Effect of the transdermal low-level laser therapy on endothelial function.

The effect of low-level laser therapy (LLLT) on the cardiovascular system is not fully established. Since the endothelium is an important endocrine element, establishing the mechanisms of LLLT action is an important issue.The aim of the study was to evaluate the effect of transdermal LLLT on endothelial function.In this study, healthy volunteers (n = 40, age = 20-40 years) were enrolled. N = 30 (14 female, 16 male, mean age 30 ± 5 years) constituted the laser-irradiated group (LG). The remaining 10 subjects (6 women, 4 men, mean age 28 ± 5 years) constituted the control group (CG). Participants were subjected to LLLT once a day for three consecutive days. Blood for biochemical assessments was drawn before the first irradiation and 24 h after the last session. In the LG, transdermal illumination of radial artery was conducted (a semiconductor laser λ = 808 nm, irradiation 50 mW, energy density 1.6 W/cm(2) and a dose 20 J/day, a total dose of 60 J). Biochemical parameters (reflecting angiogenesis: vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), angiostatin; antioxidative status: glutathione (GSH) and the nitric oxide metabolic pathway: symmetric dimethylarginine (SDMA), asymmetric dimethylarginine (ADMA) and L-arginine) were assessed. In the LG, a significant increase in GSH levels and considerable decrease in angiostatin concentration following the LLLT were observed. No significant differences in levels of the VEGF, FGF, SDMA, ADMA were observed.LLLT modifies vascular endothelial function by increasing its antioxidant and angiogenic potential. We found no significant differences in levels of the nitric oxide pathway metabolites within 24 h following the LLLT irradiation.

Kidney microcirculation response to adenosine stimulation in renal artery stenosis.

The purpose of this study was to assess the vasoconstrictive effects of adenosine in the kidney microcirculation in hypertensive patients with renal artery stenosis (RAS). Twelve patients with resistant hypertension and moderate RAS were selected for the study. In all patients, systolic, diastolic and mean translesional pressure gradients, distal pressure (Pd), aortic pressure (Pa) and Pd/Pa ratio were measured using a pressure guidewire at baseline and after intrarenal bolus administration of 400 µg adenosine. We observed significant changes in mean translesional pressure gradient and systolic Pd after pharmacological stimulation. The results suggest that in hypertensive patients with RAS, vasomotor activity of the kidney microcirculation may be preserved.

Effect of the intravascular low energy laser illumination during percutaneous coronary intervention on the inflammatory process in vascular wall.

The angioplasty procedure is associated with a release of numerous factors triggering the local inflammatory reaction in vascular wall and leading thus to the restenosis. In this study, we hypothesize that the low-energy laser irradiation may exert beneficial effect by limiting this process. A group of 101 subjects (75 men and 26 women, mean age: 59.1 ± 10.3) treated with percutaneous coronary intervention (PCI), were recruited to this study. While 52 patients (40 men and 12 women) were subjected to the intravascular low-energy laser irradiation (λ=808 nm) of dilated lesion during the PCI, the remaining patients (35 men and 14 women) constituted the control group. The levels of interleukin 1ß, 6 and 10 (IL 1ß, IL 6 and IL 10) were measured immediately before the procedure, and then at the 6th, 12th hour as well as after 1 month following the PCI. Significantly lower levels of IL 1ß and IL 6 in the irradiated group during each analysis after the procedure were observed. Moreover, significantly lower IL 10 level in irradiated group within 6 and 12 hours after PCI was observed. Irradiation of the lesion with low-energy laser radiation during the PCI procedure results in a decrease in the levels of pro-inflammatory IL 1ß and IL 6 as well as in an increase in the levels of anti-inflammatory IL 10, which may result in decreased risk for restenosis.

Platelet-Derived Drug Targets and Biomarkers of Ischemic Stroke-The First Dynamic Human LC-MS Proteomic Study.

(1) Objective: The aim of this dynamic LC-MS (liquid chromatography and mass spectrometry) human platelet proteomic study was to identify the potential proteins candidates for biomarkers of acute ischemic stroke (AIS), their changes during the acute phase of stroke and to define potential novel drug targets. (2) Methods: A total of 32 patients (18-80 years old) were investigated that presented symptoms of AIS lasting less than 24 h from the onset, confirmed by neurological examination and/or new cerebral ischemia visualized in the CT (computed-tomography) scans. The analysis of platelet proteome was performed using LC-MS at baseline, and then on the third and seventh day from the onset of symptoms. The control group was demographically matched without any clinical signs of acute brain injury. (3) Results: The differences between platelets, at 24 h after first symptoms of stroke subjects and the control group included: ß-amyloid A4 and amyloid-like protein 2, coactosin-like protein, thymidine phosphorylase 4 (TYMP-4), interferon regulatory factor 7 (IRF7), vitamin K-dependent protein S, histone proteins (H2A type 1 and 1-A, H2A types 2B and J, H2Av, -z, and -x), and platelet basic protein. The dynamic changes in the platelet protein concentration involved thrombospondin-1, thrombospondin-2, filamin A, B, and C. (4) Conclusions: This is the first human dynamic LC-MS proteomic study that differentiates platelet proteome in the acute phase of ischemic stroke in time series and compares the results with healthy controls. Identified proteins may be considered as future markers of ischemic stroke or therapeutic drug targets. Thymidine phosphorylase 4 (TYMP-4) holds promise as an interesting drug target in the management or prevention of ischemic stroke.

Effect of the Renin-Angiotensin-Aldosterone System Reactivity on Endothelial Function and Modulative Role of Valsartan in Male Subjects with Essential Hypertension.

BACKGROUND: The aim of the study was to evaluate the relationship between renin-angiotensin-aldosterone (RAA) system activity and reactivity, and the endothelial function profile in normotensive subjects (N), and in essential hypertensives (H), followed by analysis of the modulatory role of an angiotensin receptor blocker (ARB): valsartan, administered in the management of hypertension. METHODS: A total of 101 male subjects were enrolled to the study: 31H and 70N. The nitric-oxide (NO) bioavailability (l-Arginine, asymmetric dimethylarginine (ADMA)), symmetric dimethylarginine (SDMA), endothelial vasodilative function (flow mediated dilation (FMD)), oxidative-stress markers (malonyldialdehyde (MDA), thiol index (GSH/GSSG), nitrotyrozine (N-Tyr)), and pro-inflammatory/angiogenic parameters (sICAM-1, sVCAM-1, PAI-1, sE-selectin, PAI-1, thromboxane -B2) were assessed at baseline, then after intravenous -l-arginine administration, which was repeated after the 4-day acetylsalicylic acid (ASA) administration (75 mg/24 h). In hypertensives, this whole protocol was repeated following 2 weeks of valsartan therapy. RESULTS: No effect of valsartan and ASA on the flow-mediated vasodilation (FMD) and the NO bioavailability in hypertensives was observed. Administration of valsartan increased plasma renin activity (PRA), but without a decrease in the aldosterone levels. ASA treatment minimized the pre-existing differences between the groups, and increased the PRA in the N-subgroup with the highest ARR values. The blood concentrations of proinflammatory sICAM-1, sE-selectin, sVCAM-1, and PAI-1 were higher, whereas the anti-inflammatory 6-keto-PGF1 alpha level was lower in hypertensive subjects. The levels of angiogenic VEGF did not differ between groups. CONCLUSIONS: Our study does not confirm the modulative effect of valsartan on endothelial function. Normotensive men showed an increase in FMD after l-arginine administration, possibly indicating baseline impairment of the NO synthesis.

[Can angiography system with large-area flat digital panel induce higher irradiation in a patient during coronary angiography]. / Czy angiografy z plaskim panelem cyfrowym o dutej powierzchni powoduja wieksze napromieniowanie chorego poddanego koronarografii.

BACKGROUND: Nowadays, angiography systems with flat digital panel are used in cardiology and invasive radiology as the detector of irradiation. The so called universal systems with a magnified panel are becoming more common. In this study we tried to find out whether in practice the increased surface area of detectors may increase the absorption dose in a patient. MATERIAL AND METHODS: The study included 486 patients who underwent coronary angiography carried out by the same physicians. In 268 subjects the procedure was performed in cathlab A equipped with a cardiac angiography system, whereas in 218 subjects in cathlab B using universal angiography system. In the study the absorbed dose of irradiation by the patient was determined and its ratio to body mass, body mass index (BMI) and body surface area (BSA) was evaluated. RESULTS: The mean dose absorbed by the person under study did not differ between both catheterization laboratories. Similarly, there were no differences in the ratio of the absorbed dose and BMI. But the comparison of the ratio of the absorbed dose and the body mass showed significantly higher values in cathlab A, where. higher values of the ratio of the absorbed dose and BSA were also found (p < 0.01). CONCLUSIONS: In the present study it was found that the use of universal angiography systems with a larger surface area of the detecting panel is not connected with the increase in the irradiation dose absorbed by the patent during coronary angiography as compared with classical cardiac angiography systems.

[Relationship between chronic exposure to lead, cadmium and manganese, blood pressure values and incidence of arterial hypertension]. / Zwiazek miedzy przewleklym narazeniem na olów, kadm i mangan a wartoscia cisnienia tetniczego oraz wystepowaniem nadcisnienia tetniczego.

BACKGROUND: Chronic exposure to heavy metals may cause the increase in blood pressure (BP). The aim of the study was to determine the relationship between chronic exposure to lead, cadmium and manganese, BP values and the incidence of arterial hypertension (AT). MATERIAL AND METHODS: The study group consisted of 171 men occupationally and chronically exposed to heavy metals (group I), and 19 healthy men included into the control group (group II). Concentrations of lead and cadmium in blood, manganese in serum, free protoporphyrins in erytrocytes, and delta aminolevulinic acid in urine as well as blood pressure were measured. Six subgroups of the exposed individuals were chosen: those exposed to lead (subgroup A), to cadmium--(subgroup B), to manganese (subgroup C), to lead and cadmium (subgroup D), to lead and manganese (subgroup E), and to cadmium and manganese (subgroup F). RESULTS: In group I, the values of systolic blood pressure and mean blood pressure were statistically significantly higher than in group II. Moreover, systolic blood pressure was significantly higher in subgroups A, B, D and E in comparison with group II. Diastolic pressure was significantly lower in group II than in subgroups A and D, and mean blood pressure was significantly higher in subgroups A, D and E in comparison with group II. The incidence of arterial hypertension was significantly higher in subgroups A and D than in group II. The independent risk factors for the incidence of arterial hypertension in the study group were higher blood concentrations of lead and, cadmium. CONCLUSIONS: In men occupationally exposed to heavy metals there is a tendency to higher levels of BP. Higher blood concentrations of lead and cadmium were found to be the independent risk factors for the incidence of arterial hypertension in subjects chronically exposed to heavy metals.

Cardiovascular risk factors and the concentration of asymmetric dimethylarginine.

BACKGROUND: The most commonly recognized cardiovascular risk factors (CVRF) include smoking cigarettes, manifestation of arterial hypertension (AH), hypercholesterolemia, hypertriglyceridemia, manifestation of type 2 diabetes mellitus (DM), and the presence of overweight or obesity. In recent years, investigations have documented the significance of asymmetric dimethylarginine concentration (ADMA) in the pathogenesis of diseases affecting the cardiovascular system. OBJECTIVES: To evaluate the relationship between the number of CVRF and blood ADMA concentration. MATERIAL AND METHODS: The study was conducted on a sample of 138 individuals (mean age 54.90 ±10.38 years). Among the participants, we distniguished subgroups with no CVRF (group A, n = 21), with 1-2 CVRF (group B, n = 53), with 3-4 CVRF (group C, n = 55), and with 5-6 CVRF (group D, n = 9). Plasma concentrations of arginine and of endogenous methylarginines were estimated. RESULTS: Plasma ADMA concentrations proved to be significantly higher in groups B, C and D than those in group A. Regression analysis allowed us to demonstrate that in the studied population of patients, manifestation of type 2 DM, followed by AH and hypercholesterolemia, were linked to the highest probability of elevated plasma ADMA concentration. CONCLUSIONS: Higher concentration of ADMA in the blood may be a marker for higher cardiovascular risk, especially associated with hypertension, type 2 DM and hypercholesterolemia.

[Renal hypertension. A case report - therapeutic dilemmas]. / Nadcisnienie tetnicze nerkopochodne. Dylematy terapeutyczne - opis przypadku.

Hypertension associated with fibromuscular dysplasia of renal artery is the most common form of secondary hypertension among young patients. In this article we present a case of a 27-year-old patient, with drug-resistant hypertension. Stenosis of right renal artery and small right kidney were found on ultrasonography, angio-CT and angiography. There was no sign of renal atrophy therefore we performed percutaneous transluminal angioplasty. After the procedure we observed a decrease in blood pressure and no need to use hypertensive medication. Diagnosis and treatment of this condition are discussed.

[Repeat angioplasty of the left anterior descending coronary artery due to restenosis. How many times could we do it?]. / Wielokrotna angioplastyka tetnicy zstepujacej przedniej. Ile razy nalezy poszerzac tetnice z powodu restenozy?

Coronary angioplasty is widely accepted method of myocardium revascularisation. Repeat restenosis is often an indication for surgical treatment. Unfortunately, some patients are not treated surgically for various reasons. This leads to major therapeutic problems. We present a case of a 79-year-old female with repeat angioplasty done 6 times to the left anterior descending artery due to acute coronary syndromes in a 4-year period. The patient did not agree to recommended surgical treatment. We observed gradually deteriorating left ventricular function. The patient finally agreed to surgery, but left ventricle injury added to other clinical problems resulted in disqualification from operation.

[Left ventricular thrombus--variability of causes and clinical presentation--four case reports]. / Skrzeplina w swietle lewej komory. Róznorodnosc przyczyn i przebiegu klinicznego na podstawie czterech przypadków.

Thrombi occurring in heart chambers, particularly in the left ventricle, are very often due to diseases leading to heart dilation. Thrombi could dissolve spontaneously or as a result of pharmacological treatment. They could also be mobilizes and produce emboli. The risk of emboli vary significantly from low to extremely high due to different morphology and mobility of thrombi. The most effective treatment of thrombi is to cure the underlying disease. Additionally antithrombotic agents or surgical treatment may be applied. In this article 4 cases with different clinical course treated only with drugs are presented.

Interactions between the Cyclooxygenase Metabolic Pathway and the Renin-Angiotensin-Aldosterone Systems: Their Effect on Cardiovascular Risk, from Theory to the Clinical Practice.

Coronary artery disease (CAD) and stroke are the most common and serious long-term complications of hypertension. Acetylsalicylic acid (ASA) significantly reduces their incidence and cardiovascular mortality. The RAAS activation plays an important role in pathogenesis of CVD, resulting in increased vascular resistance, proliferation of vascular-smooth-muscle-cells, and cardiac hypertrophy. Drugs acting on the renin-angiotensin-aldosterone system (RAAS) are demonstrated to reduce cardiovascular events in population with cardiovascular disease (CVD). The cyclooxygenase inhibitors limit the beneficial effect of RAAS-inhibitors, which in turn may be important in subjects with hypertension, CAD, and congestive heart failure. These observations apply to most of nonsteroidal anti-inflammatory drugs and ASA at high doses. Nevertheless, there is no strong evidence confirming presence of similar effects of cardioprotective ASA doses. The benefit of combined therapy with low-doses of ASA is-in some cases-significantly higher than that of monotherapy. So far, the significance of ASA in optimizing the pharmacotherapy remains not fully established. A better understanding of its influence on the particular CVD should contribute to more precise identification of patients in whom benefits of ASA outweigh the complication risk. This brief review summarizes the data regarding usefulness and safety of the ASA combination with drugs acting directly on the RAAS.

Effect of electromagnetic field accompanying the magnetic resonance imaging on human heart rate variability - a pilot study.

The effect of electromagnetic field on cardiovascular system in the literature is defined in ambiguous way. The aim of this study was to evaluate the effect of electromagnetic field on the heart rate variability (HRV) during the examination with magnetic resonance. Forty-two patients underwent Holter ECG heart monitoring for 30 minutes twice: immediately before and after the examination with magnetic resonance imaging (MRI). HRV was analysed by assessing a few selected time and spectral parameters. Is has been shown that standard deviation of NN intervals (SDNN) and very low frequency rates increased, whereas the low frequency:high frequency parameter significantly decreased following the MRI examination. These results show that MRI may affect the HRV most likely by changing the sympathetic-parasympathetic balance.

Corrigendum to "Low-Level Laser Irradiation Exerts Antiaggregative Effect on Human Platelets Independently on the Nitric Oxide Metabolism and Release of Platelet Activation Markers".

[This corrects the article DOI: 10.1155/2017/6201797.].

Endothelial Function in Children with Acute Lymphoblastic Leukemia (ALL) May Reflect the Clinical Outcome.

Endothelial dysfunction is a common feature of early complications of hemato-oncologic therapy. The aim of our study was to assess the profile of endothelial function at diagnosis time, then during initial treatment phase of acute lymphoblastic leukemia (ALL), and to verify the presence of its correlation with early clinical outcome (ECO). 28 ALL children and 18 healthy age-matched control ones were recruited. Study group was examined at baseline and at 33rd and 78th day of treatment. At each protocol step the endothelial function was assessed by measurement of sP-selectin (CD62-P), PAI-1(serpinE1), sE-selectin (CD62E), sICAM-1(sCD54), sVCAM-1(sCD106), and VEGF concentrations. Higher baseline sICAM-1 and sVCAM-1 levels and lower sP-selectin and VEGF were observed in children with ALL. sICAM-1, sVCAM-1, and sE-selectin levels were decreasing following the treatment with protocol I. Higher sE-selectin and lower baseline sICAM-1 levels were observed in children treated unsuccessfully. Lower PAI-1 levels were observed in children who survived. Higher baseline sE-selectin levels and lower sICAM-1 and VEGF were observed in children treated unsuccessfully. A decrease in sE-selectin and lower PAI-1 at the 78th day of therapy were associated with better ECO. High baseline VEGF and sE-selectin levels, significant increase in PAI-1, and low initial sICAM-1 levels are prognostics for poorer prognosis in the ALL children.

[Multiple percutaneous coronary stent implantation due to myocardial bridging--a case report]. / Wielokrotny zabieg stentowania mostka miesniowego--opis przypadku.

We present a case of a woman who had acute coronary syndrome caused by myocardial bridge. She was treated with percutaneous coronary intervention and stent implantation. Two months after the procedure the patient had myocardial infarction because of subacute thrombosis and during the second intervention another stent was implanted. After a few months another acute coronary syndrome occurred because of restenosis and balloon angioplasty with stent implantation was performed. Despite this the artery occluded and sufficient collateral circulation was developed. Current opinions concerning percutaneous coronary interventions of myocardial bridges are presented.

[Giant coronary artery aneurysm successfully treated with surgery--a case report]. / Znacznych rozmiarów tetniak naczynia wiencowego skutecznie leczony kardiochirurgicznie. Opis przypadku wraz z omówieniem etiologii, diagnostyki i leczenia.

We report a case of a 54-year-old woman presenting with nonspecific chest pain and clinical symptoms of heart failure. Various diagnostic tools, including both noninvasive methods and coronary angiography, revealed the presence of a giant aneurysm of the right coronary artery. The aneurysm formed a mediastinal mass of a huge size, with blood flow in it, and caused cardiac displacement within the thorax cavity. Surgical management of this anomaly was effective. Aetiology, clinical symptoms, diagnostic tools and treatment options of coronary artery aneurysms are discussed.

[Coexistence of Takayasu's disease and atherosclerosis in computed tomography angiography examination--case report]. / Wspólistnienie choroby Takayasu i miazdzycy tetnic w obrazie angiografii metoda tomografii komputerowej--opis przypadku.

Takayasu disease is a syndrome of unknown etiology having an immunological basis and appearing mainly in young women. It leads to characteristic changes in arteries as confirmed by diagnostic imaging methods. The case of a 51-year-old woman with recognized Takayasu's disease and stenocardial complaints arising from atheroma of the coronary arteries is presented. Computed tomography angiography examination showed changes typical for both Takayasu's disease and atherosclerosis. The potential influence of the inflammation appearing in Takayasu's disease on atheroma is discussed. The clinical signs accompanying Takayasu's disease and diagnostic imaging methods for their detection are presented.

Effect of endovascular coronary low-level laser therapy during angioplasty on the release of endothelin-1 and nitric oxide.

BACKGROUND: Nitric oxide (NO) and endothelin-1 are potentially significant factors contributing to the pathogenesis of post-angioplasty restenosis. It may be postulated that low-level laser therapy (LLLT) can favorably influence the process of restenosis by affecting those factors. OBJECTIVES: The aim of the study was to evaluate the effect of LLLT applied during percutaneous coronary intervention (PCI) on the factors participating in the homeostasis of vascular tone - NO and endothelin-1. MATERIAL AND METHODS: In a randomized, prospective study of 52 subjects undergoing PCI, an additional 808 nm intravascular LLLT was applied at a dose of 9 J/cm2 in the lesion part. The control group was 49 subjects with PCI only. We assessed the concentration of nitrites/nitrates reflecting NO metabolism as well as endothelin-1 in both groups before PCI, and at 6 h, 12 h and 1 month after the procedure. In addition, half a year after PCI, a follow-up angiography was performed. RESULTS: Statistically higher nitrite/nitrate concentrations were observed in the laser group as compared to the control group in all tests except the pre-PCI assays. Endothelin-1 levels were significantly higher in the laser group 6 h after PCI with a significant decrease in subsequent tests, which was not observed in the control group. The restenosis rate was 15.0% in the laser group and 32.4% in the control group (however the difference was not statistically significant). CONCLUSIONS: LLLT applied during the PCI procedure can influence the process of restenosis by modifying NO and endothelin-1 concentrations.

Low-Level Laser Irradiation Exerts Antiaggregative Effect on Human Platelets Independently on the Nitric Oxide Metabolism and Release of Platelet Activation Markers.

AIM: The goal of the study is to develop a model allowing to investigate precisely the effect of low-level laser therapy (LLLT) on platelet aggregation and to verify the hypothesis regarding the role of the nitric oxide (NO) bioavailability and platelet activation markers in modulating platelet aggregation. METHODS: A total of 41 healthy volunteers at the age of 21-45 years were investigated. At first, platelet aggregation in response to three agonists (TRAP, ADP, and collagen) was evaluated following previous exposure to different doses of laser radiation (λ = 662 nm) to assess the dose-response effect. Subsequently, plasma levels of platelet activation markers (PF4-platelet factor-4 and sP-selectin) as well as the substrate for nitric oxide synthase, L-arginine, and its competitive inhibitors (ADMA-asymmetric dimethylarginine and SDMA-symmetric dimethylarginine) were measured. RESULTS: All doses of laser irradiation significantly reduced the aggregation. However, the most pronounced effect was observed for 19.7 J/cm2. No significant differences in the levels of platelet activation markers nor in the nitric-oxide-metabolic-pathway compounds between analyzed groups were noted. CONCLUSIONS: We have demonstrated in the established in vitro experimental model that the LLLT in a reproducible manner decreases the whole blood platelet aggregation regardless of the NO bioavailability or changes in the platelet activation markers.