No description available.

Background: Telomeres are repetitive, gene-poor regions that cap the ends of DNA and help to maintain chromosomal integrity. Their shortening is caused by inflammation and oxidative stress within the cellular environment and ultimately leads to cellular senescence. Shortened leukocyte telomere length (LTL) is hypothesized to be a novel biomarker for age-related diseases and may therefore be useful in the prediction of cardiometabolic outcomes above conventional risk factors. Methods: A systematic review and meta-analysis was undertaken to summarize existing literature on the association between LTL and myocardial infarction (MI), stroke, and type 2 diabetes (T2D). MEDLINE (1966–present), and EMBASE (1980-present) were last searched on September 9th 2013. Studies were combined using the generic inverse variance method and both fixed and random effects models. Additionally, LTL was measured in 3972 MI patients and 4321 controls from an international study on risk factors for MI (INTERHEART), and 8635 participants from an epidemiological study on dysglycemia and T2D (EpiDREAM) prospectively followed (approximately 3.5 years) for incident cardiometabolic events. Results: Based on current literature, a 1-standard deviation decrease in LTL was significantly associated with stroke (OR=1.21, 95% CI=1.06-1.37; I2=61%), myocardial infarction (OR=1.24, 95% CI=1.04-1.47; I2=68%), and type 2 diabetes (OR=1.37, 95% CI=1.10-1.72; I2=91%). Stratification by measurement technique, study design, study size, and ethnicity explained heterogeneity in certain cardiometabolic outcomes. Within INTERHEART participants, a 1 unit decrease in LTL was associated with an increased risk of MI (OR=2.17, 95% CI=1.74-2.72). Effect estimates were consistent across all ethnic groups (p=0.19). In EpiDREAM a significant association between LTL and T2D or incident cardiometabolic outcomes was not observed. Conclusion: Telomere length appears to be a marker for MI above conventional risk factors. Further research is needed to explain existing heterogeneity in the literature with respect to LTL and T2D. / Thesis / Master of Science (MSc)

Otolin-1 is a collagenous, C1q domain-containing extracellular matrix protein that has been identified and characterized in the inner ear. Recently, mass spectrometry analysis of left ventricular cardiac tissue detected a peptide of Otolin-1. Experimental analysis confirms Otolin-1 is an insoluble protein present in the left ventricular extracellular matrix whose expression decreases dramatically post-myocardial infarction beginning at day 5 post-MI. The protein is localized to the gap junctions of cardiac myocytes, and depletion of protein levels in the infarcted region of the left ventricle shows strong association with ventricular dimensions, observed via echocardiography.

No / Myocardial infarction (MI) is an acute life-threatening disease with a high incidence worldwide. Aim of this study was to test lectin-carbohydrate binding-induced red blood cell (RBC) agglutination as an innovative tool for fast, precise and cost effective diagnosis of MI. Five lectins (Ricinus communis agglutinin (RCA), Phaseolus vulgaris erythroagglutinin (PHA), Datura stramonium agglutinin (DSA), Artocarpus agglutinin (ArA), Triticum agglutinin (TA)) were tested for ability to differentiate between agglutination characteristics in patients with MI (n = 101) or angina pectoris without MI (AP) (n = 34) and healthy volunteers (HV) as control (n =68) . RBC agglutination was analyzed by light absorbance of a stirred RBC suspension in the green to red light spectrum in an agglutimeter (amtec, Leipzig, Germany) for 15 min after lectin addition. Mean cell count in aggregates was estimated from light absorbance by a mathematical model. Each lectin induced RBC agglutination. RCA led to the strongest RBC agglutination (~500 RBCs/aggregate), while the others induced substantially slower agglutination and lead to smaller aggregate sizes (5-150 RBCs/aggregate). For all analyzed lectins the lectin-induced RBC agglutination of MI or AP patients was generally higher than for HV. However, only PHA induced agglutination that clearly distinguished MI from HV. Variance analysis showed that aggregate size after 15 min. agglutination induced by PHA was significantly higher in the MI group (143 RBCs/ aggregate) than in the HV (29 RBC-s/aggregate, p = 0.000). We hypothesize that pathological changes during MI induce modification of the carbohydrate composition on the RBC membrane and thus modify RBC agglutination. Occurrence of carbohydrate-lectin binding sites on RBC membranes provides evidence about MI. Due to significant difference in the rate of agglutination between MI > HV the differentiation between these groups is possible based on PHA-induced RBC-agglutination. This novel assay could serve as a rapid, cost effective valuable new tool for diagnosis of MI.

published_or_final_version / abstract / Community Medicine / Doctoral / Doctor of Philosophy

<p>Myocardial infarction (MI) causes high morbidity and mortality worldwide and for effective prevention and treatment MIs have to be adequately detected. </p><p>The existence of clinically unrecognized MIs (UMIs) has been known for the past hundred years, but an ultimate tool for their detection has not yet been found. Using persistent Q waves on electrocardiography as a sign of MI, it has been estimated that UMIs constitute at least ¼ of all MIs and have mortality rates similar to those of recognized MIs (RMIs). These estimates are misleading, however, since persistent Q waves do not necessarily represent MIs.</p><p>The late enhancement technique in magnetic resonance imaging (LE MRI) has been developed over the past decade and accurately determines myocardial viability. The aim of this research was to investigate the prevalence and impact of UMI and RMI in a population-based sample of 70-year-olds, assessed with MRI.</p><p>Cardiac function and viability were examined with MRI in 259 randomly selected 70-year-old subjects (127 women, 132 men) participating in a larger population-based study (PIVUS). Information on other parameters of cardiovascular disease was obtained and related to the findings.</p><p>Three methods for segmentation of the left ventricular mass were used in the first 100 subjects; these differed in accuracy and led to differences in systolic function values. In the subsequent 159 examinations one of the segmentation methods was used. </p><p>The viability images were assessable in 248 subjects (123 women, 125 men). Among these, the prevalence of UMI, 19.8%, definitely exceeded the expectations and UMIs constituted 4/5 of all MIs. The prevalence of RMI was 4.4%. MRI-detected UMIs differed from RMIs in several respects; they were smaller, frequently located inferolaterally, did not appear to be associated with atherosclerosis, and displayed increased collagen turnover. The pathogenesis of these UMIs remains to be investigated, but our observations suggest that they are caused by ischemia. Subjects with UMI showed increased cardiac morbidity, a decreased ejection fraction and an increased left ventricular mass, indicating an increased cardiovascular risk.</p><p>It is thus important to detect these UMIs, and this is adequately achieved by LE MRI. However, to decide upon prevention and treatment of these UMIs we need to know more about their pathogenesis and prognosis.</p>

Myocardial infarction (MI) causes high morbidity and mortality worldwide and for effective prevention and treatment MIs have to be adequately detected. The existence of clinically unrecognized MIs (UMIs) has been known for the past hundred years, but an ultimate tool for their detection has not yet been found. Using persistent Q waves on electrocardiography as a sign of MI, it has been estimated that UMIs constitute at least ¼ of all MIs and have mortality rates similar to those of recognized MIs (RMIs). These estimates are misleading, however, since persistent Q waves do not necessarily represent MIs. The late enhancement technique in magnetic resonance imaging (LE MRI) has been developed over the past decade and accurately determines myocardial viability. The aim of this research was to investigate the prevalence and impact of UMI and RMI in a population-based sample of 70-year-olds, assessed with MRI. Cardiac function and viability were examined with MRI in 259 randomly selected 70-year-old subjects (127 women, 132 men) participating in a larger population-based study (PIVUS). Information on other parameters of cardiovascular disease was obtained and related to the findings. Three methods for segmentation of the left ventricular mass were used in the first 100 subjects; these differed in accuracy and led to differences in systolic function values. In the subsequent 159 examinations one of the segmentation methods was used. The viability images were assessable in 248 subjects (123 women, 125 men). Among these, the prevalence of UMI, 19.8%, definitely exceeded the expectations and UMIs constituted 4/5 of all MIs. The prevalence of RMI was 4.4%. MRI-detected UMIs differed from RMIs in several respects; they were smaller, frequently located inferolaterally, did not appear to be associated with atherosclerosis, and displayed increased collagen turnover. The pathogenesis of these UMIs remains to be investigated, but our observations suggest that they are caused by ischemia. Subjects with UMI showed increased cardiac morbidity, a decreased ejection fraction and an increased left ventricular mass, indicating an increased cardiovascular risk. It is thus important to detect these UMIs, and this is adequately achieved by LE MRI. However, to decide upon prevention and treatment of these UMIs we need to know more about their pathogenesis and prognosis.

Thesis (Ph. D.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains xii, 263 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 233-242).

published_or_final_version / Medicine / Master / Doctor of Medicine

Hjärtinfarkt är den dominerande dödliga sjukdomen i Sverige, vilket fler kvinnor än män avlider i. Kvinnor insjuknar senare i livet och upplever fler och mer diffusa symptom än män. Stress är en vanlig förekommande riskfaktor, vilket kan skapas från samhällets förväntningar på kvinnor. Det finns förväntningar om omsorgsfulla kvinnor som samtidigt ska prestera bra både på arbetet och i hemmet, vilket genererar stress. Förväntningar från samhället och kroppens biologi skiljer sig mellan män och kvinnor. Män har historiskt sett representerat normen för människan i forskning och därför är det viktigt att uppmärksamma kvinnors erfarenheter. Syftet med studien var att belysa kvinnors erfarenheter av livet efter hjärtinfarkt. En litteraturstudie användes som metod, vilket genererade tio vetenskapliga artiklar som resulterade i tre teman och nio kategorier. Kvinnornas erfarenheter visade att hjärtinfarkt medförde ett avbrott i livet och med hjälp av närstående samt egna reflektioner lärde kvinnorna känna sig själva igen. En ny prioriteringsordning skapades med fokus på kvinnornas hälsa och liv. Studien visar att stress är en stor faktor i kvinnors erfarenheter efter hjärtinfarkt och att kvinnors erfarenheter behöver uppmärksammas för att vårdpersonal ska kunna ge adekvat vård. Det hade varit betydelsefullt om framtida forskning hade uppmärksammat hur stress skiljer sig mellan könen vid hjärtinfarkt, eftersom stress är en riskfaktor.