Abstract
Introduction
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease, affecting approximately 25% of the population worldwide. In the majority of patients with ...NAFLD, other metabolic disorders, such as obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome, are usually present.
Purpose
To study how NAFLD and steatosis are associated with left ventricular (LV) concentric remodeling and LV hypertrophy (LVH).
Methods
In this cross-sectional study we examined 1649 participants (997 women) of the Corinthia region, with a mean age of 64±12 years. Several demographic and clinical characteristics were recorded. Echocardiography was performed to all subjects. LV mass was calculated with the method of Devereux et al. LV mass was subsequently indexed for body surface area (BSA), and LVH was defined as left ventricular mass indexed for BSA ≥ 115 g/m2 in men and ≥ 95 g/m2 in women. Hepatic steatosis index (HSI) with the formula (8 × (ALT/AST) + BMI + (2, if diabetes mellitus) + (2, if female)) was used as a predictor of NAFLD. HSI values >36 was used to rule in steatosis.
Results
From the study population, 1353 were included in the steatosis category. Between the steatosis and non-steatosis group, there was a significant difference in age, gender, BMI and BSA and in several cardiovascular risk factors, including hypertension (Table 1). Interestingly, LV mass 155±38 gr vs. 142±31 gr, p<0.001) and LV mass index (82±17 gr/m2 vs. 79±14 gr/m2, p=0.01) were increased in the steatosis compared to non-steatosis group. LVH prevalence was higher in the steatosis compared to non-steatosis group (11% vs. 2%, p<0.001). Since significant confounders may interfere in the association of steatosis with LVH, we proceeded to a logistic regression analysis that confirmed the independent predictive value of steatosis to LVH (Table 2).
Conclusion
These findings highlight the interaction of cardiometabolic risks factors, liver steatosis and NAFLD with left ventricular remodeling and left ventricular hypertrophy independently of other known cardiovascular risk factors.
Abstract
Introduction
Both anthracyclines and trastuzumab are key regiments for the treatment of breast cancer, but their concurrent use is contraindicated because of their cardiotoxicity. Their ...effects on vascular function have been less well studied.
Purpose
We explored the effects of the anthracycline-based chemotherapy followed by trastuzumab-based treatment on endothelial function and arterial stiffness in patients with breast cancer.
Methods
46 female patients (54.56±11.5 years old) with breast cancer scheduled for anthracycline-based chemotherapy followed by the combination of trastuzumab and taxane were enrolled. Trastuzumab was continued until the completion of one-year treatment. All participants underwent assessment of the brachial flow mediated dilatation (FMD), endothelial independent dilatation (EID), carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) at baseline (BL), at the end of anthracycline treatment (FU1), 3 months following initiation of trastuzumab with taxane (FU2) and at the completion of treatment with trastuzumab (FU3).
Results
Over the follow-up period (15 months) there was significant deterioration in FMD (p=0.04) (Table 1, Figure 1). Importantly, while there was no significant difference in FMD between BL vs FU1 (p=0.6), FMD has been significantly deteriorated over the treatment with trastuzumab with taxane FU1 vs FU2 (p=0.01) and FU2 vs FU3 (p=0.01) (Table 1, Figure 1). EID did not change over the follow-up period (Figure 1). Similarly, PWV has been significantly increased over the follow up period (p=0.03). There was no significant difference in PWV BL vs FU1 (p=0.1), however PWV has been significantly increased over the treatment with trastuzumab with taxane FU1 vs FU 2 (p=0.02) and FU2 vs FU3 (p=0.01) (Table 1, Figure 1). A similar pattern of impairment was observed with AIx (Table 1, Figure 1).
Conclusion
We report a significant adverse effect of the anthracycline- and trastuzumab-based therapy on the arterial stiffness and endothelial function. This effect is more considerable after the exposure to trastuzumab.
Figure 1. Changes of FMD, PWV, Alx, EID during FU
Funding Acknowledgement
Type of funding source: None
Abstract The in vitro activity of daptomycin was evaluated against 360 multidrug-resistant Staphylococcus aureus isolates (including hospital-acquired isolates) and multidrug-susceptible ...community-acquired methicillin-resistant S. aureus with known virulence genes. All isolates were inhibited at ≤1 μg/mL, suggesting that daptomycin has excellent activity against both hospital-acquired and community-acquired S. aureus isolates.
Abstract Background/objectives Acute coronary syndromes (ACS) continue to pose a significant medical and socioeconomic burden worldwide. Optimal management strategy aims to improve short and ...long-term outcome. The present study aims to assess short-term outcome of real-world ACS patients and evaluate the achievement rate of secondary prevention goals. Methods The TARGET study is an observational study enrolling 418 consecutive ACS patients from 17 centers countrywide (78.0% males, 63.9 ± 12.9 years). After the in-hospital phase, patients were followed for 6 months. In total, 366 patients were included in the prospective phase of the study. At the end of the follow-up, mortality, major adverse cardiovascular events (MACE), prescription pattern of cardiovascular medications, lipid levels, adherence rate to treatment and behavioral recommendations were measured. Results The overall mortality was 4.8% and the rate of MACE was 17.5%. At 6 months, a significantly lower proportion of patients received antiplatelet agents and statins as compared to hospital discharge. At the end of the follow-up, 87.7% of patients remained on statin treatment, yet only 18.2% of patients had LDL cholesterol levels less than 70 mg/dL. The adherence pattern to lifestyle and dietary recommendations remained low (66.2% quit smoking, 55.8% and 81.3% followed physical activity and dietary recommendations respectively). Conclusion Despite the low rate of mortality and MACE occurrence rate in this countrywide observational study, the attainment rate of secondary prevention goals is relatively poor. Improvement interventions focusing in these gaps of optimal care provision are expected to have a favorable impact on the prognosis of real world ACS patients.
The 18Ne(α,p)21Na reaction plays a significant role in Type-I X-ray bursts. It is a major path in the breakout from the hot-CNO cycles to the synthesis of heavier elements in the αp- and ...rp-processes. An experiment to determine the cross section of this reaction was performed with the ANASEN active-target detector system, determining the cross section at energies between 2.5 and 4 MeV in the center-of-mass frame. The measured cross sections for reactions populating the ground state in 21Na are consistent with results obtained from the time-inverse reaction, but significantly lower than the previously published experimental data of direct measurements. The total cross sections are also compared with those derived from indirect methods and statistical-model calculations. Furthermore, this experiment establishes a new experimental data set on the excitation function of the 18Ne(α,p)21Na reaction, revealing the significance of the excited states' contributions to the total reaction cross section and allowing us to separate the contribution of the (α,2p) reaction. The impact of the measured cross section on thermal reaction rates is discussed.
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