|Year : 2011 | Volume
| Issue : 1 | Page : 10-18
|Date of Web Publication||11-Mar-2011|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Invited Lectures. Int J Nutr Pharmacol Neurol Dis 2011;1:10-8
The Scale-Free Network Dynamics of Cardiomyocytes: Highly Conserved Properties
Miguel A. Aon Sonia Cortassa, Brian O'Rourke, and David Lloyd 1
The Johns Hopkins University Institute of Molecular Cardiobiology, Baltimore, Maryland 21205-2195 USA 1 Microbiology Group, Cardiff School of Biosciences, Main Building, Cardiff University, Cardiff CF10 3AT, Wales,
The temporal organization of biological processes requires massive parallel processing on a synchronized time-base. Control is heterarchical. Analyses of the new time series data from isolated cardiomyocytes show scale-free network organization, as indicated by fractal scaling and inverse power law behavior. The variables studied for cardiomyocytes were mitochondrial membrane potential and reactive oxygen species, as indicated by fluorescence in the two-photon laser scanning microscopy images. By applying Relative Dispersional and Power Spectral Analyses we demonstrated broad frequency distribution and evidence of long-term memory of the oscillatory dynamics. The multiple time scales (ms to hours) exhibited by the heart multi-oscillatory systems suggested simultaneously frequency and amplitude-modulated functional responses. Thereby, modulation on the molecular scale, on a short time-scale, (e.g., by pharmacological intervention) could escalate up through the system and rapidly affect the performance at the level of the whole organ.
Experiments with a self-organized culture of yeast Saccharomyces cerevisiae also showed similar characteristics, whereby, the gases (O 2 , CO 2 ) dissolved in the culture medium, monitored directly by a membrane inlet mass spectrometer probe and showed a time structure embedded in a chaotic attractor, implicit to the autonomy of living cells is their network organization. The topological architecture of different kinds of networks was shown to obey non-random scaling principles. These mechanisms and the organization of dynamic functional properties, as outputs in different time domains, were central to the nature of biological clocks, for cellular and organismic timekeeping. Natural selection had thus ensured the sustained and robust yet flexible integrated performance characteristic of such scale-free networks.
Omega-3 Fatty Acids and Cvd: And the Chronomics Project
De Meester F 4,5 , Wilson DW 1 , Singh R B 2,5, Wilczyρska A3,4,5 , Cornelissen, G, 6 and Halberg, F 6
1 Durham University, School of Medicine and Health, Stockton-on-Tees, UK, 2 Halberg Hospital and Research Institute, Moradabad, India, 3 University of Silesia, Institute of Psychology, Katowice, Poland, 4 Development and Management Frontiers Ltd., Gliwice, Poland, 5 TsimTsoum Institute, Krakow, Poland, and 6 University of Minnesota, Halberg Chronobiology Center, Minneapolis, USA
The Tsim Tsoum concept is based on 'a return to natural foods,' enjoyed some centuries ago, when ingestion of ω-3 and ω-6 were roughly equal, unlike in Western societies today, with fruits, vegetables, green vegetables, seeds, eggs, honey, and so on. These authors provide evidence for their assertions concerning 'protective' effects or otherwise of flavonoids (e.g., citrus fruits: hersperin); isofavonoids (e.g., soya, legumes: genistein, diadzein, Biochanin A, formononetin, equol, etc.); polyphenolic flavonoids (e.g., green tea: the antioxidants (-) epigallocatechin and its -3-gallate); lignans (e.g., grain, pulses: enterolactone, enterodiol, etc.), where many have weak estrogenic properties and exert their effect in endocrine tissues. Alpha-linolenic, eicosapentaenoic, and docosahexaenoic acids, constituents of the Mediterranean diet, are associated with one of the lowest reported incidence of cardiovascular disease in Crete and Kohama Island (Japan), but the diet is also rich in phytoestrogens. High w-3/w-6 fatty acid ratios are thought to reduce the level of pro-inflammatory responses in blood vessels and elsewhere. This substantial body of evidence, and much more besides, indicates that dietary factors associated with the pre-industrial era appear as universal markers for holistic health and these may be important in the pathogenesis of some cardiovascular diseases and cancers, which is the main consideration of the Tsim Tsoum concept.
Role of Lipid Messengers in Cellular Signal Transduction: Some Perspectives in Cardiovascular Diseases
Shailendra K. Vajpeyee
Government Medical College and New Civil Hospital, Surat, India
Involvement of lipids in cardiovascular disease has been known for several decades, however, some complex new functions and interactions that are both beneficial and adverse, have been recently attributed to lipid molecules. It is now well understood that lipids are not merely structural components of cell membranes, but serve as substrates for enzymes that generate second messengers involved in cell signaling. Broadly defined, lipid signaling refers to biological signaling, involving a lipid messenger that binds a protein target, such as a receptor, kinase or phosphatase, which in turn mediates the effects of these lipids on specific cellular responses. Lipid signaling is thought to be qualitatively different from other classical signaling paradigms (such as monoamine neurotransmission) because lipids can freely defuse through membranes. One consequence of this is that lipid messengers cannot be stored in vesicles prior to release and are therefore often biosynthesized 'on demand,' at their intended site of action. As many such lipid signaling molecules cannot circulate freely in a solution, they exist bound to special carrier proteins in the serum.
There are mainly four groups of these compounds (1) Sphingolipid second messengers like ceramide, sphingosine, sphingosine-1-phosphate (S1P), glucosylceramide, and ceramide1-phosphate; (2) Inositol phospholipids or phosphoinositides including phosphatidylinositol bisphosphate (PIP 2 ) and phosphatidylinositol trisphosphate (PIP 3 ), and diacylglycerol (DAG); (3) Activators of G-protein couples receptors (GPCRs), for example, lysophosphatidic acid (LPA), sphingosine-1-phosphate, platelet activating factor (PAF), endocannabinoids, prostaglandins, and retinoic acid derivatives, and (4) Activators of nuclear receptors, namely, steroid hormones, retinoic acid derivatives, and prostaglandins. Generation of these ligands is regulated through various enzyme systems, such as, sphingomyelinase, sphingosine kinase (SK), phosphatidylinositol 3'-kinases (PI3Ks), phospholipase C, and phospholipase A2.
Ceramide can induce apoptosis, but via conversion to sphingosine and then to S1P, it can also exert cardioprotection. Some of the sphingomyelinases also have actions on vascular tone, atherosclerosis, ischemia / reperfusion injury, and heart failure. S1P receptor activation is associated with protection and hypertrophic growth of cardiomyocytes. The effects of S1P on the electrophysiological and contractile responses of cardiomyocytes are well-established. The role of high density lipoprotein (HDL) is well-known, but it also turns out to be the major carrier of S1P in the plasma. HDL has many salutary effects and some of these are mediated through S1P signaling, for example, endothelial nitric oxide (NO) synthase (eNOS)-mediated NO production and prostacyclin production (promoting vasorelaxation), as well as, the effects of S1P and HDL on endothelial barrier integrity, angiogenesis, and endothelial precursor cell responsiveness. Inflammatory cell adhesion regulation by HDL and S1P involves induction of NO and prostacyclin, as well as, inhibition of ROS generation.
These are only few examples of the involvement of lipid messengers and their signaling in cardiovascular pathophysiology. This presentation will serve not only to update the knowledge of cardiovascular scientists in this rapidly moving and complex field, but also to stimulate new lines of investigation that may enlighten therapeutic approaches in the treatment of cardiovascular disease.
Animal Models for Cardiovascular Diseases
Department of Zoology (DDE), Annamalai University, Annamalai nagar- 608 002, Tamilnadu, India
Animal models of cardiovascular diseases (CVD) have proved to be critically important for the discovery of pathophysiological mechanisms and for the advancement of diagnosis and therapy. They offer a number of advantages, principally, the availability of adequate healthy controls and the absence of confounding factors, such as, marked differences in age, concomitant pathologies and pharmacological treatment, and animal models suitable for cardiovascular diseases. Epidemiological studies using rats and mice have shown that in utero malnutrition is a risk factor for adult cardiovascular diseases. Offsprings of mouse models on 30% maternal calorie restriction showed a significant increase in systolic blood pressure, as well as cardiac remodeling associated morphological parameters such as cardiac enlargement and coronary perivascular fibrosis in adulthood; mice (Swiss; C57B1) were suitable for the study. Animal models (rabbits, rats, mice, and hamsters) for metabolic syndrome were associated with development of cardiovascular diseases and type 2 diabetes, to assess the effects of a preparation of plant sterols, oleic oil, and fatty acids mixed with their diet (hyper, hypolipidemic) preparation. Animal models (rats) were used to evaluate blood pressure and cardiac function in control as well as induced acute myocardial infarction. For diagnosis and treatment of heart failure such as dilated cardiomyopathy (DCM), small animal rodent models, rats, mice, and hamsters, in particular, were used. In these rodents it was possible to exteriorize the heart via a small thoracic incision, occlude a coronary artery, reposition the heart in the thoracic cavity, repair the incision in a few minutes, and obtain rapid recovery within hours. In the principal experimental animal models of dilated cardiomyopathy (DCM) and naturally occurring DCM, two special strains of hamsters Bio 14.6 and CHF147 were used to develop cardiomyopathy. The dog and pig were also mostly used to study DCM. This article will discuss both small and large laboratory animals that are used as ideal models for studying CVD and DCM.
Opportunities for Postdoctoral Research at the School Of Medicine And Health, Queen's Campus, Durham
Director of Postgraduate Studies, Durham University
This talk will be two-fold, namely, (a) the postgraduate opportunities that are provided by the School of Medicine and Health at Durham University, and (b) a brief discourse on the Durham Conference in July 2011, that, in part, focuses on some concepts of Eastern Medicine, shared by a growing body of researchers in health and disease, which focus on mind– body interaction in Cardiovascular Disease (CVD) and gastrointestinal disorders such Irritable Bowel Syndrome (IBS). Most of the staff at the School of Medicine are Fellows of the Wolfson Institute. The Institute is based at the Queen's Campus, Stockton, and focuses on interdisciplinary research in medicine and health, as well as, the application of medical and health research on society. The School provides Postgraduate Degrees in Masters of Philosophy, Masters of Science, Doctor of Medicine, and others, centered around, for example, the following themes: Clinical and Health Services; Public Policy, Health and Well-being; Medical Education; Nutrition and Obesity-related Behaviors; The Life Sciences and the Life Cycle; and the Medical Humanities, which are either taught or by research, as appropriate. The facilities are excellent. These opportunities will be discussed.
We are currently organizing a conference on 'Mind– Body Interactions in Health and Disease' at the Durham University in collaboration with many International Leaders in the field of Chronomics (F. Halberg), Tsim Tsoum Initiatives in Nutrition (R.B. Singh and F De Meester), Gastrointestinal Disorders (A.P.S. Hungin), and Cardiovascular Disease. There have been many classical treatises on mind and soul, perhaps beginning with the Legendary Yellow Emperor (2697 – 2597 B.C.), but it is the one by Renι Descartes (1649; 1972) on the pineal gland, 'emotion' and 'animal spirits (anima; res cogitans); mind)'and 'Cartesian Gap' that is also considered to be of some relevance to the topic of this conference, for example, psychotherapy and activity-dependent gene expression, or the role of melatonin production that may implicate the pineal gland, and gastrointestinal cytokines, growth factors, and hormones in the development of functional GI disorders. The draft program, which will be discussed, will be soon available, and the prospects for exciting vistas to emerge are potentially considerable.
Durham welcomes collaboration with our Indian colleagues and invites you to the School of Medicine and to the Durham Conference in 2011.
The Brain– Gut Connection and Metabolic Syndrome
R B Singh, Fabien De Meester1, Agnieska Wilczynska1, D W Wilson1
Halberg Hospital and Research Institute, Civil Lines, Moradabad-10(UP), 244001, India. 1APS Hungin The Tsim Tsoum Institute, Krakow, School of Medicine and Health Durham University, UK. Email [email protected]
Many experts have long accepted the brain– gut axis and its influence on obesity, insulin resistance, and cardiovascular function. In experimental studies, it has been shown, how moderate intestinal inflammation affects complex behavior and how much treatment of such an inflammation can influence factors from mind to matter or brain to gut and the heart. Treatment with a potent cholecystokinin antagonist is associated with complete abolition of the satiation effect of fatty acids. It is probable that the presence of long chain polyunsaturated fatty acids (LCPUFAs) in the duodenum stimulates the release of cholecystokinin, which in turn acts on the cholecystokinin receptors present on the abdominal vagus. After the food is ingested, it stimulates the secretion of incretins from the gut, which increase insulin secretion and initiate the gut– brain– liver axis, in response to small amount of triglycerides in the duodenum, to rapidly increase insulin secretion. LCPUFAs, particularly w-3 fatty acids; alpha-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid are cleaved from the triglycerides by the gastrointestinal enzymes. Administration of these fatty acids in a dose-dependent manner, in small amounts, may be associated with a rapid increase in insulin sensitivity. These studies indicate that a long chain fatty acid metabolite, known as long chain fatty acid coenzyme A (LCFA CoA), is sensed by the gut, possibly by specific receptors that are yet to be discovered. However, increased intake of trans fat, w-6 fat, and saturated fat as well as refined carbohydrates, particularly in the presence of physical inactivity may suppress gut– brain and liver axis by decreasing incretins, as well as cholecystokinin and leptin, resulting in insulin resistance and metabolic syndrome, which is known to predispose cardiovascular diseases (CVDs). There is a rapid stimulation of leptin secretion from the gastric fundus on food ingestion, an effect that could be reproduced by cholecystokinin administration. Leptin gene expression and immunoreactivity have been reported in the gastric fundus. Leptin is known to enhance satiety — inducing the effect of cholecystokinin, indicating that cholecystokinin and leptin may function in concert with each other to induce satiety and food consumption. Mediterranean diet, Coenzyme Q10, and w-3 PUFAs have been reported to be protective against metabolic syndrome and CVDs, but the exact mechanism of the beneficial effects is not known. It is possible that a part of the benefit may be due their protective effects on the cell membrane phospholipids of the neuron, gut, liver, and beta cells of the pancreas apart from their direct effects on cardiovascular function.
Healthy Food for Healthy Heart
GLA Institute of Pharmaceutical Research, Mathura
Heart disease is the leading cause of death throughout the world. Dietary advice for reducing heart disease risk includes eating a balanced diet with more fresh fruits and vegetables, more fish, less sugar, more fiber, and for many people, fewer calories. Furthermore, you can make your heart and the rest of your cardiovascular system even healthier by adding more of these foods: Pomegrenate juice, which is rich in antioxidants, polyphenols ellagitannins, and vitamin B5, decreases LDL and increases HDL by 20% in humans and reduces the oxidation of LDL by up to 90%. It can significantly reduce the size of the arterial plaque. Garlic, which is rich in antioxidants may decrease the progression of cardiovascular disease by decreasing LDL and total cholesterol and raising HDL, by decreasing platelets and blood pressure. Of late, garlic has also been found to decrease two other markers of cardiovascular disease, homocysteine and C-reactive protein, and it can reduce vascular calcification in human patients with high blood cholesterol. Onion, which is a rich source of flavonoids, with a number of sulfides, may lower blood lipids and blood pressure. Onions also have natural anti-clotting properties due to the presence of substances with fibrinolytic activity and can also suppress platelet clumping.
Nuts, which are a major source of monounsaturated fats like linoleic and linolenic acids, which do not elevate blood cholesterol levels, can lower serum LDL cholesterol. Furthermore, nuts supply one of the best natural sources of vitamins E and B2 (riboflavin, an antioxidant), and are rich in protein, folate, fiber, and essential minerals responsible for blood pressure control, immunological responses, and blood clotting. Beans are extremely rich in fiber and help to control heart disease. A study suggests that beans can lower the total cholesterol, LDL-C, thereby, reducing the risk of CHD. Okra or Lady Finger is a powerhouse of soluble fiber in the form of gums and pectins, which help to lower serum cholesterol, reducing the risk of heart disease.
Nip Cardiovascular Diseases at its Bud: Preventive Strategies for Cardiovascular Diseases
S. K. Hayath Basha
Department of Biochemistry, Islamiah College, Vaniyambadi
Today, except for natural calamities like Tsunami, earthquake, and cyclone that take millions of lives at a time, three diseases, Cardiovascular Disease (CVD), Cancer, and Diabetes mellitus are still challenging to human life. Human unraveling, to find a complete cure from them, still continues. Among these, the rapidly increasing CVD is becoming a serious threat to the health of mankind in all the parts of the world. The World Health Organization's (WHO's) recent statistics state that an estimated 16.7 million — or 29.2% of the total global deaths — result from various forms of cardiovascular disease (CVD). As of 2007, it is the leading cause of death in the United States, England, Canada, and Wales, accounting for 25.4% of the total deaths in the United States. Around 80% of CVD deaths take place in the low and middle-income countries. However, CVD can be nipped in its bud by changing our lifestyle in three ways, first by changing our food habits, second by simple physical exercise or slight modification in our routine everyday work, and third by attaining a calm and serene mind through prayer, meditation, and relaxation exercises.
Antihyperlipidemic and Beneficial Role of Coumarin, Naturally Occurring Flavonoids in Experimental Type 2 Diabetes
L. Pari and N. Rajarajeswari
Department of Biochemistry and Biotechnology, Faculty of Science Annamalai University, Annamalainarar-608002 Tamil Nadu, India E-mail:[email protected]
Dyslipidemia is one of the most common complications of diabetes mellitus, significantly contributing to cardiovascular morbidity and mortality, in diabetic patients. At present, dyslipidemia is most commonly treated with lipid-lowering drugs, some of which are associated with serious adverse side effects. The effects of the dietary components on plasma lipid metabolism have recently received considerable attention, highlighting the importance of natural products such as lipid metabolism regulators.
Many medicinal plants have been found to be useful in successfully managing hyperlipidemia, these include Coumarin (1, 2-benzopyrone), a naturally occurring flavonoid in various plants, including tonka beans, sweet clover, bilberry, green tea, and chicory.
In this study, we examined a lipid-lowering effect along with the antioxidant role of Coumarin in normal and experimental type 2 diabetic rats. Experimental type 2 diabetes mellitus was induced by a single intraperitonial injection of streptozotocin, 15 minutes after the intraperitonial administration of nicotinamide. Normal and type 2 diabetic rats were orally administered with 100 mg/kg body weight of Coumarin for 45 days. The results showed that there were significant increases in tissue lipids, total serum cholesterol, triglycerided, and low-density lipoprotein cholesterol (LDL-C) and a decrease in high-density lipoprotein cholesterol (HDL-C) in the experimental diabetic rats. Oxidative stress in diabetic rats was also indicated by the increased levels of thiobarbituric acid reactive substances (TBARS) and hydroperoxides, with decreased levels of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Administration of Coumarin over a period of 45 days returned these levels to near normal. These results suggest that Coumarin has hypolipidemic as well as antioxidant effects in type 2 diabetic rats.
Food for Healthy Heart: Revisiting The Age Old Dietary Principles
Nandita J. Arbatti
Department of Biochemistry, Government Medical College, Surat, India
Looking back at the scenario of 'Health Related Problems' of the developed and developing countries during past 60 to 70 years, a rising trend is witnessed for certain ailments like cardiovascular disorders, diabetes, obesity, arthritis, cancer, and so on, in spite of tremendous advancements in the field of medical sciences. Earlier, heart diseases and diabetes were considered to be rich man's diseases, that too, appearing mostly in the latter half of life, that is, after 50 years of age. Contrary to this, these disorders have now engulfed the entire world and many of the developing countries are emerging as the leading contributors to the suffering world population. A clear shift in the age of onset can be marked with a large number of young individuals being diagnosed as diabetics and heart patients. Mental stress and a sedentary lifestyle are stated to be the main causes for this. However, this is not completely true, as the contribution of these predisposing factors can at best be approximately 30% only. The nutritionists and epidemiologists around the world are unanimous that along with the lifestyle, food habits have played a very important role in the rising incidence of these diseases. The gradual shifting of dietary patterns over the past decades is evidently responsible for the metabolic disorders, which in turn lead to a variety of incapacitating and life-threatening diseases. This is best exemplified by the craze for 'Junk Foods,' which is proving to be the nemesis for mankind. The question is, what is so bad about the loosely defined word 'Junk Food'? It is nothing but refined food in various forms prepared from wheat, rice, sugars, salt, butter, oils, an so on. The ancient 'Ayurvedic Scriptures' have well-defined guidelines for leading a healthy and disease-free life by way of adopting a proper diet (Aahaar) and lifestyle (Vihaar). Use of unrefined organic food is going to be the mainstay for achieving this goal over the years and decades to come. Hence, more light will be thrown on this subject during the discussion.
Health Policies for Diet, Physical Activity, And Cardiovascular Diseases Among the Indian Population
Office of Global Health, National Heart Lung and Blood Institute National Institutes of Health, Bethesda, MD, USA
Chronic diseases, such as cardiovascular diseases (CVD) due to heart disease and stroke, cancer, chronic respiratory diseases, and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Unfortunately, 80% of chronic diseases, death, and disabilities occur in developing countries. They account for 53% of the deaths and 44% of the disabilities in India. In terms of healthcare expenditure, India spends less than 2% of its GDP.
Obesity, a primary risk factor for CVD, has reached epidemic proportions globally, with approximately 1.6 billion persons (aged 15 years old and above) being overweight. Childhood obesity is one of the most serious public health challenges of the twenty-first century. Globally, in 2010, the number of overweight children, under the age of five, is estimated to be over 42 million. Unhealthy diets and physical inactivity are two of the main modifiable risk factors for most of the main chronic diseases. Overweight and obesity, as well as related noncommunicable diseases, are largely preventable. It is recognized that prevention is the most feasible option for curbing the childhood obesity epidemic, as the current treatment practices are largely aimed at bringing the problem under control rather than effecting a cure. The goal in fighting the childhood obesity epidemic is to achieve an energy balance, which can be maintained throughout the individual's life-span.
Healthy diets and regular, adequate physical activity are the major factors in the promotion and maintenance of good health throughout the entire course of life. Unhealthy diets and physical inactivity are two of the main risk factors for raised blood pressure, raised blood glucose, abnormal blood lipids, overweight / obesity, and for major chronic diseases such as cardiovascular diseases, cancer, and diabetes. According to the WHO, overall, 2.7 million deaths are attributable to low fruit and vegetable intake, and 1.9 million deaths are attributable to physical inactivity.
India needs a major national public health policy to contain the growing epidemic of CVD, diabetes, and obesity. The Government of India, through the newly created national strategy on NCD prevention, is trying to address this issue, both in urban and rural India. The general recommendations for a healthy public policy are, to:
- Increase consumption of fruit and vegetables, as well as legumes, whole grains, and nuts
- Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats
- Limit the intake of sugars;
- Limit daily dietary salt intake to less than 5 g, from all sources; and
- Be physically active — at least 60 minutes of regular, moderate-tovigorous intensity each day that is developmentally appropriate and involves a variety of activities. More activity may be required for weight control.
Obesity and Cardiovascular Disease
V. V. Muthusamy
Sugapriya Hospital, Madurai
Obesity has become a global epidemic. It is associated with numerous comorbid conditions like cardiovascular disease, diabetes mellitus, hypertension, certain cancers, sleep apnea, and so on. Obesity is an independent risk factor for cardiovascular disease. It is associated with reduced life expectancy. Apart from an altered metabolic profile, a variety of alterations occur in the cardiac structure and function in obese individuals. Obesity affects the heart through its influence on the risk factors, such as, dyslipidemia, inflammatory markers, sleep apnea, and prothrombotic state. Overweight and obesity are associated with numerous cardiac complications, such as, coronary artery disease, heart failure, various cardiac arrythmias, and sudden death.
The adipose tissue acts as an endocrine organ. It produces a variety of peptides. The adipose tissue is a significant source of tumor necrosis factor-alpha, interleukin-6, resistin, leptin, adiponectin, angiotensinogen, insulin-like growth factor, lipoprotein lipase, retinol binding protein, acylation stimulating protein, cholesteryl ester transfer protein, insulin binding protein factor-3, and the like. IL-6 modulates c-reactive protein production in the liver; CRP is the marker of the inflammatory state, leading to an acute coronary syndrome.
Obesity increases total blood volume and heart rate. Left ventricular (LV) filling pressure and volume are increased leading to chamber dilatation. The LV mass increases. It is associated with LV eccentric hypertrophy and LV diastolic dysfunction. Left Auricular (LA) enlargement occurs and it predisposes atrial fibrillation. Long duration obesity leads to LV systolic dysfunction and finally frank heart failure. Obesity leads to obesity cardiomyopathy (adipositas cordis ). Various tissues of the heart, like S.A. node, A.V. node, right bundle branch, and the myocardium near the atrioventricular ring are replaced by fat cells. These can cause conduction defects like S.A. block, bundle-branch block, and A.V. block. Locally secreted adipokines can have injurious effects on the myocardial cells. Myocardial necrosis can also occur. Accumulation of triglycerides in the myocytes can cause myocardial cell dysfunction due to lipotoxicity.
Obesity can cause congestive heart failure. The increase in the risk of heart failure is 5 – 7% for each increment of the BMI unit. Approximately 11 – 14% of obese persons develop heart failure. A variety of cardiac arrhythmias occur in obesity, with an increased incidence of sudden cardiac death. Sudden death is 40 times higher in obese individuals. The most common cause of cardiac arrhythmias in obese patients is the increased QT interval.
Obesity is an independent risk factor for coronary heart disease. Obese patients have a two-to-three-fold higher risk for CAD. Hypertension (HTN) is commonly associated with obesity. Incidence of HTN is six times more in obese individuals. HTN in obesity is due to various mechanisms, hemodynamic, endocrine, and metabolic. Inceased BMI and Waist-Hip ratio are independent risk factors for stroke. This could be due to the prothrombotic and proinflammatory states associated with obesity. Obese people are prone to venous thrombosis and pulmonary embolism. Pulmonary hypertension and right-sided heart failure also occur in obesity. Sleep apnea is commonly associated with obesity, leading to various cardiac arrhythmias, pulmonary hypertension, right- and left-sided heart failure, CAD, stroke, and sudden cardiac death. Clinical assessment of the cardiac status is very difficult. An electocardiogram (ECG) can show a variety of changes like low-voltage complexes, ST segment changes, axis deviation, and so forth. Echocardiac assessment of the cardiac status is also difficult. Weight reduction appears efficacious in reducing the risks of coronary heart disease, congestive heart failure, and cardiac arrhythmias. Maintaining the BMI to less than 25 in adult life is recommended. Diets should be modestly restricted in calories. Restriction of fat to less than 30% of the total calories should be advised. A weight reduction of 0.45 kg per week is reasonable. Training programs that increase the physical activity have beneficial results. Once ideal weight is achieved, then the patient should adopt the weight maintainance phase which is very important.
Drug treatment for obesity is recommended only if the BMI is > 30 and not responding to diet regulation and adequate physical exercise. Sibutramine, Obistat, and Rimanobant are available at present. When the BMI is more than 40, surgery (Bariatric Surgery) is the treatment of choice. Prevention of obesity by diet and regular physical activity remains the highest priority for maintaining cardiovascular health.
Overall and Abdominal Adiposity on Blood Pressure: Consistency and Evaluation of Their Association in an Adult Indian Population
K. K. Reddy
Division of Human Genetics,Department of Anthropology,Sri Venkateswara University,Tirupati- 517 502, A.P. E-mail: [email protected]
To assess the relationship and consistency of the overall and abdominal obesity on blood pressure in an adult Indian population, a cross-sectional descriptive design was used, with height, weight, circumferences of waist and hip, systolic blood pressure (BP), and diastolic BP, besides the information on demographic variables, collected from 303 males + 357 females (untreated for hypertension), between the age of 21 and 60 years. Men were found to have higher abdominal obesity (0.90 ± 0.07) than women (0.84 ± 0.08) (P < 0.05), while there was no difference in body mass index (BMI). Average systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found to increase linearly over the whole variation range of BMI, waist hip ratio (WHR), and age groups. The correlation coefficients of SBP and DBP for age, varied from 0.153 – 0.275 (P < 0.05) in men to 0.219 – 0.171 in women. In males, the adiposity indicators (BMI, WHR) were positively associated with blood pressure, while in females, only BMI showed a positive association. The prevalence of hypertension increased with age and BMI quartiles. Men with higher WHR were 2.988 times and women with higher WHR were 1.177 times at a risk of developing hypertension. The odds of hypertension were more than six-fold among the elderly in the male sex (OR = 6.213:95% CI; 1.815,21.273), but in females it was only two-fold (OR = 2.423:95% CI; 0.801,7.334). The odds of hypertension rose steadily with an increase in BMI reaching 7.579 (95CI; 1.510,38.046) in males and 15.56 (95% CI; 1.883,128.526) in females with BMI > 25 kgm-2. Adjustment for age, decreased the odds of hypertension in males and increased it in females in the BMI category of > 25 kgm-2, while there was no change in the remaining quartiles. These findings suggested a consistent linear relation of adiposity with BP, independent of age.
South Indian Edible Oils and Their Combinationon Hypertension
K. V. Pugalendi
Department of Biochemistry and Biotechnology, Annamalai University
Hypertension, which affects more than one billion individuals worldwide, is an important modifiable risk factor for CVD. In this study, we have investigated south Indian edible oils and their combination, on hypertension. Five hundred and fifty-five hypertensive patients, who were on medication for hypertension and / or diabetes mellitus, were recruited at various time intervals from the Rajah Muthiah Medical College and Hospital, Annamalai University, Tamilnadu, India. Hypertensive patients who were on medication with nifedipine (20 – 30 mg / day) and a calcium channel blocker as antihypertensive medication were divided into four groups, namely, sesame (n = 356), sunflower (n = 87), groundnut (n = 47), and palm (n = 25) oil groups. The respective oils (Idhayam gingelly oil, SVS groundnut oil, and sunflower and palm oil trade names) were supplied to the patients at 4 – 5 kg of oil per month for a 4 – 5 member family, which constituted approximately 35 g of oil per day per person. They were instructed to use the respective oils as the sole edible oil for cooking or otherwise, for 60 days, while the control group (n = 40) were treated only with nifedipine. Anthropometry, blood pressure, biochemical, and hematological parameters were measured at baseline and after 60 days.
Among the different oil groups, sesame oil-treated group decreased SBP and DBP to normalcy and the dosage of the drug was also reduced. Sunflower oil seemed to have no influence on blood pressure, while groundnut oil and palm oil elevated blood pressure and also the drug dosage when compared to the nifedipine-control group. Total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels reduced, while high-density lipoprotein cholesterol was elevated significantly upon sesame and sunflower oil substitution, whereas, significant elevation of HDL-C and TG was noted in the groundnut oil group. TC, HDL-C, and TG were elevated upon palm oil substitution. A significant reduction of plasma sodium and elevation of potassium was observed in the sesame- and sunflower-oil treated groups, while no significant alterations were noted in the groundnut and palm oil group. Body weight and body mass index reduced in the sesame- and sunflower-oil groups, while there were no alterations in the groundnut and palm oil group. Hemoglobin and white blood corpuscles increased while platelets and prothrombin time reduced upon sesame oil substitution. Hemoglobin increased and while platelets and prothrombin time reduced in the sunflower oil group. Platelets decreased in the groundnut oil group. Elevation of platelet level and prothrombin time was observed in the palm oil substituted group.
Furthermore, we also studied the effect of a combination of edible oils (sesame + sunflower oil, sesame + groundnut oil) on blood pressure, lipid profile, and electrolytes in drug (nifedipine)-taking patients with hypertension. Our study showed that sesame oil reduced blood pressure even in combination with sunflower oil, which did not have any effect on blood pressure. A combination of sesame oil and groundnut oil with nifedipine had the same effect as nifedipine alone, although the oil mix improved the lipid profile. The BP elevating ability of groundnut oil was nullified by the BP lowering effect of sesame oil, and hence, there was no difference in the BP and BMI between the drug administered alone and the drug with oil mix.
Diet for a Healthy Heart
Department of Biochemistry, Rajah Muthiah Medical College, Annamalai University, Annamalai Nagar - 608002
The leading cause of death in the world is ischemic heart disease, which is usually due to coronary artery disease. India will bear 60% of the world's heart disease burden in the next two years. In addition, compared to people in other developed countries, the average age of patients with heart disease is lower among Indian people and Indians are more likely to have the types of heart diseases that lead to worse outcomes.The prevalence of CAD in urban India is about double the rate in rural India and about four-fold higher than in the USA. The rates appear to be higher in south India, with Kerala having a prevalence of 13% in urban areas and 7% in rural areas.
Higher rates of CAD in urban India compared to rural India suggest important roles for nutritional and environmental factors. There is a significantly higher body mass index (BMI) in urban India compared to rural India (BMI, 24 versus 20 in men and 25 versus 20 in women). There is also a higher rate of abdominal obesity among the urban population, with urban men having a waist to hip ratio (WHR) of 0.99 compared to 0.95 among rural men. This increase in BMI and WHR results in significant dyslipidemia and insulin resistance and a three-fold increase in diabetes. When compared to Whites, Asian Indians have a lower prevalence of hypertension, hypercholesterolemia, obesity, and smoking, but a higher prevalence of high triglycerides (TG), low high-density lipoprotein (HDL), glucose intolerance, and central obesity. The usual measure of central obesity is the WHR. As the excess fat is usually concentrated in the hips in women and the waist in men, the optimum value for the WHR is lower in women (< 0.85) than in men (< 0.95). Central obesity is not only more common, but also more dangerous in Asian Indians. Approximately 80% of the deaths in diabetic patients are attributable to cardiovascular disease (CVD), which in turn is highly correlated with dyslipidemia.
The National Cholesterol Education Program (NCEP) III recommends > 50% of total calories from carbohydrates, < 20% from protein, and 25 – 35% from fat. Diets of any type containing more energy than needed or expended will lead to obesity and dyslipidemia. Intake of Saturated Fat (SAFA), Trans-unsaturated Fatty Acids (TRUFA), Monounsaturated Fatty Acids (MUFA), and Polyunsaturated Fatty Acids (PUFA), are the principal determinants for the risk of developing CAD. Diet very low in fat and very high in carbohydrates can aggravate dyslipidemia by increasing TG and decreasing HDL levels. There appears to be a threshold for carbohydrate consumption. Intake of carbohydrates > 282 g / day often leads to high TG and atherogenic dyslipidemia.
Heart healthy diet guidelines are:
- Only 8 – 10% of the day's total calories from saturated fat
- Only 30% or less of the day's total calories from fat
- Less than 300 milligrams of dietary cholesterol a day
- Limit sodium intake to 2400 milligrams a day
- Only enough calories for maintaining normal body weight
Eight steps for a healthy heart diet to prevent heart disease
- Unhealthy fats and cholesterol are to be restricted
- Low-fat protein sources are preferred
- Plenty of vegetables and fruits are to be consumed
- Whole grains are preferred
- Salt should be restricted
- Control the portion size
- Planning diet makes the person adhere to a healthy diet
- Occasional treat
Purification of an Antibacterial Peptide from Chicken Heart Tissues by Rp-Hplc Against Pseudomonas Aeruginosa
T. S. Saravanan
Department of Zoology, Jamal Mohamed College, Trichy
Antibiotic resistance is an increasing problem worldwide. The emergence and spread of multidrug-resistant bacteria to the classical antibiotics leads to treatment failure associated with severe and chronic infectious diseases. Therefore, there is an urgent need to find suitable alternatives to the classical antibiotics, without developing resistance. The antimicrobial peptides of animal sources can form suitable alternatives, by their mode of action to combat this problem. The RP-HPLC purification of the acid-extracted crude proteins of a chicken heart has yielded four single peak fractions, two at 214 nm and the other two at 281 nm wave lengths. Among the four fractions, the second fraction purified by 214 nm [P2(214)] displays a potent antibacterial activity against P. aeruginosa ATCC and has been identified as an active peptide fraction. The MIC of this active peptide is found to be 6 μg/ml. Furthermore, this peptide does not cause hemolysis on any human hRBCs. The molecular weight of this active peptide is determined to be 13 kDa, which is equal to the molecular weight of the 'cathelin' domain of the cathelicidin family peptides, including human cathelicidin.
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