Background & Aims: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between them in order to inform future research.
Methods: In the Edinburgh Type 2 Diabetes Study, a population-based cohort aged 60-74 years with type 2 diabetes, 831 participants underwent ultrasound assessment for fatty liver and had serum aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), aspartate to platelet ratio index (APRI), European Liver Fibrosis panel (ELF), Fibrosis-4 Score (FIB4) and liver stiffness measurement (LSM) measured.
Background & Aims: Type 2 diabetes is an established risk factor for the presence and progression of fatty liver. Little is known about the distributions and correlates of hepatic non-invasive biomarkers in community-based populations with diabetes, unselected for liver disease. We aimed to identify the distribution of, and metabolic risk factors associated with serum cytokeratin-18 (CK18) and the Enhanced Liver Fibrosis score (ELF), in a large, representative cohort of people with type 2 diabetes (the Edinburgh Type 2 Diabetes Study, ET2DS).
View Article and Find Full Text PDFBackground: Autonomic imbalances including parasympathetic withdrawal and sympathetic overactivity are cardinal features of heart failure regardless of etiology; however, mechanisms underlying these imbalances remain unknown. Animal model studies of heart and visceral organ hypertrophy predict that nerve growth factor levels should be elevated in heart failure; whether this is so in human heart failure, though, remains unclear. We tested the hypotheses that neurons in cardiac ganglia are hypertrophied in human, canine, and rat heart failure and that nerve growth factor, which we hypothesize is elevated in the failing heart, contributes to this neuronal hypertrophy.
View Article and Find Full Text PDFObjective: Macrovascular disease may contribute to increased risk of accelerated cognitive decline in patients with type 2 diabetes. We aimed to determine associations of measures of macrovascular disease with cognitive change in a cognitively healthy older population with type 2 diabetes.
Research Design And Methods: Eight hundred thirty-one men and women (aged 60-75 years) attended two waves of the prospective Edinburgh Type 2 Diabetes Study (ET2DS).
Objective: Type 2 diabetes is an established risk factor for development of hepatic steatosis and nonalcoholic fatty liver disease (NAFLD). We aimed to determine the prevalence and clinical correlates of these conditions in a large cohort of people with type 2 diabetes.
Research Design And Methods: A total of 939 participants, aged 61-76 years, from the Edinburgh Type 2 Diabetes Study (ET2DS)-a large, randomly selected population of people with type 2 diabetes-underwent liver ultrasonography.
Right ventricular (RV) involvement in acute inferior left ventricular (LV) myocardial infarction increases the risks of cardiogenic shock and in-hospital mortality. Acutely impaired RV performance results in reduced LV preload and, in combination with impaired LV contractility, causes severely reduced LV stroke volume and cardiac output. Here we report long-term patient survival after acute biventricular myocardial infarction (MI) using simultaneous RV support with a TandemHeart percutaneous ventricular assist device (Cardiac Assist Technologies, Pittsburgh, Pennsylvania) and LV support with an intra-aortic balloon pump.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
June 2008
Percutaneous intervention for symptomatic subclavian artery chronic occlusion is an occasionally performed, minimally invasive alternative to surgical bypass. Potential complications include stroke, perforation, and recanalization failure. We discuss a case of successful percutaneous revascularization of symptomatic subclavian artery chronic occlusion using coronary devices and dual cerebral embolic protection.
View Article and Find Full Text PDFJ Invasive Cardiol
November 2007
Partial or total occlusion of septal perforator branches can occur during stenting of the proximal and mid portion of the left anterior descending artery, secondary to plaque snow plowing and/or stent "jailing". Flow compromise in a sizeable septal branch can result in a myocardial infarction or in atrioventricular conduction abnormalities. Complete heart block has been described at the time of the procedure, and though it is usually transient, it may require temporary pacing.
View Article and Find Full Text PDFTransient left ventricular apical ballooning is a newly defined syndrome characterized by sudden onset of chest symptoms, electrocardiographic changes characteristic of myocardial ischemia, transient left ventricular dysfunction-particularly in the apical region, low-grade troponin elevation, and no significant coronary stenosis by angiogram. This syndrome is also referred to as Takotsubo cardiomyopathy, "Ampulla" cardiomyopathy, Human Stress cardiomyopathy, and Broken Heart Syndrome. Emergency physicians, family physicians, general internists, and cardiologists may all encounter this syndrome at the point of contact.
View Article and Find Full Text PDFWhether arterial closure devices can be used safely in a coagulopathic population undergoing cardiac catheterization and at high risk for groin complications, such as liver transplant candidates, is unknown. In this prospective, non-randomized consecutive series of 80 liver transplant candidates undergoing coronary angiography, manual compression and arterial closure devices were compared. Ilio-femoral angiography was performed to determine suitability for use of the closure device.
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