Levels of Consumption, Satisfaction and Symptoms Relating to Two Types of Meals with Modified Texture in Dysphagic Subjects (P01-004-19)

Abstract Objectives This study investigated levels of consumption, satisfaction and symptoms between patients given one of two texture modified models, (i) smoothed dishes prepared traditionally in a kitchen (CF), and (ii) homogenized meals obtained from dehydrated and rehydrated instantaneous preparations by means of special equipment (OI). Methods The study is an observational cohort of 30 patients aged between 41–81 years old with complex disability, intellectual disabilities, dysmorphism and medium-gravity dysphagia, and psychiatric, neurological, gastroenterological and endocrine comorbidities. Fifteen patients were fed the OI menu, and 15 were fed the CF menu. Follow-up was assessed at 2- and -4 months. Dissatisfaction scores were investigated using a modified Chernoff's scale based on three levels of smiles (the higher the score, the higher the dissatisfaction). Consumption of daily meals (breakfast, lunch, snack, dinner) and aquagel were recorded. Symptoms scoring (0–14) has been built by counting the occurrence of symptoms on a weekly basis (0 = never/absences of symptoms; 1 = one symptom per week; 3 = one to two symptoms per week; 10 = one to two symptoms per day; 14 = always). Statistical analysis was performed using R. Results Over the entire follow-up period (4 months), mean levels of consumption are significantly higher in the OI group in comparison to the CF group (p-values < 0.001), and dissatisfaction significantly lower (p-values < 0.001). This is also evident when analysis is stratified by meal occasion. Analysis of trends over time identified a clear tendency toward improved consumption and greater satisfaction. Significantly lower symptom scores are always evident in the OI group in comparison to the CF group. Conclusions Analysis of levels of consumption, dissatisfaction scoring and symptoms scoring shows that patients receiving the modified homogenized instantaneous meal (OI) have overall higher consumption levels, greater satisfaction, and less symptoms than patients receiving traditionally prepared smoothed dishes (CF). Funding Sources Zeta Research S.r.l.

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Metabolic and Nutritional Effects of Two Types of Meals with Modified Texture in Feeding Dysphagic Subjects (P01-003-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz028.p01-003-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Dario Gregori ◽

Samir Giuseppe Sukkar ◽

Mario Diurni ◽

Laura Formenti ◽

Megan French ◽

...

Keyword(s):

Nutritional Status ◽

Phase Angle ◽

Substantial Improvement ◽

Anthropometric Parameters ◽

Special Equipment ◽

Feeding Method ◽

Funding Sources ◽

Time Restrictions ◽

Complex Disability ◽

Dysphagic Patients

Abstract Objectives Long-term hospice dysphagic patients are at risk of malnutrition, often not wanting to consume meals. Difficulties in preparing meals for these patients can include variability in manually prepared recipes, the need for varied and appetizing menus and dishes, and time restrictions for administering food. This study investigated two feeding models, (i) smoothed dishes prepared traditionally in a kitchen (CF), and (ii) meals obtained from dehydrated and rehydrated preparations by means of special equipment (OI). Methods The study is an observational cohort of 30 patients aged between 51–81 years old with complex disability, intellectual disabilities, dysmorphism and medium-gravity dysphagia, and psychiatric, neurological, gastroenterological and endocrine comorbidities. Fifteen patients were fed the OI menu, and 15 were fed the CF menu. Follow-up was assessed at 2- and -4 months. Changes in anthropometric parameters and in nutritional status were assessed. Results BCI phase angle was significantly lower in patients with OI than in CF subjects. Patients differed also in terms of body composition, showing a BCI significantly lower with lean and fat mass in the OI group. In addition, body water was significantly higher in the CF group. Conclusions The instantaneous homogenized feeding method produces a substantial improvement in nutritional status in comparison to traditional smoothed meals, especially with regards to protein framework and phase angle in OI. Funding Sources ZETA RESEARCH S.r.l.

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Anticoagulation after VA-ECMO decannulation, providing new insights

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.168 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

A Maestro-Benedicto ◽

A Duran-Cambra ◽

M Vila-Perales ◽

J Sans-Rosello ◽

J Carreras-Mora ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Cardiogenic Shock ◽

Anticoagulation Therapy ◽

Thromboembolic Events ◽

Bleeding Events ◽

Membrane Oxygenation ◽

Funding Sources ◽

Va Ecmo ◽

A Prospective Study

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential tool for the management of refractory cardiogenic shock. Little is known about the incidence of thromboembolic events after V-A ECMO decannulation, although some studies report a high incidence of cannula-related venous thrombosis after venovenous extracorporeal membrane oxygenation (VV-ECMO). Due to this fact, in our institution anticoagulation therapy is systematically prescribed for at least 3 months after VA-ECMO per protocol. AIM The main objective of this study was to explore the feasibility of 3-month anticoagulation therapy after VA-ECMO decannulation. METHODS We performed a prospective study that included 27 consecutive patients who were successfully treated with VA-ECMO in a medical ICU between 2016 and 2019 and were prescribed 3-month anticoagulation therapy per protocol after decannulation. Exclusion criteria was dying on ECMO or while on the ICU. Data analysis included demographics, mean days on ECMO, 3-month survival, and thromboembolic and bleeding events (excluding immediate post-decannulation bleeding, since anticoagulation was prescribed 24h after). RESULTS Our cohort consisted mainly of men (N = 21, 78%), with a mean age of 60 ± 11 years and a mean time on VA-ECMO of 8 ± 3 days, who primarily suffered from post-cardiotomy cardiogenic shock (N = 9, 34%) or acute myocardial infarction (N = 6, 23%). 5 patients (18%) received a heart transplant. Regarding anticoagulation, 15 patients (60%) had other indications apart from the protocol, like incidental thrombus diagnosis (N = 7, 26%) or valve surgery (N = 5, 18%). Anticoagulation therapy was not feasible in 1 patient (4%) with severe thrombopenia. No patients had severe or life-threatening bleeding events in the follow-up, although 8 patients (30%) had bleeding events, mainly gastrointestinal bleeding (N = 4, 15%), requiring withdrawal of anticoagulation in 1 patient. The incidence of thromboembolic events was 7%; two patients with low-risk pulmonary embolisms. During the 3-month follow-up survival rate was 95%. CONCLUSIONS This is the only study to date addressing the strategy of 3-month anticoagulation therapy after VAECMO, showing it is feasible and safe and may be helpful in reducing or ameliorate thromboembolic complications in the follow-up, although it is not exempt of complications. Abstract Figure. Kaplan-Meier survival analysis

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Prevalence and Course of IgA and IgG Antibodies against SARS-CoV-2 in Healthcare Workers during the First Wave of the COVID-19 Outbreak in Germany: Interim Results from an Ongoing Observational Cohort Study

Healthcare ◽

10.3390/healthcare9050498 ◽

2021 ◽

Vol 9 (5) ◽

pp. 498

Author(s):

Mark Reinwald ◽

Peter Markus Deckert ◽

Oliver Ritter ◽

Henrike Andresen ◽

Andreas G. Schreyer ◽

...

Keyword(s):

Cohort Study ◽

Healthcare Workers ◽

Significant Proportion ◽

Clinical Signs ◽

Signs And Symptoms ◽

Observational Cohort Study ◽

Igg Antibodies ◽

University Hospitals ◽

Observational Cohort

(1) Background: Healthcare workers (HCWs) are prone to intensified exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the ongoing pandemic. We prospectively analyzed the prevalence of antibodies against SARS-CoV-2 in HCWs at baseline and follow up with regard to clinical signs and symptoms in two university hospitals in Brandenburg, Germany. (2) Methods: Screening for anti-SARS-CoV-2 IgA and IgG antibodies was offered to HCWs at baseline and follow up two months thereafter in two hospitals of Brandenburg Medical School during the first wave of the COVID-19 pandemic in Germany in an ongoing observational cohort study. Medical history and signs and symptoms were recorded by questionnaires and analyzed. (3) Results: Baseline seroprevalence of anti-SARS-CoV-2 IgA was 11.7% and increased to 15% at follow up, whereas IgG seropositivity was 2.1% at baseline and 2.2% at follow up. The rate of asymptomatic seropositive cases was 39.5%. Symptoms were not associated with general seropositivity for anti-SARS-CoV-2; however, class switch from IgA to IgG was associated with increased symptom burden. (4) Conclusions: The seroprevalence of antibodies against SARS-CoV-2 was low in HCWs but higher compared to population data and increased over time. Screening for antibodies detected a significant proportion of seropositive participants cases without symptoms.

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Diastolic dyssynchrony in patients with LV only fusion pacing CRT without RV lead

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.034 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

A Gurgu ◽

L Petrescu ◽

C Vacarescu ◽

CT Luca ◽

C Mornos ◽

...

Keyword(s):

Lateral Wall ◽

Positive Outcome ◽

Type I ◽

Exercise Tests ◽

Type Iii ◽

Funding Sources ◽

End Diastolic Volume ◽

Chamber View ◽

Systolic And Diastolic Function

Abstract Funding Acknowledgements Type of funding sources: None. Background CRT improves both systolic and diastolic function, thus increasing cardiac output. However, less data is available concerning diastolic dyssynchrony and fusion pacing CRT. The aim of our study was to assess the outcome of LV diastolic asynchrony in a population of fusion pacing CRT without right ventricular (RV) lead. Methods Prospective data were collected from a cohort of patients (pts) with right atrium/left ventricle leads (RA/LV CRT). Baseline and every 6 months follow-up included standard ETT and classical dyssynchrony parameter measurements. Diastolic dyssynchrony was done by offline speckle-tracking derived TDI timing assesment of the simultaneity of E" and A" basal septal and lateral wall 4 chamber view. New parameters were introduced: E" and respectively A" time (E"T / A"T) as the time difference between E" (respectively A" ) peaks septal and lateral wall. Exercise tests, drugs optimization and device individual programmimg were systematically performed in order to maintain constant fusion and improve CRT response. Patients were divided in three groups: super-responders (SR), responders (R) and non responders (NR). Results Sixty-two pts (35 male) aged 62 ± 11 y.o. with idiopathic DCM implanted with a RA/LV CRT were analyzed: 34%SR / 61%R / 5%NR. Baseline initial characteristics: QRS 164 ± 18 ms; EF 27 ± 5.2; 29% had type III diastolic dysfunction (DD), 63% type II DD, 8% type I DD. Average follow-up was 45 ± 19 months; mean LVEF at the last follow-up was 37 ± 7.9%. The E"T decreased from 90 ± 20 ms to 25 ± 10 ms in SR with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs 243.2 ± 82 ml at baseline, p < 0.0028) and lower LV filling pressures (E/E" 13.2 ± 4.6 vs 11.4 ± 4.5, p =0.0295). DD profile improved in 65% of R with a reduction in E/A ratio (1.46 ± 5.3 vs. 0.82 ± 3.9 at baseline, p= 0.4453). Non-sudden cardiac death occurred in 3 NR pts (2%) with type III DD, severe LA volume and larger E" T /A"T (E"T> 85 msec A"T > 30 msec). Significant cut off value calculated by ROC curve for LV diastolic dyssynchrony is E"T > 80 ms and A"T of > 25 msec. Conclusions Fusion pacing CRT without RV lead showed a positive outcome; improving LV diastolic dyssynchrony in responders and super-responders patients is obvious. Larger randomized studies are needed to define the role of diastolic asynchronism as a predictor of favorable response in fusion pacing. Abstract Figure. Typical TDI patterns in LV fusion pacing

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99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.409 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S179-S180

Author(s):

Thana Khawcharoenporn ◽

Pimjira Kanoktipakorn

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Prophylaxis ◽

Transurethral Resection ◽

Tertiary Care ◽

Multidrug Resistant ◽

Prophylactic Antibiotics ◽

Care Hospital ◽

Extended Spectrum Beta Lactamase ◽

Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

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Trends in cause-specific readmissions in heart failure with preserved versus reduced and mid-range ejection fraction

European Heart Journal ◽

10.1093/ehjci/ehaa946.0952 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

X.T Cui ◽

E Thunstrom ◽

U Dahlstrom ◽

J.M Zhou ◽

J.B Ge ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Temporal Trend ◽

Funding Source ◽

Preserved Ejection Fraction ◽

Readmission Rates ◽

P Values ◽

National Board ◽

Over Time

Abstract Background It remains unclear whether the readmission of heart failure (HF) patients has decreased over time and how it differs among HF with preserved ejection fraction (EF) (HFpEF) versus reduced EF (HFrEF) and mid-range EF (HFmrEF). Methods We evaluated HF patients index hospitalized from January 2004 to December 2011 in the Swedish Heart Failure Registry with 1-year follow-up. Outcome measures were the first occurring all-cause, cardiovascular (CV) and HF readmissions. Results Totally 20,877 HF patients (11,064 HFrEF, 4,215 HFmrEF, 5,562 HFpEF) were included in the study. All-cause readmission was highest in patients with HFpEF, whereas CV and HF readmissions were highest in HFrEF. From 2004 to 2011, HF readmission rates within 6 months (from 22.3% to 17.3%, P=0.003) and 1 year (from 27.7% to 23.4%, P=0.019) in HFpEF declined, and the risk for 1-year HF readmission in HFpEF was reduced by 7% after adjusting for age and sex (P=0.022). Likewise, risk factors for HF readmission in HFpEF changed. However, no significant changes in cause-specific readmissions were observed in HFrEF. Time to the first readmission did not change significantly from 2004 to 2011, regardless of EF subgroup (all P-values>0.05). Conclusions Although the burden of all-cause readmission remained highest in HFpEF versus HFrEF and HFmrEF, a declining temporal trend in 6-month and 1-year HF readmission rates was found in patients with HFpEF, suggesting that non-HF-related readmission represents a big challenge for clinical practice. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions.

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Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽

10.3390/nu13020407 ◽

2021 ◽

Vol 13 (2) ◽

pp. 407

Author(s):

Laetitia Lengelé ◽

Olivier Bruyère ◽

Charlotte Beaudart ◽

Jean-Yves Reginster ◽

Médéa Locquet

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Performance ◽

Community Dwelling ◽

Timed Up And Go ◽

P Values ◽

Student’S T ◽

The Impact ◽

Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

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Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis

Technology and Health Care ◽

10.3233/thc-213062 ◽

2021 ◽

pp. 1-10

Author(s):

Mansour H. Al-Askar ◽

Fahad A. Abdullatif ◽

Abdulmonem A. Alshihri ◽

Asma Ahmed ◽

Darshan Devang Divakar ◽

...

Keyword(s):

Photodynamic Therapy ◽

Null Hypothesis ◽

Gingival Index ◽

P Values ◽

Inflammatory Parameters ◽

Probing Depth ◽

Crestal Bone Loss ◽

Group 3 ◽

Soft Tissue Inflammation

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

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SAT0210 FACTORS ASSOCIATED WITH TIME TO SEVERE LUPUS NEPHRITIS IN A COHORT OF COLOMBIAN PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6282 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1048.2-1048

Author(s):

S. Herrera ◽

J. C. Diaz-Coronado ◽

D. Rojas-Gualdrón ◽

L. Betancur-Vasquez ◽

D. Gonzalez-Hurtado ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Involvement ◽

Classification Criteria ◽

P Value ◽

Systemic Lupus ◽

P Values ◽

Interval Censored ◽

Severe Lupus Nephritis ◽

Age And Sex

Background:Systemic lupus erythematosus (SLE) clinical manifestations, and their severity, vary according to age, ethnicity and socioeconomic status. Both Hispanic and Afro-Americans have a higher incidence and more sever presentation when compared to Caucasian patients with SLEObjectives:To analyze clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed for one year, between January 2015 and December 2018Methods:Retrospective follow-up study based in clinical records. Patients with SLE diagnosis that fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. We included patients with diagnosis of lupus nephritis according to Wallace and Dubois criteria. Patients who did not have at least two follow-up measurements or had a cause of nephritis other than lupus were excluded. The main outcome was defined as time from diagnosis to sever renal involvement defined as creatinine clearance ≤50 ml/min, 24-hour proteinuria ≥3.5 grams o end stage renal disease.We analyzed clinical and immunological characteristics. Descriptive statistical analyses of participant data during the first evaluation are reported as frequencies and percentages for categorical variables, and as medians and interquartile ranges (IQR) for quantitative variables. Age and sex adjusted survival functions and Hazard ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models por interval-censored data. P values < 0.05 were considered statistically significantResults:548 patients were analyzed: 67 were left-censored as they presented renal involvement at entry, 6 were interval censored as outcome occurred between study visits, and 475 were right-censored as involvement was not registered during follow-up. 529 (96.5%) patients were female, median age at entry was 46 (IQR = 23) and median age to diagnosis was 29.5 (IQR = 20.6). 67% were mestizo, 13% Caucasian and 0.3% Afro-Colombian. Age and sex adjusted variables associated with time to severe lupus nephritis were high blood pressure HR = 3.5 (95%CI 2.2-5.6; p-value <0.001) and Anti-RO (per unit increase) HR = 1.002 (95%CI 1.001-1.004; p-value = 0.04). Figure 1 shows age and sex adjusted survival function.Conclusion:In our cohort the appearance of severe lupus nephritis occurs in less than 15% of patients at 10 years. Both high blood pressure and elevated anti-Ro titers were associated with a higher rate of onset in the presentation of severe lupus nephritis, as seen in some polymorphs of anti Ro.References:Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Diego Rojas-Gualdrón: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Santiago Monsalve: None declared, Sebastian Guerra-Zarama: None declared, Juan david Lopez: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ana Sierra: None declared, Deicy Hernandez-Parra: None declared, Ricardo Pineda.Tamayo: None declared

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Acute Stress-Induced Blood Lipid Reactivity in Hypertensive and Normotensive Men and Prospective Associations with Future Cardiovascular Risk

Journal of Clinical Medicine ◽

10.3390/jcm10153400 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3400

Author(s):

Cathy Degroote ◽

Roland von Känel ◽

Livia Thomas ◽

Claudia Zuccarella-Hackl ◽

Jens C. Pruessner ◽

...

Keyword(s):

Essential Hypertension ◽

Cardiovascular Risk ◽

Stress Reactivity ◽

Density Lipoprotein ◽

Blood Lipid ◽

Lipoprotein Cholesterol ◽

Cvd Risk ◽

P Values ◽

D Dimer

Hyperreactivity to stress may be one explanation for the increased risk of cardiovascular disease (CVD) in individuals with essential hypertension. We investigated blood lipid reactivity to the Montreal Imaging Stress Task (MIST), a psychosocial stressor, in hypertensive and normotensive men and tested for prospective associations with biological risk factors. Fifty-six otherwise healthy and medication-free hypertensive and normotensive men underwent the MIST. We repeatedly measured cortisol and blood lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)) immediately before and up to 1 h after stress. Lipid levels were corrected for stress hemoconcentration. Thirty-five participants completed follow-up assessment 2.9 ± 0.12 (SEM) years later. CVD risk was assessed by prospective changes in TC/HDL-C ratio, IL-6, D-dimer, and HbA1c from baseline to follow-up. The MIST induced significant changes in all parameters except TC (p-values ≤ 0.043). Compared with normotensives, hypertensives had higher TC/HDL-C-ratio and TG (p-values ≤ 0.049) stress responses. Blood lipid stress reactivity predicted future cardiovascular risk (p = 0.036) with increases in HbA1c (ß = 0.34, p = 0.046), IL-6 (ß = 0.31, p = 0.075), and D-dimer (ß = 0.33, p = 0.050). Our results suggest that the greater blood lipid reactivity to psychosocial stress in hypertensives, the greater their future biological CVD risk. This points to lipid stress reactivity as a potential mechanism through which stress might increase CVD risk in essential hypertension.

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