scholarly journals A primer on current progress in cardiac fibrosis

2017 ◽  
Vol 95 (10) ◽  
pp. 1091-1099 ◽  
Author(s):  
Danah Al Hattab ◽  
Michael P. Czubryt
Keyword(s):  
Cardiovascular Disease ◽  
Cardiac Fibrosis ◽  
Significant Risk ◽  
Specific Treatment ◽  
Significant Risk Factor ◽  
Novel Treatments ◽  
Matrix Deposition ◽  
Wall Stiffness ◽  
Systolic And Diastolic Function ◽  
New Research

Cardiac fibrosis is a significant global health problem that is closely associated with multiple forms of cardiovascular disease, including myocardial infarction, dilated cardiomyopathy, and diabetes. Fibrosis increases myocardial wall stiffness due to excessive extracellular matrix deposition, causing impaired systolic and diastolic function, and facilitating arrhythmogenesis. As a result, patient morbidity and mortality are often dramatically elevated compared with those with cardiovascular disease but without overt fibrosis, demonstrating that fibrosis itself is both a pathologic response to existing disease and a significant risk factor for exacerbation of the underlying condition. The lack of any specific treatment for cardiac fibrosis in patients suffering from cardiovascular disease is a critical gap in our ability to care for these individuals. Here we provide an overview of the development of cardiac fibrosis, and discuss new research directions that have recently emerged and that may lead to the creation of novel treatments for patients with cardiovascular diseases. Such treatments would, ideally, complement existing therapy by specifically focusing on amelioration of fibrosis.

Hyperhomocysteinaemia: a significant risk factor for cardiovascular disease in renal transplant recipients

1994 ◽  
Vol 9 (8) ◽  
pp. 1103-1108 ◽  
Author(s):  
Z. A. Massy ◽  
B. Chadefaux-Vekemans ◽  
A. Chevalier ◽  
C. A. Bade ◽  
T. B. Drüeke ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Renal Transplant ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

Novel role for cardiac myocyte-derived β-2 microglobulin in mediating cardiac fibrosis

2018 ◽  
Vol 132 (19) ◽  
pp. 2117-2120
Author(s):  
Michael J. Boyer ◽  
Satoru Eguchi
Keyword(s):  
Cardiac Fibrosis ◽  
Cardiac Myocyte ◽  
Cardiac Fibroblasts ◽  
Significant Risk ◽  
Growth Factor Receptor ◽  
Pressure Overload ◽  
Significant Risk Factor ◽  
Cardiac Complications

Hypertension is a significant risk factor for the development of cardiovascular ailments, including ischemic heart disease and diastolic dysfunction. In a recent issue of Clinical Science, Li et al. [Clin. Sci. (2018) 132, 1855–1874] report that β-2 microglobulin (β2M) is a novel secreted soluble factor released by cardiac myocytes during pressure overload that promotes profibrotic gene expression in cardiac fibroblasts both in vitro and in vivo. Their study further identifies elevated β2M levels as a possible biomarker for hypertensive patients with cardiac complications. The authors propose a mechanism that mechanically stretched cardiomyocytes release soluble β2M which, through paracrine communication with cardiac fibroblasts, transactivates epidermal growth factor receptor (EGFR) to initiate acute signal transduction and up-regulate profibrotic genes, thereby promoting fibrosis. Here, we will discuss the background, significance of the study, alternative mechanisms, and future directions.

scholarly journals Age-Associated TET2 Mutations: Common Drivers of Myeloid Dysfunction, Cancer and Cardiovascular Disease

2020 ◽  
Vol 21 (2) ◽  
pp. 626 ◽  
Author(s):  
Christina K. Ferrone ◽  
Mackenzie Blydt-Hansen ◽  
Michael J. Rauh
Keyword(s):  
Cardiovascular Disease ◽  
Inflammatory Diseases ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
On Chip ◽  
Developed World ◽  
The Impact ◽  
Inactivating Mutations

Acquired, inactivating mutations in Tet methylcytosine dioxygenase 2 (TET2) are detected in peripheral blood cells of a remarkable 5%–10% of adults greater than 65 years of age. They impart a hematopoietic stem cell advantage and resultant clonal hematopoiesis of indeterminate potential (CHIP) with skewed myelomonocytic differentiation. CHIP is associated with an overall increased risk of transformation to a hematological malignancy, especially myeloproliferative and myelodysplastic neoplasms (MPN, MDS) and acute myeloid leukemia (AML), of approximately 0.5% to 1% per year. However, it is becoming increasingly possible to identify individuals at greatest risk, based on CHIP mutational characteristics. CHIP, and particularly TET2-mutant CHIP, is also a novel, significant risk factor for cardiovascular diseases, related in part to hyper-inflammatory, progeny macrophages carrying TET2 mutations. Therefore, somatic TET2 mutations contribute to myeloid expansion and innate immune dysregulation with age and contribute to prevalent diseases in the developed world—cancer and cardiovascular disease. Herein, we describe the impact of detecting TET2 mutations in the clinical setting. We also present the rationale and promise for targeting TET2-mutant and other CHIP clones, and their inflammatory environment, as potential means of lessening risk of myeloid cancer development and dampening CHIP-comorbid inflammatory diseases.

scholarly journals Fluoxetine treatment prevents cardiovascular changes in baroreflex and chemoreflex in rats subjected to chronic stress

2020 ◽  
Author(s):  
Egidi Mayara Silva Firmino ◽  
Luciana Bärg Kuntze ◽  
Davi Campos Lagatta ◽  
Daniel Penteado Martins Dias ◽  
Leonardo Barbosa Moraes Resstel
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Stress ◽  
Autonomic Function ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Male Rats ◽  
Cardiovascular Changes ◽  
Fluoxetine Treatment ◽  
Increased Risk ◽  
Repeated Restraint Stress

AbstractStress may influence the autonomic regulation, pathogenesis of cardiovascular disease and play an important role in animal behavior as depression. Depression is evidenced as a significant risk factor for cardiovascular changes. This is of great importance as some studies show an association between symptoms of depression and increased risk of cardiovascular disease (CVD) morbidity. Additionality, those alterations can be alleviated by use of antidepressants such as fluoxetine, which is a selective serotonin reuptake inhibitor (SSRIs). The link between depression and cardiovascular changes is known to be mediated in part by autonomic mechanisms that contribute to the regulation of cardiovascular function. However, studies on the effects of SSRIs on cardiovascular autonomic function are inconsistent. Thus, in the present study we investigated, in adult male rats, the effect of chronic and acute treatment with fluoxetine on changes in autonomic mechanisms of baroreflex and chemoreflex induced by the repeated restraint stress (RRS) or chronic variable stress (CVS) on baroreflex and chemoreflex in a protocol of 14 days of stress sessions. The results found demonstrated that exposure to chronic stress (RRS and CVS) promove changes on cardiovascular and ventilatory responses controlled by autonomic reflexes, such as baroreflex and chemoreflex. Additionality, that chronic fluoxetine treatment for 21 days was able to prevent not only anhedonic behavior, but also of autonomic changes cardiovascular induced by chronic stress. Taken together, our results show that pharmacological treatment with fluoxetine may be also helpful to prevent cardiovascular events on account of depressive states, by correcting alterations in autonomic function.

scholarly journals The Effects of Alcohol Consumption in Type 2 Diabetic Mellitus Individuals

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Addisu Dabi Wake
Keyword(s):  
Cardiovascular Disease ◽  
Alcohol Consumption ◽  
Glycemic Control ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Mellitus ◽  
Heavy Alcohol ◽  
Type 2 Diabetic Mellitus ◽  
Heavy Alcohol Consumption

There is a considerable increase in the proportion of diabetic mellitus (DM) globally. The prevalence of Type 2 DM (T2DM) is increasing across the all over the world. The consumption of alcohol is also rising globally including among the T2DM individuals. Alcohol drinking, principally the heavier consuming is a significant risk factor for many health problems and, thus, it is a main contributor to the global burden of disease. Therefore, the present review article was intended to investigate the effects of alcohol consumption among T2DM individuals which mainly focused on its effect on glycemic control, cardiovascular disease (CVD), mortality associated with T2DM. Several studies have found that light to moderate alcohol consumption among T2DM patients have the beneficial effects regarding the glycemic control, cardiovascular disease, mortality associated with T2DM. However, heavy alcohol ingestion among these individuals has the critical adverse effects. As suggestions, advice on alcohol use should largely aim at lowering heavy ingestions among T2DM subjects. These individuals should be advised on decreasing heavy alcohol consumption since the consequences of heavy amount of alcohol consumption has a severe and substantial impacts on T2DM patients. Further, more attention is needed regarding to these critical public issues to avoid the complications associated with the heavy alcohol consumption among T2DM patients. Health education programs should be created and also any programs that can improve the awareness of these individuals is required to take place in order to improve their health.

scholarly journals Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 752
Author(s):  
Iwona Popiolek ◽  
Piotr Hydzik ◽  
Pawel Jagielski ◽  
Monika Zrodlowska ◽  
Karol Mystek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Significant Risk ◽  
Specific Treatment ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Paracetamol Overdose ◽  
Univariable Analysis ◽  
Over The Counter ◽  
Severe Hepatotoxicity

Background and Objectives: Over-the-counter availability and a good safety profile make paracetamol one of the most common analgesics in developed countries but also the leading cause of liver failure due to overdose. The objectives of the study were to identify modifiable risk factors for severe hepatotoxicity following paracetamol overdose in adults. Materials and Methods: A retrospective cohort study involved the consecutive adult patients hospitalized in a toxicological center over a period of seven years due to paracetamol overdose. Complete medical datasets of laboratory and anamnestic variables were analyzed and validated by means of logistic regression model. Results: A total of 185 patients entered the study, including 25 individuals who developed severe hepatotoxicity (plasma aminotransferases levels above 1000 UI/L) and 31 individuals with mild to moderate liver injury (plasma aminotransferases levels above upper normal range, but below 1000 UI/L). In the univariable analysis, significant hepatotoxicity risk factors were male gender, alcohol abuse, an ingested paracetamol dose, and a timespan from ingestion to hospital admission. The later one was the only significant risk factor in the multivariable model (adjusted odds ratio 1.08; 95% CI: 1.03–1.12). Conclusions: A delay in hospital admission, resulting in a delayed administration of disease-specific treatment outweighs any other known risk factors of paracetamol-induced hepatotoxicity.

Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Cun-Xian Jia ◽  
Lin-Lin Wang ◽  
Ai-Qiang Xu ◽  
Ai-Ying Dai ◽  
Ping Qin
Keyword(s):  
Risk Factor ◽  
Family Income ◽  
Rural China ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Health Condition ◽  
Physical Illness ◽  
Rural Residents ◽  
Increased Risk ◽  
Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

scholarly journals Risk factors of poor prognosis and impairment of activities of daily living in patients with hemorrhagic gastroduodenal ulcers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Arai ◽  
Jun Kato ◽  
Nobuo Toda ◽  
Ken Kurokawa ◽  
Chikako Shibata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Poor Prognosis ◽  
Significant Risk ◽  
Care Facility ◽  
Significant Risk Factor ◽  
Advanced Age ◽  
Gastroduodenal Ulcers ◽  
Poor Outcomes

Abstract Background Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. Methods In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. Results Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08–16.2), and heart disease (OR 3.05; 95% CI 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36–28.7). Conclusion In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.

Neurodevelopmental outcome of healthy term newborn with serum bilirubin >15 mg/dl at one year

2020 ◽  
pp. 1-6
Author(s):  
P. Dubey ◽  
J. Shrivastava ◽  
B.P. Choubey ◽  
A. Agrawal ◽  
V. Thakur
Keyword(s):  
Serum Bilirubin ◽  
Tertiary Care ◽  
Neurodevelopmental Outcome ◽  
Significant Risk ◽  
Central India ◽  
Significant Risk Factor ◽  
Motor Domain ◽  
Medical Emergency ◽  
One Year ◽  
Group 1

BACKGROUND: Neonatal hyperbilirubinemia is a common medical emergency in early neonatal period. Unconjugated bilirubin is neurotoxic and can lead to lifelong neurological sequelae in survivors. OBJECTIVE: To find out the association between serum bilirubin and neurodevelopmental outcome at 1 year of age using Development Assessment Scale for Indian Infants (DASII). METHODS: A prospective cohort study was conducted in the Department of Pediatrics of a tertiary care institution of Central India between January 2018 and August 2019. Total 108 term healthy neonates, with at least one serum bilirubin value of >15 mg/dl, were included. Subjects were divided into three groups based on the serum bilirubin; group 1: (15–20 mg/dl) –85(78.7%) cases, group 2: (20–25 mg/dl) –17(15.7%), and group 3: (>25 mg/dl) –6(5.5%). Developmental assessment was done using DASII at 3, 6, 9, 12 months of age. RESULTS: Out of 108 cases, 101(93.5%) received phototherapy, and 7(6.5%) received double volume exchange transfusion. Severe delay was observed in 5(4.6%) and mild delay in 2(1.9%) cases in the motor domain of DASII at one year. Severe delay in the motor domain was associated with mean TSB of 27.940±2.89 mg/dl and mild delay with mean TSB of 22.75±1.76 mg/dl (p = 0.001). On cluster analysis, delay was observed in locomotion 1 score in 11(13%) cases (p = 0.003) and manipulation score in 6(7.1%) cases in group 1. CONCLUSION: Increased serum bilirubin was a significant risk factor for the delayed neurodevelopment in babies with neonatal jaundice. Even a moderate level of bilirubin significantly affects the developmental outcome.

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