Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. Results: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). Conclusions: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.
Several human diseases have been associated with mitochondrial voltage-dependent anion channel-1 (VDAC1) due to its role in calcium ion transportation and apoptosis. Recent studies suggest that VDAC1 may interact with endothelium-dependent nitric oxide synthase (eNOS). Decreased VDAC1 expression may limit the physical interaction between VDAC1 and eNOS and thus impair nitric oxide production, leading to cardiovascular diseases, including pulmonary arterial hypertension (PAH). In this report, we conducted meta-analysis of genome-wide expression data to identify VDAC1 influenced genes implicated in PAH pathobiology. First, we identified the genes differentially expressed between wild-type and Vdac1 knockout mouse embryonic fibroblasts in hypoxic conditions. These genes were deemed to be influenced by VDAC1 deficiency. Gene ontology analysis indicates that the VDAC1 influenced genes are significantly associated with PAH pathobiology. Second, a molecular signature derived from the VDAC1 influenced genes was developed. We suggest that, VDAC1 has a protective role in PAH and the gene expression signature of VDAC1 influenced genes can be used to i) predict severity of pulmonary hypertension secondary to pulmonary diseases, ii) differentiate idiopathic pulmonary artery hypertension (IPAH) patients from controls, and iii) differentiate IPAH from connective tissue disease associated PAH.
The purpose of this study was to confirm that regular physical exercise habit and calcium intake play a role in reducing the risk of cardiovascular disease, particularly to confirm that regular exercise is important in reducing serum lipid levels in postmenopausal women. Subjects were classified into regular exercise group(more than 3 times/wk, more than 30 min per exercise) and non-regular exercise group. A convenient frequency method was used to assess the nutritional intake of subjects. Anthropometric measurement such as body weight and height, and blood pressure were measured. There was no significant difference between non-regular exercise group and regular exercise group in energy intake and calcium intake. The total cholesterol and LDL-cholesterol concentrations in non-regular exercise group were significantly higher than those in regular exercise group. There were no significant correlations between age or weight with blood lipids and blood pressure in regular exercise group, while there were significant positive correlations between age or weight with blood lipids and blood pressure in non-regular exercise group. The levels of serum cholesterol, triglyceride, blood pressure and atherogenic index increased with age in non-regular exercise women. The blood pressure in low total Ca intake/plant Ca intake ratio group was significantly higher than that in high total Ca intake/plant Ca intake ratio group. There was a highly significant positive correlation between Ca intake and HDL-cholesterol in non-regular exercise women. And, there was a highly significant negative correlation between Ca intake and blood pressure in regular exercise women. The results suggest that increased habitual physical activity and calcium intake should be recommended by way of decreasing blood lipids and blood pressure in postmenopausal women. (Korean J Nutrition 34(4) : 417∼425, 2001)
The aim of this study was to investigate the effects of kaempferol on the pharmacokinetics of nimodipine in rats. Nimodipine and kaempferol interact with cytochrome P450 (CYP) enzymes and P-glycoprotein (P-gp), and the increase in the use of health supplements may result in kaempferol being taken concomitantly with nimodipine as a combination therapy to treat orprevent cardiovascular disease. The effect of kaempferol on P-gp and CYP3A4 activity was evaluated and Pharmacokinetic parameters of nimodipine were determined in rats after an oral (12 mg/kg) and intravenous (3 mg/kg) administration of nimodipine to rats in the presence and absence of kaempferol (0.5, 2.5, and 10 mg/kg). Kaempferol inhibited CYP3A4 enzyme activity in a concentration-dependent manner with 50% inhibition concentration ($IC_{50}$) of $17.1{\mu}M$. In addition, kaempferol significantly enhanced the cellular accumulation of rhodamine-123 in MCF-7/ADR cells overexpressing P-gp. Compared to the oral control group, the area under the plasma concentration-time curve ($AUC_{0-\infty}$) and the peak plasma concentration ($C_{max}$) of nimodipine significantly increased, respectively. Consequently, the absolute bioavailability of nimodipine in the presence of kaempferol (2.5 and 10 mg/kg) was 29.1-33.3%, which was significantly enhanced compared to the oral control group (22.3%). Moreover, the relative bioavailability of nimodipine was 1.30- to 1.49-fold greater than that of the control group. The pharmacokinetics of intravenous nimodipine was not affected by kaempferol in contrast to those of oral nimodipine. Kaempferol significantly enhanced the oral bioavailability of nimodipine, which might be mainly due to inhibition of the CYP3A4-mediated metabolism of nimodipine in the small intestine and /or in the liver and to inhibition of the P-gp efflux transporter in the small intestine by kaempferol. The increase in oral bioavailability of nimodipine in the presence of kaempferol should be taken into consideration of potential drug interactions between nimodipine and kaempferol.
Recently, the cardiovascular disease has been widely problematic in humans probably due to fibrin formation via the unbalanced Western style diet. Although direct (human plasmin) and indirect methods (plasminogen activators) have been available, bacterial enzyme methods have been studied because of their cheap and mass production. To detect a novel bacterial fibrinolytic enzyme, 111 bacterial strains with fibrinolytic activity were selected from kimchi. Among them, 14 strains were selected because of their stronger activity than 0.02 U of plasmin. Their 16S rRNA sequence analysis revealed that they belong to Bacillus, Leuconostoc, Propionibacterium, Weissella, Staphylococcus, and Bifidobacterium. The strain B. subtilis ZA400, with the highest fibrinolytic activity, was selected and the gene encoding fibrinolytic enzyme (bsfA) was cloned and expressed in the E. coli overexpression system. The purified enzyme was analyzed with SDS-PAGE, western blot, and MALDI-TOF analyses, showing to be 28.4 kDa. Subsequently, the BsfA was characterized to be stable under various stress conditions such as temperature (4-40oC), metal ions (Mn2+, Ca2+, K2+, and Mg2+), and inhibitors (EDTA and SDS), suggesting that BsfA could be a good candidate for development of a novel fibrinolytic enzyme for thrombosis treatment and may even be useful as a new bacterial starter for manufacturing functional fermented foods.
Purpose: Indoxyl sulfate and p-cresyl sulfate are important protein-bound uremic retention solutes whose levels can be partially reduced by renal replacement therapy. These solutes originate from intestinal bacterial protein fermentation and are associated with cardiovascular outcomes and chronic kidney disease progression. The aims of this study were to investigate the levels of indoxyl sulfate and p-cresyl sulfate as well as the effect of probiotics on reducing the levels of uremic toxins in pediatric patients on dialysis. Methods: We enrolled 20 pediatric patients undergoing chronic dialysis; 16 patients completed the study. The patients underwent a 12-week regimen of VSL#3, a high-concentration probiotic preparation, and the serum levels of indoxyl sulfate and p-cresyl sulfate were measured before treatment and at 4, 8, and 12 weeks after the regimen by using fluorescence liquid chromatography. To assess the normal range of indoxyl sulfate and p-cresyl sulfate we enrolled the 16 children with normal glomerular filtration rate who had visited an outpatient clinic for asymptomatic microscopic hematuria that had been detected by a school screening in August 2011. Results: The baseline serum levels of indoxyl sulfate and p-cresyl sulfate in the patients on chronic dialysis were significantly higher than those in the children with microscopic hematuria. The baseline serum levels of p-cresyl sulfate in the peritoneal dialysis group were significantly higher than those in the hemodialysis group. There were no significant changes in the levels of these uremic solutes after 12-week VSL#3 treatment in the patients on chronic dialysis. Conclusion: The levels of the uremic toxins p-cresyl sulfate and indoxyl sulfate are highly elevated in pediatric patients on dialysis, but there was no significant effect by probiotics on the reduction of uremic toxins in pediatric dialysis patients. Therefore, studies for other medical intervention to reduce uremic toxins are also necessary in pediatric patients on dialysis.
Amyloid ${\beta}-peptide\;(A{\beta})$ contributes to the pathogenesis of Alzheimer's disease (AD), causing neuronal death through apoptosis. In this study, the neuroprotective role of BF-7, extracted form sericultural product, was examined against $A{\beta}-induced$ toxicity in cultured human neuronal cell SKN-SH. In order to know if the BF-7 has positive role on the cognition and memory in human, the mixture of BF-7, DHA and EPA (BDE) was examined using Rey Kim and K-WAIS test with 50 healthy high school student. We report here that BDE significantly attenuated $A{\beta}-induced$ apoptosis through the reduction of ROS accumulation, and diminished caspase-like protease activity. Moreover, the memory index and memory preservation, and attentative concentration of BDE treated group for 1 month were significantly improved, in contrast to the case of placebo control treated with DHA and EPA. This result represent that the BF-7 play significant positive role on learning memory. Taken together, our result suggested the natural product BF-7 is a good substance for the brain functionally and physiologically.
Whether the $FTO$ polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the $FTO$ rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the $FTO$ risk allele whose BMI is $29kg/m^2$ or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than $25kg/m^2$. In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the $FTO$ risk alleles who had BMI of $29kg/m^2$ or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.
Kim, Cheol Woo;Figueroa, Arturo;Park, Chan Ho;Kwak, Yi Sub;Kim, Kwi Baek;Seo, Dae Yun;Lee, Hyung Rock
Nutrition Research and Practice
/
v.7
no.5
/
pp.347-351
/
2013
Food-dependent exercise-induced anaphylaxis (FDEIAn) is induced by different types and various intensities of physical activity, and is distinct from food allergies. It has been shown that consumption of allergenic food followed by exercise causes FDEIAn symptoms. Intake of allergenic food or medication before exercise is a major predisposing factor for FDEIAn. Urticaria and severe allergic reactions are general symptoms of FDEIAn. Dermatological tests and serum IgE assays are the typical prescreening methods, and have been used for several decades. However, these screening tests are not sufficient for detecting or preventing FDEIAn. It has been found that exercise may stimulate the release of mediators from IgE-dependent mast cells that can result in FDEIAn when a certain threshold level has been exceeded. Mast cell degradation might be a major factor to induce FDEIAn but this has not been determined. A number of foods have been reported to be involved in the onset of FDEIAn including wheat, eggs, chicken, shrimp, shellfish, nuts, fruits, and vegetables. It is also known that aspirin increases the occurrence of type I allergy symptoms when combined with specific foods. Moreover, high intensity and frequent exercise are more likely to provoke an attack than low intensity and less frequent exercise. In this paper, we present the current views of the pathophysiological mechanisms underlying FDEIAn within the context of exercise immunology. We also present a detailed FDEIAn definition along with etiologic factors and medical treatment for cholinergic urticaria (UC) and exercise-induced anaphylaxis (EIA).
Abdominal obesity (AO) is a strong risk factor for type 2 diabetes and cardiovascular disease, which has shown a remarkable increase in Korea. This study aimed to identify prevalence of AO and related risk factors in Korean adults. A total of 5,132 men and women aged 20-85 years old from the 2001 Korean National Health and Nutrition Examination Survey were included in the analyses. AO was defined as waist circumference >=90 cm in men and >=85 cm in women as proposed by Korean Society of Obesity. Multiple logistic regression was carried out to identify risk factors for AO. Three models were specified: (i) demographic and socioeconomic factors (model 1: age, education, poverty income ratio, employment), (ii) lifestyle factors and covariates (model 2: physical activity, cigarette smoking, alcohol consumption, dietary quality, type 2 diabetes, co-morbidity) and (iii) demographic, socioeconomic and lifestyle factors (model 3). The prevalence of AO was 24.1 % in men, 23.5% in women. High poverty income ratio in men and low education attainment in women were risk factors for AO in model. 1. There was a significant association of AO with alcohol consumption, physical inactivity and dietary quality in men, alcohol consumption and cigarette smoking in women. These factors except alcohol consumption in men became insignificant in model 3. This findings underscore the importance of developing AO prevention programs in Korea that target the at risk groups identified in this study. A program focusing on low income men or less educated women would be more efficient.
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