Effect of sleeve gastrectomy, Roux-en-Y gastric bypass, and ileal transposition on myocardial ischaemia-reperfusion injury in non-obese non-diabetic rats.

Bariatric surgery (BS) improves outcomes in patients with myocardial infarction (MI). Here we tested the hypothesis that BS-mediated reduction in fatal MI could be attributed to its infarct-limiting effect. Wistar rats were randomized into five groups: control (CON), sham (SHAM), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and ileotransposition (IT). Ten weeks later, animals were subjected to 30-min myocardial ischemia plus 120-min reperfusion. Infarct size (IS) and no-reflow area were determined histochemically. Fasting plasma levels of glucagon-like peptide-1 (GLP-1), leptin, ghrelin, and insulin were measured using ELISA. Compared with SHAM, RYGB and SG reduced IS by 22% (p = 0.011) and 10% (p = 0.027), and no-reflow by 38% (p = 0.01) and 32% (p = 0.004), respectively. IT failed to reduce IS and no-reflow. GLP-1 level was increased in the SG and RYGB groups compared with CON. In both the SG and RYGB, leptin level was decreased compared with CON and SHAM. In the SG group, ghrelin level was lower than that in the CON and SHAM. Insulin levels were not different between groups. In conclusion, RYGB and SG increased myocardial tolerance to ischemia-reperfusion injury of non-obese, non-diabetic rats, and their infarct-limiting effect is associated with decreased leptin and ghrelin levels and increased GLP-1 level.

May Measurement Month 2017 in Russia: hypertension treatment and control-Europe.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. The most recent publication compared data from three surveys performed in Russian population aged 25-64 showed that the prevalence of hypertension increased by approximately 20% from 2003 to 2013. This study presents screening data collected in 2017 though the MMM17 initiative in Russia. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 in 19 Russian cities. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. The recruitment of MMM17 participants in Russia occurred in shopping malls, colleges and universities, supermarkets, business centres, parks, and squares. Russian young cardiologists as an official section of Russian Society of Cardiology was actively involved. A total of 5660 individuals were screened. After multiple imputation, 2709 (47.9%) had hypertension. Of individuals not receiving antihypertensive medication, 753 (20.3%) were hypertensive. Of individuals receiving antihypertensive medication, 1094 (55.9%) had uncontrolled BP. Comparing with the worldwide results of MMM17 screening, Russian participants had a higher proportion of hypertension, comparable antihypertensive prescription rate, and worse hypertension control. Thus, the MMM17 project appears to be an important step in evaluating hypertension burden in Russia and emphasizes the further need to improve hypertension awareness, treatment, and control.

Treat-to-target versus dose-adapted statin treatment of cholesterol to reduce cardiovascular risk.

Clinical guidelines should be based on the best available evidence and are of great importance for patient care and disease prevention. In this respect, the 2013 American College of Cardiology/American Heart Association report is highly appreciated and well-recognized. The report included critical questions concerning hypercholesterolaemia, but its translation into a clinical guideline initiated intense debate worldwide because of the recommendation to switch from a treat-to-target approach for low-density-lipoprotein-cholesterol to a statin dose-based strategy.