Circulating endothelial-derived apoptotic microparticles and insulin resistance in non-diabetic patients with chronic heart failure

2016 ◽  
Vol 54 (7) ◽  
Author(s):  
Alexander E. Berezin ◽  
Alexander A. Kremzer ◽  
Giovanni Cammarota ◽  
Anthony Zulli ◽  
Daniel Petrovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Chronic Heart Failure ◽  
Functional Class ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Flow Cytofluorometry ◽  
Hs Crp ◽  
Artery Disease ◽  
The Relationship

AbstractThe objective of this study was to assess the relationship between insulin resistance and apoptotic endothelial-derived microparticles (EMPs) in patients with chronic heart failure (CHF).The study involved 300 CHF patients (186 males) aged 48–62 years with angiographically proven coronary artery disease and/or previously defined myocardial infarction. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). EMPs phenotype was determined by flow cytofluorometry.Depending on HOMA-IR cut-off point (over and <2.77 mmol/L×μU/mL) all patients were divided into two cohorts with (n=171) or without (n=129) IR, respectively. Circulating EMPs were higher in CHF patients with IR than in patients without IR. Interestingly, EMPs were directly related to NYHA functional class of CHF, HOMA-IR, NT-pro-BNP, hs-CRP and BMI. There was a significant association between the level of EMPs and HbAIR may be a contributing factor increasing circulating levels of apoptotic EMPs in non-diabetic CHF patients.

Anemia an Old Player or a Cut-Throat in Patients with Coronary Artery Disease or Chronic Heart Failure.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3762-3762
Author(s):  
Giorgio Corinaldesi ◽  
Christian Corinaldesi
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Heart Failure ◽  
Apoptotic Cell ◽  
Binding Capacity ◽  
Left Ventricular ◽  
Functional Class ◽  
Peak Oxygen Consumption ◽  
Artery Disease

Abstract Anemia is associated with an increased number of adverse cardiovascular events (CVD) in particular with coronary artery disease (CAD), and chronic heart failure (CHF), and it is also correlated with gender, aging, renal insufficiency, low BMI. Anemia involves inflammatory cytokines (C-reactive protein, IL-6, MCP-1, TNF-alfa), it reduces marrow response to erythropoietin (EPO) and heme-oxygenases-1(HO-1), it also reduces red cells life span and it may impairs reuse of iron, it mostly reduces, the peak VO-2 (peak aerobic power). The latter appears to be an independent factor that may be associated with an adverse outcome, in fact, for a reduction of one gram of heamoglobin (Hb) the risk of morbility and mortality increase respectively by 32% and 18%. The aim of the study was to determine the clinical implication of anemia in patients with CHF or CAD; we have studied 48 patients (32 male, 16 female) with CHF, and 52 patients (34 male, 18 female) with CAD, with a range of Hb concentration included between 9.4gr/dl and 12.6gr/dl. We have evaluated moreover the tolerance to exercise on a treadmill and six minute walk distance (210+/− 32 m in CAD), (180+/− 28 m in HF), the presence of rest dyspnea, the presence of supraventricular or ventricular arrhythmias (atrial/or ventricular premature beats, sinus tachycardia, or ventricular tachycardia, atrial fibrillation); lower levels of Hb, Fe, TIBC correlate with a greater tendency to develop ventricular arrhytmias instead of supraventricular arrhytmias. Anaemia management included erythropoietin stimulating protein, blood transfusion; we have used darbopoietin 50 mcg every week, and this treatment is associated to a significant improvement in functional class and cardiac and renal function. Epo has a strong cardioprotective effect: reducing left ventricular hypertrophy, infarct size, a higher beta natriuretic peptide level, apoptotic cell death, increase FE and capillary vessels; we have remarked a longer endurance time of exercise testing a greater distance walked (282+/− 64 m in CAD), (248+/− 32m in CHF), a significant increased in the peak oxygen consumption VO2 from 12.6+/− 2.4 to 16.2+/− 2.8 mL/Kg x min. in CAD, 9.8+/− 2.0 to 13.2 +/− 3.4 mL/Kg x min. in CHF. Our data also confirm the link between an increased tendency to develop CVD and a decreased level of Hb. RISK FACTORS CAD CHF Sex (M/F) 32/16 34/18 Age (Years) 62+/− 6 66+/− 4 Hb (g/dl) 10.8+/− 1.8 10.6+/− 1.2 MCV (fl) 82.6+/− 4.4 77+/− 4.2 Iron (mg/dl) (Fe) 42.8+/− 10.2 36+/− 9.4 Total Iron Binding Capacity (TIBC) 316+/− 68.8 280+/− 62.8

scholarly journals Prognostic role of metabolic risk factors (hyperhomocysteinemia) in the development of chronic heart failure

2015 ◽  
Vol 18 (1) ◽  
pp. 20
Author(s):  
Ye. N. Berezikova ◽  
M. G. Pustovetova ◽  
S. N. Shilov ◽  
A. V. Yefremov ◽  
A. T. Teplyakov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Blood Serum ◽  
Homocysteine Level ◽  
Functional Class ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Relationship Of ◽  
The Relationship

The aim of the study was to assess the relationship of homocysteine levels in the blood serum with the severity and nature of chronic heart failure (CHF) in patients with coronary heart disease. 94 patients with CHF were examined. The control group included 32 patients without cardiovascular disorders. At baseline and after 12 months of observation the homocysteine levels in the blood serum were determined by enzyme-linked immunosorbent assay. Correlative relationship of hyperhomocysteinemia with ischemic myocardial remodeling and with reduced inotropic function in CHF patients was observed. The homocysteine level in the blood serum of CHF patients significantly exceeded that of the control group and moderately increased with the progression of the disease severity of functional class. In the group with an unfavorable course of CHF the baseline homocysteine level proved to have the greatest value as compared to that in the group with a favorable course. In patients with a favorable course of CHF the homocysteinemia level tended to decrease towards the end of prospective study, whereas in patients with an unfavorable course, on the contrary, hyperhomocysteinemia persisted (p<0.01). In case the hyperhomocysteinemia baseline exceeds 18.5 mkmol/L (ROC-AreaSE = 0.860.04, sensitivity 71 %, specificity 90%), the severity and characteristics of the ischemic CHF could be most likely predicted. Thus, hyperhomocysteinemia is related with the severity and nature of CHF. Determining the level of homocysteine in the blood serum can be recommended for early prediction of the severity and nature of CHF.

The role of obesity in renal damage in patients with chronic heart failure

2020 ◽  
Vol 24 (5) ◽  
pp. 29-36
Author(s):  
M. E. Statsenko ◽  
S. V. Fabritskaya ◽  
Y. A. Ryndina
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Chronic Heart Failure ◽  
Resistance Index ◽  
Cardiovascular Complications ◽  
Functional Class ◽  
Overweight And Obesity ◽  
Significant Deterioration ◽  
Risk Of Progression ◽  
Clinically Significant

THE AIM: to study the functional state ofthe kidneys in patientswith chronic heart failure (CHF)and obesity. PATIENTS AND METH­ODS. 116 patients with CHF l-lll functional class (FC) 45-65 years old are divided into three comparable groups depending on body mass index (BMI). A physical examination was performed, evaluated the renal function, the level of leptin and adiponectin, assessed the insulin resistance index, the combined risk of progression of chronic kidney disease (CKD), and the development of cardiovascular complications was analyzed. RESULTS. Among patients with CHF and obesity, a statistically significant decrease in glomerular filtration rate (GFR) was observed compared with patients of the 1st group (61.3 [46.2; 67.1] vs 73.2 [62.1; 86.3] ml/min / 1.73 m2), a clinically significant decrease in GFR <60 ml/min /1.73 m2 (CKD C3a-3b), high (A2) and very high (A3) albu­minuria (AU) compared in patientswith normal and overweight. The leptin concentration significantly increased from the 1st to the 3rd group, while the adiponectin concentration decreased from the 1st to the 3rd group. Statistically significant correlations were established between the concentration of leptin and GFR (r = -0.52), AC (r = 0.36), between the concentration of adiponectin and GFR (r = 0.38), AC (r = -0.32). Significant associations were found among patientswith overweight and obesity between the severity of AU, GFR, and HOMA-IR, metabolic index. CONCLUSION. A significant deterioration in the functional parameters ofthe kidneys in patientswith CHF with increasing body weight, as well as an increase in the combined risk of CKD progression and the development of cardiovascular complications with comparable FC, was established. The revealed reliable relationships reflect the significant pathogenetic contribution of the hormonal activity of visceral adipose tissue and insulin resistance to the development and progression of renal dysfunction in patients with heart failure and obesity.

scholarly journals CORRELATION BETWEEN INSULIN RESISTANCE AND SEVERITY OF CORONARY ARTERY DISEASE IN NON-DIABETES

2016 ◽  
Vol 9 (6) ◽  
pp. 331
Author(s):  
Mukund Srinivasan
Keyword(s):  
Insulin Resistance ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Care Hospital ◽  
Gensini Score ◽  
Increased Risk ◽  
Artery Disease

Objective: There is an increased risk of CAD in both diabetes and non-diabetes. Insulin resistance has been associated with development of CAD in this both populations. However, there are not many studies on correlation between insulin resistance and severity of CAD in non-diabetes. The present study aimed to establish a correlation between insulin resistance and severity of CAD in non-diabetic individuals.Methods: A cross-sectional study of 79 consecutive Non-diabetic patients undergoing coronary angiogram for evaluation of clinically suspected coronary artery disease at a tertiary care hospital in Mangalore, Karnataka were recruited. Clinical history, anthropometric and biochemical parameters were analyzed. Insulin resistance was determined by Homeostasis model assessment (HOMA-IR). The severity of CAD was assessed by modified Gensini score. Pearson correlation was done to find out the relation between HOMA-IR and Gensini core.Results: The correlation between log of HOMA-IR and severity of coronary artery disease as assessed by Gensini score (r = -0.053 and p= 0.64) was not significant in non-diabetic patients. The correlations between severity of coronary artery disease and other known risk factors of coronary artery disease were also was not significant.Conclusion: HOMA-IR is negatively associated with severity of CAD in non-diabetes.

scholarly journals sST2 Protein Serum Levels in Patients with Chronic Heart Failure

2020 ◽  
Vol 10 (4) ◽  
pp. 342-346
Author(s):  
Roman Tokmachev ◽  
Andrey Kravchenko ◽  
Andrey Budnevsky ◽  
Evgeniy Ovsyannikov ◽  
Tatiana Chernik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Positive Association ◽  
Serum Levels ◽  
Functional Class ◽  
Reduced Ejection Fraction ◽  
Nyha Classification ◽  
Universal Indicator ◽  
Hs Crp

The purpose of this study was to determine the blood concentration of sST2 and evaluate the correlations between sST2 and the clinical, instrumental, and echocardiographic characteristics of patients with CHFrEF (chronic heart failure with reduced ejection fraction) and CHFpEF (chronic heart failure with preserved ejection fraction), as well as to evaluate the sST2 informativeness in comparison with NT-proBNP. The study involved 160 patients diagnosed with CHF (86 men and 74 women, mean age of 72.4±8.7 years). According to the LVEF value, the patients were divided into two groups: CHFpEF (EF≥50%) was recorded in 69 people, CHFrEF (EF<50%) - in 91 people. The functional class (FC) of CHF was determined according to the NYHA classification (1994). NT-proBNP and hs-CRP levels had a stronger positive association with sST2 levels in CHFrEF patients than in CHFpEF patients. The results obtained (regardless of the EF) indicated a statistically significant direct correlation between the levels of sST2 and LAVI. The weak direct correlation between sST2 and NYHA FC, in contrast to the direct strong correlation between NT-proBNP and sST2, indicates that sST2, which is quite important both for determining the current state of the patient and for predicting the course of the disease, still cannot be used as a single and universal indicator. In this regard, further comprehensive study of the diagnostic and prognostic capabilities of the sST2 and NT-proBNP biomarkers in CHF patients with different EF is required.

scholarly journals Correlation between Insulin Resistance and LVEF in non Diabetic Chronic Heart Failure Patients admitted in a Tertiary Care Hospital

2021 ◽  
Vol 17 (2) ◽  
pp. 99-102
Author(s):  
Md Azharul Islam ◽  
Manzoor Mahmood ◽  
Khurshed Ahmed ◽  
Sajal Krishna Banerjee ◽  
Syed Ali Ahsan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Chronic Heart Failure ◽  
Negative Correlation ◽  
Whole Body ◽  
Model Assessment ◽  
Care Hospital ◽  
Heart Failure Patients ◽  
Study Results

Background: Insulin resistance is a well-established composite index of systemic inflammatory and metabolic disorders. A wide variety of methods like, HOMA-IR (Homeostatic model assessment insulin resistance), FGIR (Fasting glucose insulin ratio), ISI-Composite (an index of whole body insulin sensitivity), QUICKI (quantitative insulin sensitivity check index) etc are available for assessing IR. Objective: To find out the correlation between insulin resistance and LVEF in non diabetic chronic heart failure patients. Methodology: This cross sectional study was carried out in the Department of Cardiology in Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from February, 2019 to June, 2020. Patients admitted with chronic heart failure with reduced ejection fraction were included in this study. Patients with diabetic, prediabetic and patient who did not give written informed consent were excluded in this study. Results: LVEF 25-29% was 16 patients out of which 10(66.7%) had significant insulin resistance. LVEF 30- 34% was found in 28 patients, among them 16(41.0%) had no insulin resistance. LVEF 35-39% was found in 19 patients out of which 18(46.2%) had no insulin resistance. The difference was statistically significant (p<0.05). A negative correlation (r=-0.340; p=0.006) was found between insulin resistance and LVEF. Conclusion: Majority non diabetic chronic heart failure patients had no insulin resistance. Significant negative correlation was found between insulin resistance and LVEF. University Heart Journal Vol. 17, No. 2, Jul 2021; 99-102

scholarly journals Leptin, hs-CRP and HOMA-IR in patients with type 2 diabetes: The role of different levels of vitamin D deficiency

2019 ◽  
Vol 9 (11) ◽  
pp. 695
Author(s):  
Salome Sadat Salehi‍ ◽  
Soghra Rabizadeh ◽  
Sahar Karimpour Reyhan Reyhan Karimpour ◽  
Marjan Mouodi ◽  
Manouchehr Nakhjavani ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Type 2 Diabetic Patients ◽  
25 Hydroxy Vitamin D ◽  
Hs Crp

Background: To evaluate the effects of different levels of vitamin D deficiency on blood glucose, leptin, and high sensitivity C-reactive protein (hs-CRP), insulin resistance and their associations.Methods: We quantified serum vitamin D level, hs-CRP, leptin, and fasting  blood  sugar (FBS)  levels in 25 type-2 diabetic patients with very low serum levels of 25-hydroxy vitamin D (deficient), ≤15 ng/ml; and 25 age, sex, and body mass index (BMI)-matched  type-2 diabetic patients with low serum levels of 25-hydroxy vitamin D (insufficient), 16 to 30 ng/ml. Homeostasis model assessment of insulin resistance (HOMA-IR) was  calculated  by  a  formula based  upon  values  of  FBS and insulin concentrations.Results: The mean value of vitamin D levels was 7.67±3.10 in vitamin D deficient group and 23.20±9.97 in vitamin D insufficient group. Patients with vitamin D deficiency had significantly higher FBS, postprandial glucose (PPG) and hemoglobin A1C (HbA1C) as compared to vitamin D insufficient group (p<0.01). We studied correlations of hs-CRP, HOMA-IR, and leptin in both vitamin D insufficient and deficient groups. There were significant positive correlations between leptin with hs-CRP (r = 0.58, p<0.01) and with HOMA-IR (r = 0.49, p<0.05) in vitamin D deficient group; Which these correlations remained significant after multiple adjustment for age, sex, BMI, systolic and diastolic blood pressure.Conclusion: In conclusion vitamin D deficient diabetic patients had elevated FBS, PPG and HbA1C compared with insufficient ones. The results also could possibly point the effect of vitamin D deficiency level on leptin associations with hs-CRP and insulin resistance.Keywords: Vitamin D deficiency, type 2 diabetes, leptin, C reactive protein, homeostasis model assessment of insulin resistance  

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