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Steven K. Malin - One of the best experts on this subject based on the ideXlab platform.

Emily M. Heiston - One of the best experts on this subject based on the ideXlab platform.

Roland E Schmieder - One of the best experts on this subject based on the ideXlab platform.

  • effects of the selective sodium glucose cotransporter 2 inhibitor empagliflozin on vascular function and central hemodynamics in patients with type 2 diabetes mellitus
    Circulation, 2017
    Co-Authors: K Striepe, Agnes Jumar, Christian Ott, Marina V Karg, Markus P Schneider, D Kannenkeril, Roland E Schmieder
    Abstract:

    From a clinical perspective, type 2 diabetes mellitus might also be regarded as a vascular Disease, characterized by increased arterial stiffness. Empagliflozin is a selective sodium-glucose cotransporter 2 inhibitor shown to improve glycemic control after short- and long-term Treatment.1 In the EMPA-REG OUTCOME study (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), a prospective randomized double-blind study in patients with type 2 diabetes mellitus with established Cardiovascular Disease, Treatment with empagliflozin reduced the primary combined Cardiovascular end point (3P-MACE [3-point major adverse Cardiovascular event]), as well as secondary end points of hospitalization because of heart failure, Cardiovascular morbidity, total mortality, and renal end points.2 We tested the hypothesis that improvements of vascular function and stiffness are involved in the observed improved Cardiovascular and renal outcomes with empagliflozin Treatment. In this investigator-initiated prospective, double-blind, randomized, placebo-controlled, crossover, interventional single-center trial, 76 female and male patients (18–75 years of age) with diagnosed type 2 diabetes mellitus were randomized to either empagliflozin 25 mg orally once daily or placebo for 6 weeks, followed by the second 6-week Treatment with the other compound (crossover). In 64 patients, any antidiabetic agent was withdrawn 4 weeks before the baseline examination. We analyzed the effects …

Salman Razvi - One of the best experts on this subject based on the ideXlab platform.

  • Thyroid hormones and Cardiovascular Disease
    Nature Reviews Cardiology, 2017
    Co-Authors: Avais Jabbar, Alessandro Pingitore, Simon H. S. Pearce, Azfar Zaman, Giorgio Iervasi, Salman Razvi
    Abstract:

    Thyroid hormones have an important role in maintaining Cardiovascular homeostasis, and subtle changes in thyroid hormone concentrations adversely influence the Cardiovascular system. In this Review, Jabbar et al . discuss the role of thyroid hormones in the pathogenesis and management of Cardiovascular Diseases such as heart failure and acute myocardial infarction, and outline the utility of therapy with thyroid hormones for the management of these conditions. Thyroid hormones have a direct effect on the heart Patients with hypothyroidism or hyperthyroidism have increased risk of Cardiovascular Disease Treatment with thyroid hormones in patients with hypothyroidism improves Cardiovascular risk factors, but the effect on Cardiovascular events has not been assessed in randomized, controlled trials In experimental settings, thyroid hormones influence myocardial remodelling and function after myocardial infarction, but the utility of thyroid hormone replacement therapy in patients with acute cardiac events is yet to be elucidated Intracellular and circulating thyroid hormone concentrations (mainly T_3) decrease after acute myocardial infarction and in chronic heart failure, and this reduction is associated with poor outcomes Small studies showed that Treatment with thyroid hormones is safe and beneficial in patients with chronic heart failure; however, larger, adequately powered trials are required to confirm safety and assess efficacy Myocardial and vascular endothelial tissues have receptors for thyroid hormones and are sensitive to changes in the concentrations of circulating thyroid hormones. The importance of thyroid hormones in maintaining Cardiovascular homeostasis can be deduced from clinical and experimental data showing that even subtle changes in thyroid hormone concentrations — such as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome — adversely influence the Cardiovascular system. Some potential mechanisms linking the two conditions are dyslipidaemia, endothelial dysfunction, blood pressure changes, and direct effects of thyroid hormones on the myocardium. Several interventional trials showed that Treatment of subclinical thyroid Diseases improves Cardiovascular risk factors, which implies potential benefits for reducing Cardiovascular events. Over the past 2 decades, accumulating evidence supports the association between abnormal thyroid function at the time of an acute myocardial infarction (MI) and subsequent adverse Cardiovascular outcomes. Furthermore, experimental studies showed that thyroid hormones can have an important therapeutic role in reducing infarct size and improving myocardial function after acute MI. In this Review, we summarize the literature on thyroid function in Cardiovascular Diseases, both as a risk factor as well as in the setting of Cardiovascular Diseases such as heart failure or acute MI, and outline the effect of thyroid hormone replacement therapy for reducing the risk of Cardiovascular Disease.

Rong-li Yin - One of the best experts on this subject based on the ideXlab platform.

  • Transport properties of puerarin and effect of Radix Angelicae Dahuricae extract on the transport of puerarin in Caco-2 cell model.
    Journal of ethnopharmacology, 2012
    Co-Authors: Xin-li Liang, Li-jun Zhao, Zheng-gen Liao, Guo-wei Zhao, Jing Zhang, Yun-chao Chao, Ming Yang, Rong-li Yin
    Abstract:

    Abstract Ethnopharmacological relevance Angelicae Dahurica ( Hoffm. ) Benth.& Hook.f.ex Franch.&Sav combined with Pueraria labota ( Willd. ) Ohwi has been widely used as herb-pairs in traditional Chinese medicine (TCM) for utilization of antipyretic analgesic and anti-inflammatory drugs, and modern pharmacological studies have shown that application compatibility of the two drugs has the effects of Cardiovascular Disease Treatment. The previous study has proved that Radix Angelicae Dahuricae extract could enhance the intestinal absorption of puerarin in Pueraria. But the underlying compatibility mechanism of the two herbs remains unknown. In this study we tried to further evaluate the improvement of Radix Angelicae Dahuricae extract on the puerarin using the Caco-2 cell model and explore the transport properties of puerarin through the above research to discuss the possible effect mechanism of Radix Angelicae Dahuricae extract on the transport of puerarin and the underlying compatibility mechanism of the two herbs. Aim of study The aim of this work was to study the transport properties of puerarin in Radix Pueraria across Caco-2 cell membrane and to explore how the Radix Angelicae Dahuricae extract affected the transport of puerarin using the well-characterized, human-based intestinal Caco-2 cell model as a platform. Materials and methods The bidirectional transport, and the effects of time, drug concentration, pH, P-gp inhibitors (Verapamil, Cyclosporin A), MRP inhibitor (MK-571) and EDTA-Na 2 (tight junction modulator) on the absorption of puerarin were observed. Then the influence of extract of Radix Angelicae Dahuricae on the transport of puerarin was studied. Drug concentration was measured by HPLC and the apparent permeability coefficients ( Papp ) and apparent permeability ratio ( PDR ) were calculated. Results and conclusions The results showed that the transport ( Papp ) of puerarin in Caco-2 cell monolayer model had time and concentration dependence, and the transport showed saturation characteristics with the time and concentration of puerarin to a certain degree. The Papp of puerarin transported on Caco-2 cell monolayer model was significantly changed when the specified inhibitors of P-gp were added to the model and the PDR decreased from 1.74 to 0.43. The absorption of puerarin was improved when combined with Radix Angelicae Dahuricae . The intestinal absorption of puerarin is by passive diffusion as the dominating process and active transportation was mediated by P-gp and MRP transporter in Caco-2 cell monolayer model, and Radix Angelicae Dahuricae could enhance the intestinal absorption of puerarin.