Theodosia Konsola

Role of Endothelial Dysfunction and Arterial Stiffness in the Development of Diabetic Retinopathy

Diabetic retinopathy (DR) remains one of the most important diabetic microvascular complications and a leading cause of irreversible blindness, highlighting the importance of close monitoring. The atherosclerotic progression in patients with insulin resistance is precipitated by endothelial dysfunction and vascular impairment (1). Therefore, we examined the association of endothelial dysfunction and arterial stiffness with DR and how these measurements can be used for the early identification and monitoring of patients at high risk to develop DR. In this case-control study, we included 100 healthy control (CL) subjects and 200 consecutive subjects with type 2 diabetes recruited from the 1st Department of Ophthalmology of the University of Athens Medical School where they were referred to evaluate for DR. All participants underwent a complete ophthalmological examination by the same experienced ophthalmologist, which included fundoscopy after pupillary dilation, fluorescein angiography, and colorful fundus photographs. The diabetic patients, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification, were categorized into three groups: 1 ) no DR (NDR) (108 …

Arterial Wall Elastic Properties and Endothelial Dysfunction in the Diabetic Foot Syndrome in Patients With Type 2 Diabetes

Diabetic foot (DF) syndrome is the most common lower-extremity complication of poorly controlled type 2 diabetes (T2D) (1). DF affects the quality of life of T2D patients and is associated with increased morbidity (2). T2D-related mechanisms induce endothelial dysfunction and adverse effects on vascular biology (3). We have recently shown that measurements of endothelial function and arterial stiffness are strongly associated with diabetic retinopathy (4), but their association with DF has not been explored yet. To examine this, we enrolled 284 consecutive T2D subjects visiting our outpatient diabetes clinic and 196 age- and sex-matched healthy control subjects without evidence of diabetes or cardiovascular or other disease. Subjects with known malignancy, hepatic impairment, or acute or chronic inflammatory disease were excluded from the study. Study protocol was approved by the institutional ethics committee. Endothelial function was assessed by the flow-mediated dilation (FMD) of the brachial artery and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) were assessed by SphygmoCor (AtCor Medical) as …

The impact of T786C and G894T polymorphisms of eNOS on vascular endothelial growth factor serum levels in type 2 diabetes patients.

Endothelial dysfunction (ED) and chemokines such as vascular endothelial growth factor (VEGF) are of vital importance for the development of diabetic vascular complications [1–3]. VEGF is a secreted mitogen which plays a key role in the regulation of angiogenesis, vasculogenesis and vascular permeability to water and proteins [4]. Moreover, the action of VEGF is crucial for themaintenance of the proper endothelial and vascular function. The interaction between VEGF and its receptors is disrupted in diabetes, leading to pathological angiogenesis,which in turn contributes tomicrovascular diseases, such as diabetic retinopathy and diabetic nephropathy [5]. Nitric oxide (NO) is the most important regulator of vascular homeostasis and therefore, a common feature of ED is its diminished bioavailability in the vasculature [6,7]. In the setting of diabetes and insulin resistance, the activity of endothelial nitric oxide synthase (eNOS) is impaired, since insulin-mediated activation of eNOS via PI3kinase/Akt pathway is inhibited [8]. Moreover, diabetes mellitus (DM) enhances the production of reactive oxygen species (ROS), thus resulting in less NO generation and consequent vascular dysfunction [9,10].

Novel biomarkers in heart failure: usefulness in clinical practice

Biomarkers have become an increasingly important tool in clinical practice, helping to improve patient care. In heart failure (HF), brain natriuretic peptide and N-terminal prohormone of the brain natriuretic peptide have been widely applied in prognosis, clinical diagnosis and treatment. Recently, several novel biomarkers have been examined on their efficacy to improve diagnosis, determine the pathophysiologic state of HF, improve clinical decision making, clinical outcome, guide treatment and assess prognosis of HF patients. In this special report, the authors summarize the usefulness and significance of the most promising novel biomarkers in patients with HF.

MicroRNAs: Biomarkers for Cardiovascular Disease in Patients with Diabetes Mellitus

Diabetes mellitus (DM) is a complex metabolic disorder characterized by low insulin production/secretion by pancreatic beta cells and/or low responsiveness by insulin target tissues MicroRNAs have been associated with DM, but it is not clear whether this is a cause or an effect of metabolic abnormalities related to DM. In the hyperglycemic environment miRNAs are in involved in multiple stages of cardiovascular disease development and progression. In diabetic patients with cardiovascular disease miRNAs could potentially serve as early biomarkers for diagnosis and as therapeutic agents. The current review focuses on the involvement of miRNAs in molecular mechanisms underlying the pathogenesis of DM and its cardiovascular complications.

Associations between Adiponectin Gene Variability, Pro-inflammatory and Angiogenetic Markers: Implications for Microvascular Disease Development in Type 2 Diabetes Mellitus?

BACKGROUND Adiponectin gene (ADIPOQ) variability may affect the risk for type 2 diabetes mellitus (T2DM) but it remains unclear whether it is involved in microvascular complications. OBJECTIVE To explore the impact of ADIPOQ variability on markers of inflammation and angiogenesis in T2DM. METHODS Overall, 220 consecutive T2DM patients from our outpatient diabetic clinic were genotyped for G276T (rs1501299) and T45G (rs2241766) single nucleotide polymorphisms of ADIPOQ gene. Serum levels of interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), vascular endothelial growth factor (VEGF) were measured by enzyme-linked immunosorbent assay and high sensitivity Creactive protein (hsCRP) by immunonephelometry. RESULTS Homozygosity for the G allele on rs2241766 was associated with significantly lower serum VEGF and ICAM-1 levels compared with other genotype groups, but had no effect on IL-6. Genetic variability on rs1501299 was not associated with either VEGF or ICAM-1 levels, but T homozygotes for rs1501299 had significantly lower IL-6 concentrations compared with G carriers. Furthermore, the presence of the G allele on rs2241766 was associated with significantly lower HbA1c, whereas no associations were observed for both body mass index and hsCRP with either rs2241766 or rs1501299. CONCLUSION Genetic variability on adiponectin gene was associated with serum levels of inflammatory and angiogenetic markers. Further research is required to elucidate the role of adiponectin in the development and/or progression of microvascular disease in T2DM patients.

THE IMPACT OF ENDOTHELIAL DYSFUNCTION IN THE DEVELOPMENT OF DIABETIC RETINOPATHY: ROLE OF INFLAMMATION

Diabetic Retinopathy (DR) is a leading cause of blindness. Measurement of endothelial function and arterial stiffness are associated with adverse cardiovascular outcomes. We investigated the possible association of DR with endothelial function, arterial stiffness and inflammation. We enrolled 100

THE IMPACT OF ATRIAL FIBRILLATION ON ENDOTHELIAL DYSFUNCTION

Atrial fibrillation (AF) progress from paroxysmal to chronic (long standing persistent or permanent) over time. Endothelial dysfunction may be developed as a result of atrial fibrillation but may also contribute to the progression in the chronic form of the disease. In this cohort study we enrolled

THE ROLE OF SYSTEMIC INFLAMMATION IN PAROXYSMAL AND CHRONIC ATRIAL FIBRILLATION

Atrial fibrillation (AF) is a common encountered disorder associated with various cardiovascular diseases. Although, AF is well associated with left ventricle dysfunction and adverse cardiac remodeling there are limited data concerning the role of systemic inflammatory status in the progression from