Does hormonal status influence the clinical presentation of acute coronary syndromes in women?

Background: Previous studies suggest that the clinical presentation of acute coronary syndromes (ACS) may differ between women and men. It is not known if different clinical presentations may be explained by hormonal status in women with ACS. Our objective was to compare the clinical presentation of ACS between premenopausal (PRE) women and post-menopausal women with hormone replacement therapy (HRT) and without (POST).

A convenient five-drug cocktail for the assessment of major drug metabolizing enzymes: a pilot study.

Aims: To assess the feasibility of administering at the same time low doses of five probe drugs, metoprolol (25 mg), chlorzoxazone (250 mg), tolbutamide (250 mg), dapsone (100 mg) and caffeine (100 mg) to determine simultaneously the activities of CYP2D6, CYP2E1, CYP2C9, CYP3A4, CYP1A2, N-acetyltransferase-2 and xanthine oxidase.

Methods: Ten healthy young non-smoking males received the following drugs or combinations of drugs over a 5-week period: week 1) metoprolol; 2) tolbutamide; 3) caffeine, chlorzoxazone and dapsone; 4) caffeine, chlorzoxazone, dapsone and metoprolol; 5) caffeine, chlorzoxazone, dapsone, metoprolol and tolbutamide. The drugs were self-administered at bedtime and urine was collected for the following 8 h.

The brown adipocyte: update on its metabolic role.

Brown adipocytes are multilocular lipid storage cells that play a crucial role in non-shivering thermogenesis. These cells are located in brown adipose tissue (BAT) depots which are found in abundance in small mammals as well as in newborns of larger mammals, including humans. Brown adipocytes comprise a very large number of mitochondria packed with cristae and are densely innervated by the sympathetic nervous system (SNS).

Impact of prolonged cyclooxygenase-2 inhibition on inflammatory markers and endothelial function in patients with ischemic heart disease and raised C-reactive protein: a randomized placebo-controlled study.

Background: The impact of cyclooxygenase (COX)-2 antagonist treatment on acute coronary risk is controversial. We investigated the effect of prolonged COX-2 inhibition on inflammatory profile and endothelial function in patients with ischemic heart disease and high serum C-reactive protein (CRP) values.

Methods And Results: In a double-blind study, 35 stable subjects on low-dose aspirin with > or =2 previous acute coronary events and 2 of 2 screening CRP values >2.

Actions of PPARgamma agonism on adipose tissue remodeling, insulin sensitivity, and lipemia in absence of glucocorticoids.

Peroxisome proliferator-activated receptor gamma (PPARgamma) agonists improve insulin sensitivity and lipemia partly through enhancing adipose tissue proliferation and capacity for lipid retention. The agonists also reduce local adipose glucocorticoid production, which may in turn contribute to their metabolic actions. This study assessed the effects of a PPARgamma agonist in the absence of glucocorticoids (adrenalectomy, ADX).

Modifications in food-group consumption are related to long-term body-weight changes.

Background: Dietary patterns play an important role in the control of body weight.

Objective: The aim of this study was to verify whether changes in some dietary patterns over a 6-y follow-up period would be associated with weight changes.

Design: A sample of 248 volunteers of the Québec Family Study were measured twice (visit 1: 1989-1994; visit 2: 1995-2000).

Cardiac resynchronization therapy: device-based medicine for heart failure.

Cardiac resynchronization therapy (CRT) or biventricular pacing is a novel adjunctive therapy for patients with advanced heart failure (HF). Many patients with severe HF have a left bundle branch block or an intraventricular conduction delay, with up to 25% of patients with a QRS > 120 ms, resulting in significant left ventricular (LV) dyssynchrony and a high mortality rate. The efficacy of CRT is based on the reduction in the conduction delay between the two ventricles and optimization of the ejection fraction, decrement in mitral regurgitation, LV remodeling, thus resulting in symptom improvement.

Impact of bariatric surgery on cardiac structure, function and clinical manifestations in morbid obesity.

Obesity results from the excessive accumulation of fat. Risk of premature death is doubled compared to nonobese individuals, and risk of death from cardiovascular disease is increased fivefold. In patients with morbid obesity, a variety of adaptations and alterations in cardiac structure and function occur in the individual, as an excess amount of adipose tissue accumulates.

Differential modulation of Nav1.7 and Nav1.8 peripheral nerve sodium channels by the local anesthetic lidocaine.

1 Voltage-gated Na+ channels are transmembrane proteins that are essential for the propagation of action potentials in excitable cells. Nav1.7 and Nav1.

Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics.

Background: It is important to assess cardiovascular risk factors to properly verify the potential consequences of atypical antipsychotic-related weight gain. The objective of the present study was to evaluate whether 2 atypical antipsychotics differ regarding their impact on the cardiovascular disease risk profile compared with a reference group.

Method: We conducted a cross-sectional, multicenter study to assess anthropometric indices of obesity and to obtain a comprehensive fasting metabolic risk profile.

Loss of function associated with novel mutations of the SCN5A gene in patients with Brugada syndrome.

Background: Ventricular fibrillation is one of the leading causes of death in North America. Brugada syndrome is characterized by ST segment elevation on the right precordial leads V1 through V3 and right bundle branch block, and may cause sudden death. Mutations in the SCN5A gene encoding the cardiac voltage-gated Na+ channel (hNav1.

Pathogenesis of hypersensitivity pneumonitis.

Purpose Of Review: Hypersensitivity pneumonitis is a group of immunologically mediated diseases caused by an abnormal response to a wide variety of inhaled antigens. Its pathogenesis is complex and involves many immunological concepts. This review discusses recent advances in our understanding of the pathogenesis of hypersensitivity pneumonitis.

The C-terminal region as a modulator of rNa(v)1.7 and rNa(v)1.8 expression levels.

Mammalian cells poorly express rNa(v)1.8 channels. In contrast, rNa(v)1.

Surgical treatment of commissural prolapse: case report and review of the options.

Repair of commissural prolapse associated with chordal rupture may represent a challenging problem for the cardiac surgeon. The case of a patient with chronic mitral regurgitation and prolapse of the posterior commissural area associated with chordal rupture is presented. A technique was proposed that involved partial resection of the degenerative leaflet segment, plication of the posterior annulus and chordal transfer to create a neocommissure.

Additive effects of leptin and topiramate in reducing fat deposition in lean and obese ob/ob mice.

The objective of the present study was to investigate the effects of the antiepileptic drug topiramate (TPM) on components of energy balance in lean and obese (ob/ob) mice in the presence or absence of leptin. Lean and ob/ob mice infused with either leptin or phosphate-buffered saline were treated with TPM for 7 days. TPM was mixed into the diet and administered at a dose of 60 mg/kg/day, whereas leptin was infused at the rate of 100 microg/kg/day using osmotic minipumps, which were subcutaneously implanted in the interscapular region.

Determinants of gastrointestinal complications in cardiac surgery.

We designed this study to define determinants of gastrointestinal complications after cardiac surgery. From January 1992 through December 2000, 11,058 patients underwent cardiac surgery on cardiopulmonary bypass at our institution. Data were prospectively collected and univariate and multivariate analyses conducted.

Combined effects of PPARgamma2 P12A and PPARalpha L162V polymorphisms on glucose and insulin homeostasis: the Québec Family Study.

Peroxisome proliferator-activated receptors gamma2 and alpha are nuclear factors known to be important regulators of lipid and glucose metabolism. Two polymorphisms, namely PPARgamma2 P12A and PPARalpha L162V, were investigated for their individual and interaction effects on glucose and insulin homeostasis. Genotypes were determined in 663 nondiabetic adults participating in the Québec Family Study and who underwent an oral glucose tolerance test (OGTT).

Postprandial hyperlipidemia: another correlate of the "hypertriglyceridemic waist" phenotype in men.

Fasting hypertriglyceridemia has been reported to be predictive of an exaggerated triglyceride (TG) response to an oral fat load. Abdominal obesity has also been associated with postprandial hyperlipidemia. The objective of the present study was to quantify the contribution of abdominal obesity and fasting hypertriglyceridemia to the magnitude of postprandial lipemia.

Contribution of visceral adiposity to the exaggerated postprandial lipemia of men with impaired glucose tolerance.

Objective: Impaired glucose tolerance (IGT) has been associated with alterations in numerous coronary heart disease risk factors, including postprandial hyperlipidemia. An excess visceral adipose tissue accumulation is also predictive of IGT and of an exaggerated postprandial lipemia. The objective of the present study was therefore to compare the respective contributions of visceral adipose tissue accumulation versus IGT with the variation in postprandial lipemia.

Impact of postprandial variation in triglyceridemia on low-density lipoprotein particle size.

The fasting atherogenic dyslipidemia of visceral obesity, which includes the presence of small, dense low-density lipoprotein (LDL) particles, is predictive of an increased risk of coronary heart disease (CHD). It has also been suggested that progression of atherosclerosis may be accelerated in the presence of postprandial hyperlipidemia independently from the fasting dyslipidemic state. Studies have shown that the best predictor of postprandial hyperlipidemia and of the small, dense LDL phenotype is fasting triglyceride (TG) concentration.

Hydrogen peroxide modulates the Kv1.5 channel expressed in a mammalian cell line.

Reactive oxygen species have been implicated in different types of cardiac arrhythmias including human atrial fibrillation. Kv1.5, the presumed molecular correlate of I(Kur), is an important determinant of human atrial repolarization.