Adrenomedullin and non-dipping circadian pattern in newly diagnosed essential hypertension.

OBJECTIVE: There is frequently a relationship between nocturnal hypertension and non-dipping pattern and endothelial dysfunction. Studies conducted previously have indicated that adrenomedullin (AM) (a potent, long-lasting, vasodilatory peptide) is capable of regulating endothelial cell function. The aim of the current research is to investigate the association between absolute night-time blood pressure (BP) and circadian BP pat-tern with serum AM and high-sensitivity C-reactive protein (hsCRP) levels in cases in whom untreated arterial hypertension has been newly diagnosed. METHODS: Ambulatory BP monitoring was performed in 100 individuals with hypertension (50 dippers,50 non-dippers) and 50 healthy controls for 24 hours. Measurement and recording of AM and hsCRP serum levels were performed. RESULTS: A strong correlation between night-time BP levels and AM and hsCRP levels was determined(p<0.001). On the contrary, higher AM levels were determined in the non-dipper group compared to the dipper and normotensive groups (non-dipper group, 258±27 pg/mL; dipper group, 199±30 pg/mL; normotensive group, 150±11 pg/mL; p<0.001). The non-dipper group exhibited significantly higher hsCRP levels in comparison with the remaining two groups (p=0.017). An independent association was determined between AM (p=0.014) and hsCRP (p=0.032) and a non-dipping pattern in a multivariate logistic regression analysis. CONCLUSIONS: The nocturnal hypertensive and non-dipper groups exhibited increased AM levels. An independent association was identified between AM and hsCRP and a non-dipping pattern. It is implied that increased AM levels in individuals with non-dipper hypertension may be related to a longer exposure time to high BP. The mentioned findings indicate a potential future part of AM in identifying patients with hypertension that are at higher risk of target organ damage (Tab. 3, Fig. 4, Ref. 41).

Nesfatin 1: a promising biomarker predicting successful reperfusion after coronary artery bypass surgery.

OBJECTIVES: Nesfatin-1 is an antiiflammatory, antiapoptotic, and anorexigenic peptide that has many roles in cardiomyocyte metabolism and viability. Inflammation plays an important role in the pathogenesis of atherosclerosis. In this study, we aimed to evaluate the alterations in serum nesfatin-1 levels of the patients undergoing coronary artery bypass operation due to atherosclerotic coronary artery disease. MATERIALS AND METHODS: The study included 49 patients (30 men, 19 women) undergoing coronary artery bypass surgery. Serum nesfatin-1 levels were measured from venous blood samples of the patients collected before and three months after the operation. The relationship of nesfatin-1 levels with accompanying conditions was also analyzed. RESULTS: Nesfatin-1 levels at third month, postoperatively, were significantly higher than preoperative nesfatin-1 levels of the patients (41.94±13.90 pg/ml and 27.06±8.01pg/ml, respectively; p<0.001). Both preoperative and postoperative nesfatin-1 levels were negatively correlated with age (p<0.001). The postoperative increase in nesfatin-1 levels was significantly higher in diabetic patients than in nondiabetic patients (p<0.001). CONCLUSION: This study revealed that serum nesfatin-1 levels increased significantly in patients undergoing coronary artery bypass operation. Nesfatin-1 level may have a role in assessing myocardial perfusion during the follow-up of these patients (Tab. 4, Fig. 4, Ref. 25).

The effects of iloprost on lung injury induced by skeletal muscle ischemia-reperfusion.

PURPOSE: The aim of this study was to investigate the effects of iloprost (I) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model. MATERIALS AND METHODS: Twenty-four Wistar Albino rats were randomized into four groups (n = 6). Laparotomy was performed in all groups under general anesthesia. Only laparotomy was applied in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes. Group iloprost (Group I) received intravenous infusion of iloprost 0.5 ng/kg/min, without ischemia and reperfusion. Group I/R/I received intravenous infusion of iloprost 0.5 ng/kg/min immediately after 2 hours of ischemia. At the end of the study, lung tissue was obtained for determining total oxidant status (TOS) and total antioxidant status (TAS) levels, histochemical and immunohistochemical determination. RESULTS: Diffuse lymphocyte infiltration was detected in immunohistochemical examination of lung tissue in Group I/R. The connective tissue around bronchi, bronchioles and vessel walls was found to be increased. Although minimal local lymphocyte infiltration was detected in some fields in Group I/R/I, the overall tissue was found to be similar to Group S. iNOS expression was significantly higher in Group I/R, when compared with Group S and significantly lower in Group I/R/I compared to Group I/R.TOS levels were significantly higher in Group I/R, when compared with groups S and I (p = 0.028, p = 0.016, respectively) and significantly lower in group I/R/I, when compared with Group I/R (p = 0.048). TAS levels were significantly higher in Group I/R, when compared with groups S, I (p = 0.014, p = 0.027, respectively) and significantly lower in Group I/R/I, when compared with Group I/R (p = 0.032). CONCLUSION: These results indicate that administration of iloprost may have protective effects against ischemia reperfusion injury (Fig. 8, Tab. 1, Ref. 30)

Antioxidative effects of adrenomedullin and vascular endothelial growth factor on lung injury induced by skeletal muscle ischemia-reperfusion.

PURPOSE: The aim of this study was to investigate the effects of adrenomedullin (AM) and vascular endothelial growth factor (VEGF) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model. MATERIALS AND METHODS: Thirty-six Wistar rats were randomized into six groups (n=6). Laparotomy was performed in all groups under general anesthesia. Nothing else was done in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes, respectively. Group VEGF and Group AM received intravenous infusion of VEGF (0.8 µg/kg) or AM (12 µg /kg) respectively, without ischemia and reperfusion. Group IR+VEGF and Group IR+AM received intravenous infusion of VEGF (0.8 µg/kg) or AM (12 µg /kg) respectively immediately after 2 hours period of ischemia. At the end of reperfusion period. Lung tissue samples were taken for biochemical examination. Total oxidant status (TOS) and total antioxidant status (TAS) levels in lung tissue were determined by using a novel automated method. p<0.05 was considered as statistically significant. RESULTS: TOS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.004, p=0.011, p=0.017, respectively) and significantly lower in groups I/R+AM and I/R+VEGF, when compared with Group I/R (p=0.018, p=0.006, respectively). TAS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.006 p=0.016, p=0.016, respectively) and significantly lower in Group I/R+AM, when compared with Group I/R (p=0.016). CONCLUSION: These findings indicate that AM and VEGF acted effectively on the prevention of lung injury induced by skeletal muscle ischemia-reperfusion injury in a rat model (Fig. 2, Ref. 30).