Iron status, catabolic/anabolic balance, and skeletal muscle performance in men with heart failure with reduced ejection fraction.

BACKGROUND: Metabolic derangements related to tissue energetics constitute an important pathophysiological feature of heart failure. We investigated whether iron deficiency and catabolic/anabolic imbalance contribute to decreased skeletal muscle performance in men with heart failure with reduced ejection fraction (HFrEF), and whether these pathologies are related to each other. METHODS: We comprehensively examined 23 men with stable HFrEF (median age [interquartile range]: 63 [59-66] years; left ventricular ejection fraction: 28 [25-35]%; New York Heart Association class I/II/III: 17/43/39%). We analyzed clinical characteristics, iron status, hormones, strength and fatigability of forearm flexors and quadriceps (surface electromyography), and exercise capacity (6-minute walking test). RESULTS: None of the patients had anemia whereas 8 were iron-deficient. Flexor carpi radialis fatigability correlated with lower reticulocyte hemoglobin content (CHR, p < 0.05), and there was a trend towards greater fatigability in patients with higher body mass index and lower serum ferritin (both p < 0.1). Flexor carpi ulnaris fatigability correlated with lower serum iron and CHR (both p < 0.05). Vastus medialis fatigability was related to lower free and bioavailable testosterone (FT and BT, respectively, both p < 0.05), and 6-minute walking test distance was shorter in patients with higher cortisol/FT and cortisol/BT ratio (both p < 0.05). Lower ferritin and transferrin saturation correlated with lower percentage of FT and BT. Men with HFrEF and iron deficiency had higher total testosterone, but lower percentage of FT and BT. CONCLUSIONS: Iron deficiency correlates with lower bioactive testosterone in men with HFrEF. These two pathologies can both contribute to decreased skeletal muscle performance in such patients.

Xanthohumol Effect on 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Treated Japanese Quails in Terms of Serum Lipids, Liver Enzymes, Estradiol, and Thyroid Hormones.

Dioxins are compounds classified as persistent organic pollutants, from which 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is the most toxic to living organisms. TCDD is considered a carcinogen and has proinflammatory influence on animals and humans, promoting free radicals' formation, and binding with the aryl hydrocarbon receptor (AhR) leads to expression of cytochrome p-450 genes that in turn predisposes to mutations. Natural flavonoids, in this case xanthohumol (XN), have been reported to attenuate TCDD toxicity through inhibition of the transformation of the AhR. Moreover, XN shows antioxidant properties. The aim of the study was to compare the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin and XN on lipid, liver enzyme, estradiol, and thyroid enzyme levels in the serum of Japanese quails. Adult, six-month-old, Japanese quails were divided into eight groups according to treatment procedures. Serum levels of total cholesterol (TCh), high-density lipoproteins (HDLs), triglycerides (TGs), estradiol, triiodothyronine, and thyroxine, and activities of alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase were measured. In comparison with the control group, 2,3,7,8-tetrachlorodibenzo-p-dioxin significantly decreased concentrations of serum HDLs and thyroid hormones and significantly increased the serum TCh level. Levels of serum TGs, liver enzymes, and estradiol were not changed after 2,3,7,8-tetrachlorodibenzo-p-dioxin treatment. Based on our data, XN treatment may also increase the levels of thyroid hormones. Moreover, the tested dioxin disrupts the liver function, especially changing lipids' metabolism. Therefore, more studies are needed for better understanding the mechanism of toxic influence of 2,3,7,8-tetrachlorodibenzo-p-dioxin on key metabolic pathways and organs in living organisms.

Expression of sex steroid receptors and aromatase in adipose tissue in different body regions in men with coronary artery disease with and without ischemic systolic heart failure.

Background: The hormonal metabolism of adipose tissue differs across regions of fat. This issue has never been verified in male patients with coronary artery disease (CAD) with and without systolic heart failure (SHF).Methods: We examined 90 male patients with CAD with and without SHF and 42 healthy controls.Results: In patients with CAD with and without SHF, androgen receptor (AR) expression in adipose tissue of the lower leg was higher than AR expression of the thoracic wall and epicardial adipose tissue (EAT) (both p < .0001 for SHF patients and both p < .001 for patients without SHF). Expression of aromatase in adipose tissue of the lower leg among patients with CAD and SHF was higher than aromatase expression of the thoracic wall and EAT (p < .001 and p < .05, respectively), and in patients without SHF, it was higher only than aromatase expression of the thoracic wall (p < .05). There were no differences in expression of estrogen receptor (ER) between three regions of adipose tissue both in men with CAD with and without SHF.Conclusions: In male patients with CAD, site-related differences of adipose tissue in expression of AR and aromatase are present regardless of coexisting SHF with the highest hormonal activity within peripheral subcutaneous adipose tissue.

Dynamic Analysis of Changes of Protein Levels and Selected Biochemical Indices in Rat Serum in the Course of Experimental Pleurisy.

A significant role is played in inflammation by the liver, which, stimulated by inflammatory mediators, synthetizes plasma proteins with various dynamics. The purpose of these studies is to generate a detailed dynamic analysis of changes to concentrations of plasma and serum protein fractions and selected acute-phase proteins as well as nonspecific biochemical indices during the course of an induced pleurisy. The studies were conducted on female inbred Buffalo rats, which were divided into two groups: a control group (C) and an experimental group (IP) in which pleurisy was induced. In the IP group, significant changes in biochemical indices were observed between the 48th and 96th hours of pleurisy. A reduction of albumin, transferrin, urea, and creatinine concentrations was observed, while concentrations of the complement components C3 and C4, haptoglobin, and fibrinogen increased. An early increase of IL-1 was observed, while increases of IL-6 and TNF were noted in the later period. The maximum intensity of the processes described above occurred between the 72nd and 96th hours of pleurisy.

Could an analysis of mean corpuscular volume help to improve risk stratification in non-anemic patients with acute myocardial infarction?

BACKGROUND: Nowadays, when the majority of patients with acute myocardial infarction (AMI) are treated with primary percutaneous coronary intervention and modern pharmacotherapy, risk stratification becomes a challenge. Simple and easily accessible parameters that would help in a better determination of prognosis are needed. The aim of the study was to estimate the prevalence of high mean corpuscular volume (MCV, defined as MCV > 92 fL) and to establish its prognostic value in non-anemic patients with AMI. METHODS: We retrospectively analyzed the data of 248 consecutive non-anemic patients hospitalized due to AMI (median age: 65 [59-76] years, men: 63%, ST segment elevation myocardial infarction: 31%, and median left ventricular ejection fraction [LVEF]: 50%). RESULTS: The prevalence of high MCV was 39 ± 6% (± 95% confidence interval) in the entire AMI population. High MCV was more prevalent in males, patients with low body mass index, non-diabetics and cigarette smokers (all p < 0.05). During the 180-day follow-up, there were 38 (15%) events, defined as another AMI or death. In a multivariable Cox proportional hazard model, female gender (p < 0.01), low LVEF (p < 0.001), previous AMI (p < 0.05), arterial hypertension (p < 0.05), and high MCV (p < 0.001) were prognosticators of pre-defined events. CONCLUSIONS: In non-anemic patients with AMI, high MCV is an independent prognostic factor of poor outcome defined as another AMI or death.

Effect of tocopherol on biochemical blood parameters in pleuritis-induced rats treated with 2,3,7,8-tetrachlorodibenzo-p-dioxin.

The aim of this study was to evaluate the effect of tocopherol on pleuritis-induced rats exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Rats were treated with a single TCDD dose of 5 µg/kg body weight (b.w.) and then for 3 weeks they were daily supplemented with tocopherol at a dose of 30 mg/kg b.w. The inflammation was initiated by intrapleural injection of a single dose of 1% carrageenin solution in a volume of 0.15 ml. Changes in biochemical blood parameters were measured three times at the 24th, 72nd and 120th hour of pleuritis and the blood was collected from 20 animals of each group of rats (group with the control inflammation; group treated with TCDD and with control inflammation; group treated with TCDD, supplemented with tocopherol and with the inflammation). The following biochemical parameters were measured: tumor necrosis factor (TNF), interleukin-1 (IL-1), IL-2, IL-4, IL-6, procollagen, telopeptide, fibrinogen, cholesterol, urea, creatinine, aspartate aminotransferase (AspAT) and alanine aminotransferase (AlAT). Daily supplementation of tocopherol caused significant changes in the level of TNF, IL-1, IL-4, IL-6, urea, creatinine, AspAT and AlAT. According to the results of these studies, we suggest that tocopherol supplementation in high doses could act as a protective treatment to improve liver metabolism.

Lipid index changes in the blood serum of patients with hyperplastic and early neoplastic lesions in the ovaries.

BACKGROUND: The authors used the lipid index (WL) to monitor lipid changes before and after surgery. The surgical operation performed was the simultaneous enucleation of a cystic tumor of the hilum ovarii in its entirety (with diagnosis of a simple cyst or teratoma adultum) in groups of 20 patients. OBJECTIVES: To compare the lipid index WL in the blood serum of patients undergoing surgery treatment at the following times: before and 7 days after surgery, and 6 and 12 months after surgery. MATERIAL AND METHODS: The research material was the blood serum of women aged about 24 years. The authors divided the patients into 3 groups: two groups of 20 women and a control group. The concentrations of the lipid parameters were measured and the lipid index WL was calculated. RESULTS: Statistically significant differences were found between the lipid index of serum from patients with diagnosed ovarian neoplasms and the index of serum from healthy subjects; differences were demonstrated in the postoperative period, particularly 6 and 12 months after surgery. CONCLUSIONS: The lipid index WL proved useful in diagnosing ovarian neoplasm (simple cysts and teratoma adultum) and in monitoring the postoperative period.

Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency FERRIC-HF: a randomized, controlled, observer-blinded trial.

OBJECTIVES: We tested the hypothesis that intravenous iron improves exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure (CHF) and iron deficiency. BACKGROUND: Anemia is common in heart failure. Iron metabolism is disturbed, and administration of iron might improve both symptoms and exercise tolerance. METHODS: We randomized 35 patients with CHF (age 64 +/- 13 years, peak oxygen consumption [pVO2] 14.0 +/- 2.7 ml/kg/min) to 16 weeks of intravenous iron (200 mg weekly until ferritin >500 ng/ml, 200 mg monthly thereafter) or no treatment in a 2:1 ratio. Ferritin was required to be <100 ng/ml or ferritin 100 to 300 ng/ml with transferrin saturation <20%. Patients were stratified according to hemoglobin levels (<12.5 g/dl [anemic group] vs. 12.5 to 14.5 g/dl [nonanemic group]). The observer-blinded primary end point was the change in absolute pVO2. RESULTS: The difference (95% confidence interval [CI]) in the mean changes from baseline to end of study between the iron and control groups was 273 (151 to 396) ng/ml for ferritin (p < 0.0001), 0.1 (-0.8 to 0.9) g/dl for hemoglobin (p = 0.9), 96 (-12 to 205) ml/min for absolute pVO2 (p = 0.08), 2.2 (0.5 to 4.0) ml/kg/min for pVO2/kg (p = 0.01), 60 (-6 to 126) s for treadmill exercise duration (p = 0.08), -0.6 (-0.9 to -0.2) for New York Heart Association (NYHA) functional class (p = 0.007), and 1.7 (0.7 to 2.6) for patient global assessment (p = 0.002). In anemic patients (n = 18), the difference (95% CI) was 204 (31 to 378) ml/min for absolute pVO2 (p = 0.02), and 3.9 (1.1 to 6.8) ml/kg/min for pVO2/kg (p = 0.01). In nonanemic patients, NYHA functional class improved (p = 0.06). Adverse events were similar. CONCLUSIONS: Intravenous iron loading improved exercise capacity and symptoms in patients with CHF and evidence of abnormal iron metabolism. Benefits were more evident in anemic patients. (Effect of Intravenous Ferrous Sucrose on Exercise Capacity in Chronic Heart Failure; http://www.clinicaltrials.gov/ct/show/NCT00125996; NCT00125996).

[Lipid index (WL) in the blood serum of women undergoing surgery in the perimenopausal age]. / Wartosc wskaznika lipidowego w surowicy krwi kobiet poddanych operacjom ginekologicznym w okresie okolomenopauzalnym.

OBJECTIVES: In the blood serum from women divided into 4 groups (healthy women aged 24 and 45 years and patients after the gynaecological surgery with sparing or radical resection of uterus) the lipids index (WL) was determined. MATERIAL AND METHODS: The WL index expresses the correlations among the HDL, LDL, triglycerides and A1 and B apolipoproteins. In the perimenopausal period in women the decrease in the lipids index WL was observed comparing to the women at age of 25. RESULTS: During the diseases indicated the necessity of gynecological surgery in women in the perimenopausal period further decrease in the lipids index WL was noticed. Contrary to the sparing operation, surgical intervention with radical resection of uterus causes the following WL decrease observed in 3rd month after it. CONCLUSION: It may suggest that these differences have hormonal background.