scholarly journals The Mediterranean Diet Benefit on Cardiovascular Hemodynamics and Erectile Function in Chronic Heart Failure Male Patients by Decoding Central and Peripheral Vessel Rheology

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 108
Author(s):  
Athanasios Angelis ◽  
Christina Chrysohoou ◽  
Evangelia Tzorovili ◽  
Aggeliki Laina ◽  
Panagiotis Xydis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Mediterranean Diet ◽  
Serum Prolactin ◽  
Doppler Velocity ◽  
Heart Failure Patients ◽  
Cardiovascular Hemodynamics ◽  
The Mediterranean

Background: Mediterranean diet was evaluated on erectile performance and cardiovascular hemodynamics, in chronic heart failure patients. Methods: 150 male stable heart failure patients were enrolled in the study (62 ± 10 years, New York Heart Association (NYHA) classes I–II, ejection fraction ≤40%). A detailed echocardiographic evaluation including estimation of the global longitudinal strain of the left ventricle and the systolic tissue doppler velocity of the tricuspid annulus was performed. Erectile dysfunction severity was assessed by the Sexual Health Inventory for Men-5 (SHIM-5) score. Adherence to the Mediterranean diet was evaluated by the MedDietScore. Results: The SHIM-5 score was positively correlated with the MedDietScore (p = 0.006) and augmentation index (p = 0.031) and inversely correlated with age (p = 0.002). MedDietScore was negatively associated with intima-media-thickness (p < 0.001) and serum prolactin levels (p = 0.05). Multi-adjusted analysis revealed that the inverse relation of SHIM-5 and prolactin levels remained significant only among patients with low adherence to the Mediterranean diet (p = 0.012). Conclusion: Consumption of Mediterranean diet benefits cardiovascular hemodynamics, while suppressing serum prolactin levels. Such physiology may enhance erectile ability independently of the of the left ventricle ejection fraction.

P4534The Mediterranean diet benefit in chronic heart failure by decoding central and peripheral vessel rheology, atheroma formation and serum prolactin levels

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Angelis ◽  
C Chrysohoou ◽  
A Laina ◽  
C.-K Antoniou ◽  
K Konstantinou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Wave Reflection ◽  
Serum Prolactin ◽  
Peripheral Vessel ◽  
Diet Compliance ◽  
Male Patients ◽  
Diet Score

Abstract Background Central hemodynamics and especially wave reflection amplification exhibit a vital parameter of chronic heart failure (CHF) physiology. Erectile dysfunction (ED) displays a poor peripheral vessel rheology and serum prolactin role is still debated in CHF mechanisms. The Mediterranean diet (Med-diet) is famous for its vasoprotective and wellbeing properties. Purpose To investigate the effect of the Med-diet in central hemodynamics, erectile status, atheroma formation and serum prolactin levels in male patients with chronic heart failure. Methods 123 CHF male patients under optimal medical therapy enrolled the study (mean age: 65±8 yo, NYHA class II, ejection fraction <40%). All underwent evaluation of the carotid – femoral pulse wave velocity (PWV), estimation of central pressures and augmentation index (AIx) as parameter of wave reflection amplification (sphygmocor device). Ejection fraction (EF) of the left ventricle was estimated by using 2D echocardiography (Simpson method). ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values point to better erectile function and a great Med-diet compliance respectively. Detection of atheroma was based on the intima- media thickness (IMT) of the common carotid artery. Prolactin levels were assessed in morning blood samples taken before 09:00 am. Results The SHIM −5 score (mean: 12±4) was associated to the AIx (p=0,03, r=0,75) and both positively and strongly related to the Med-diet score (p=0,01, r=0,8 and p=0,01, r=0,75 respectively). Med-diet compliance was negatively associated to IMT (p=0,02, r=−0,8) and serum prolactin levels (p=0,03, r=−0,6).Moreover, we notice a positive association between prolactin and the IMT (p=0,04, r=0,7). By multiple linear regression analysis the relation of SHIM-5 and Med-diet score remained significant (p=0,04) after adjustment for BMI, central pulse and mean arterial pressures. We further subdivide our population according to the mean Med-diet value (28) into high and low Med-diet adherence groups. Only in the group with the greater Med-diet adherence (n=73, 60%) AIx was strongly associated to the SHIM-5 score (p=0,02) even after adjustment for PWV, age and BMI. Prolactin levels there were still related to IMT (p=0,04) after adjustment for PWV, AIx, BMI and central pulse pressure. All statistics remained significant when adjusting for ejection fraction of the left ventricle. Conclusion High adherence to the Med-diet benefits CHF hemodynamics by enforcing wave reflection amplification, thus generating a stronger pulse signal to peripheral vasculature. Moreover suppresses serum prolactin levels that relates to atheroma formation. Both actions enhance erectile performance independently of the EF of the left ventricle. It is important to advise CHF patients to adopt this dietary pattern in order to improve hemodynamic status and the sense of wellbeing.

scholarly journals Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial

2018 ◽  
Vol 26 (1-2) ◽  
pp. 64-72 ◽  
Author(s):  
Santiago Jiménez-Marrero ◽  
Sergi Yun ◽  
Miguel Cainzos-Achirica ◽  
Cristina Enjuanes ◽  
Alberto Garay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Usual Care ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients

Background The efficacy of telemedicine in the management of patients with chronic heart failure and left ventricular ejection fraction ≥40% is poorly understood. The aim of our analysis was to evaluate the efficacy of a telemedicine-based intervention specifically in these patients, as compared to standard of care alone. Methods The Insuficiència Cardiaca Optimització Remota (iCOR) study was a single centre, randomised, controlled trial, designed to evaluate a telemedicine intervention added to an existing hospital/primary care multidisciplinary, integrated programme for chronic heart failure patients. 178 participants were randomised to telemedicine or usual care, and were followed for six months. For the present sub-analysis, only iCOR participants (n = 116) with left ventricular ejection fraction ≥40% were included. The primary study endpoint was the incidence of an acute non-fatal heart failure event, defined as a new episode of worsening of symptoms and signs consistent with acute heart failure requiring intravenous diuretic therapy. The healthcare-related costs in each study group were also evaluated. Results The incidence of the first occurrence of the primary endpoint was significantly lower in the telemedicine arm (22% vs 56%, p<0.001), with a hazard ratio of 0.33 comparing to the usual care arm (95% confidence interval 0.17–0.64). Telemedicine was also associated with lower mean overall chronic heart failure care-related costs compared to usual care (8163€ vs 4993€, p=0.001). The results were consistent in both left ventricular ejection fraction of 40–49% and left ventricular ejection fraction ≥50% patients. Conclusions Our results suggest that telemedicine is a promising strategy for the management of chronic heart failure patients with left ventricular ejection fraction ≥40%. These findings should be replicated in larger cohorts.

Statins and Left Ventricular Function

2018 ◽  
Vol 23 (46) ◽  
pp. 7128-7134 ◽  
Author(s):  
Agamemnon Bakakos ◽  
Evangelos Oikonomou ◽  
Georgia Vogiatzi ◽  
Gerasimos Siasos ◽  
Sotiris Tsalamandris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Current Evidence ◽  
Heart Failure Patients ◽  
Reductase Inhibitors ◽  
Randomized Control ◽  
Coronary Events ◽  
Pleiotropic Actions

Background: Statins are a well-established class of drugs in both preventing coronary events and treating cardiovascular atherosclerotic disease, however their use in heart failure is still in debate. </P><P> Objectives: To establish whether statins&#39; pleiotropic actions in endothelium, inflammation, remodeling of the heart and anti-arrhythmic potential may be in favorable of heart failure patients. </P><P> Methods: We proceed to literature search of English bibliography under the terms heart failure, statins, 3- hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors. </P><P> Results: Various experimental and clinical trials on the use of statins in the different subtypes of heart failure according to the ejection fraction of the left ventricle have been conducted to conclude whether statins should be part of their patients&#39; treatment. The evidence shows that the subgroup of patients with ischemic heart disease and those with preserved ejection fraction seems to have better results from the use of statins although randomized control trial in the total heart failure population did not show any benefit in mortality. </P><P> Conclusion: Statins may be beneficial to left ventricle systolic and diastolic performance of heart failure patients however their result in mortality cannot be established based on current evidence.

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