid valve and the right atrial (RA) pressure. The RA pressure is generally assumed from different formulas. An accurate RA pressure estimation will add precision to PASP calculation. One of the methods to estimate RA pressure is the inferior vena cava collapsibility index (IVCCI) . In 45 patients referred for right heart catheteri zation, the authors tested a formula for the calculation of PASP based on the estimation of RA pressure from IVCCI and compared this method with two other formulas. The first method (method 1) assumed a constant RA pressure of 10 mm Hg irre spective of right ventricular pressure. The formula used was Doppler gradient + 10 (mm Hg). In the second method (method 2), a clinical estimate of RV pressure was made from the formula: right ventricular-right atrial Doppler gradient x 1.1 + 14. In the third method (method 3), the patients were classified into three groups on the basis of IVCCI: group A, IVCCI greater than 45%; group B, IVCCI between 35% and 45%; and group C, IVCCI less than 35%. The formula used was Doppler gradient + 6, 9, or 16 mm Hg in the presence of normal (group A), moderately reduced (group B), or markedly reduced (group 3) IVCCI. A good correlation between Doppler and catheter measurements of PASP was found for methods 1, 2, and 3, respectively (r=0.8933, SEE=6.4, r=0.8921, SEE=7.0, and r=0.8989, SEE=6.7). Correlation between invasive and noninvasive PASP was similar with the three methods, but correlation in method 2 was less satisfactory than with the other two methods. The mean difference between Doppler-derived and hemodynamic PASP was also high in method 2. In conclusion, the result of this study validates a relatively new, simple echo-Doppler formula for Doppler estimation of PASP based on a noninvasive evaluation of RA pressure through the IVCCI. However, this method is not better than the traditional method 1 for noninvasive PASP estimation.
Erythrocyte Passive Potassium Flux is Increased in Patients with Ischemic Coronary Disease (ICD) and in Subjects with Family History of ICD
Authors: Saitta Antonino , Saitta Michele N. , Bonaiuto Michele , Castaldo Maria , Sardo Adriana , Imbalzano Egidio , Cinquegrani Maurizio , Squadrito Francesco , Hannaert Patrick A. 
Published: July 2008

Background. It has been proposed that ischemic coronary disease (ICD) associated potassium loss could be due to modifications of potassium permeability. We investigated whether a positive family history of ICD can influence this parameter. We have compared potassium permeability in erythrocytes from ICD patients and from positive family history subjects (FICD) with control subjects. Methods. All patients and subjects were carefully selected for the absence of hypertension and dysmetabolic pathologies. ICD group: 24 patients (19 males, 5 females; ages 43 to 69) all affected by ischemic coronary disease, under no drug treatment; FICD group: 18 subjects (all males, ages 27 to 42) with a verified positive ICD family history, without hypertensive family history and cardiovascular pathology; control group: 16 subjects (11 males, 5 females; ages 28 to 48) without positive family history of ICD. Passive potassium efflux (PPE) was spectrophotometrically measured in K-free medium containing ouabain and bumetanide. The kinetic constant was calculated by dividing PPE by the erythrocyte potassium concentration. Results. No statistically significant differences were noted between the intracellular potassium content of the three groups. However, (1) the passive potassium permeability of the ICD group was significantly higher (kK=0.055 ±0.021 h-1, n=24) than that of the control group (kK=0.023 ±0.008 h-1, n=16; p<0.00001), (2) the FICD group was higher (kK=0.036 ±0.012 h-1, n=18) than the control group (p<0.001), and (3) the ICD group was higher than the FICD group (p<0.001). Conclusions. Our results suggest an inheritability of ICD, paralleling the familial aggre gation of the pathology. Erythrocyte potassium permeability could represent an early marker of ischemic coronary disease and be used as a prophylactic tool.
Insulin Resistance, Hyperinsulinemia, and Hypertriglyceridemia in Patients with Coronary Artery Disease Independent of Obesity
Authors: Alexopoulos Dimitris K. , Kyriazopoulou Venetsana E. , Vagenakis Apostolos G. , Psyrogiannis A. 
Published: July 2008

Insulin resistance and hyperinsulinemia both in normal persons and those with non- insulin dependent diabetes mellitus (NIDDM) (type 2 diabetes) appears to be related to obesity. It seems also that insulin plays a role in modulating the obesity-related factors (eg, hyperinsulinemia, hyperglycemia, hypertension, hypertriglyceridemia, hypercholes terolemia, low concentrations of high-density lipoprotein cholesterol) and takes its place among the many risk factors for coronary artery disease (CAD) associated with obesity. Insulin resistance and hyperinsulinemia could play the same role in pathogenesis of CAD independently of obesity. The authors determined blood glucose and immunoreactive insulin and plasma triglyceride concentrations in the fasting state at 60 and 120 minutes after a glucose load of 75 g in 68 patients (54 men, 14 women) with angiographic evidence of CAD and in 65 healthy volunteers matched to the patients for age, gender, and body mass index (43 men and 22 women). Patients with CAD and the healthy volunteers were categorized as obese (body mass index ≥ 26 kg/m2) and nonobese (body mass index < 26 kg/m2) . Four groups of subjects were analyzed: Group A included 40 healthy (28 men and 12 women) nonobese volunteers; group B, 25 healthy (15 men and 10 women) obese volunteers; group C, 39 (30 men and 9 women) nonobese patients with CAD; and group D, 29 (24 men and 5 women) obese patients with CAD. Fasting and postchallenged 60- and 120-minute glucose values were similar in groups A and C. However, significantly higher insulin values (mU/L) were observed in group C than in group A during fasting (12.2 ±6.2 vs 91 ±3, p<0.05), and postchallenged at 60 minutes (103.1 ± 53.2 vs 71.9 ±64.3, p < 0.01 ) and 120 minutes (5 7.9 ± 41.2 vs 44.9 ±41.3, p < 0.01 ) . Fasting glucose and insulin values were similar in groups B and D. However, significantly higher glucose (mg/dL) and insulin values were observed in group D than in group B postchallenged at 60 and 120 minutes: glucose at 60 minutes (188.7 ±45.1 vs 154.2 ±37.5, p<0.05); insulin at 60 minutes (127.5 ±98.5 vs 112.1 ±81.1, p < 0.05); glucose at 120 minutes (124.2 ±46.1 vs 99.5 ±28.9, p < 0.05); insulin at 120 minutes (86.1 ± 5 7.6 vs 62.8 ± 27.9, p < 0.05) . The glucose and insulin values during 60- and 120-minute fasting as well as postchallenged were similar in groups B and C. Significantly higher plasma triglyceride concentrations were observed in group C than in group A (149.0 ±64.1 vs 114.6 ±46.6, p < 0.01 ) and in group D compared with group B (229.4 ± 104. 7 vs 144.9 ±65.1, p < 0.001. Plasma triglyceride concentrations were similar in groups B and C. The authors conclude that patients with documented CAD are insulin resistant inde pendently of obesity.
Clinical Characteristics in Japanese Patients with Coexistent Hypertrophic Cardiomyopathy and Coronary Vasospasm
Authors: Hamada Mareomi , Kazatani Yukio , Matsuzaki Keisuke , Murakami Eiki , Shigematsu Yuji , Hiwada Kunio , Kodama Koji 
Published: July 2008

There are only a few reports concerning coexistent hypertrophic cardiomyopathy (HCM) and vasospastic angina. Clinical characteristics in patients with both diseases have not been clarified yet. This study was designed to elucidate the relationship between chest pain and coronary vasospasm in HCM patients and to delineate clinical characteristics in patients with both HCM and coronary vasospasm. First, 36 patients with HCM underwent acetylcholine provocation test for coronary vasospasm and were divided into two groups on the basis of presence or absence of coronary vasospasm. Next, the following risk factors for coronary artery disease were compared between the two groups: hypertension, smoking, hyperlipidemia, diabetes mellitus, and hyperuricemia. Coronary vasospasm was induced in 10 (28%) of 36 patients with HCM. There were no significant differences in age and male gender between the two groups. Smoking was more prominent in HCM patients with than without coronary vasospasm (80% vs 35%, p<0.05), but there were no differences in the prevalence of other risk factors between the two groups. In conclusion, coronary vasospasm appears to play a significant role in the etiology of myocardial ischemia in Japanese patients with HCM, and smoking might be a major risk factor for coexistence of HCM and coronary vasospasm.
Effect of Moxonidine and Cilazapril on Microcirculation as Assessed by Finger Nailfold Capillaroscopy in Mild-to-Moderate Hypertension
Authors: Martina Benedict , Surber Christian , Jakobi Clemens , Sponagel Lucas , Gasser Paul 
Published: July 2008

Disorders in peripheral microcirculation are observed in arterial hypertension and may be improved by antihypertensive treatment. In this pilot study the authors measured capillary blood cell velocity in the finger nailfold in 14 patients (mean age 50 ± 14 years, range 30-71 years; 9 men, 5 women) with mild-to-moderate essential hypertension. After a 3-week placebo period, patients received double-blind randomized treatment with either 0.2- to 0.4-mg moxonidine (n=7) or 2.5- to 5.0-mg cilazapril (n=7). Finger nailfold video capillaroscopy was performed at baseline and after 8 weeks of treatment. Blood pressure was measured by conventional office technique. Capillary blood cell velocity, 1 minute after local finger cooling, increased in the Moxonidine group (0.65 ±0.53 mm/sec to 1.13 ±0.77 mm/sec; p<0.05) after 8 weeks treatment compared to the baseline. The increase in the Cilazapril group from 0.79 ±0.45 mm/sec to 0.93 ±1.03 mm/sec did not reach a level of statistical significance. Blood pressure decreased from 151 ±8/101 ± 5 to 147 ±6/98 ± 7 mmHg in the Moxonidine group and from 164 ± 12/102 ±6 to 140 ±9/93 ±9 mmHg in the cilazapril group. Moxonidine increased nailfold capillary blood cell velocity 1 minute after local finger cooling in patients with mild-to-moderate hypertension. This improvement of the peripheral microcirculation may be associated with reversal of vascular dysfunction in hypertension.