93 Melatonin and oxidative stress in the prevention of cardiovascular disease

Abstract Aims Arterial hypertension, especially if not well-controlled, is one of the main risk factors predisposing to fatal cardiovascular diseases (CVDs). Moreover, the diagnosis of essential hypertension are increasing, therefore oxidative stress and chronic inflammation have also been identified as potential responsible for the development of endothelial damage. Among all the molecules, melatonin (MT) was chosen for its role as a powerful antioxidant and anti-inflammatory endogenous molecule. This trial aims to evaluate the early intervention at the base of the inflammatory and oxidative cascade (that results in the development of hypertension), to restore an oxidative balance leading to positive results even at the endothelial and vascular level using MT in addition to anti-hypertensive therapy. Methods The trial is randomized, prospective and monocentric control. We enrolled 23 patients with hypertension in absence of other cardiovascular or autoimmune diseases that could alter the oxidative background, from March 2018 to April 2019 (recruitment period). Patients were randomly assigned to two groups: ‘melatonin group’ (in which 16 patients add 1 mg/day of melatonin for a year, to their already settled therapy), and a ‘control’ group (consisting of 7 patients with no changes in their therapy). The average follow-up was 1 year from randomisation. Patients were evaluated before and after a period of 1 year through MT plasma concentration and serum antioxidant capacity (TAC) by specific quantitative ELISA method. Therefore endothelial dysfunction and arterial stiffness were evaluated too (using the non-invasive methods of EndoPAT and SphygmoCor). Results In ‘melatonin group’ arterial stiffness index statistically decreased (P 0.022), according to a significant increase in plasma melatonin values (P 0.003) and significant decrease in TAC levels (P 0.041) despite the ‘control’ group. The improvement of endothelial function was not significant (P 0.688). Blood pressure had not a significative improvement too (P 0.401). Conclusions Data obtained could confirm the hypothesis of activation of plasma antioxidant system against a situation of altered oxidative balance. In fact, it is possible to hypothesize a correlation between TAC and arterial stiffness that confirm the antioxidant role of MT. The combination between antihypertensive therapy and antioxidant supplementation is able to improve the vascular stiffness. Data obtained are still preliminary and present some limitations but we can think of proposing this trial as a future basis for other extensive and prolonged studies.

Download Full-text

Parameters of arterial stiffness in hypertensive patients with and without subclinical carotid atherosclerosis

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-4-427-435 ◽

2021 ◽

Vol 27 (4) ◽

pp. 427-435

Author(s):

V. E. Gumerova ◽

S. A. Sayganov ◽

V. V. Gomonova

Keyword(s):

Arterial Stiffness ◽

Pulse Pressure ◽

Augmentation Index ◽

Subclinical Atherosclerosis ◽

Stiffness Index ◽

Control Group ◽

Hypertensive Patients ◽

Significant Difference ◽

Arterial Stiffness Index ◽

Plaque Detection

Objective. To assess the relationship between arterial stiffness parameters in hypertensive patients with and without atherosclerotic lesions.Design and methods. We included 127 subjects who were divided into 3 groups: patients with hypertension (HTN) without atherosclerosis (n = 42); patients with HTN and subclinical atherosclerosis (SА) (n = 52) and control group which consisted of individuals without HTN, SA, or coronary artery disease (n = 33). All groups matched by age and gender. All subjects underwent following examinations: ultrasonography of extracranial segments of carotid arteries, 24-hour blood pressure monitoring with the assessment of arterial stiffness parameters.Results. In subjects with HTN compared to controls, pulse wave velocity in aorta (PWVao) was significantly higher (11,3 ± 1,5; 12,3 ± 1,8 vs 10,4 ± 1,3 m/s; p < 0,05), as well as pulse pressure (PP) (46,4 ± 9,8; 45,6 ± 10,6 vs 39,9 ± 6,5 mmHg; p < 0,05), central pulse pressure (PPао) (35,5 ± 8,5; 34,9 ± 8,5 vs 30,9 ± 5,4 mmHg; p < 0,05), and arterial stiffness index (ASI) (141 (127, 159); 139 (128,5, 160,5) vs 126 (118, 138) mmHg; p < 0,05). In subjects with HTN and SA, PWVao was significantly higher compared to other groups (p < 0,05). No significant difference in augmentation index was found (–32,5 (–45, –12); –22 (–36, –12); –37 (–50, –17); p = 0,25). Аmbulatory arterial stiffness index was higher in controls (0,5 ± 0,2) compared to HTN group (0,4 ± 0,2; p = 0,05), while HTN and SA group did not differ significantly (0,5 ± 0,2; p = 0,3). PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection.Conclusions. In HTN patients, arterial stiffness is changed compared to healthy individuals. PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection. In patients with HTN and SA arterial stiffness is higher, which might have additional predictive value in risk stratification.

Download Full-text

AMBULATORY ARTERIAL STIFFNESS MONITORING IN PATIENTS WITH ASTHMA

The Russian Archives of Internal Medicine ◽

10.20514/2226-6704-2019-9-4-301-307 ◽

2019 ◽

Vol 9 (4) ◽

pp. 301-307

Author(s):

N. A. Karoli ◽

O. T. Zarmanbetova ◽

A. P. Rebrov

Keyword(s):

Arterial Stiffness ◽

Augmentation Index ◽

Target Organ Damage ◽

Vascular Wall ◽

Organ Damage ◽

Stiffness Index ◽

Control Group ◽

Target Organs ◽

Gender And Age ◽

Arterial Stiffness Index

Cardiovascular disease is one of the major causes of death throughout the world. Early detection of target organ damage is important for more successful prevention of cardiovascular diseases and improvement of patient outcomes. One of these target organs is the vascular wall, and its damage consists in loss of elastic properties and increase in stiffness. Many studies have shown that the increasing stiffness of the vascular wall is an independent predictor of cardiovascular risk. Objective: To evaluate parameters of the ambulatory arterial stiffness monitoring in patients with bronchial asthma. Materials and methods. The study enrolled 119 patients with asthma. The group of control included 30 practically healthy volunteers comparable by gender and age with the patients of the main group. Each patient underwent ambulatory blood pressure and arterial stiffness monitoring using BPLab MnSDP-2 device (Petr Telegin, Russia). Results: In patients with asthma higher values of augmentation index, arterial stiffness index and pulse wave velocity in the aorta in comparison with patients of the control group, as well as violation of the 24-hour profile of arterial stiffness were noted. Conclusion. Patients with asthma demonstrated significantly increased arterial stiffness in comparison with control group.

Download Full-text

The relationship between arterial stiffness index and coronary heart disease and its severity

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02350-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Longjian Gao ◽

Dasheng Lu ◽

Guangwei Xia ◽

Hao Zhang

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Arterial Stiffness ◽

Roc Analysis ◽

Stiffness Index ◽

Control Group ◽

Disease Group ◽

Vessel Disease ◽

Arterial Stiffness Index

Abstract Background Arterial stiffness index (ASI) is closely related to coronary atherosclerosis. This study aims to explore whether ASI can predict coronary heart disease (CHD) and its severity. Methods In this study, a total of 726 patients with suspected CHD were recruited. Based on coronary angiography results, the subjects were assigned into three groups: the control group (without obvious coronary artery disease), single-vessel disease group, and multi-vessel disease group (the number of vessels diseased ≥ 2). At the same time, according to the results of angiography, myocardial enzyme spectrum, electrocardiogram, color Doppler echocardiography and clinical manifestations, these patients were divided into four groups: the control group, stable angina (SA) Group, unstable angina (UA) group, and acute myocardial infarction (AMI) group. We have compared whether there were differences in ASI and related baseline data between groups. Receiver operating curve (ROC) analysis was conducted to determine whether ASI could predict CHD and evaluate the severity. Results ASI was positively correlated with the number of diseased branches of coronary artery. The value of ASI was increased as the number of the diseased branches increased. The ASI value in the SA group was significantly higher compared with the control group. Furthermore, the ASI value in the UA and AMI groups was remarkably increased compared with the control and SA groups. The results of ROC analysis indicated that the sensitivity and specificity of ASI was 71.0% and 85.4% in diagnosing CHD, respectively. While ASI was used in predicting the severity of CHD, the sensitivity was 72.1% and specificity 57.9%. Conclusion ASI is of great value in the diagnosis of coronary heart disease and the prediction of its severity.

Download Full-text

P3460Structural and functional changes of vascular wall in women of perimenopausal period with long-term menopausal hormone therapy

European Heart Journal ◽

10.1093/eurheartj/ehz745.0333 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S N Tolstov ◽

I A Salov ◽

A P Rebrov

Keyword(s):

Arterial Stiffness ◽

Functional State ◽

Brachial Artery ◽

Vascular Wall ◽

Main Group ◽

Stiffness Index ◽

Control Group ◽

Functional Changes ◽

Postmenopausal Period ◽

Arterial Stiffness Index

Abstract Introduction Features of changes in the vascular wall in women of the menopausal period are not sufficiently illuminated. Most of the studies evaluating the effect of menopausal hormonal therapy (MHT) on the structural and functional state of the vascular wall were limited to the time frame from several months to 1–3 years, which distinguishes them from our study. Purpose To evaluate structural and functional changes in the vascular wall in women of early postmenopausal period with prolonged use of low doses of MHT 1 mg of 17β-estradiol (E2) and 2 mg drospirenone (DRSP). Methods The study included 162 women in the early postmenopausal period with climacteric syndrome were divided into 2 groups: the main group of 84 women assigned MHT 1 mg E2 /2 mg DRSP, control group of 78 women who did not receive MHT. Duration of follow-up 5,2 (4,8; 5,7) years. Explored pulse wave velocity (PWV). Bbrachial blood pressure was measured non-invasively over the 24 h with an electronic, oscillometric, automated device (BPLab) with the assessment of 24-h central arterial pressure (CAP), aortic augmentation index (AIx), arterial stiffness index (ASI); ambulatory arterial stiffness index (AASI). Endothelium-dependent vasodilation (EDV) of the brachial artery was evaluated. Results In women of the main group PWV made up 7.19±1.7 m/s initial and 7.53±1.3 m/s to the end of the study (p>0.05); in the control group - 7,21±1.8 m/s and 7.95±1.9 m/s (p<0.001). In the women of the main group by the end of the study a decrease in the CAP was noted from 38.4±6.2 to 35.3±4.1 mm Hg. (p<0.001), in the women of the control group there were no changes of 41.4±9.6 and 40.9±9.8 mm Hg. (p<0.001 between women of both groups at the end of the study). In women of the control group, a significant increase in AIx was found from 31.0 (20.0; 35.0)% initially to 33.0 (29.0; 37.0)% by the end of the study (p<0.05) and no changes in women of the main group – 27.0 (20.0; 35.0)% and 28.0 (20.0; 33.0)%. Multidirectional changes ASI were revealed: a decrease in women of the main group from 132.0 (121.0; 142.0) to 127.0 (115.5; 137.0) cu and an increase from 133.0 (111.0; 155.0) to 148.0 (134.2; 171.0) cu in women of the control group (p<0.01 between women of both groups at the end of the study). By the end of the study, there was a decrease in AASI in women of the main group from 0.379 (0.320; 0.463) to 0.264 (0.203; 0.329) cu (p<0.001) and the absence of changes AASI value in women of the control group – 0.360 (0.283; 0.471) and 0.370 (0.310; 0.476) cu. In women of the main group, an increase in the brachial artery EDV was found from 8.6±7.4% initially to 11.1±6.8% by the end of the study (p<0.05) and no change in women in the control group −7.3±5.6% and 6.2±5.0%. Conclusion In women in early postmenopause with prolonged MHT of 1 mg E2/2 mg DRSP positive changes in the structural and functional state of the vascular wall were established.

Download Full-text

[PP.29.26] AMBULATORY ARTERIAL STIFFNESS INDEX IN PATIENTS WITH METABOLIC SYNDROME AND NEWLY DIAGNOSED HYPERTENSION BEFORE AND AFTER ONE YEAR OF TREATMENT WITH LOSARTANE AND TELMISARTANE

Journal of Hypertension ◽

10.1097/01.hjh.0000492235.04624.48 ◽

2016 ◽

Vol 34 ◽

pp. e306

Author(s):

I. Rihacek ◽

M. Soucek ◽

B. Kianicka ◽

P. Frana ◽

M. Plachy ◽

...

Keyword(s):

Metabolic Syndrome ◽

Arterial Stiffness ◽

Stiffness Index ◽

Newly Diagnosed ◽

Before And After ◽

One Year ◽

Arterial Stiffness Index

Download Full-text

Oxidative Stress Status in Patients with Choledocholithiasis: Before and After Endoscopic Sphincterotomy and Biliary Clearance

Revista de Chimie ◽

10.37358/rc.18.8.6493 ◽

2018 ◽

Vol 69 (8) ◽

pp. 2172-2176

Author(s):

Catalin Victor Sfarti ◽

Alin Ciobica ◽

Carol Stanciu ◽

Gheorghe G. Balan ◽

Irina Garleanu ◽

...

Keyword(s):

Oxidative Stress ◽

Endoscopic Sphincterotomy ◽

Specific Activity ◽

Oxidative Stress Marker ◽

Control Group ◽

Oxidative Stress Parameter ◽

Extrahepatic Cholestasis ◽

Biliary Clearance ◽

Oxidative Stress Status ◽

Before And After

Choledocholithiasis may cause biliary obstruction which leads to hepatocellular injury. Oxidative stress has been proposed as a possible mechanism involved in this disorder. This study evaluates the oxidative stress burden in patients with choledocholithiasis and secondary cholestasis, before and after endoscopic sphincterotomy. Experimental part: Patients diagnosed with choledocholithiasis and secondary extrahepatic cholestasis were included in the study between January 1st 2016 and October 31st 2016. In all patients oxidative stress markers were collected within 2 hours before and 48 hours after therapeutic ERCP. Selected markers were superoxide dismutase (SOD), glutathione peroxidase (GPX) and malondialdehyde (MDA). The results were compared to those from a group of 40 healthy subjects. Significantly lower concentrations of SOD (p = 0.03) and GPX (p [ 0.0001) activities, associated with an increased level of MDA level (p [ 0.0001) were shown in patients before biliary clearance compared with the healthy control group. After ERCP the only oxidative stress parameter which showed improvement was the SOD specific activity (p = 0.037). This study shows that extrahepatic cholestasis secondary to choledocholithiasis is associated with increased oxidative stress status. After biliary clearance one oxidative stress marker was significantly improved (SOD), suggesting a possible antioxidant effect of such procedure.

Download Full-text