Background: Mediterranean diet was evaluated on erectile performance and cardiovascular hemodynamics, in chronic heart failure patients. Methods: 150 male stable heart failure patients were enrolled in the study (62 ± 10 years, New York Heart Association (NYHA) classes I–II, ejection fraction ≤40%). A detailed echocardiographic evaluation including estimation of the global longitudinal strain of the left ventricle and the systolic tissue doppler velocity of the tricuspid annulus was performed. Erectile dysfunction severity was assessed by the Sexual Health Inventory for Men-5 (SHIM-5) score. Adherence to the Mediterranean diet was evaluated by the MedDietScore. Results: The SHIM-5 score was positively correlated with the MedDietScore (p = 0.006) and augmentation index (p = 0.031) and inversely correlated with age (p = 0.002). MedDietScore was negatively associated with intima-media-thickness (p < 0.001) and serum prolactin levels (p = 0.05). Multi-adjusted analysis revealed that the inverse relation of SHIM-5 and prolactin levels remained significant only among patients with low adherence to the Mediterranean diet (p = 0.012). Conclusion: Consumption of Mediterranean diet benefits cardiovascular hemodynamics, while suppressing serum prolactin levels. Such physiology may enhance erectile ability independently of the of the left ventricle ejection fraction.
Background/Aim: Τhe aim of this study was to investigate the possible effect of the Mediterranean diet (Med Diet) on the progression of age-related macular degeneration (AMD) in patients with early or intermediate stages of dry AMD. Patients and Methods: The present study included 164 patients with early or intermediate dry AMD. Data collected included demographics, anthropometric data, ophthalmic and medical history. AMD progression was evaluated using patients' optical coherence tomography (OCT) and visual acuity. Using the MedDietScore, sample's attachment to Med Diet was evaluated, and distinguished into high and low. The association of supplement intake and adherence to Med Diet with AMD progression was investigated using logistic regression. Results: Sample's mean age was 73±7.4 years. A positive correlation was found between dietary supplementation and slowing of AMD progression, as well as between high adherence to Med Diet and slowing of AMD progression. In contrast, smokers had 51.4% higher risk of AMD progression (p=0.043). The rate of slowing AMD progression was higher in patients who followed Med Diet and received a dietary supplement, compared to patients who followed one or none of the aforementioned recommendations (p<0.001). Conclusion: Adherence to the Med Diet could have a positive effect on delaying AMD progression in advanced stages, both in patients receiving or not antioxidants. Therefore, our study proposes to strengthen recommendations to AMD patients to follow a Med Diet.Age-related macular degeneration (AMD) is the leading cause of blindness among individuals over 55 years of age in developed countries. There are two types of AMD: non exudative or dry AMD and neovascular/exudative or wet AMD. Early AMD is characterized by drusen formation and/or pigmentation changes in the retinal pigment epithelium (RPE). Advanced AMD can show as atrophic changes in the macula (geographic atrophy form) or choroidal neovascularization (neovascular AMD) (1). Several studies have shown the protective effect of antioxidant dietary supplements on delaying AMD progression. Supplementation with lutein, zeaxanthin, vitamins C and E, and zinc has been shown to significantly reduce the risk of AMD progression in a dose-response relationship (2, 3). This suggests that a diet rich in carotenoids and vitamins could also help the retina from oxidative stress and delay macular degeneration.The Mediterranean diet (Med Diet) is a plant-based dietary pattern traditionally found in countries of the Mediterranean basin such as Greece, Spain, and Italy. Med diet is considered as one of the healthiest diets, as adherence 1809
Objective: For estimation of overall cardiovascular risk ESH proposes stratification according to BP, prevalence of risk factors, asymptomatic TOD, diabetes, kidney and symptomatic cardiovascular disease, while the ESC HeartScore constitutes another potent predictive tool of adverse outcome. The purpose is to compare the predictive role of ESH stratification and ESC HeartScore for the incidence of the composite end-point of coronary artery disease (CAD) and stroke in a cohort of essential hypertensive patients. Design and method: We followed up 2150 essential hypertensives (mean age 55.7 years, 1085 males, office BP = 145/91 mmHg) for a mean period of 8 years. All subjects had at least one annual visit. CAD was defined as the history of myocardial infarction or significant coronary artery stenosis revealed by angiography or coronary revascularization procedure. Stroke was defined as rapid onset of a new neurological deficit persisting at least 24 hours unless death supervened confirmed by imaging findings. Results: The incidence of CAD, stroke and their composite over the follow-up period were 2.8% 1.11% and 3.9% respectively. By using the ESH stratification, 15.3% was of low and moderate risk, 54.4% was of moderate to high and high risk and 30.3% was high to very high and very high risk. According to the ESC HeartScore 89.2% was of low to moderate risk, 10% of high risk and 0.8% of very high risk. Cox-regression analyses revealed that high to very high and very high ESH risk category was related to increased risk for the composite end-point of CAD and stroke (hazard ratio = 4.5, p < 0.0001), while focusing on the ESC Heart Score the composite end-point was predicted by the high risk category (hazard ratio = 3.43, p < 0.0001). The ESH risk model had better fit than the ESC HeartScore due to the lowest Akaike's values (1442.66 vs 1498.31, respectively). Conclusions: The ESH risk stratification constitutes a better prediction model for CAD and stroke than the ESC HeartScore in essential hypertension and its estimation is essential in order to improve overall risk assessment in this setting.
Cardiorespiratory response, right ventricular and global diastolic function is known to deteriorate the clinical course of patients with chronic heart failure with reduced ejection fraction (HFrEF), even under optimal treatment. In this work we sought to evaluate the impact of sacubitril/valsartan initiation in patients with chronic HFrEF in NYHA clinical status II-III, under optimal medical and invasive treatment. Methods 180 patients (85% male, mean age 62±9 years old, 60% ischemic heart failure, 73% with ICD, 45%with CRT and 45% with diabetes mellitus) in NYHA classification II-III-, who were prescribed Sacubitril-Valsartan were evaluated. Clinical status, biochemical parameters, cardiorespiratory exercise response and bi-ventricular Doppler indices were evaluated at first visit and 6 months after. The pulsed tissue Doppler imaging of the systolic and diastolic function of mitral and tricuspid annulus was characterized by the systolic waves Smv and Stv, and the diastolic waves: Emv and Amv; E was the early filling wave in transmitral velocity. Left atrial maximal volume and global longitudinal strain of the left ventricle (GLPS) were measured. In cardiorespiratory exercise Vo2max, VE/VCO2 and Mets achieved were evaluated. All of them received b-blockers, 90% eplerenone or spironolactone, 25% ivabradine and 90% diuretic treatment. Seventy percent of them started with the dose of 50mg of sacubitril/valsartan; while 80% finally received the full dose of 200 mg bid. One third of them were on clinical status NYHA III. Results Eight of the patients discontinued the medication due to hypotension or renal function worsening. All patients expressed improvement in clinical status; while diuretic therapy was down titrated in all of them and discontinued in 30%. As compared with the initial examination, tricuspid annulus systolic wave velocity increased by 5% (p=0.04); maximum volume of left atrium was decreased by 6% (p=0.004); GLPS average was improved by 41% (p=0.001) and E/Emv ratio was decreased by 22% (p=0.04). Moreover, improvement in Stv was more prominent in DCM as compared to IHF patients; In cardio respiratory exercise VE/VCO2 decreased by 5% (p=0.05); while VO2 max showed a trend in improvement (p=0.06), with no difference detected between DCM and ICM patients; although there was a significant increase (47%) in METS achieved (p=0.02). Conclusion Sacubitril/valsartan initiation was associated with improved left diastolic function and right ventricular function, along with functional status improvement in patients with HFrEF. These finding underline the beneficial role of sacubitril/valsartan initiation on the hemodynamic course of patients with systolic heart failure and clinical status deterioration. Funding Acknowledgement Type of funding source: None
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