Classical risk factors play a major role in the initiation and development of atherosclerosis. However, the estimation of risk for cardiovascular events based only on risk factors is often ...insufficient. Efforts have been made to identify biomarkers that indicate ongoing atherosclerosis. Among important circulating biomarkers associated with peripheral arterial disease (PAD) are inflammatory markers which are determined by the expression of different genes and epigenetic processes. Among these proinflammatory molecules, interleukin-6, C-reactive protein, several adhesion molecules, CD40 ligand, osteoprotegerin and others are associated with the presence and progression of PAD. Additionally, several circulating prothrombotic markers have a predictive value in PAD. Genetic polymorphisms significantly, albeit moderately, affect risk factors for PAD via altered lipoprotein metabolism, diabetes, arterial hypertension, smoking, inflammation and thrombosis. However, most of the risk variants for PAD are located in noncoding regions of the genome and their influence on gene expression remains to be explored. MicroRNAs (miRNAs) are single-stranded, noncoding RNAs that modulate gene expression at the post-transcriptional level. Patterns of miRNA expression, to some extent, vary in different atherosclerotic cardiovascular diseases. miRNAs appear to be useful in the detection of PAD and the prediction of progression and revascularization outcomes. In conclusion, taking into account one’s predisposition to PAD, i.e., DNA polymorphisms and miRNAs, together with circulating inflammatory and coagulation markers, holds promise for more accurate prediction models and personalized therapeutic options.
Exercise training is associated with an acute net increase in coagulation, which may increase the risk of atherothrombosis in coronary artery disease (CAD) patients. We sought to compare the acute ...haemostatic effects of a bout of moderate-intensity continuous (MICT) and high-intensity interval training (HIIT) in patients with CAD. Patients after a recent myocardial infarction were randomized into a HIIT or MICT session of exercise training on a stationary bike. Blood was sampled at baseline, after the exercise bout and after a one-hour resting period. We measured overall haemostatic potential (OHP), overall coagulation potential (OCP), fibrinogen, D-dimer and von Willebrand factor (vWF) and calculated overall fibrinolytic potential (OFP). Linear mixed models for repeated measures were constructed to assess the treatment effect. A total of 117 patients were included. OCP, OHP, fibrinogen, D-dimer and vWF significantly increased after exercise and returned to baseline after a one-hour rest, OFP decreased after exercise and returned to baseline levels after a one-hour rest. Linear mixed models showed a significant difference between HIIT and MICT in fibrinogen (p 0.043) and D-dimer (p 0.042). Our study has shown that an exercise bout is associated with a transient procoagulant state in patients with CAD, with similar exercise-induced haemostatic changes for HIIT and MICT.
Herein, we prepared a series of nanocomposite membranes based on chitosan (CS) and three compositionally and structurally different N-doped graphene derivatives. Two-dimensional (2D) and quasi 1D ...N-doped reduced graphene oxides (N-rGO) and nanoribbons (N-rGONRs), as well as 3D porous N-doped graphitic polyenaminone particles (N-pEAO), were synthesized and characterized fully to confirm their graphitic structure, morphology, and nitrogen (pyridinic, pyrrolic, and quaternary or graphitic) group contents. The largest (0.07%) loading of N-doped graphene derivatives impacted the morphology of the CS membrane significantly, reducing the crystallinity, tensile properties, and the KOH uptake, and increasing (by almost 10-fold) the ethanol permeability. Within direct alkaline ethanol test cells, it was found that CS/N rGONRs (0.07 %) membrane (P
. = 3.7 mWcm
) outperformed the pristine CS membrane significantly (P
. = 2.2 mWcm
), suggesting the potential of the newly proposed membranes for application in direct ethanol fuel cells.
The most frequent neutralisation procedure, applied on chitosan (CS) films includes treatment with NaOH base. Such treatment endows CS films with stability in water, yet, same can significantly ...decrease the film performance. In the present paper, we investigate Mg(OH)
2
nanoparticles as a neutralisation agent for CS solutions followed by casting into films. This is combined and compared with classical casting and film drying from non-neutralized solutions followed by NaOH treatment after film formation. The influence on the properties of resulting films is investigated in detail and large differences are found for structure and barrier properties. The stable, opaque-to-transparent CS films (depending on Mg(OH)
2
content and post-treatment) were obtained by facile casting method of neat CS or CS–Mg(OH)
2
dispersions, in the complete absence of cross-linkers and plasticizers. FTIR data demonstrate the Mg(OH)
2
and NaOH deprotonation effect, and strongly suggest intensive H-bonding interaction between CS and Mg(OH)
2
. X-ray photoelectron spectroscopy showed differences in the hydroxide content and protonation of CS nitrogen. The reduction of surface roughness and increase of homogeneity, the tensile strength and elongation, as well as thermal stability and excellent oxygen barrier properties were measured for CS enclosing the Mg(OH)
2
nanoparticles. Further treatment with 1 M NaOH causes re-packing of CS polymer chains, improving the crystallinity and water vapour barrier properties, degrading the mechanical properties by increasing the films brittleness and increasing the char formation due to reduced thermal stability.
Graphic abstract
Background. Metabolic abnormalities and hypercoagulability seem to have an important predictive role in patients with coronary artery disease (CAD). The triglyceride-glucose (TyG) index has emerged ...as a good marker for metabolic syndrome with predictive value for cardiovascular events. Overall haemostatic potential (OHP) is a reliable global haemostatic essay to identify hypercoagulability in CAD patients. The aim of our study was therefore to evaluate a possible correlation between the TyG index and haemostatic derangements in patients with CAD. Methods. Consecutive patients referred for the first follow-up visit after acute myocardial infarction between December 1, 2018, and March 31, 2020, and did not meet exclusion criteria were included. We determined OHP, overall coagulation potential (OCP), overall fibrinolytic potential (OFP), fibrinogen, D-dimer, and von Willebrand factor from peripheral blood samples. The TyG index was calculated with the previously described and validated formula. Linear regression models were constructed for the multivariate analysis. Results. A total of 117 patients (mean age 56±10 years, 20% women) were included. A correlation was found between TyG index and OCP (r=0.229,p=0.026), TyG index and OHP (r=0.202,p=0.050), and TyG index and fibrinogen (r=0.271,p=0.005). In the multivariate model which accounted for sex, age, and BMI, the correlation between TyG index and OCP (R2 0.108; ANOVA for regression p=0.035; beta 2.08 0.79-4.01, p=0.042) and between TyG index and fibrinogen (R2 0.11; ANOVA for regression p=0.015; beta 0.35 0.08-0.62, p=0.012) emerged as statistically significant. Conclusion. The TyG index, a marker of metabolic syndrome, has a strong correlation with a hypercoagulability state in CAD, as determined by the OCP and higher fibrinogen levels. Our findings suggest that metabolic syndrome may be an important driver of atherothrombotic risk in patients with CAD.
Antithrombin (AT) deficiency increases the risk for venous thromboembolism, therefore, a highly sensitive assay to identify this condition is crucial. The aim of this paper was to perform a ...meta-analysis comparing AT activities measured by different AT activity assays in patients with heparin binding site AT deficiency. In addition, the diagnostic sensitivity of selected assays was compared depending on the available data. An extensive literature search was performed considering results with publication date up to July 10, 2021. Seven relevant English-language observational studies, comparing AT activity measured by different AT activity assays in Caucasian Europeans with either the AT Budapest III or AT Padua I mutation were included in meta-analyses. There was no significant difference in AT activity between Labexpert and Innovance in patients with AT Budapest III (P = 0.567) and AT Padua I (P = 0.265), while AT activity determined by HemosIL was significantly higher compared to Innovance for both mutations (AT Budapest III: P < 0.001; AT Padua I: P < 0.001). These results are in line with the results of comparison of diagnostic sensitivity. In patients with AT Budapest III, the AT activity was also higher when measured with Berichrom compared to Innovance (P = 0.002), however, the results of comparison of diagnostic sensitivity across studies were variable. No significant difference (P = 0.117) in AT activity as well as diagnostic sensitivity was observed between Sta-Stachrom and Innovance. The results of our study suggest that Innovance, Labexpert and Sta-Stachrom are the most sensitive activity assays for detection of AT Budapest III and AT Padua I, whereas HemosIL showed considerably lower sensitivity for these two variants. As revealed in our study, the diagnostic sensitivity of AT activity assays to type II heparin binding site AT deficiency is different, and in some assays mutation dependent.
Dabigatran interferes with many coagulation tests. To overcome this obstacle the use of idarucizumab as an in vitro antidote to dabigatran has been proposed. The aim of this study was to test the ...effect of idarucizumab as an in vitro antidote to dabigatran in ex vivo plasma samples from routine clinical patients examined by a thrombin generation assay (TGA). From 44 patients with atrial fibrillation five blood samples were collected. Thrombin generation was measured in all samples before and after the addition of idarucizumab. When idarucizumab was added to baseline plasma (no dabigatran), it caused a significantly shorter Lag Time and Time to Peak Thrombin, and a higher Peak Thrombin and Endogenous Thrombin Potential (ETP) of TGA. Similar results were obtained when idarucizumab was added to dabigatran-containing plasma, with TGA parameters comparable to baseline + idarucizumab plasma, but not to baseline plasma. In summary, our study showed that in vitro addition of idarucizumab to plasma samples from patients increases thrombin generation. The use of idarucizumab to neutralize dabigatran in patient plasma samples as well as the clinical relevance of in vitro increased thrombin generation induced by idarucizumab needs further investigation.
Background. Heart failure with preserved ejection fraction (HFpEF) has a complex pathophysiology that encompasses systemic proinflammatory state and dysregulated levels of cardiometabolic and ...oxidative stress biomarkers. The prevalence of both HFpEF and atrial fibrillation (AF) is continuously rising, especially in the elderly. The aim of our study was to explore if there were any differences in biomarker levels and vascular function in the elderly patients with HFpEF with and without AF and to assess interconnections between clinically relevant biomarkers and cardiac and vascular function. Methods. This was a cross-sectional study of patients≥65 years with HFpEF who were divided into 2 groups based on the presence or absence of AF. We have sonographically assessed echocardiographic parameters of left ventricular systolic and diastolic function and the peripheral vascular function parameters, namely, pulse wave velocity (PWV) and flow-mediated dilation (FMD). NT-proBNP, irisin, leptin, adiponectin, insulin-like growth factor 1 (IGF-1), and malondialdehyde (MDA) blood levels were determined. Results. Fifty-two patients (mean age 80±7 years, 67% females) were included. Patients with HFpEF and AF had significantly lower levels of irisin (median 4.75 vs. 13.5 ng/mL, p=0.007), leptin (median 9.5 vs. 15.0 ng/L, p=0.023), and MDA (median 293 vs. 450 ng/mL, p=0.017) and significantly higher values of NT-proBNP (median 2365 vs. 529 ng/L, p<0.001) but not vascular function parameters, as compared to HFpEF patients without AF. MDA was significantly correlated with diastolic function (r=0.395, p=0.007) and FMD (r=0.394, p=0.011), while adiponectin was inversely associated with FMD (r=−0.325, p=0.038) and left ventricular ejection fraction (r=−0.319, p=0.029). Conclusions. Our results have demonstrated that patients with HFpEF and AF have significantly lower leptin, irisin, and MDA levels compared to patients with HFpEF but without AF. These results offer new insights into the complexity of vascular function and cardiometabolic and oxidative stress biomarkers in the context of HFpEF, AF, and aging.
The effect of resistance training (RT) in cardiac rehabilitation (CR) on insulin resistance remains elusive. We examined whether the addition of high-load (HL) or low loads (LL) RT has any effect on ...the levels of insulin resistance and lipids versus aerobic training (AT) alone in patients with coronary artery disease (CAD).
Seventy-nine CAD patients were randomised to HL-RT 70-80% of one repetition maximum (1-RM) and AT, LL-RT (35-40% of 1-RM) and AT or AT (50-80% of maximal power output), and 59 patients 75% males, 15% diabetics, age: 61 (8) years, left ventricular ejection fraction: 53 (9) % completed the study. Plasma levels of glucose, insulin, blood lipids total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol and body composition were measured at baseline and post-training (36 training sessions).
Training intervention had only time effect on lean mass (p = 0.002), total and LDL cholesterol levels (both p < 0.001), and no effects on levels of glucose and insulin resistance (homeostatic assessment 2-insulin resistance). Total and LDL cholesterols levels decreased following AT mean difference (95% confidence interval); total cholesterol: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.013; LDL: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.006 and HL-RT total cholesterol: - 0.5 mmol/l (- 0.8 mmol/l, - 0.2 mmol/l), p = 0.002; LDL: - 0.5 mol/l (- 0.7 mmol/l, - 0.2 mmol/l), p = 0.002. No associations were observed between post-training change in body composition and post-training change in blood biomarkers.
RT when combined with AT had no additional effect beyond AT alone on fasting glucose metabolism, blood lipids and body composition in patients with CAD. Trial registration number NCT04638764.
Sedimentation is a naturally occurring process of allowing particles in water bodies to settle out of the suspension under a gravity effect. In this study, the sediments of the Drava River were fully ...investigated to determine the heavy metal concentrations along the river and their potential reuse in the construction sector. Naturally dehydrated sediments from the Drava River were tested as an additive for the production of fired bricks. The dredged sediments were used as a substitute for natural brick clay in amounts up to 50% by weight, and it was confirmed that up to 20% by weight of the added sediment could be used directly in the process without critically affecting performance. Finally, the naturally dehydrated sediments were also evaluated for their use as a filling material in the construction of levees. The natural moisture content of the dehydrated sediment was too high for it to be used without additives, so quicklime was added as an inorganic binder. The test results showed an improvement in the geotechnical properties of the material to such an extent that it is suitable as a filling material for levees.
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