scholarly journals Bilirubin and cardiovascular risk

2021 ◽  
Vol 26 (9) ◽  
pp. 4511
Author(s):  
O. M. Drapkina ◽  
A. Ya. Kravchenko ◽  
A. V. Budnevsky ◽  
A. V. Kontsevaya ◽  
M. S. Ryaskina ◽  
...  

This literature review demonstrates the results of experimental and clinical studies, as well as data from meta-analyzes on the effect of bilirubin levels on cardiovascular system. Recent studies provided a new look at the role of bilirubin in cardiovascular disease. Modern concepts consider bilirubin as a powerful endogenous antioxidant with anti-inflammatory effects, capable of influencing the course of atherosclerotic cardiovascular diseases and reducing ischemic damage. The change in bilirubin levels affects the coronary blood flow, the development of collateral circulation and the morphology of coronary plaques. A low bilirubin level is associated with an increase in left ventricular mass and a decrease in its contractility, which, in turn, leads to heart failure and increases the risk of rehospitalizations. Taking into account the above effects of bilirubin, there was interest in assessing the effect of its blood level on the risk of atherosclerotic cardiovascular diseases. Recent studies have attempted to create risk stratification models for adverse cardiovascular events based on bilirubin levels.

2021 ◽  
Vol 102 (4) ◽  
pp. 510-517
Author(s):  
E V Khazova ◽  
O V Bulashova

The discussion continues about the role of systemic inflammation in the pathogenesis of cardiovascular diseases of ischemic etiology. This article reviews the information on the role of C-reactive protein in patients with atherosclerosis and heart failure in risk stratification for adverse cardiovascular events, including assessment of factors affecting the basal level of highly sensitive C-reactive protein. Research data (MRFIT, MONICA) have demonstrated a relationship between an increased level of C-reactive protein and the development of coronary heart disease. An increase in the serum level of highly sensitive C-reactive protein is observed in arterial hypertension, dyslipidemia, type 2 diabetes mellitus and insulin resistance, which indicates the involvement of systemic inflammation in these disorders. Currently, the assessment of highly sensitive C-reactive protein is used to determine the risk of developing myocardial infarction and stroke. It has been proven that heart failure patients have a high level of highly sensitive C-reactive protein compared with patients without heart failure. The level of C-reactive protein is referred to as modifiable risk factors for cardiovascular diseases of ischemic origin, since lifestyle changes or taking drugs such as statins, non-steroidal anti-inflammatory drugs, glucocorticoids, etc. reduce the level of highly sensitive C-reactive protein. In patients with heart failure with different left ventricular ejection fraction values, it was found that the regression of the inflammatory response is accompanied by an improvement in prognosis, which confirms the hypothesis of inflammation as a response to stress, which has negative consequences for the cardiovascular system.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e032633 ◽  
Author(s):  
Kuo-Liong Chien ◽  
Ting-Yu Lin ◽  
Chen-Yang Hsu ◽  
Chang-Chuan Chan ◽  
Tony Hsiu-Hsi Chen ◽  
...  

ObjectivesThe role of faecal haemoglobin as a colorectal cancer screening tool has been demonstrated. However, the association between the faecal haemoglobin concentration and the risk of cardiovascular disease events and deaths is still unclear.DesignCohort study design.SettingPopulation-based organised integrated service screening in Keelung City, TaiwanParticipantsA total of 33 355 healthy individuals aged over 40 years who were free of cardiovascular disease at study entry were followed up.Main outcomes and measuresNewly diagnosed cardiovascular disease events and deaths.ResultsAfter a median follow-up of 2.39 years, a total of 2768 participants developed cardiovascular events, and after a median follow-up of 8.43 years, 317 cases of cardiovascular deaths occurred. The risk of cardiovascular disease increased with baseline faecal haemoglobin in a dose–response manner, yielding a significant elevated risk of cardiovascular disease in parallel with the incremental concentration of faecal haemoglobin (adjusted HRs=1.04, 1.10, 1.40 and 1.23 for faecal haemoglobin concentrations of 1–19, 20–49, 50–99 and ≥100 ng/mL, trend test, p<0.0001, as compared with the reference group with undetectable faecal haemoglobin concentrations). A similar pattern was observed for the risk of cardiovascular disease deaths. In addition, the faecal haemoglobin improved the prediction performance of the model for the risk of cardiovascular diseases; the integrated discrimination improvement was 0.3% (p<0.001) for cardiovascular events and 0.1% (p=0.020) for cardiovascular deaths.ConclusionsOur data support that faecal haemoglobin concentrations may be associated with the risk of cardiovascular diseases. The biological mechanisms underlying the role of faecal haemoglobin as health outcomes should be investigated.


2016 ◽  
Vol 310 (11) ◽  
pp. H1583-H1591 ◽  
Author(s):  
Sakima A. Smith ◽  
Langston D. Hughes ◽  
Crystal F. Kline ◽  
Amber N. Kempton ◽  
Lisa E. Dorn ◽  
...  

β2-Spectrin is critical for integrating membrane and cytoskeletal domains in excitable and nonexcitable cells. The role of β2-spectrin for vertebrate function is illustrated by dysfunction of β2-spectrin-based pathways in disease. Recently, defects in β2-spectrin association with protein partner ankyrin-B were identified in congenital forms of human arrhythmia. However, the role of β2-spectrin in common forms of acquired heart failure and arrhythmia is unknown. We report that β2-spectrin protein levels are significantly altered in human cardiovascular disease as well as in large and small animal cardiovascular disease models. Specifically, β2-spectrin levels were decreased in atrial samples of patients with atrial fibrillation compared with tissue from patients in sinus rhythm. Furthermore, compared with left ventricular samples from nonfailing hearts, β2-spectrin levels were significantly decreased in left ventricle of ischemic- and nonischemic heart failure patients. Left ventricle samples of canine and murine heart failure models confirm reduced β2-spectrin protein levels. Mechanistically, we identify that β2-spectrin levels are tightly regulated by posttranslational mechanisms, namely Ca2+- and calpain-dependent proteases. Furthermore, consistent with this data, we observed Ca2+- and calpain-dependent loss of β2-spectrin downstream effector proteins, including ankyrin-B in heart. In summary, our findings illustrate that β2-spectrin and downstream molecules are regulated in multiple forms of cardiovascular disease via Ca2+- and calpain-dependent proteolysis.


2017 ◽  
Vol 233 (3) ◽  
pp. R173-R184 ◽  
Author(s):  
Ricardo Rodríguez-Calvo ◽  
Josefa Girona ◽  
Josep M Alegret ◽  
Alba Bosquet ◽  
Daiana Ibarretxe ◽  
...  

Obesity and ectopic fat accumulation in non-adipose tissues are major contributors to heart failure (HF) and cardiovascular disease (CVD). Adipocytes act as endocrine organs by releasing a large number of bioactive molecules into the bloodstream, which participate in a communication network between white adipose tissue and other organs, including the heart. Among these molecules, fatty acid-binding protein 4 (FABP4) has recently been shown to increase cardiometabolic risk. Both clinical and experimental evidence have identified FABP4 as a relevant player in atherosclerosis and coronary artery disease, and it has been directly related to cardiac alterations such as left ventricular hypertrophy (LVH) and both systolic and diastolic cardiac dysfunction. The available interventional studies preclude the establishment of a direct causal role of this molecule in CVD and HF and propose FABP4 as a biomarker rather than as an aetiological factor. However, several experimental reports have suggested that FABP4 may act as a direct contributor to cardiac metabolism and physiopathology, and the pharmacological targeting of FABP4 may restore some of the metabolic alterations that are conducive to CVD and HF. Here, we review the current knowledge regarding FABP4 in the context of HF and CVD as well as the molecular basis by which this protein participates in the regulation of cardiac function.


Author(s):  
Hidetaka Ota ◽  
Masahiro Akishita

There is a continuum of expression of cardiac structural and functional alterations that occurs with ageing in healthy humans, and these age-associated cardiac changes seem to be relevant to the increase in left ventricular hypertrophy, chronic heart failure, and arrhythmia that are commonly observed with increasing age. This chapter describes the structural and functional changes in the ageing process of the heart and blood vessels, and provides an overview of representative cardiovascular disease caused by ageing including hypertension, atherosclerosis, and heart failure. In addition, an outline of interventions that have be utilized to prevent and treat ageing related cardiovascular diseases is provided.


2015 ◽  
Vol 10 (2) ◽  
pp. 187-194
Author(s):  
Gabriel Cristian BEJAN ◽  
◽  
Dumitru MATEI ◽  
Adela IANCU ◽  
◽  
...  

Metabolic syndrome, also called insulin resistance syndrome or excess of catecholamines, is represented by several cardiometabolic factors that result in increased incidence of cardiovascular disease and type 2 diabetes. Due to sedentary lifestyle and hypercaloric food, with a high percent of saturated fats and carbohydrates, that characterize modern lifestyle of the population, especially in urban areas, the prevalence of metabolic syndrome recorded an ascending slope that makes it a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, with age between 48 and 83 years, in whom we determined the prevalence of metabolic syndrome and cardiovascular disease. The survey results showed an increased prevalence of metabolic syndrome, considering that we related to a hypertensive population, and an increased risk of non-fatal atherosclerotic cardiovascular diseases in men and fatal cardiovascular events in next 10 years especially for women.


2009 ◽  
Vol 1 ◽  
pp. CMT.S2095
Author(s):  
M. Khazaei ◽  
AM. Sharifi ◽  
S. Golbidi ◽  
I. Laher

Several clinical studies demonstrate a beneficial role of angiotensin-converting enzyme (ACE) inhibitors in patients with myocardial infarction, hypertension and diabetes mellitus. This review focuses on the effects of ramipril, a weak inhibitor of ACE that is rapidly hydrolyzed to ramiprilat, an active metabolite. The Heart Outcome Prevention Evaluation (HOPE) study evaluated the effects of ramipril in patients with a high risk for cardiovascular events without pre-existing left ventricular dysfunction or heart failure. In this review, we summarized the effects of ramipril on myocardial infarction, death, diabetes mellitus, and stroke.


Author(s):  
Theo Pezel ◽  
Bharath Ambale Venkatesh ◽  
Henrique Doria De Vasconcellos ◽  
Yoko Kato ◽  
Mahsima Shabani ◽  
...  

Both left atrial and left ventricular functional parameters influence the prognosis of patients with cardiovascular diseases. This study aimed to investigate the prognostic value of a novel left atrioventricular coupling index (LACI) in a population without history of cardiovascular diseases at baseline. Participants of the Multi-Ethnic Study of Atherosclerosis who underwent a baseline cardiovascular magnetic resonance study were analyzed. LACI was defined by the ratio of the left atrial end-diastolic volume divided by the left ventricular end-diastolic volume. Cox proportional hazard models were used to evaluate the association between LACI and atrial fibrillation, heart failure, coronary heart disease death, and hard cardiovascular disease defined by myocardial infarction, resuscitated cardiac arrest, fatal and nonfatal stroke, or coronary heart disease death. Among the 4124 participants (61.5±10.1 years, 47.4% men), 1074 cardiovascular events were observed (mean follow-up, 13.0±3.2 years). Greater LACI was independently associated with atrial fibrillation (hazard ratio, 1.86 [95% CI, 1.69–2.04]), heart failure (hazard ratio, 1.50 [95% CI, 1.38–1.62]), hard cardiovascular disease (1.23 [95% CI, 1.13–1.34]), and coronary heart disease death (hazard ratio, 1.29 [95% CI, 1.15–1.45]; all P <0.0001). After adjustment for traditional cardiovascular risk factors, LACI showed significant improvement in model discrimination and reclassification compared with currently used standard models to predict outcomes. LACI is a strong predictor for the incidence of heart failure, atrial fibrillation, hard cardiovascular disease, and coronary heart disease death. LACI has incremental prognostic value to predict cardiovascular events over traditional risk factors and better discrimination and reclassification power compared with individual left atrial or left ventricular parameters.


2016 ◽  
Vol 1 (1) ◽  

Cardiovascular disease (CVD) is the leading cause of death today and a burden on a country’s economic growth. Management of this disease continues to depend on dietary control and statins. However, the disease burden refuses to decline. It is probably because treatment regime addresses the effect and not the cause. Augmented LDL level has been traditionally perceived as the major risk factor contributing to the development of atherosclerosis, the main cause of several coronary ailments. Recent research also suggests that pre-existing chronic inflammation leads to oxidation of LDL and thus makes it pathogenic. This inflammatory repertoire, apart from leukocytes, also includes the anucleated cell fragments called platelets. Platelets conventionally associated with clotting phenomenon, also express array of inflammatory mediators creating a crucial link between immune response and thrombotic complications. In this review we will examine the role of inflammation as a primary causative agent of atherosclerotic as well as non-atherosclerotic cardiovascular diseases.


2021 ◽  
Vol 10 (7) ◽  
pp. 1508
Author(s):  
Elisabetta Tonet ◽  
Roberta Campana ◽  
Serena Caglioni ◽  
Federico Gibiino ◽  
Alessio Fiorio ◽  
...  

Malnutrition represents a common and important feature in elderly people affected by cardiovascular diseases. Several studies have investigated its prevalence and prognostic role in most clinical settings, including cardiovascular disease. However, in daily practice it usually remains unrecognized and consequently untreated. The present review was ideated to answer the main questions about nutritional status assessment in patients with cardiovascular disease: why, when, where, how to evaluate it, and what to do to improve it. The three main cardiovascular diseases, namely aortic stenosis, ischaemic heart disease, and heart failure were considered. First, the main evidence supporting the prognostic role of malnutrition are summarized and analyzed. Second, the main tools for the assessment of malnutrition in the hospital and outpatient setting are reported for each condition. Finally, the possible strategies and interventions to address malnutrition are discussed.


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