European journal of clinical investigation
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Eur. J. Clin. Invest. · Oct 2014
ReviewThe implication of periodontitis in vascular endothelial dysfunction.
Periodontitis is the most common oral infection seen in humans worldwide. It is characterized by gradual destruction of tooth supporting tissues, eventually leading to loss of tooth. The periodontal biofilm associated with periodontitis comprises of gram-positive and gram-negative bacteria, instrumental for the initiation and progression of periodontitis. Evidence-based literature has identified the nature of periodontal infection as a possible causative condition in the inducement of 'low-grade systemic inflammation and infection'. The periodontal pathogens exert systemic effects via the haematogenous route. ⋯ Chronic periodontitis results in altered vascular response, increased expression of pro-inflammatory cytokines and adhesion molecules inducing vascular endothelial dysfunction. Periodontal therapy may ameliorate the perturbed vascular endothelial function.
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Eur. J. Clin. Invest. · Oct 2014
Changes in ventricular-arterial coupling during decongestive therapy in acute heart failure.
Coupled arterial and left ventricular properties are poorly documented in acute heart failure. The aim of this prospective noninvasive study was to document early changes in ventricular-arterial coupling in patients with acutely decompensated HF (ADHF). ⋯ An early improvement in ventricular-arterial coupling was observed after diuretic-related decongestive therapy in ADHF patients and was related to a decrease in effective arterial elastance rather than to change in LV contractility.
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Eur. J. Clin. Invest. · Oct 2014
Increased arginase levels contribute to impaired perfusion after cardiopulmonary resuscitation.
The postcardiac arrest syndrome occurs after global hypoxia leading to microcirculatory impairment. Nitric oxide (NO) is a key molecule regulating microvascular function. The enzyme arginase has been suggested to modulate microvascular function by regulating NO metabolism. Therefore, we investigated whether arginase increases following global hypoxia and resuscitation and tested whether arginase inhibition influences altered microcirculation in resuscitated patients. ⋯ Circulating arginase 1 levels are increased following exposure to global hypoxia and in patients who have been successfully resuscitated after cardiac arrest. Topical arginase inhibition improves microcirculatory perfusion following resuscitation. This is of potential therapeutic importance for the postcardiac arrest syndrome.
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Irisin activates the thermogenic function in adipose tissues. However, little is known on the association between human irisin and different cardiometabolic risk factors. We analyse the influence of morbid obesity on irisin levels and its relation with leptin and different cardiovascular risk factors. ⋯ We showed decreased serum irisin levels in morbidly obese subjects, related mainly to WHR. FNDC5 expression could be regulated by leptin.
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Eur. J. Clin. Invest. · Oct 2014
Gender, age and risk of ST segment elevation myocardial infarction.
Exact associations of gender and age with occurrence of ST segment elevation myocardial infarction are inadequately known. ⋯ Men have a tripled overall risk of STEMI compared with women with highest relative risk in younger adults. Incidence rate of ST segment elevation myocardial infarction increases by estimated 41% per 5-year increase in age.