Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial ...Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial biopsies. The aim of t his study was to investigate the impact of myocardial virus persistence on endot helial function. Methods and Results -In 124 patients with suspected cardiomyop athy, myocardial biopsies were examined for virus persistence(by polymerase chai n reaction) and inflammation(by immunohistology). Endothelial function of the ra dial artery was examined by high-resolution ultrasound. Diameter changes in res ponse to reactive hyperemia (flow-mediated dilation[FMD]) compared with glycero l trinitrate(GTN-MD) were measured. Mean age of the patients(55 men, 69 women) was 45±13 years; ejection fraction was 57±17%. In 73 patients, adenovirus, en terovirus, parvovirus, or HHV6 virus(V) was detected; in 51, no virus was detect ed. FMD was significantly impaired in patients with myocardial virus persistence compared with control subjects(Co): FMD-V, 3.38±2.67%; FMD-Co, 7.34±3.44(P < 0.001). In 86 patients, myocardial inflammation was confirmed (Inf). Of those, 57 had virus, and 29 did not. FMD was significantly impaired in patients with v irus compared with controls: FMD-Inf-V, 3.24±2.66%; FMD-Inf-Co, 6.07±3.00 (P< 0.001). In 38 patients, immunohistology of the myocardial biopsies was norma l(Co); of those, 16 had virus, and 22 did not. FMD was impaired in patients with virus compared with control subjects: FMD-Co-V, 3.88±2.72%; FMD-Co-Co, 9. 00±3.32%(P< 0.001). Endothelium-independent vasodilation(GTN-MD) was not sig nificantly affected. Conclusions -Myocardial virus persistence is associated wi th endothelial dysfunction. Endothelial dysfunction in patients with myocardial virus persistence can occur independently of endothelial activation or myocardia l inflammation but is more pronounced in patients with concurrent inflammation.展开更多
To evaluate the effect of estrogen therapy (ET) on endothelial nitric oxide (N O) production and in flow-mediated vasodilation (FMV). Randomized, crossover, d ouble-blind, placebo-con-trolled study. Healthy postmenopa...To evaluate the effect of estrogen therapy (ET) on endothelial nitric oxide (N O) production and in flow-mediated vasodilation (FMV). Randomized, crossover, d ouble-blind, placebo-con-trolled study. Healthy postmenopausal women in an ac ademic research environment. Forty postmenopausal women between 45 and 72 years of age. Women received ET or placebo during two periods of 12 weeks that were se parated by 2 weeks of washout. Flow-mediated vasodilation, nitrite and nitrate, lipid profile, creatinine, and glucose were measured at weeks 12 and 24. Studen t’s t or Wilcoxon tests were used for comparative analyses, and κ.test and lim it analysis determined variability. After placebo treatment, nitrate and nitrite mean concentration was 8.28 ±1.17 mmol/L; it increased to 62.6 ±12.82 mmol/L after ET. Percentage FMV was 18.8 ±2.58 after the placebo period and did not ch ange after ET (20.1 ±1.92) in the whole sample, but in the subgroup (n = 15) of younger women (4550 years of age), percentage FMV increased from 13.6 ±3.6 aft er the placebo period to 22.2 ±3.5 after ET. An increase in plasma concentratio ns of nitrite and nitrate after ET was observed in all the women studied, but th e improvement in FMV was observed only in the younger ones. These age-related d ifferences in FMV in response to ET must be further investigated.展开更多
文摘Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial biopsies. The aim of t his study was to investigate the impact of myocardial virus persistence on endot helial function. Methods and Results -In 124 patients with suspected cardiomyop athy, myocardial biopsies were examined for virus persistence(by polymerase chai n reaction) and inflammation(by immunohistology). Endothelial function of the ra dial artery was examined by high-resolution ultrasound. Diameter changes in res ponse to reactive hyperemia (flow-mediated dilation[FMD]) compared with glycero l trinitrate(GTN-MD) were measured. Mean age of the patients(55 men, 69 women) was 45±13 years; ejection fraction was 57±17%. In 73 patients, adenovirus, en terovirus, parvovirus, or HHV6 virus(V) was detected; in 51, no virus was detect ed. FMD was significantly impaired in patients with myocardial virus persistence compared with control subjects(Co): FMD-V, 3.38±2.67%; FMD-Co, 7.34±3.44(P < 0.001). In 86 patients, myocardial inflammation was confirmed (Inf). Of those, 57 had virus, and 29 did not. FMD was significantly impaired in patients with v irus compared with controls: FMD-Inf-V, 3.24±2.66%; FMD-Inf-Co, 6.07±3.00 (P< 0.001). In 38 patients, immunohistology of the myocardial biopsies was norma l(Co); of those, 16 had virus, and 22 did not. FMD was impaired in patients with virus compared with control subjects: FMD-Co-V, 3.88±2.72%; FMD-Co-Co, 9. 00±3.32%(P< 0.001). Endothelium-independent vasodilation(GTN-MD) was not sig nificantly affected. Conclusions -Myocardial virus persistence is associated wi th endothelial dysfunction. Endothelial dysfunction in patients with myocardial virus persistence can occur independently of endothelial activation or myocardia l inflammation but is more pronounced in patients with concurrent inflammation.
文摘To evaluate the effect of estrogen therapy (ET) on endothelial nitric oxide (N O) production and in flow-mediated vasodilation (FMV). Randomized, crossover, d ouble-blind, placebo-con-trolled study. Healthy postmenopausal women in an ac ademic research environment. Forty postmenopausal women between 45 and 72 years of age. Women received ET or placebo during two periods of 12 weeks that were se parated by 2 weeks of washout. Flow-mediated vasodilation, nitrite and nitrate, lipid profile, creatinine, and glucose were measured at weeks 12 and 24. Studen t’s t or Wilcoxon tests were used for comparative analyses, and κ.test and lim it analysis determined variability. After placebo treatment, nitrate and nitrite mean concentration was 8.28 ±1.17 mmol/L; it increased to 62.6 ±12.82 mmol/L after ET. Percentage FMV was 18.8 ±2.58 after the placebo period and did not ch ange after ET (20.1 ±1.92) in the whole sample, but in the subgroup (n = 15) of younger women (4550 years of age), percentage FMV increased from 13.6 ±3.6 aft er the placebo period to 22.2 ±3.5 after ET. An increase in plasma concentratio ns of nitrite and nitrate after ET was observed in all the women studied, but th e improvement in FMV was observed only in the younger ones. These age-related d ifferences in FMV in response to ET must be further investigated.
