Concentrated green tea supplement: biological activity and molecular mechanisms.

AIM: This study was undertaken to determine the biological activity of a green tea supplement with respect to cells and erythrocyte membranes and the molecular mechanism of that activity. MAIN METHODS: The extract's activity was evaluated on the basis of its hemolytic, antioxidant and antiinflammatory actions. In addition, the extract's effect on the physical properties of the erythrocyte membrane was examined. We also conducted a detailed analysis of supplement ingredients using high-yield liquid chromatography, supplemented with standard tests of total content of polyphenols and flavonoids in the supplement. KEY FINDINGS: The study showed that green tea extract has a high antioxidant and anti-inflammatory capacity with no deleterious effect on red blood cells. The extract modifies the physical properties of the erythrocyte membrane, apparently by binding to its hydrophilic region, with consequent rigidity of the hydrophobic region, increased hydration and a moderate increase in its resistance to changes in tonicity of the medium. Because the extract's components anchor in the polar region of membrane lipids, they are able to effectively scavenge free radicals in the immediate vicinity of the membrane and hinder their diffusion into its interior. SIGNIFICANCE: Green tea supplement at concentrations markedly exceeding the blood plasma physiological polyphenol concentrations has no destructive effect on the erythrocyte membrane. Due to the high content of flavan-3-ols, the supplement exhibits high biological activity, which makes it an alternative source of those substances to the commonly used infusion of green tea leaves.

Atrial dominance in the human embryonic heart: a study of cardiac function at 6-10 weeks of gestation.

OBJECTIVE: To investigate the difference in forces developed by atrial and ventricular myocardium during contraction in human embryos using a novel method. METHODS: This was a cross-sectional study of 115 pregnancies examined at 6-10 weeks of gestation. Ventricular inflow and outflow velocities were obtained by Doppler echocardiography and the relative force development was evaluated by calculating the ratio between atrial and ventricular ejection force (EF). RESULTS: Data from 97 embryos with monophasic ventricular filling were analyzed. Both inflow and outflow cardiac velocities increased with advancing gestational age (P < 0.001). The mean peak inflow velocity (31.7 ± 10.2 cm/s) was significantly higher (P < 0.0001) than the outflow velocity (19.6 ± 6.1 cm/s). The EFinflow /EFoutflow ratio was more than 1.0 in all but four (96%) cases. CONCLUSION: Our study indicates the possibility of atrial dominance in the embryonic period of heart development, which may have clinical implications, as deviations from this normal pattern may indicate human embryonic cardiac dysfunction.

Reference values for variables of fetal cardiocirculatory dynamics at 11-14 weeks of gestation.

OBJECTIVE: Despite the increasing popularity of first-trimester fetal echocardiography, the evaluation of fetal heart function during this period remains challenging. The parameters of normal cardiac function at 11-14 weeks' gestation are not well defined and appropriate reference values have not yet been established. The purpose of this study was to evaluate the fetal cardiocirculatory dynamics during routine first-trimester screening and establish cross-sectional reference ranges for 11-14 weeks' gestation. METHODS: Fetal echocardiography was performed on 202 women with singleton pregnancies at 11 + 0 to 13 + 6 weeks' gestation. Global cardiac function was evaluated using the heart : chest area ratio and Tei index of the left (LV) and right (RV) ventricles. The proportion of isovolumic contraction (ICT%) and ejection (ET%) times of the cardiac cycle, and the outflow velocities described the systolic function. Diastolic function was evaluated by the proportion of relaxation (IRT%) and filling (FT%) times, the ratio of the blood velocity through the atrioventricular valves during early filling (E) and atrial contraction (A) phases of the cardiac cycle, and ductus venosus pulsatility index for veins (DV-PIV). All participants had additional fetal echocardiography in the second trimester and neonatal clinical examination after birth to confirm normality. RESULTS: The mean heart : chest area ratio (0.203 +/- 0.04) and the Tei indices of both ventricles did not vary significantly during weeks 11-14, but the mean Tei index of the LV (0.375 +/- 0.092) was significantly higher than that of the RV (0.332 +/- 0.079) (P = 0.001). The fetal heart rate (FHR) decreased with increasing crown-rump length (CRL) (P < 0.00001). The LV-ICT% did not vary significantly (P = 0.27), LV-IRT% (P = 0.03) and LV-ET% decreased (P = 0.01), whereas the LV-FT% increased (P = 0.02) with CRL. The RV-ET% (P = 0.84) and RV-FT% (P = 0.60) remained relatively stable. The LV-ET% was lower than the RV-ET% (P = 0.0001). The LV (P = 0.004) and RV (P < 0.00001) outflow velocities and E : A ratios of both ventricles (P < 0.0001) increased with advancing gestation. The E-velocity of the LV (P = 0.003) and RV (P = 0.002) increased significantly but the increase in A-velocity was not significant. The outflow velocity (P = 0.008) and E-velocity (P = 0.005) of the RV were higher than that of the LV but the A-velocities were similar (P = 0.066). The mean DV-PIV was 0.97 +/- 0.23 and did not change significantly (P = 0.95) during weeks 11-14. The FHR and DV-PIV did not correlate with the Tei index of either ventricle. CONCLUSION: We have established reference ranges for the noninvasive evaluation of fetal cardiocirculatory dynamics at 11-14 weeks' gestation.

Acylation stimulating protein is associated with pregnancy weight gain.

Among the proteins secreted by adipocytes, acylation stimulating protein (ASP), which plays a crucial role in energetic balance regulation, merits particular attention. ASP is a protein of the C3 complement system, responsible for glucose and lipids metabolism in an insulin-independent mechanism. ASP's role during pregnancy and its interactions with pregnancy hormones remains unknown. The lipogenic character of ASP may impose a question as to what extent this hormone participates in pregnant women lipogenesis, and what is the basal and postprandial ASP secretion during the second trimester of pregnancy. The results of the examinations of 26 pregnant women during the second trimester of their first pregnancy were analyzed. Due to the limited data available in the literature, a control group was examined. The group consisted of 8 healthy non-pregnant patients within similar age ranges. Blood samples were collected in order to determine ASP, total cholesterol, HDL, LDL and triglyceride levels. Basal ASP levels present in obese pregnant women (group OBP; 30.20 +/- 2.13 ng/mL) were significantly higher than those in the healthy control group (group LnP; 20.49 +/- 1.97 ng/mL), P<0.05. Mann-Whitney U test- analysis of these group differences indicated that OBP patients had significantly higher ASP levels than controls at 30 (P<0.01), 60 (P<0.01), and 120 (P<0.01) min after a meal. After a meal, the incremental ASP area under the curve in group OBW patients was significantly higher from that observed in control group LnP (718,9 +/- 263,9 ng/mL x 2h vs. 35,1 +/- 14,6 ng/mL x 2h, P<0.05). Basal concentration of triglycerides, total cholesterol and LDL cholesterol were significantly higher in all pregnant women compared to the group of non-obese non-pregnant women. It was found that lipid parameters were highly dependent upon body mass gain during pregnancy. Group OBP demonstrated significantly higher basal concentrations of all parameters of lipid metabolism in comparison with the remaining groups of pregnant patients. In conclusion, we found abnormalities of ASP and lipid profiles in lean, overweight, and obese pregnant women strictly connected with obesity. Acylation stimulating protein correlated with lipid parameters, suggesting increased risk of dyslipidemia in obese pregnant women.

Doppler study of the peripheral flows in early gestation.

The aim of this study was to determine the first trimester human peripheral arterial and venous blood flow between 5 - 10 weeks of gestation. Two hundred twenty four women with singleton, uncomplicated pregnancies were prospectively studied with transvaginal ultrasound. Ductus venosus, umbilical artery waveforms and pulsatility indexes (PI) were assessed as well as the waveform of the umbilical vein and the mean velocity (V(mean)) of the umbilical artery flow. The heart rate was also obtained and analyzed. The fetal heart rate showed a positive correlation with increasing gestational age R=0.76 (p<0.000001). Recordings from the umbilical artery, umbilical vein and ductus venosus were obtained starting from 7 weeks of gestation. The signal from the ductus venosus presented always as antegrade flow during atrial contractions. The pulsatility index (PI) of DV as well as PI of the umbilical artery remained unchanged during the study (statistically non-significant). The umbilical artery, using Doppler tracing was investigated and an absent diastolic flow was documented in every case. Umbilical artery V(mean) increased from 3.8 + 0.32 cm/s to 9.0 + 0.21 cm/s from 7 to 10 weeks of gestation (p< 0.005). Recordings from the umbilical vein showed the pulsation during atrial contractions. Ductus venosus blood velocity and waveform patterns did not change significantly during the study period. Pulsation in the umbilical vein is a typical Doppler finding at the embryonic time. Placental volume blood flow increased significantly with no change in the placental vascular impedance.

Doppler study of the embryonic heart in normal pregnant women.

OBJECTIVE: To describe normal fetal cardiac and hemodynamic development in normal early first trimester pregnancies. MATERIALS AND METHODS: Eighty-eight women with singleton, uncomplicated pregnancies were prospectively studied with transvaginal ultrasound, pulsed and color Doppler. Heart diameter, heart rate, and inflow and outflow waveforms with valve signals were documented. The proportion of the cardiac cycle of isovolumetric relaxation time (IRT%) and isovolumetric contraction time (ICT%) as well as Tei index were calculated. RESULTS: Ninety-one percent of studies were successful. Heart diameter and the fetal heart rate showed a positive correlation with increasing gestational age: R = 0.80 (p < 0.000001), R = 0.76 (p < 0.000001), respectively. Mean heart diameter at 6 weeks was 1.28 +/- 0.26 mm and mean fetal heart rate was 117 +/- 6 bpm compared to 3.88 +/- 0.54 mm and 171 +/- 6 bpm at 10 weeks. The inflow waveform was monophasic (atrial contraction) in all cases from 6 to 9 weeks. Eight pregnancies (9%) miscarried between 6 and 12 weeks of gestation and the heart exams were characterized by increased IRT% compared with the survivors. In survivors, IRT% decreased between 7 and 8 weeks, from 32.9 +/- 10.7% to 20.8 +/- 5.7% (p < 0.0001). ICT% decreased from 18.6 +/- 4.4% of the cardiac cycle at 8 weeks to 12.6 +/- 4.4% at 9 weeks (p < 0.0008) (after heart development period). CONCLUSIONS: Doppler examination of the fetal cardiac function is possible after 5 weeks of gestation. After 8 weeks of gestation, the fetal heart is morphologically mature but has not yet achieved effective myocardial compliance. The embryonic human heart is dependent on the atrial contraction for ventricular filling throughout the period of cardiac development. Non-survivors manifest myocardial dysfunction.

Basal and postprandial gut peptides affecting food intake in lean and obese pregnant women.

Maternal obesity has been reported as a risk factor for various maternal and fetal complications. The aim of the present study was to examine the patterns of basal and postprandial plasma concentrations of certain gut hormones affecting food intake such as acylated ghrelin, peptide YY(3-36) (PYY(3-36)), cholecystokinin (CCK), insulin and glucose in pregnant women with varying body mass gain during physiological pregnancy. The study included 34 women with singleton pregnancies in the 2(nd) trimester of gestation. The examined pregnant women were divided into 4 groups; I. control pregnancy (CP) with weight gain below 0.5 kg/week; II. overweight low weight gain <1 kg/week (OLWG), III. overweight high weight gain >1 kg/week (OHWG); morbidly obese pregnant with weight gain >1.5 kg/week (MOP). The basal acylated-ghrelin levels in MOP subjects were significantly higher than those in CP and no usual suppression of acylated ghrelin after the meal observed in CP as well as in OLWG and OHWG was found in MOP women. Basal PYY(3-36) plasma levels were similar in CP, OLWG and OHWG but in MOP was significantly reduced and no significant increase in hormone level, typically observed in CP, was detected after a meal in overweight or obese women studied. The fasting CCK and C-reactive protein (CRP) levels in MOP subjects were significantly higher than those in CP and other overweight women. In conclusion, we found that pregnant women with overweight and obesity exhibit significant changes in fasting and postprandial gut hormones affecting food intake such as acylated ghrelin, PYY(3-36) and CCK as well as in CRP and these changes might contribute, at least in part, the development of obesity in pregnancy.

[Arrhythmias in perinatal period and neonatal outcome--analysis of own experiences]. / Zaburzenia rytmu serca w okresie prenatalnym i ich wplyw na losy noworodków--analiza doswiadczen wlasnych.

OBJECTIVE: The paper presents review of different kinds of fetal arrhythmias, diagnosed in our centres. DESIGN: The aim of our study was to analyse results of echocardiographic examinations of 141 fetuses with diagnosed arrhythmias referred for fetal cardiac examination in years VI. 1996-V. 2001 and neonatal outcome. RESULTS: Premature contractions were recognised in 113 (80%) fetuses, tachyarrhythmias in 7 (5%) cases and complete atrioventricular block in 5 (4%). Heart defects were diagnosed in three cases. Three fetuses developed congestive heart failure (2x SVT, 1x HLHS + block a-v III*). From all group 6 newborns died. CONCLUSION: In case of fetal arrhythmias echocardiography should be widely applied in order to evaluate the kind of arrhythmia, sufficiency of circulation and coexistence of heart defects or functional abnormalities with arrhythmia in fetal circulation.

Fetal echocardiography in ectopia cordis.

Ectopia cordis is an extremely rare congenital abnormality occurring in 5.5 to 7.9 per 1 million live births with high lethality. Between January 1995 and October 1997 eight cases of ectopia cordis were diagnosed at our institute before birth. On the basis of echocardiography the fetal heart anatomy was categorized as either normal heart anatomy (NHA; n = 3) or congenital heart defect (CHD; n = 5). In the majority of cases (seven of eight) other abnormalities were present. Some reports have described ectopia cordis being diagnosed in the first trimester of pregnancy. In our study group the average gestational age at diagnosis was 26 weeks. The prenatal diagnosis of isolated ectopia cordis is easy; counseling the patient, the perinatal management including term, place, and method of delivery, and optimal care of the newborn are more difficult. Ectopia cordis is a malformation that pediatricians rarely encounter, even at pediatric cardiology centers. Much more frequently it is a problem for sonographers and obstetricians; however, pediatric cardiologists should be aware of diagnostic algorithm for such cases, especially when additional abnormalities are present.

Diagnostic and perinatal management of fetal extrasystole.

Fifty fetuses referred to the Polish Mother's Memorial Hospital for fetal echocardiography between January 1, 1991 and June 1, 1995 were evaluated. The mean fetal gestational age at the time of diagnosis of arrhythmia was 34.1 weeks, and the mean gestational age at the time of delivery was 38.7 weeks. Checkup echocardiographic examinations were performed every 10-14 days, for a mean 2.4 studies per fetus. In most cases (48/50, 96%), premature atrial contractions were present during the first echocardiography examination. The fetal heart study was normal in 30 cases; in 7 (14%) there was tricuspid valve regurgitation, in 7 (14%) an atrial septal aneurysm, in 4 congenital heart defects, in 1 myocardial hypertrophy, and in 1 disproportion in the four-chamber view. Of the 50 fetuses, 43 underwent regular echocardiographic monitoring alone; in 7 cases, based on the presence of additional echocardiographic findings, pharmacotherapy was applied (digoxin, verapamil, or both). Three neonates died after delivery owing to malformations in two cases (one critical aortic stenosis, one spina bifida plus hygroma colli) and due to myocarditis in one case. In six of seven newborns treated in utero, myocarditis was diagnosed after birth (including the one with neonatal demise). Most of the newborns were in good condition after birth, their mean Apgar score being 8.6 and the mean birth weight 3259 g. We concluded that most extrasystoles represent an isolated anomaly, not affecting the fetal condition. Their presence should not influence the obstetric care and may require only echocardiographic monitoring. In most of our cases the premature contractions subsided after birth, although sometimes they preceded fetal supraventricular tachycardia or appeared after congenital myocarditis.

Fetal functional pulmonary atresia with ascites resolving spontaneously before birth. A case report.

In this case we report functional pulmonary atresia in a fetus with significant tricuspid valve regurgitation and severe ascites, with spontaneous improvement without prenatal intervention and a subsequent follow-up at 8 weeks after birth.