European journal of clinical investigation
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Eur. J. Clin. Invest. · Jan 2025
Altered fibrin clot properties and elevated von Willebrand factor are associated with progression to permanent atrial fibrillation: A cohort study.
The role of a prothrombotic state in atrial fibrillation (AF) progression to permanent arrythmia (PerAF) is unclear. Formation of denser and poorly lysable fibrin clots has been observed in AF patients also with sinus rhythm in association with higher stroke risk. We investigated whether altered fibrin clot properties and other prothrombotic state markers may contribute to AF transition to PerAF. ⋯ Suppressed fibrin clot susceptibility to lysis and elevated vWF could contribute to progression to PerAF despite anticoagulation, which suggests links between blood coagulation and AF progression.
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Sotatercept binds free activins by mimicking the extracellular domain of the activin receptor type IIA (ACTRIIA). Additional ligands are BMP/TGF-beta, GDF8, GDF11 and BMP10. The binding with activins leads to the inhibition of the signalling pathway and the deactivation of the bone morphogenic protein (BMP) receptor type 2. ⋯ Its effects, demonstrated in the STELLAR study, are the improvement of exercise capacity and the FC-WHO functional class, together with the reduction of the risk of clinical worsening events. In addition to its antiremodeling effects on the pulmonary circulation, sotatercept has several haematological effects that could suggest its use in the treatment of some blood disorders other than PAH. In this review, we will discuss the effects of the drug on PAH and in parallel provide an in-depth overview of its application in haematological disorders, focusing on clinical and preclinical studies.
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Eur. J. Clin. Invest. · Jan 2025
Care pathway for patients hospitalized with venous thromboembolism.
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a potentially fatal disease with a multifactorial nature, impacting different medical and surgical specialties. Recently, new guidelines and direct oral anticoagulants facilitated early discharge for most DVT patients and non-severe PE patients. ⋯ This study is the first to portray the distribution and care pathways of VTE patients across hospital departments. Despite recent clinical guidelines, many patients still require inpatient management, highlighting the need for dedicated care pathway.
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Eur. J. Clin. Invest. · Jan 2025
Long-term fasting induces a remodelling of fatty acid composition in erythrocyte membranes.
Long-term fasting (LF) activates an adaptative response to switch metabolic fuels from food glucose to lipids stored in adipose tissues. The increase in free fatty acid (FFA) oxidation during fasting triggers health benefits. We questioned if the changes in lipid metabolism during LF could affect lipids in cell membranes in humans. We thus analysed the FA composition in erythrocyte membranes (EM) during 12.6 ± 3.5 days of LF and 1 month after food reintroduction. ⋯ Long-term fasting triggers changes in the FA composition of EM.
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Eur. J. Clin. Invest. · Jan 2025
ReviewA scoping review evaluating the current state of gut microbiota and its metabolites in valvular heart disease physiopathology.
The human microbiome is crucial in regulating intestinal and systemic functions. While its role in cardiovascular disease is better understood, the link between intestinal microbiota and valvular heart diseases (VHD) remains largely unexplored. ⋯ TMAO has been mainly identified as a prognostic marker in VHD. Gut microbiota dysbiosis has been observed in various forms of VHD and deserve further study.