ascorbic-acid and Heart-Valve-Diseases

The effect of ascorbic acid on inflammatory markers after cardiothoracic surgery (CTS) was studied.. In this randomized, double-blind, placebo-controlled trial, patients undergoing cardiopulmonary bypass graft surgery or valve replacement surgery from April 2009 through March 2010 at Hartford Hospital were randomized to receive ascorbic acid (2-g loading dose followed by 500 mg every 12 hours) or matching placebo the evening before surgery and for four days postoperatively. Inflammatory mediators were measured preoperatively and on postoperative days 1-4. Intergroup comparisons were performed using two-tailed t tests and Fisher's exact test. Multiple comparisons were conducted using repeated analyses of variance with Bonferroni tests.. Of the 62 patients screened, 24 met the study inclusion criteria. Of these, 13 were assigned to receive ascorbic acid and 11 received placebo. Ascorbic acid did not affect the natural course of inflammatory marker rise for C-reactive protein (CRP) concentration, white blood cell (WBC) count, or fibrinogen concentration versus placebo at any evaluated time point (p > 0.05 for all intergroup comparisons). Intragroup analyses demonstrated significant differences among baseline and postoperative measures of all inflammatory mediators (p < 0.05). No significant differences were noted in inflammatory markers between patients undergoing cardiothoracic surgery with or without cardiopulmonary bypass, regardless of treatment group.. Ascorbic acid did not attenuate the rise in inflammatory markers after CTS when compared with placebo. The use of off-pump surgery did not significantly change the levels of CRP and fibrinogen or the WBC count postoperatively when compared with on-pump surgery with a biocompatible polymer coating.

Topics: Aged; Ascorbic Acid; Atrial Fibrillation; Biomarkers; C-Reactive Protein; Cardiac Surgical Procedures; Coronary Artery Bypass; Coronary Artery Bypass, Off-Pump; Double-Blind Method; Female; Fibrinogen; Heart Valve Diseases; Humans; Inflammation; Leukocyte Count; Male; Middle Aged; Vitamins

To establish human heart valve interstitial cells calcification culture model in vitro, and observe the effect of bone morphogenetic protein-2 (BMP-2) on calcification of human heart valve interstitial cells.. Human heart valve interstitial cells were cultured in vitro, and divided into control group: cells were cultured in conventional media plus recombinant human BMP-2 treatment and experimental group: besides above treaments, calcification inducers ( recombinant human BMP-2, β-glycerophosphate, L-ascorbic acid, dexamethasone) were added to the culture media. The two group of cells were cultured for 14 days and were stained by Von Kossa, then the cell calcification was observed in this valvular interstitial cells calcification culture model in vitro. Protein expression of intercellular adhesion molecule 1 (ICAM-1), interleukin 8, BMP-2 and BMP-4 was determined by Western blot and BMP-2 secretion was measured by ELISA.. In the control group, the structure of human heart valve interstitial cells was clear, and the spindle and radial growth shaped cellular morphology was visible, and Von Kossa staining was negative. In the experimental group, the nuclei become darker in color, and granular sediment distribution was seen surrounding cells, and Von Kossa staining was positive, the cells were forming nodules of calcification. The protein expression of ICAM-1, interleukin 8, BMP-2 and BMP-4 in the experimental was significantly higher than that of the control group (all P < 0.05). The expression of BMP-2 in the experimental group was also significantly higher than that in control group ((92.5 ± 4.9) pg/ml vs. (22.2 ± 1.9) pg/ml, P < 0.05).. Human BMP-2, β-glycerophosphate, L-ascorbic acid, and dexamethasone can induce human heart valve interstitial cells calcification and enhance inflammation in vitro by stimulating the secretion of BMP-2.

Topics: Ascorbic Acid; Bone Morphogenetic Protein 2; Calcinosis; Cells, Cultured; Glycerophosphates; Heart Valve Diseases; Humans; Recombinant Proteins; Transforming Growth Factor beta

Aortic valve calcification (AVC) is an active process characterized by osteoblastic differentiation of the aortic valve interstitial cells (AVICs). Taurine is a free β-amino acid and plays important physiological roles including protective effect of cardiovascular events. To evaluate the possible role of taurine in AVC, we isolated human AVICs from patients with type A dissection without leaflet disease. We demonstrated that the cultured AVICs express SM α-actin, vimentin and taurine transporter (TAUT), but not CD31, SM-myosin or desmin. We also established the osteoblastic differentiation model of the AVICs induced by pro-calcific medium (PCM) containing β-glycerophosphate disodium, dexamethasone and ascorbic acid in vitro. The results showed that taurine attenuated the PCM-induced osteoblastic differentiation of AVICs by decreasing the alkaline phosphate (ALP) activity/expression and the expression of the core binding factor α1 (Cbfα1) in a dose-dependent manner (reaching the maximum protective effect at 10 mM), and taurine (10 mM) inhibited the mineralization level of AVICs in the form of calcium content significantly. Furthermore, taurine activated the extracellular signal-regulated protein kinase (ERK) pathway via TAUT, and the inhibitor of ERK (PD98059) abolished the effect of taurine on both ALP activity/expression and Cbfα1 expression. These results suggested that taurine could inhibit osteoblastic differentiation of AVIC via the ERK pathway.

Topics: Adult; Alkaline Phosphatase; Aortic Valve; Ascorbic Acid; Bicuspid Aortic Valve Disease; Biomarkers; Calcinosis; Calcium; Cell Differentiation; Core Binding Factor Alpha 1 Subunit; Dexamethasone; Extracellular Signal-Regulated MAP Kinases; Fibroblasts; Gene Expression; Glycerophosphates; Heart Defects, Congenital; Heart Valve Diseases; Humans; MAP Kinase Signaling System; Membrane Glycoproteins; Membrane Transport Proteins; Myocytes, Smooth Muscle; Osteoblasts; Protein Kinase Inhibitors; Taurine

Amyloidosis results from protein infiltration of the extracellular space of organs and tissues. Several amyloidosis proteins have been identified. Protein AL, (deriving from immunoglobulin light chain), protein AA and prealbumin are the most involved in this disease. When AL amyloidosis involves the heart, the illness is often terminal. Most clinical symptoms are heart failure and arrhythmia or block conduction. This case was characterised by the unusual combination of hypertension and amyloidosis. The diagnosis suggested by the echocardiographic but was confirmed by the damaged organ's biopsy. The present case concerns a young woman, who has hypertension and a pulmonary oedema. The echocardiographic scan showed a septal hypertrophy with a shining and granite-like aspect which is compatible with heart amyloidosis. Systolic and diastolic disorder with mitral and aortic regurgitation were also revealed. The kidney and rectum biopsies confirmed amyloidosis AL of the Kappa dysglobulinemia type, without extraosseous plasmocytoma. The heart and kidney failure symptoms disappeared after treatment with diuretics and ACE inhibitors.

Topics: Adult; Amyloidosis; Angiotensin-Converting Enzyme Inhibitors; Ascorbic Acid; Biopsy; Cardiomegaly; Colchicine; Diuretics; Echocardiography; Female; Heart Failure; Heart Valve Diseases; Humans; Hypertension; Immunoglobulin kappa-Chains; Nephritis; Paraproteinemias; Pulmonary Edema; Radiography; Rectum

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Cardiac Catheterization; Cineangiography; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Hemodynamics; Humans; Male; Middle Aged; Phonocardiography; Tricuspid Valve; Tricuspid Valve Stenosis

Topics: Aortic Valve Insufficiency; Ascorbic Acid; Cardiac Catheterization; Eisenmenger Complex; Electrocardiography; Electrodes; Heart Septal Defects; Heart Septal Defects, Ventricular; Heart Valve Diseases; Humans; Hydrogen; Indicator Dilution Techniques; Methods; Mitral Valve Insufficiency; Platinum; Pulmonary Valve Stenosis; Tetralogy of Fallot; Tricuspid Valve Insufficiency

Topics: Ascorbic Acid; Blood Circulation Time; Cardiac Catheterization; Cardiovascular Diseases; Coronary Circulation; Electrodes; Heart Septal Defects; Heart Valve Diseases; Humans; Hydrogen; Indicator Dilution Techniques; Methods; Oximetry; Regional Blood Flow