Inhibition of xanthine oxidase to prevent statin-induced myalgia and rhabdomiolysis

Although statins remain the cornerstone of lipid-lowering therapy for reducing the burden of atherosclerotic vascular disease, their administration has been associated with muscle-related adverse effects, including myalgia and rhabdomyolysis. Such adverse events are probably due to reduced antioxidant defenses associated with fewer intermediate metabolites in the cholesterol synthesis pathway. We hypothesize that the concomitant inhibition of xanthine oxidase via coadministration of allopurinol with statins could diminish reactive oxygen species (ROS)-related muscle damage, which would have in turn have positive effects on both the incidence of muscle-related adverse events and cardiovascul…

Exercising recommendations for paroxysmal AF in young and middle-aged athletes (PAFIYAMA) syndrome.

We have recently described a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘paroxysmal AF in young and middle-aged athletes’ (‘PAFIYAMA’). Provided that other risk factors for AF and underlying conditions have been excluded (1), the diagnostic criteria for this syndrome entail a number of conditions, classified as major and minor. An enhanced risk of AF has been clearly documented in endurance athletes (top-class, elite and recreational) (2-5), and such risk typically ranges between 1.2- to 15-fold compared to the general, sedentary population (the better cardiovascular fitness, the higher incidence of AF) (6-11). Anecdotally, the last auth…

Irisin: A new potential hormonal target for the treatment of obesity and type 2 diabetes

Desmopresssin and hemodilution: implications in doping.

Blood doping improves physical performance in sport. This is the reason why the antidop- ing authorities subject athletes to blood tests. Plasma volume expanders are prohibited agents used to reduce an artifi cial increase in hemato- logical values using diff erent illegal practices. The aim of our study was to test whether desmo- pressin (DDAVP)-induced hemodilution would alter the concentration of hematological param- eters used to detect blood doping in sports. This was an intra-subject crossover study. Venous blood samples were obtained from eight physi- cally active males on two occasions. On the fi rst o ccasion the subjects ingested 1.5 L of mineral water and 4.3 μ g / kg of DDAVP. O…

Statins and other drugs: Facing COVID-19 as a vascular disease

Angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and HMG-CoA reductase inhibitors ("statins") have been hypothesized to affect COVID-19 severity. However, up to now, no studies investigating this association have been conducted in the most vulnerable and affected population groups (ie, older adults residing in nursing homes). The objective of this study was to explore the association of ACEi/ARB and/or statins with clinical manifestations in COVID-19-infected older adults residing in nursing homes.We undertook a retrospective multicenter cohort study to analyze the association between ACEi/ARB and/or statin use with clinical outcome of COVID-19. The …

Time-dependent results in troponin exercise-induced fluctuations

Exercise training intensity and connexin 43 expression in hypertrophic cardiomyopathy.

• Moderate-intensity exercise improved peak oxygen consumption in hypertrophic cardiomyopathy.

Physical exercise as an epigenetic modulator: Eustress, the "positive stress" as an effector of gene expression.

Physical exercise positively influences epigenetic mechanisms and improves health. Several issues remain unclear concerning the links between physical exercise and epigenetics. There is growing concern about the negative influence of excessive and persistent physical exercise on health. How an individual physically adapts to the prevailing environmental conditions might influence epigenetic mechanisms and modulate gene expression. In this article, we put forward the idea that physical exercise, especially long-term repetitive strenuous exercise, positively affects health, reduces the aging process, and decreases the incidence of cancer through induced stress and epigenetic mechanisms. We pr…

In Reply – Association of Renin Angiotensin System Blockers with Outcomes in Patients With COVID-19

Increased Cardiovascular Risk Associated With E-Cigarette Use

Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is being defined as the worst pandemic disease of modern times. Several professional health organizations have published position papers stating that there is no evidence to change the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the management of elevated blood pressure in the context of avoiding or treating COVID-19 infection. In this article, we review the evidence on the relationship between the renin-angiotensin-aldosterone system and COVID-19 infection. In agreement with current guidelines, patients with hypertension should continue taki…

Undetected coronary artery disease in apparently healthy athletes

UEM1901 5.864 JCR (2019) Q1, 18/138 Cardiac & Cardiovascular Systems 1.459 SJR (2019) Q1, 58/362 Cardiology and Cardiovascular Medicine; Q2, 36/104 Epidemiology No data IDR 2019 UEM

PPARδ Modulation by GW501516: An Unsuccessful Exercise Mimetic.

Anti-gout drugs as potential therapy for atrial fibrillation.

Atrial fibrillation (AF) is an important cardiovascular disease in theelderly [1]. Noticeably, it has been increasingly demonstrated thatserum uric acid (UA) is associated with AF [2–9]. In a recent meta-analysis performed by Tamariz and coworkers, the authors concludedthat high levels of UA and AF are clearly associated [10]. Interestingly,serum UA has been linked to AF in obstructive sleep apnea patients[11], whereas it has been also associated with thromboembolic risk inpatients with nonvalvular AF [12].The treatment of gout, a metabolic disorder caused by chronic hyper-uricemia, is based on administration of colchicine, xanthine oxidase (XO)competitive inhibitors such as allopurinol, and…

In reply-Angiotensin-Converting Enzyme 2 and the Resolution of Inflammation: In Support of Continuation of Prescribed Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers.

AMP-activated protein kinase (AMPK) signaling pathway: A potential mechanism involved in PAFIYAMA syndrome?

Modulation of Heart Rate by Acute or Chronic Aerobic Exercise. Potential Effects on Blood Pressure Control.

It was initially assumed that heart rate and arterial blood pressure were modulated by normal respiration and muscle contraction. The arterial baroreflex, an inverse relationship between blood pressure and heart rate, was later reported. Nonetheless, it was then assumed that those responses involved vagal modulation. We summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on blood pressure (BP) control. Numerous studies have tried to clarify whether aerobic exercise modifies neurally-mediated vasoconstriction, but they report contradictory results. In view of these incongruities, the aim of this narrative rev…

Inconsistency in circulating irisin levels: what is really happening?

The discovery of irisin as a novel and promising peptidic hormone for the treatment of obesity and diabetes has recently been reported. As a result, great hopes have been raised based on this finding, hypothesizing that irisin might provide additional benefits, not only for obesity and diabetes, but also for a wide range of pathological conditions requiring therapeutical and clinical attention. However, controversial results and conclusions on circulating irisin concentrations and correlations with other variables, including its role in metabolism, have recently been reported. Although laboratory assessment of irisin by ELISA is easily available and may provide interesting information for t…

Disruption of the antioxidant shield in fibroblasts from Werner syndrome

New Molecular Targets and Lifestyle Interventions to Delay Aging Sarcopenia

The term sarcopenia was originally created to refer age-related loss of muscle mass with consequent loss of strength (Morley et al., 2001). There are now four international definitions of sarcopenia (Cruz-Jentoft et al., 2010; Muscaritoli et al., 2010; Morley et al., 2011). In essence they all agree, requiring a measure of walking capability [either low gait speed or a limited endurance (distance) in a 6-min walk], together with an appendicular lean mass of <2 SDs of a sex and ethnically corrected normal level for individuals 20–30 years old. Sarcopenia is a prevalent health problem among the elderly. On average, 5–13 and 11–50% of people aged 60−70 years and ≥80 years, respectively suffer …

Histone carbonylation is a nuclear event with special relevance during cell proliferation and aging

Should atrial fibrillation be considered a cardiovascular risk factor for a worse prognosis in COVID-19 patients?

Erythropoietin and the heart: physiological effects and the therapeutic perspective.

Erythropoietin (Epo) has been thought to act exclusively on erythroid progenitor cells. The identification of Epo receptor (EpoR) in non-haematopoietic cells and tissues including neurons, astrocytes, microglia, immune cells, cancer cell lines, endothelial cells, bone marrow stromal cells, as well as cells of myocardium, reproductive system, gastrointestinal tract, kidney, pancreas and skeletal muscle indicates that Epo has pleiotropic actions. Epo shows signals through protein kinases, anti-apoptotic proteins and transcription factors. In light of interest of administering recombinant human erythropoietin (rhEpo) and its analogues for limiting infarct size and left ventricular (LV) remodel…

Exercise effects on cardiovascular disease: from basic aspects to clinical evidence.

Contains fulltext : 283453.pdf (Publisher’s version ) (Closed access) Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobi…

Expression of the genetic suppressor element 24.2 (GSE24.2) decreases DNA damage and oxidative stress in X-linked dyskeratosis congenita cells.

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al.

Atrial fibrillation in highly trained endurance athletes — Description of a syndrome

Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulati…

Irisinemia: A Novel Concept to Coin in Clinical Medicine?

Skeletal muscle can express and release substances such as cytokines or other peptides capable of modulating metabolic processes. These cytokines, named ‘myokines', function as hormones either locally within the muscle or by targeting distant organs. A novel peptidic myokine named ‘irisin' has been recently identified. It has been noted that circulating irisin levels are lower in type 2 diabetes (T2D) compared with nondiabetic controls as well as in patients with chronic kidney disease. In addition, a negative correlation between the hemoglobin A1c (HbA1c) and circulating levels of irisin has been also observed. Thus, the blood concentration of irisin may reflect the metabolic status of pat…

PAFIYAMA syndrome evidence in highly trained population