scholarly journals Graves’ Disease and Cardiac Complications

2021 ◽  
Author(s):  
Abdulla Arslan ◽  
Hakan Altay
Keyword(s):  
Cardiovascular System ◽  
Myocardial Oxygen Consumption ◽  
Diastolic Pressure ◽  
Cardiac Contractility ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Diastolic Relaxation ◽  
Underlying Mechanisms

Graves’ disease is an autoimmune thyroid disease and a common cause of hyperthyroidism. Thyroid hormones have multiple adverse effect on cardiovascular system through many direct and indirect mechanisms. They increases heart rate, cardiac contractility, systolic and mean pulmonary artery pressure, cardiac output, diastolic relaxation, and myocardial oxygen consumption, whereas decrease systemic vascular resistance and diastolic pressure. All these hemodynamic changes in cardiovascular system can eventually lead to heart failure, tachyarrhythmias, systemic and pulmonary hypertension, if left untreated. Cardiovascular complications of Graves’ disease are frequent and important cause of increased morbidity and mortality. This chapter reviews the cardiovascular complications of Graves’ hyperthyroidism with underlying mechanisms and treatment.

scholarly journals COVID-19 and the Cardiovascular System: How the First PostModern Pandemic ‘Weakened’ our Hearts

2020 ◽  
Vol 3 ◽  
pp. e15
Author(s):  
Syeda Tasneem Towhid ◽  
◽  
Nadira Naznin Rakhi ◽  
ASM Shamsul Arefin ◽  
Otun Saha ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Cardiac Injury ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Holistic Approach ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Cardiovascular Damage ◽  
Preventative Measures ◽  
Life Threatening

The global spread of SARS-CoV-2 with its diverse signs and symptoms manifested in COVID-19 patients across different age groups and geographic locations perplexed the clinicians and public health experts. Emerging variants of SARS-CoV-2 through continuous mutation with a limited arsenal of treatment made the study of viral pathogenesis and factors associated with disease outcomes in a holistic approach inevitable, among which pre-existing cardiovascular complications were found to be significantly associated with adverse outcome of COVID-19. In addition, COVID-19 has already been reported to cause cardiac injury and different cardiovascular complications in patients irrespective of preexisting cardiovascular complications, which highlights the importance of recognizing the complications at the onset, although these arising complications might be an indirect effect of SARS-CoV-2 induced cytokine storm or hypoxia rather the virus itself. Also, the drugs used for the clinical management of the patients may have an impact on the induced cardiac complications. Thus, the effect of SARS-CoV-2 on the cardiovascular system needs to be investigated in order to predict the clinical outcome and to devise a proper treatment strategy. Besides, the interaction of vaccines or therapeutics to be approved with the cardiovascular system needs to be evaluated to avoid confounding effects leading to cardiovascular complications followed by post-approval retraction. However, potential biomarkers (eg. troponin, D-dimers, fibrin) associated with cardiac injury may be potentially useful in predicting life-threatening conditions early enough to save lives. In conclusion, this review summarizes the molecular pathogenesis of cardiovascular damage caused by SARS-CoV-2 in COVID-19 patients, as well as prescribed treatment and preventative measures.

scholarly journals Chronic exposure to tramadol induces cardiac inflammation and endothelial dysfunction in mice

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marwa H. Bakr ◽  
Eman Radwan ◽  
Asmaa S. Shaltout ◽  
Alshaimaa A. Farrag ◽  
Amany Refaat Mahmoud ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular System ◽  
Troponin I ◽  
Cardiovascular Complications ◽  
Enos Expression ◽  
Serum Samples ◽  
Cardiac Damage ◽  
Tramadol Hydrochloride ◽  
Cardiac Inflammation ◽  
Underlying Mechanisms

AbstractTramadol is an opioid extensively used to treat moderate to severe pain; however, prolonged therapy is associated with several tissues damage. Chronic use of tramadol was linked to increased hospitalizations due to cardiovascular complications. Limited literature has described the effects of tramadol on the cardiovascular system, so we sought to investigate these actions and elucidate the underlying mechanisms. Mice received tramadol hydrochloride (40 mg/kg body weight) orally for 4 successive weeks. Oxidative stress, inflammation, and cardiac toxicity were assessed. In addition, eNOS expression was evaluated. Our results demonstrated marked histopathological alteration in heart and aortic tissues after exposure to tramadol. Tramadol upregulated the expression of oxidative stress and inflammatory markers in mice heart and aorta, whereas downregulated eNOS expression. Tramadol caused cardiac damage shown by the increase in LDH, Troponin I, and CK-MB activities in serum samples. Overall, these results highlight the risks of tramadol on the cardiovascular system.

Impact of the period of the day on mortality and major cardiovascular complications after vascular surgeries

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F.A.M Cardozo ◽  
T Artioli ◽  
B Caramelli ◽  
D Calderaro ◽  
P.C Yu ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Total Mortality ◽  
Mortality Rates ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Funding Source ◽  
Confounding Variables ◽  
Significant Difference ◽  
One Year ◽  
Night Period

Abstract Introduction Patients submitted to arterial vascular surgeries are at a high risk of postoperative cardiac and non-cardiac complications, therefore developing strategies to lower perioperative complications is essential to optimize outcomes for this subgroup. Recent studies have suggested that the period of the day in which surgeries are performed may influence postoperative major cardiovascular complications but there is still no evidence of this association in vascular surgeries. Purpose Our goal is to evaluate whether the period of the day in which surgeries are performed may influence mortality and cardiovascular outcomes in patients undergoing non-cardiac vascular procedures. Methods Patients who underwent non-cardiac vascular surgeries between 2012 and 2018 were prospectively included at our cohort. For this analysis, subjects were categorized into two groups: those who underwent surgery in the morning (7am - 12am) and those who underwent surgery in the afternoon/night (12:01pm - 6:59am). The primary endpoints were to compare the incidence of major adverse cardiac events (MACE - acute myocardial infarction, acute heart failure, arrhythmias, and cardiovascular death) and total mortality between morning and afternoon/night surgeries within 30 days and one year. The secondary endpoint was the incidence of perioperative myocardial injury (PMI) in both groups. PMI was defined as an absolute elevation of high-sensitivity cardiac troponin T (hs-cTnT) concentrations ≥14ng/L. Multivariable analysis using Cox proportional regression (with Hazard Ratio – HR and Confidence Interval – 95% CI) was performed to adjust for confounding variables, including emergency and urgent surgeries. Results Of 1267 patients included, 1002 (79.1%) underwent vascular surgery in the morning and 265 (20.9%) in the afternoon/night. After adjusting for confounding variables, the incidence of MACE at 30 days was higher among those who underwent surgery in the afternoon/night period (37.4% vs 20.4% – HR 1.43, 95% CI: 1.10–1.85; p=0.008). Mortality rates were also elevated in the afternoon/night group (21.5% vs 9.9%, HR 1.59, 95% CI: 1.10–2.29; p=0.013). After one-year of follow-up the worst outcomes persisted in patients operated in the afternoon/night: higher incidence of MACE (37.7% vs 21.2%, HR 1.37, 95% CI: 1.06–1.78; p=0.017) and mortality (35.8% vs 17.6%, HR 1.72, 95% CI 1.31–2.27; p<0.001). There was no significant difference in the incidence of PMI between groups (p=0.8). Conclusions In this group of patients, being operated in the afternoon/night period was independently associated with increased mortality rates and incidence of MACE. Mortality and MACE at one year Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): FAPESP - Fundação de Amparo a Pesquisa do Estado de São Paulo

scholarly journals Bone Morphogenetic Proteins and Diabetic Retinopathy

Biomolecules ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 593
Author(s):  
Khaled Elmasry ◽  
Samar Habib ◽  
Mohamed Moustafa ◽  
Mohamed Al-Shabrawey
Keyword(s):  
Diabetic Retinopathy ◽  
Bone Morphogenetic Proteins ◽  
Potential Role ◽  
Microvascular Dysfunction ◽  
Cardiovascular Complications ◽  
Bmp Signaling ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Retinal Inflammation ◽  
Underlying Mechanisms

Bone morphogenetic proteins (BMPs) play an important role in bone formation and repair. Recent studies underscored their essential role in the normal development of several organs and vascular homeostasis in health and diseases. Elevated levels of BMPs have been linked to the development of cardiovascular complications of diabetes mellitus. However, their particular role in the pathogenesis of microvascular dysfunction associated with diabetic retinopathy (DR) is still under-investigated. Accumulated evidence from our and others’ studies suggests the involvement of BMP signaling in retinal inflammation, hyperpermeability and pathological neovascularization in DR and age-related macular degeneration (AMD). Therefore, targeting BMP signaling in diabetes is proposed as a potential therapeutic strategy to halt the development of microvascular dysfunction in retinal diseases, particularly in DR. The goal of this review article is to discuss the biological functions of BMPs, their underlying mechanisms and their potential role in the pathogenesis of DR in particular.

scholarly journals Defect of a subpopulation of natural killer immune cells in Graves’ disease and Hashimoto’s thyroiditis: normalizing effect of dehydroepiandrosterone sulfate

2005 ◽  
Vol 152 (5) ◽  
pp. 703-712 ◽  
Author(s):  
Sebastiano Bruno Solerte ◽  
Sara Precerutti ◽  
Carmine Gazzaruso ◽  
Eleonora Locatelli ◽  
Mauro Zamboni ◽  
...  
Keyword(s):  
Nk Cells ◽  
Hashimoto’S Thyroiditis ◽  
Nk Cell ◽  
Secretory Activity ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Tnf Α

Background: The study of the natural killer (NK) immune compartment could provide important findings to help in the understanding of some of the pathogenetic mechanisms related to autoimmune thyroid diseases (Graves’ disease (GD) and Hashimoto’s thyroiditis (HT)). Within this context, it was suggested that alterations in NK cell cytotoxicity (NKCC) and NK production of cytokines might occur in subjects with GD and HT, whereas the normalization of NK functions could potentially contribute to the prevention of the onset or the progression of both diseases. Objective: Due to the hypothesis of alterations in NK in autoimmune thyroid diseases, we were interested to evaluate NKCC in GD and HT patients and to modulate NK function and secretory activity with cytokines and dehydroepiandrosterone sulfate (DHEAS) in an attempt to normalize NK cell defect. Design: We studied 13 patients with recent onset Graves’ disease, 11 patients with Hashimoto’s thyroiditis at first diagnosis and 15 age-matched healthy subjects. Methods: NK cells were concentrated at a density of 7.75 × 106 cells/ml by negative immunomagnetic cell separation and validated by FACScan as CD16 + /CD56 + cells. NK cells were incubated with interleukin-2 (IL-2) and interferon-β (IFN-β) and co-incubated with DHEAS at different molar concentrations for measuring NKCC and the secretory pattern of tumor necrosis factor-α (TNF-α) from NK cells. Results: Lower spontaneous, IL-2- and IFN-β-modulated NKCC was demonstrated in GD and HT patients compared with healthy subjects (P < 0.001). A decrease in spontaneous and IL-2-modulated TNF-α release from NK cells was also found in both groups of patients (P < 0.001). The co-incubation of NK cells with IL-2/IFN-β + DHEAS at different molar concentrations (from 10−8 to 10−5 M/ml/NK cells) promptly normalized NKCC and TNF-α secretion in GD and HT patients. Conclusions: A functional defect of a subpopulation of NK immune cells, involving both NKCC and the secretory activity, was demonstrated in newly-diagnosed GD and HT patients. This defect can be reversed by a dose-dependent treatment with DHEAS. The impairment of NK cell activity in autoimmune thyroid diseases could potentially determine a critical expansion of T/B-cell immune compartments leading to the generation of autoantibodies and to the pathogenesis of thyroid autoimmunity.

Effect of human urotensin-II infusion on hemodynamics and cardiac function

2003 ◽  
Vol 81 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Ghada S Hassan ◽  
Fazila Chouiali ◽  
Takayuki Saito ◽  
Fu Hu ◽  
Stephen A Douglas ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Diastolic Pressure ◽  
Cardiac Contractility ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Urotensin Ii ◽  
Ventricular Systolic Pressure ◽  
Wide Range ◽  
Dose Dependent Decrease

Recent studies have shown that the vasoactive peptide urotensin-II (U-II) exerts a wide range of action on the cardiovascular system of various species. In the present study, we determined the in vivo effects of U-II on basal hemodynamics and cardiac function in the anesthetized intact rat. Intravenous bolus injection of human U-II resulted in a dose-dependent decrease in mean arterial pressure and left ventricular systolic pressure. Cardiac contractility represented by ±dP/dt was decreased after injection of U-II. However, there was no significant change in heart rate or diastolic pressure. The present study suggests that upregulation of myocardial U-II may contribute to impaired myocardial function in disease conditions such as congestive heart failure.Key words: urotensin-II, rat, infusion, heart.

Development of Autoimmune Thyroid Disease in Multiple Sclerosis Patients Post-Alemtuzumab Improves Treatment Response

2020 ◽  
Vol 105 (9) ◽  
pp. e3392-e3399 ◽  
Author(s):  
Alina Sovetkina ◽  
Rans Nadir ◽  
Antonio Scalfari ◽  
Francesca Tona ◽  
Kevin Murphy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Tertiary Referral Center ◽  
T2 Lesions ◽  
Relapsing Remitting ◽  
Edss Score ◽  
Multiple Sclerosis Patients

Abstract Context Alemtuzumab is an anti-CD52 monoclonal antibody used in the treatment of relapsing-remitting multiple sclerosis (MS). Between 20% and 40% of alemtuzumab-treated MS patients develop autoimmune thyroid disease (AITD) as a side effect. Objective The objective of this work is to determine whether MS disease progression following alemtuzumab treatment differs in patients who develop AITD compared to those who do not. Design, Setting, and Patients A retrospective analysis of 126 patients with relapsing-remitting MS receiving alemtuzumab from 2012 to 2017 was conducted at a tertiary referral center. Main Outcome Measures Thyroid status, new relapses, Expanded Disability Status Scale (EDSS) score change, and disability progression following alemtuzumab were evaluated. Results Twenty-six percent (33 out of 126, 25 female, 8 male) of alemtuzumab-treated patients developed AITD, 55% of which was Graves disease. EDSS score following alemtuzumab was reduced in patients who developed AITD compared to those who did not (median [interquartile range]; AITD: –0.25 [–1 to 0.5] vs non-AITD: 0 [1-0]. P = .007]. Multivariable regression analysis confirmed that the development of AITD was independently associated with EDSS score improvement (P = .011). Moreover, AITD patients had higher relapse-free survival following alemtuzumab (P = .023). There was no difference in the number of new focal T2 lesions and contrast-enhancing magnetic resonance imaging lesions developed following alemtuzumab between the 2 groups. Conclusion Graves disease was the most common form of AITD developed by MS patients following alemtuzumab. This study suggests that MS patients who develop AITD may have an improved response to alemtuzumab, as measured by reduced disability and lower relapse rate.

scholarly journals A Case of Thyrotoxicosis due to Simultaneous Occurrence of Subacute Thyroiditis and Graves’ Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Kazunori Kageyama ◽  
Noriko Kinoshita ◽  
Makoto Daimon
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Disease ◽  
Rare Case ◽  
Autoimmune Thyroid Disease ◽  
Subacute Thyroiditis ◽  
Simultaneous Occurrence ◽  
Graves Disease ◽  
Inflammatory Disorder ◽  
Autoimmune Thyroid ◽  
Prompt Diagnosis

Subacute thyroiditis is an inflammatory disorder of the thyroid. Graves’ disease is an autoimmune thyroid disease in which thyroid hormones are overproduced. Here we present a rare case of thyrotoxicosis due to the simultaneous occurrence of both diseases. Prompt diagnosis and therapy are required to prevent complications in patients with thyrotoxicosis.

scholarly journals Cardiovascular system and coronavirus disease-2019 (COVID-19): mutual injuries and unexpected outcomes

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Eman Sobh ◽  
Muhammad Saad Reihan ◽  
Tamer M. S. Hifnawy ◽  
Khloud Gamal Abdelsalam ◽  
Sohaila Sabry Awad ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Poor Prognosis ◽  
Clinical Decision ◽  
Cardiovascular Complications ◽  
Main Body ◽  
Negative Consequences ◽  
Coronary Syndrome ◽  
System A ◽  
High Index Of Suspicion ◽  
Unexpected Outcomes

Abstract Background Cardiovascular system involvement in coronavirus disease-2019 (COVID-19) has gained great interest in the scientific community. Main body Several studies reported increased morbidity and mortality among COVID-19 patients who had comorbidities, especially cardiovascular diseases like hypertension and acute coronary syndrome (ACS). COVID-19 may be associated with cardiovascular complications as arrhythmia, myocarditis, and thromboembolic events. We aimed to illustrate the interactions of COVID-19 disease and the cardiovascular system and the consequences on clinical decision as well as public health. Conclusions COVID-19 has negative consequences on the cardiovascular system. A high index of suspicion should be present to avoid poor prognosis of those presenting with unusual presentation.

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