Detection of asymptomatic paroxysmal atrial fibrillation with the trans-telephonic electrocardiograph system.

Paroxysmal atrial fibrillation (PAF) carries an equally high annual stroke rate as chronic atrial fibrillation (AF). Furthermore, the frequency and duration of PAF are thought to be associated with stroke risk. In this pilot study, a trans-telephonic electrocardiograph (TTE) monitoring system was used to detect asymptomatic PAF and to study the relationship between ischemic stroke and the frequency of PAF. Between December 2004 and April 2006, 70 patients enrolled in the TTE monitoring program. Patients either transmitted electrocardiograms (ECGs) daily or upon experiencing cardiac symptoms. Of the 70 patients included, 25 were diagnosed with PAF. In total, 11% (855/7,768) of the recordings were diagnosed as PAF, yet less than 2% of total calls collected and less than 17% of all the calls with PAF were associated with obvious symptoms. Four patients developed five ischemic strokes resulting in a calculated annual stroke rate of 0.56%. Patients with stroke had more episodes of AF (56.5±106.3 versus 6.7±85.9, p=0.685) and symptomatic AF episodes (9.8±17.5 versus 4.9±8.1, p=0.381) than the patients who did not have a stroke, but the differences were not statistically significant because of the low numbers of patients and episodes. Most PAF episodes were asymptomatic, and the TTE system could easily detect these episodes. Furthermore, these four patients tended to have more episodes of PAF and more symptomatic attacks of PAF than patients who did not have a stroke.

Grape seed extract ameliorates tumor necrosis factor-α-induced inflammatory status of human umbilical vein endothelial cells.

BACKGROUND: Inflammation has played a key role in the causation of atherosclerosis. However, the effects of grape seed extract (GSE) on the pro-inflammatory intracellular signaling, enzyme activity, and inflammatory mediators of endothelial cells have not been sufficiently studied, and less information exists on the comparison between GSE and vitamin C, a well-known antioxidant compound, on their anti-inflammatory properties. PURPOSE: We investigated the effects of GSE and vitamin C on the cell viability, oxidative stress, monocyte adhesion, the expression of nuclear factor-κB inhibitor (IκB), intercellular adhesion molecule-1 (ICAM-1) and cyclooxygenase-2 (COX-2), and the production of prostaglandin E(2) (PG E(2)) in TNF-α-treated human umbilical vein endothelial cells (HUVECs). METHODS: Cell viability was measured by MTT assay. The adhesion of THP-1 to HUVECs was evaluated by cell adhesion assay. The oxidized nucleoside 8-hydroxydeoxyguanosine (8-OHdG) (an indicator of oxidative damage to DNA), ICAM-1, and PG E(2) were measured by ELISA. IκB and COX-2 expression were evaluated by western blot analysis. RESULTS: TNF-α (10, 20, and 50 ng/mL), GSE (50 and 200 µg/mL), or vitamin C (100 µM) did not affect cell viability. GSE (50-100 µg/mL) attenuated TNF-α (20 ng/mL)-induced 8-OHdG production, THP-1 adhesion, the expression of IκB degradation, ICAM-1 and COX-2, and the production of PGE(2) in a dose-dependent manner. Vitamin C (100 µM) also showed significant antioxidative and anti-inflammatory effects. CONCLUSIONS: GSE effectively ameliorates TNF-α-induced inflammatory status of HUVECs. The findings of the present study suggest that consumption of GSE may be beneficial to inflammatory atherosclerosis.

The antioxidant effects of quercetin metabolites on the prevention of high glucose-induced apoptosis of human umbilical vein endothelial cells.

Diabetes mellitus is an important risk factor for CVD. A previous study showed that high glucose induced the apoptosis of human umbilical vein endothelial cells (HUVEC) via the sequential activation of reactive oxygen species, Jun N-terminal kinase (JNK) and caspase-3. The apoptosis cascade could be blocked by ascorbic acid at the micromolar concentration (100 microm). In addition to ascorbic acid, quercetin, the most abundant dietary flavonol, has been recently actively studied in vascular protection effects due to its antioxidant effect at low micromolar concentrations (10-50 microm). Quercetin sulfate/glucuronide, the metabolite of quercetin in blood, however, has been rarely evaluated. In the present study, we investigated the effect of quercetin sulfate/glucuronide on the prevention of high glucose-induced apoptosis of HUVEC. HUVEC were treated with media containing high glucose (33 mm) in the presence or absence of ascorbic acid (100 microm) or quercetin sulfate/glucuronide (100 nm, 300 nm and 1 microm). For the detection of apoptosis, a cell death detection ELISA assay was used. The level of intracellular H2O2 was measured by flow cytometry. JNK and caspase-3 were evaluated by a kinase activity assay and Western blot analysis. The results showed that high glucose-induced apoptosis was inhibited by quercetin sulfate/glucuronide in a dose-dependent manner. The effect of quercetin sulfate/glucuronide on H2O2 quenching, inhibition of JNK and caspase-3 activity at the nanomolar concentration (300 nm) was similar to that of ascorbic acid at the micromolar concentration (100 microm). The findings of the present study may shed light on the pharmacological application of quercetin in CVD.

The thicker the skin fold, the less hematoma development: a novel parameter other than body mass index associated with transradial vascular complication.

It was reported recently that body mass index (BMI) is a prognostic factor of vascular complications after radial puncture, and that extremely thin patients are at higher risk than obese subjects. However, the underlining mechanism of this phenomenon has rarely been studied. Therefore, we conducted a survey measuring a novel parameter, the skin fold thickness, and other potential risk factors in our patients developing postprocedure hematoma. In 1176 consecutive patients undergoing percutaneous radial catheterization, 18 (1.53%) developed hematoma afterward. When a patient with hematoma had been identified, the next patient having no hematoma after radial puncture was enrolled into the control group, which thus turned out to have 18 patients. In addition, we also compared the BMI, skin fold thickness, and other potential risk factors, including heparin dosage and antiplatelet medication, between these 2 groups. We found hematoma patients to be older (69.5 +/- 10.3 years vs 61.50 +/- 11.7 years, P = .037), to have more cases of coronary intervention (10/18 vs 4/18, P = .04), to have lower BMI (23.63 +/- 4.03 vs 27.25 +/- 4.38, P = .014), and to have thinner skin folds of forearm (5.94 +/- 4.56 vs 9.27 +/- 3.06 mm, P = .015), deltoid area (14.61 +/- 9.00 vs 19.73 +/- 7.15 mm, P = .042), and waist (21.94 +/- 9.90 vs 29.00 +/- 8.46 mm, P = .028) than the nonhematoma group. On the contrary, no statistical difference in heparin dosage or other factors was noted between the 2 groups. We conclude that the vascular complication rate after radial catheterization is higher in elderly patients with lower BMI, body weight, or thinner skin folds.

Evaluation of scalp and auricular acupuncture on EEG, HRV, and PRV.

In this study, the EEG, ECG and blood-pressure-pulse recorder were employed to evaluate heart rate variability, pulse rate variability, and EEG of 10 adults after scalp (experimental test I) at Sishencong scalp acupoint and auricular (experimental test II) acupuncture at Shenmen auricular acupoint for about 10 min. Comparison of the results between the experimental tests and a control with no stimulation test showed that both the heart rate and pulse rate were decreased, and the blood pressure fell. The high and low frequency power of FFT analysis of heart rate was increased and decreased, respectively; indicating that the parasympathetic nerves were activated and the sympathetic nerves were inhibited. The analysis of the power spectrum of EEG showed that the number of low frequency waves was increased after acupuncture stimulation. Therefore, acupuncture on either Sishencong or Shenmen might calm the mind, slow down the heart rate, and activate the parasympathetic nerves.

In vitro antibacterial and cytotoxic activities of plasma-modified polyethylene terephthalate nonwoven dressing with aqueous extract of Rhizome Atractylodes macrocephala.

In this study, a natural and non-cytotoxic antibacterial dressing containing aqueous extract of Rhizome Atractylodes macrocephala (RAM), which has been widely used in traditional herbal medicine and documented with antibacterial activities in literatures, was developed by aid of the extraction technique, nonwoven substrates and plasma-induced grafting technology. The effectiveness of these herbal antibacterial dressings with different treatment were investigated through the assays of grafting yield, SEM, FTIR, antibacterial activities and cytotoxicity. The remarkable grafting of RAM extracts onto PET nonwovens after plasma treatment, with the best of 51.24%, revealed that the surface property of PET substrates were improved effectively, and the successful grafting can also be confirmed from SEM and FTIR results by the appearance of new peaks associated with the presence of polysaccharides and flavonoids in aqueous extracts. The plasma treatment further increased the broad-spectrum antibacterial effects of PET nonwoven dressings containing RAM extract with the best inhibition width of 12.84mm and 16.81mm against S. aureus and E. coli, respectively, which was no less than ones of commercial antibacterial dressings.

Effects of electrical acupuncture on acupoint BL15 evaluated in terms of heart rate variability, pulse rate variability and skin conductance response.

In this research, heart rate variability (HRV), pulse rate variability (PRV) and human skin conductance (SC) of all acupoints on Heart Meridian were used to evaluate the effects of electrical acupuncture (EA) on acupoint BL15 (Bladder Meridian). Ten healthy volunteers (aged 23 +/- 6) were selected as the control group on the first day, and then used again as the experimental group on the second day. The control group received sham EA during the study, while subjects of the experimental group were stimulated by 2 Hz EA on acupoint BL15 for 10 minutes. Electrocardiogram (ECG), wrist blood pressure pulse meter and skin conductance response (SCR) device were used to measure and analyze HRV, PRV and SCR for the two groups before and after stimulation. From the spectrum analysis of ECG and pulse pressure graph, we found that the EA applied on BL15 could induce a significant increase in the normalized high frequency power (nHFP) component of HRV and PRV, as well as a significant decrease in the normalized low frequency power (nLFP) part (p < 0.05). Moreover, both the heart rate and pulse rate were reduced in the analysis of the time domain of ECG and PRV. Furthermore, most of the SCR values at acupoints were decreased after stimulation. These results also indicate that the stimulation of BL15 by EA could cause relaxation, calmness and reduce feeling of tension or distress.

A study of electrical conductance of meridian in the obese during weight reduction.

This study was designed to investigate the electrical conductance of meridian in the obese during weight reduction. Ten obese including overweight (Body Mass Index, BMI > 26) and 30 healthy (non-overweight) people were recruited from Chung Yuan Christian University. The obese subjects were instructed to follow a weight reduction program that included diet control, exercise and oral intake of Prozac. A device, the design of which is based on the Ryodoraku theorem, was used to measure the electrical conductance of 12 meridians on both sides of the subjects. The results showed that: (1) the average coefficient of variation of the electrical conductances in 24 meridians of the obese group was statistically different from that of the healthy group (p < 0.05); (2) the average coefficient of variation of electrical conductance in the obese after weight reduction was significantly decreased than before the weight reduction program (p < 0.05); (3) the BMI and the electrical conductance of meridian was correlated in the obese (r = -0.77, p < 0.001) as well as in the healthy group (r = -0.92, p < 0.001). These findings suggest that electrical conductance of meridians can be a parameter to monitor weight, especially for obese people.

Indoxyl sulfate induces renin release and apoptosis of kidney mesangial cells.

BACKGROUND: Indoxyl sulfate is considered to play a pathological role in the progression of chronic kidney disease. The aim of this study was to investigate the deleterious effects of indoxyl sulfate on kidney mesangial cells. MATERIALS AND METHODS: Rat renal mesangial cells were exposed to indoxyl sulfate at a serial concentrations. Cytotoxicity of indoxyl sulfate on renal mesangial cells was determined using MTT assay. Protein levels of cleaved caspase-3, angiotensin, angiotensin converting enzyme (ACE) and renin were detected by immunoblotting. Reverse transcriptional PCR was performed to determine the mRNA expression. RESULTS: Level of cleaved caspase-3 was augmented while the cell viability was inhibited by indoxyl sulfate in a dose-dependent manner. The mRNA expressions of pro-renin and ACE were upregulated in mesangial cells exposed to indoxyl sulfate. Level of renin and ACE was increased in response to indoxyl sulfate exposure in time-dependent fashion. CONCLUSION: Indoxyl sulfate increased viability and induced cell death of renal mesangial cells, which is time-dependent. The loss of cell viability is attributed to caspase-3 activity through apoptosis pathway. RAS in renal mesangial cells is activated in response to indoxyl sulfate treatment.

DPP-4 inhibitor attenuates toxic effects of indoxyl sulfate on kidney tubular cells.

Diabetic nephropathy is a common causative factor of chronic kidney disease (CKD). DPP-4 inhibitor has the ability to improve kidney function and renal microvasculature. In the present study, we investigate the deleterious effects of IS on proximal tubular cells and the protective role of DPP-4 inhibitor. Human kidney 2 (HK-2) cells were exposed to IS in the presence or absence of DPP-4 inhibitor. Effects of DPP-4 inhibitor on viability of HK-2 cells were determined by MTT assay. Reactive oxygen species (ROS) production was examined using fluorescent microscopy. Levels of cleaved caspase-3, transforming growth factor-beta (TGF-ß), α-smooth muscle actin (α-SMA) and NF-kappaB p65 and phosphorylation of AKT and extracellular signal-regulated kinase (ERK) were detected by immunoblotting. Production of ROS and level of cleaved caspase-3 were increased by IS in a dose-dependent manner. The phosphorylation of AKT and ERK p65 were decreased alongside activation of NF-κB. Expression of TGF-ß and α-SMA, were upregulated in IS-treated HK-2 cells. Treatment with DPP-4 inhibitor resulted in a significant increase in cell viability and a decrease of ROS production in IS-treated HK-2 cells. DPP-4 inhibitor restored IS-induced deactivations of AKT and ERK and inhibited activation of NF-κB in IS-treated HK-2 cells. Moreover, DPP-4 inhibitor could also attenuate IS-induced up-regulation of TGF-ß and α-SMA expression. These findings suggest that DPP-4 inhibitor possesses anti-apoptotic activity to ameliorate the IS-induced renal damage, which may be partly attributed to regulating ROS/p38MAPK/ERK and PI3K-AKT pathways as well as downstream NF-κB signaling pathway.

Naringenin more effectively inhibits inducible nitric oxide synthase and cyclooxygenase-2 expression in macrophages than in microglia.

Macrophages and microglia are thought to account for initial disease progression in acute myocardial infarction and acute ischemic stroke. Before our study, the inhibitory effects of naringenin, a flavonoid, on lipopolysaccharide (LPS)-induced inflammation in macrophages and microglia have not been fully reported and compared. We hypothesized that naringenin can effectively inhibit LPS-induced inflammation of macrophages and microglia at different concentrations, the range of which is broader, with the lowest concentration more easily achieved in macrophages. In this study, we compared the anti-inflammatory effects of naringenin on LPS-stimulated RAW 274.6 macrophages and BV2 microglia and the suppression effects of naringenin and vitamin C (a well-known anti-inflammatory agent) on LPS-induced nitrite production. The results show that macrophages could maintain cell viability at higher naringenin concentrations and were more easily activated by LPS in comparison to microglia (200 vs 100 µmol/L; 0.1 vs 1 µg/mL). Under LPS (1 µg/mL) stimulation in both cell types, naringenin (up to 200 µmol/L in macrophages and 100 µmol/L in microglia) inhibited nitrite production and inducible nitric oxide synthase and cyclooxygenase-2 expression in a dose-dependent manner. The range of naringenin concentrations for inhibition was broader, and the lowest concentration was more easily achieved in macrophages; the lowest effective concentrations of naringenin to achieve constant suppression effect were 50 µmol/L in macrophages and 100 µmol/L in microglia, respectively. Vitamin C (100 µmol/L), compared with naringenin (100 µmol/L), had less and no suppression effect on LPS (1 µg/mL)-induced nitrite production in macrophages and microglia, respectively. In conclusion, naringenin more effectively inhibits the LPS-induced inflammatory status, including nitrite production and inducible nitric oxide synthase and cyclooxygenase-2 expression, in macrophages than in microglia. The findings of the present study suggest that consumption of naringenin-containing flavonoids might be beneficial to the cardiovascular and cerebrovascular inflammatory process.

Brachial artery flow-mediated vasodilation in patients with cardiac syndrome X.

Cardiac syndrome X (CSX) differs from coronary artery disease (CAD) and is characterized by angina, positive stress test, and patent coronary arteries. The probable mechanism is a microvascular disorder associated with endothelial dysfunction. In this study, brachial artery flow-mediated vasodilation was used as well as the endothelin-1 assay to assess endothelial function in patients with cardiac syndrome X (CSX), coronary artery disease (CAD), and healthy controls. All subjects underwent a 2-step brachial artery flow-related vasodilatation test. Serum endothelin-1, one of the most potent constricting factors, was measured for all participants. Patients with CSX had a lower brachial artery dilation ratio than controls but higher than that of CAD patients. Control subjects and CSX patients had higher endothelin-1 levels than CAD patients. CSX patients were found to have worse endothelial function than healthy volunteers, but patients with CAD had even worse endothelium function than CSX patients.

Analysis of the correlation between the facial temperature and the stenosis of carotid arteries.

Death caused by stroke above the age of 60 years placed second in the world, and is the fifth leading cause in people aged 15 to 59 years old. Several methods for early detection of stroke are magnetic resonance angiography, and carotid duplex, both diagnoses are cost and time consuming. This research is aimed to provide a noninvasive, cost effective, and rapid technique for diagnosing carotid artery stenosis by using thermography. In this study, 64 images from 32 people were used to analysis the correlation between the temperature of the face and the stenosis of carotid arteries by automatically selecting and calculating the mean and standard deviation of the facial temperature. We find that external carotid artery affects the facial temperature significantly.