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Fulltext Heart and bile acids - Clinical consequences of altered bile acid metabolism

Vasavan T, Ferraro E, Ibrahim E, Dixon P, Gorelik J, Williamson C

Biochim Biophys Acta Mol Basis Dis, 2018 04;1864(4 Pt B):1345-1355.
PMID: 29317337 DOI: 10.1016/j.bbadis.2017.12.039

Cardiac dysfunction has an increased prevalence in diseases complicated by liver cirrhosis such as primary biliary cholangitis and primary sclerosing cholangitis. This observation has led to research into the association between abnormalities in bile acid metabolism and cardiac pathology. Approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy. Bile acids are directly implicated in this, causing QT interval prolongation, cardiac hypertrophy, cardiomyocyte apoptosis and abnormal haemodynamics of the heart. Elevated maternal serum bile acids in intrahepatic cholestasis of pregnancy, a disorder which causes an impaired feto-maternal bile acid gradient, have been associated with fatal fetal arrhythmias. The hydrophobicity of individual bile acids in the serum bile acid pool is of relevance, with relatively lipophilic bile acids having a more harmful effect on the heart. Ursodeoxycholic acid can reverse or protect against these detrimental cardiac effects of elevated bile acids.

Matched MeSH terms: Heart/drug effects; Heart/physiopathology
Comparative study of immunopathophysiological responses induced by B. melitensis and its lipopolysaccharide in mouse model infected via intranasal route of exposure

Osman AY, Saharee AA, Jesse FF, Kadir AA

Microb Pathog, 2017 Sep;110:365-374.
PMID: 28710016 DOI: 10.1016/j.micpath.2017.07.014

In this study, we developed a mouse model and characterized the effects of intranasal inoculation of virulent Brucella melitensis strain 16M and its lipopolysaccharide (LPS). The effects of the exposure were compared with respective control groups. Both Brucella melitensis-infected and LPS-infected groups showed no significant clinical presentation with minor relevance in the mortality associated with the infection. In Brucella melitensis-infected group, significant histopathological changes in comparison to the LPS infected group with increase bacterial burden in the lungs, reproductive and reticuloendothelial organs were observed. However, both infected groups showed elevated levels of pro-inflammatory cytokine expression (IL-1β and IL6) and antibody production (IgM an IgG) as early as 3 days post-infection with predominance in LPS infected group. In contrast, low levels of sex related hormonal changes was recorded in both infected groups throughout the experimental period. This is the first detailed investigation comparing the infection progression and host responses in relation to the immunopathophysiological aspects in mouse model after intranasal inoculation with B. melitensis and its lipopolysaccharide. The study revealed a significant difference between infected and control groups with overlap in clinical, pathological, and immunological responses as well as sex related hormonal changes resulting from the infections.

Matched MeSH terms: Heart/drug effects; Heart/microbiology
Fulltext Association of dietary omega-3 fatty acids with prevalence of metabolic syndrome: the National Heart, Lung, and Blood Institute Family Heart Study

Lai YH, Petrone AB, Pankow JS, Arnett DK, North KE, Ellison RC, et al.

Clin Nutr, 2013 Dec;32(6):966-9.
PMID: 23711994 DOI: 10.1016/j.clnu.2013.05.002

Metabolic syndrome (MetS), characterized by abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and insulin resistance is a major public health concern in the United States. Omega-3 fatty acids have been relatively well studied in relation to many individual cardiovascular risk factors; however, their effects on MetS are not well established.
Fulltext Fluid Structure Interaction on Paravalvular Leakage of Transcatheter Aortic Valve Implantation Related to Aortic Stenosis: A Patient-Specific Case

Basri AA, Zuber M, Basri EI, Zakaria MS, Aziz AFA, Tamagawa M, et al.

Comput Math Methods Med, 2020;2020:9163085.
PMID: 32454886 DOI: 10.1155/2020/9163085

This study investigated the impact of paravalvular leakage (PVL) in relation to the different valve openings of the transcatheter aortic valve implantation (TAVI) valve using the fluid structure interaction (FSI) approach. Limited studies were found on the subject of FSI with regards to TAVI-PVL condition, which involves both fluid and structural responses in coupling interaction. Hence, further FSI simulation with the two-way coupling method is implemented to investigate the effects of hemodynamics blood flow along the patient-specific aorta model subjected to the interrelationship between PVL and the different valve openings using the established FSI software ANSYS 16.1. A 3D patient-specific aorta model is constructed using MIMICS software. The TAVI valve identical to Edward SAPIEN XT 26 (Edwards Lifesciences, Irvine, California), at different Geometrical Orifice Areas (GOAs), is implanted into the patient's aortic annulus. The leaflet opening of the TAVI valve is drawn according to severity of GOA opening represented in terms of 100%, 80%, 60%, and 40% opening, respectively. The result proved that the smallest percentage of GOA opening produced the highest possibility of PVL, increased the recirculatory flow proximally to the inner wall of the ascending aorta, and produced lower backflow velocity streamlines through the side area of PVL region. Overall, 40% GOA produced 89.17% increment of maximum velocity magnitude, 19.97% of pressure drop, 65.70% of maximum WSS magnitude, and a decrement of 33.62% total displacement magnitude with respect to the 100% GOA.

Matched MeSH terms: Heart Valve Prosthesis
Fulltext Association between prehospital field to emergency department delta shock index and in-hospital mortality in patients with torso and extremity trauma: A multinational, observational study

Kim DK, Jeong J, Shin SD, Song KJ, Hong KJ, Ro YS, et al.

PLoS One, 2021;16(10):e0258811.
PMID: 34695147 DOI: 10.1371/journal.pone.0258811

Hemorrhage, a main cause of mortality in patients with trauma, affects vital signs such as blood pressure and heart rate. Shock index (SI), calculated as heart rate divided by systolic blood pressure, is widely used to estimate the shock status of patients with hemorrhage. The difference in SI between the emergency department and prehospital field can indirectly reflect urgency after trauma. We aimed to determine the association between delta SI (DSI) and in-hospital mortality in patients with torso or extremity trauma. Patients with DSI >0.1 are expected to be associated with high mortality. This retrospective, observational study used data from the Pan-Asian Trauma Outcomes Study. Patients aged 18-85 years with abdomen, chest, upper extremity, lower extremity, or external injury location were included. Patients from China, Indonesia, Japan, Philippines, Thailand, and Vietnam; those who were transferred from another facility; those who were transferred without the use of emergency medical service; those with prehospital cardiac arrest; those with unknown exposure and outcomes were excluded. The exposure and primary outcome were DSI and in-hospital mortality, respectively. The secondary and tertiary outcome was intensive care unit (ICU) admission and massive transfusion, respectively. Multivariate logistic regression analysis was performed to test the association between DSI and outcome. In total, 21,534 patients were enrolled according to the inclusion and exclusion criteria. There were 3,033 patients with DSI >0.1. The in-hospital mortality rate in the DSI >0.1 and ≤0.1 groups was 2.0% and 0.8%, respectively. In multivariate logistic regression analysis, the DSI ≤0.1 group was considered the reference group. The unadjusted and adjusted odds ratios of in-hospital mortality in the DSI >0.1 group were 2.54 (95% confidence interval [CI] 1.88-3.42) and 2.82 (95% CI 2.08-3.84), respectively. The urgency of traumatic hemorrhage can be determined using DSI, which can help hospital staff to provide proper trauma management, such as early trauma surgery or embolization.

Matched MeSH terms: Heart Rate
Adjustments to warfarin dosing after gastric bypass and sleeve gastrectomy

Strong AT, Sharma G, Nor Hanipah Z, Tu C, Brethauer SA, Schauer PR, et al.

Surg Obes Relat Dis, 2018 05;14(5):700-706.
PMID: 29496441 DOI: 10.1016/j.soard.2017.12.021

BACKGROUND: Warfarin dosing after bariatric surgery may be influenced by alterations in gastrointestinal pH, transit time, absorptive surface area, gut microbiota, food intake, and adipose tissue.
OBJECTIVES: The aim of this study was to describe trends in warfarin dosing after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).
SETTING: Single academic center.
METHODS: All patients chronically on warfarin anticoagulation before RYGB or SG were retrospectively identified. Indications for anticoagulation, history of bleeding or thrombotic events, perioperative complications, and warfarin dosing were collected.
RESULTS: Fifty-three patients (RYGB n = 31, SG n = 22) on chronic warfarin therapy were identified (56.6% female, mean 54.4 ± 11.7 yr of age). Of this cohort, 34.0% had prior venous thromboembolic events, 43.4% had atrial fibrillation, and 5.7% had mechanical cardiac valves. Preoperatively, the average daily dose of warfarin was similar in the RYGB group (8.3 ± 4.1 mg) and SG group (6.9 ± 2.8 mg). One month after surgery, mean daily dose of warfarin was reduced 24.1% in the RYGB group (P

Matched MeSH terms: Heart Valve Prosthesis
Fulltext Lack of association of apolipoprotein E (Apo E) polymorphism with the prevalence of metabolic syndrome: the National Heart, Lung and Blood Institute Family Heart Study

Lai LY, Petrone AB, Pankow JS, Arnett DK, North KE, Ellison RC, et al.

Diabetes Metab Res Rev, 2015 Sep;31(6):582-7.
PMID: 25656378 DOI: 10.1002/dmrr.2638

OBJECTIVE: Metabolic syndrome (MetS), characterized by abdominal obesity, atherogenic dyslipidaemia, elevated blood pressure and insulin resistance, is a major public health concern in the United States. The effects of apolipoprotein E (Apo E) polymorphism on MetS are not well established.
METHODS: We conducted a cross-sectional study consisting of 1551 participants from the National Heart, Lung and Blood Institute Family Heart Study to assess the relation of Apo E polymorphism with the prevalence of MetS. MetS was defined according to the American Heart Association-National Heart, Lung and Blood Institute-International Diabetes Federation-World Health Organization harmonized criteria. We used generalized estimating equations to estimate adjusted odds ratios (ORs) for prevalent MetS and the Bonferroni correction to account for multiple testing in the secondary analysis.
RESULTS: Our study population had a mean age (standard deviation) of 56.5 (11.0) years, and 49.7% had MetS. There was no association between the Apo E genotypes and the MetS. The multivariable adjusted ORs (95% confidence interval) were 1.00 (reference), 1.26 (0.31-5.21), 0.89 (0.62-1.29), 1.13 (0.61-2.10), 1.13 (0.88-1.47) and 1.87 (0.91-3.85) for the Ɛ3/Ɛ3, Ɛ2/Ɛ2, Ɛ2/Ɛ3, Ɛ2/Ɛ4, Ɛ3/Ɛ4 and Ɛ4/Ɛ4 genotypes, respectively. In a secondary analysis, Ɛ2/Ɛ3 genotype was associated with 41% lower prevalence odds of low high-density lipoprotein [multivariable adjusted ORs (95% confidence interval) = 0.59 (0.36-0.95)] compared with Ɛ3/Ɛ3 genotype.
CONCLUSIONS: Our findings do not support an association between Apo E polymorphism and MetS in a multicentre population-based study of predominantly White US men and women.
Fulltext Pulmonary embolectomy in heparin-induced thrombocytopenia and thrombosis? Safety of heparin use

Sachithanandan A

Interact Cardiovasc Thorac Surg, 2010 Nov;11(5):681.
PMID: 20962169 DOI: 10.1510/icvts.2010.247460A
Matched MeSH terms: Heart Arrest, Induced
Fulltext EEG based evaluation of stereoscopic 3D displays for viewer discomfort

Malik AS, Khairuddin RN, Amin HU, Smith ML, Kamel N, Abdullah JM, et al.

Biomed Eng Online, 2015;14:21.
PMID: 25886584 DOI: 10.1186/s12938-015-0006-8

Consumer preference is rapidly changing from 2D to 3D movies due to the sensational effects of 3D scenes, like those in Avatar and The Hobbit. Two 3D viewing technologies are available: active shutter glasses and passive polarized glasses. However, there are consistent reports of discomfort while viewing in 3D mode where the discomfort may refer to dizziness, headaches, nausea or simply not being able to see in 3D continuously.

Matched MeSH terms: Heart Rate