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Novel Approach to Control Microbial Contamination of Germinated Wheat Sprouts: Photoactivatedchlorophillin-Chitosan Complex I. Buchovec Z. Luksiene

Abstract: High resistance of bacteria and fungi to antimicrobial treatments has led to the development of innovative and
alternative antimicrobial technologies. It is well-known that chitosan itself is an antimicrobial agent, and chlorophyllin is
water-soluble food additive (E140) and food component which in the presence of light exerts antimicrobial properties.
Complex of these two antimicrobials can be background for the development of edible active biodegradable coating.
The aim of this study was to evaluate antimicrobial efficiency of photoactivated chlorophyllin-chitosan complex against
food pathogens and fungi on the surface of germinated wheat seeds. Obtained data indicate that chlorophyllin-chitosan
complex in the presence of visible light (400nm) exhibits strong antimicrobial activity which can be used for
decontamination of sprouts.

Flavour Quality and Stability of an Encapsulated Meat-Like Process Flavouring Prepared from Soybean Based Acid Hydrolyzed Protein Hoda H.M. Fadel A. Abdel Samad

Abstract: The main objective of this study was to produce meat-like process flavouring by using a model mixture based
on acid hydrolyzed soybean protein (a-HVP) in addition to xylose, thiamine, cysteine and taurine . Glutamic was the
major amino acid in a-HVP followed by aspartic, glycine and alanine. The meat –like process flavour was encapsulated
in gum Arabic and stored at room temperature for 6 months. The changes in quality and flavour stability were followed
during storage. The results revealed that the roasty and savoury notes were increased whereas chickeny, beefy and
grilled meat notes showed significant (P< 0.05) decrease during storage. The gas chromatography-mass spectrometry (GC-MS) analysis showed that 2-methyl-3-furanthiol, the main contributor to beefy note, was the major identified compound in the fresh sample. It showed remarkable decrease after storage for 6 months. The pyrazines and thiazoles showed an opposite trend. A quite agreement was found between the results of the odour profile analysis and those of GC-MS analysis. The results of the present study give important information to the flavourists who are working in field of process flavours, especially meat-like process flavour.

Application of Flow Cytometry and Fluorescence Techniques in Somatic Cell Analysis of Raw Milk Merve Pelvan Sevcan Unluturk

Abstract: Monitoring the quality and safety of milk requires careful analysis of somatic cell count (SCC). High level of
SCC is a signal of diseases such as mastitis. Mastitis can be detected not only by measuring the inflammatory
components and pathogens but also evaluating the SCC in milk. In this study, somatic cells are counted with direct
microscopy and flow cytometry. For SCC analyses, a centrifugal lipid clearing process is applied. Cleared samples are
stained with two fluorescent dyes acridine orange (AO) and ethidium bromide (EtBr), which have different binding
mechanism to cell. These two dyes and their different applications are investigated to reveal the effect on somatic cell
count. The results are also compared with direct microscopy method. The results of flow cytometry counting method are
well correlated with the ones obtained by direct microscopy technique. In conclusion, AO can be an alternative chemical
dye for EtBr to be used in enumeration of SCC by flow cytometry technique.

Pulsed Electrical Technologies Assisted Polyphenols Extraction from Agricultural Plants and Bioresources: A Review Nadia Boussetta Nabil Grimi

Abstract: The application of pulsed electrical technologies such as high voltage electrical discharges (HVED) and
pulsed electric fields (PEF) have been currently proposed for promoting biocompounds extraction. Even if their principles
of action are different, both of these techniques have shown to be efficient for the enhancement of polyphenols
extraction from different raw materials as compared to control extraction. Depending on the product, the energy
consumption, the cell disruption, the polyphenols composition, the extraction and purification steps are different when
applying PEF or HVED. This paper thus reviews the current status of research on the application of HVED and PEF for
extraction and purification of polyphenols from plants.

Antioxidant activity of Peanut (Arachis Hypogaea L.) Skin Extract: Application in Soybean and Mustard Oil D.N. Yadav K. Yogesh

Abstract: Total phenolics of peanut skin obtained by different methods were estimated; the effect of different solvents on
extractability of total phenolic compounds has also been evaluated. The effect of peanut skin extract, possessing highest
phenolics and DPPH radical scavenging activity, was evaluated by schaal oven test in the soybean oil, while oxidative
stability of mustard oil was evaluated by Rancimat method. Total phenolics were obtained highest (76.0 ± 2.12 to 101.7 ±
5.54 mg/g GAE dw) in the roasted samples, followed by the dry samples (54.7 ± 1.78 to 89.1 ± 3.78 mg/g GAE dw), and
lowest (14.5 ± 0.95 to 21.6 ± 1.02 mg/g GAE dw) in the blanched samples; 80% methanol extraction provided better
extractability of phenolic compounds than the aqueous and 80% ethanol extraction method. The peroxide value and
induction period of different oils was also evaluated in the present study, which clearly showed that peanut skin extract
offered significantly (P < 0.05) better or at least similar protection against oxidation in the oils; than the synthetic antioxidant (BHT). Thus, peanut skin may be a good source of natural antioxidants for stabilization of various vegetable oils, during harsh processing and unavoidable storage conditions.

Antioxidant Effect of Litchi (Litchi chinensis Sonn.) Seed Extract on Raw Ground Chicken Meat Stored at 4 ± 1 °C K. Yogesh Tanbir Ahmad

Abstract: In this study, total phenolics (TP), trolox equivalent antioxidant capacity (TEAC), reducing power (RP) and 2,
2-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity (SA) were estimated in litchi (Litchi chinensis Sonn.) seed
extracts (LSE). The antioxidant potential of the LSE in raw chicken ground meat (GM) during refrigerated (4 ± 1 °C)
storage was also evaluated. In the LSE, TP and TEAC were 7.30 ± 0.06 mg TAE/gdw and 42.26 ± 0.28 mg TE/gdw
respectively. The LSE also showed remarkable SA (56.07 ± 0.51%) and RP. Addition of LSE to GM significantly altered
the cooking losses, water holding capacity and pH of GM. During storage (4 °C), the thiobarbituric acid reactive
substances (TBARS) values were observed significantly (P < 0.01) more (1.32 ± 0.03 mg malonaldehyde/kg) in the control than the treated samples; and the antioxidant efficacy was more in vacuum packaged than aerobically packaged GM samples. Thus, LSE prevents lipid oxidation in meat, and could be used in place of synthetic antioxidants, which have been proved for their negative health implications.

Corn Starch Incorporated Gomatofu: Textural and Sensory Quality Deep N. Yadav Jyotsana Dhasmana

Abstract: Gomatofu is a traditional Japanese food and is one of the mixed gels consisting of kudzu (arrowroot) starch
and sesame. In this study, an attempt has been made to replace the kudzu starch with corn starch. Central composite
rotatable design (CCRD) of response surface methodology was used to optimize the level of independent variables viz.,
sesame oil (1.5-3.5g/100 ml sesame milk), corn starch (90–110g/100g defatted sesame flour) and water content (330-
350 ml/100g defatted sesame flour). Five responses, i.e. hardness, springiness, gumminess, chewiness and overall
acceptability were evaluated. Hardness of gomatofu ranged between 0.85 to 3.62 N, springiness, 0.45 -1.82 mm,
gumminess 0.26 -2.48 N and chewiness from 0.16 to 4.52 Nmm. Overall acceptability of gomatofu samples ranged
between 5.3- 8.5. The effect of all the independent factors was significant on all the responses. Both oil and water
content inversely correlated with all the responses while, the effect of corn starch was positive. The interaction effect of
oil and corn starch was positive on hardness and overall acceptability, while negative on springiness, gumminess and
chewiness. The optimized formulation contained sesame oil 2.2 ml/100 ml sesame milk, corn starch 99.9 g/100g
defatted sesame flour and water 1001.3 ml/ 100g defatted sesame flour. Corn starch incorporated optimized gomatofu
had protein 7.5, fat 10.9, ash 1.1 and carbohydrate 80.53 % (db).

Effect of Moringa oleifera Leaf Powder Supplementation on the Micronutrient and Toxicant Contents of Maize – Soybean – Peanut Complementary Food Formulations D. Shiriki M.A. Igyor

Abstract: The effect of Moringa oleifera leaf powder supplementation on the micronutrient and toxicant composition of
maize – soybean – peanut food formulations was determined. Maize, soybeans and peanut (MSP) flours were blended
in a ratio of 60:30:10 (through material balancing to give 16g protein/100g) food as recommended by the protein advisory
group (PAG) for infant diets. While one part was used unfortified as control food sample (MSPA), the remaining three
parts were fortified with 5% (125g), 10% (250g) and 15% (375g) Moringa oleifera powder, giving samples MSPB, MSPC
and MSPD respectively. Standard methods of analysis were then used to determine the content of some representative
vitamins, amino acids, minerals and antinutritional factors in the food formulations. There was significantly increase (p < 0.05) in Vitamins A (􀀁-Carotene) and C as well as amino acids lysine and tryptophan with increase in Moringa oleifera powder, with values ranging from 2.40 to 5.43mg/100g, 2.00 to 3.80mg/100g, 34 to 145mg/100g and 13 to 45mg/100g for 􀀁-Carotene, Vitamin C, Lysine and Tryptophan respectively. Supplementation also significantly (p <0.05) increased the contents of all the mineral elements with values ranging from 498.90 to 631.72mg/100g, 81.10 to 110.94mg/100g 1.40 to 5.48mg/100g, 39.20 to 356.67mg/100g and 38.70 to 77.60mg/100g and 1.59 to 2.38mg/100g for potassium, magnesium, iron, calcium, phosphorus and zinc respectively; while oxalates, phytates and phenols contents increased significantly (p <0.05) with increase in Moringa oleifera leaf powder addition, with values ranging from 70.42 to 84.80mg/100g, 68.00 to 90.04mg/100g and 80.00 to 83.40mg/100g respectively.

Direct Determination of Heavy Metals in Honey by Potentiometric Stripping Analysis Jaroslava 􀀅varc-Gaji Zorica Stojanovic

Abstract: Honey is a valuable nutritious food rich in simple sugars, aminoacids, proteins and minerals. In addition, this
food product contains natural phenols and flavonoids, responsible for some bioactive properties. Due to known health
benefits of honey and its exquisite flavour this foodstuff is readily consumed by children and wide population imposing
necessity of strict quality control. One of quality criteria is the content of heavy metals. Elevated content of heavy metals
in honey may result from environmental or processing contamination, or may originate from soil or plant species that
honey is derived from.
In this work twenty five samples of honey from Serbia, Montenegro and Bosnia and Herzegovina were analysed in
respect to zinc, cadmium, lead and copper content. Honey samples were analysed directly, without sample preparation,
by applying potentiometric stripping analysis. Zinc, cadmium and lead were quantitated by using indium as an internal
standard, whereas copper was determined by standard addition method. Method accuracy was confirmed by blind
analysis of standard samples and with good recovery results which, for analysed samples, were in the range 91-101%.
In all analysed sampled determined metals contents were in the range permitted by Serbian regulations. Cadmium was
not detected in any of the analysed samples, whereas the content of other metals were in the range of 0.01-3.6 μg/g for
zinc, 0.02-0.8 μg/g for lead and 0.1-2.4 μg/g for copper, respectively.

Bacteriocinogenic Lactic Acid Bacteria of Caprine Products from Chaco – Argentina F.P. Rivas M.P. Castro

Abstract: The microbiota of artisanal caprine products is essential for the manufacture of fermented products, such as
cheeses and dry sausages, conferring them particular and distinctive flavors and generating high value-added products.
Many of the bacteria comprising this microbiota are able to produce bacteriocins and antimicrobial substances. The
finding of bacteriocinogenic strains within this microbiota could be the first step to introduce biopreservation into these
products. Hence, ten lactic acid bacteria (LAB) (6 Lactobacillus paracasei, 2 Lactococcus lactis, 1 Leuconostoc
mesenteroides and 1 Lactobacillus rhamnosus) isolated from artisanal caprine products from Chaco (Argentina) were
screened for antagonistic activity against other LAB and some spoilage and pathogenic microorganisms, such as Listeria
innocua (in lieu of Listeria monocytogenes), Staphylococcus aureus and Escherichia coli. The final goal was to
investigate LAB antibacterial activity within this unexplored ecological niche and to select interesting strains for the role
of bio-preservatives. Bacteriocin-like substances (BLIS) produced by the isolated strains inhibited three species of S.
aureus, L. innocua and Brochothrix thermosphacta. Titles of these antibacterial substances were within the range 100-
200 AU.mL-1. BLIS produced by the isolated strains were heat stable and effective after refrigerated storage and
freeze/thaw cycles. Moreover, BLIS activity was higher at acidic pH values, showing a decrease when these values were
closer to neutrality or they become alkaline. BLIS did not adsorb to the producer cells which is expected for future
production and application on food systems. The results presented in this study could contribute to characterize the
antimicrobial activity of the indigenous flora of artisanal caprine products manufactured in the province of Chaco,
Argentina. The isolated bacteriocinogenic strains showed a regular production of BLIS in culture broth, which offers
promising applications for the biopreservation of these products.

Production and Quality Assessment of Protein–Rich Biscuits from Blends of Wheat and Defatted Sesame Flours D.I. Gernah K. Anyam

Abstract: The effect of wheat flour supplementation with sesame flour on the quality of biscuits was determined. Biscuits
were produced from various blends of wheat and defatted sesame flour (90:10, 80:20 and 70:30), with 100% wheat flour
serving as control. Physico-chemical and sensory properties were then determined using standard methods of analysis.
Protein, fat, fiber and ash contents increased, while carbohydrate content decreased significantly (p < 0.05) ranging from 10.20 to 16.84 %, 2.08 to 5.23%, 1.20 to 2.66%, 1.37 to 2.03 and 76.45 to 63.53% respectively from control to the sample with 30% defatted sesame substitution. While there was no significant increase (p > 0.05) in weight (9.35 to
9.86g), there was significant (p < 0.05) increase in diameter and spread ratio of biscuits with values ranging from 4.30 to 4.83 and 30.07 to 58.19, respectively. There was a significant difference (p < 0.05) in thickness between the control (100% wheat) and other samples changing from 1.43 to 0.83cm. Mean sensory scores showed an increase in appearance, aroma and texture of biscuits though there was a decline at the highest level (30%) of substitution. The 10% defatted sesame sample gave the highest scores for taste and acceptability. The study shows that acceptable and nutritious biscuits could be produced from composite blends of wheat flour and defatted sesame flour.

Hominy Feed Value for Bioethanol and Bakery Functional Ingredient Mara L. Pereira Manuel Malfeito-Ferreira

Abstract: To increase the value of hominy feed, a by-product from corn milling, its potential for oil extraction and
fermentation to produce ethanol was study. The novelty of the work was to study the use of the fermentation residue as
an enhancing ingredient in bakery products. The fermentation was conducted by simultaneous saccharification and
fermentation as well as saccharification followed by fermentation. After 48 h of fermentation of 30 % (w/ v) defatted
hominy feed aqueous solution, ethanol concentration varied from 7.8 to 12.5 % (v/ v). The post-fermentation residue
showed an increase in protein and fiber contents, from 10 % to 30 % and 14 % to 26 %, respectively, when compared
with the source material. This residue presented a significant level of antioxidants, around 620 􀀁mol/ 100g. When this
residue was incorporated into bread, rolls and cookies at levels of 7%, an increment of 23% of protein content can be
reached and up to 50% of total fiber as well. This fiber increment corresponded to 47% of soluble and 19% of insoluble
fibers. However, a negative impact onbread volume was observed: a reduction of 1.5% of diameter, 17 – 19% of volume,
18 – 24% of height, 9 – 12% of porosity and 6–11% of elasticity. But surprisingly, the bread life time increased 100%,
i.e., the rolls looked as fresh as just baked, the day after.

Hominy Feed Value for Bioethanol and Bakery Functional Ingredient Mara L. Pereira Manuel Malfeito-Ferreira

Abstract: To increase the value of hominy feed, a by-product from corn milling, its potential for oil extraction and
fermentation to produce ethanol was study. The novelty of the work was to study the use of the fermentation residue as
an enhancing ingredient in bakery products. The fermentation was conducted by simultaneous saccharification and
fermentation as well as saccharification followed by fermentation. After 48 h of fermentation of 30 % (w/ v) defatted
hominy feed aqueous solution, ethanol concentration varied from 7.8 to 12.5 % (v/ v). The post-fermentation residue
showed an increase in protein and fiber contents, from 10 % to 30 % and 14 % to 26 %, respectively, when compared
with the source material. This residue presented a significant level of antioxidants, around 620 􀀁mol/ 100g. When this
residue was incorporated into bread, rolls and cookies at levels of 7%, an increment of 23% of protein content can be
reached and up to 50% of total fiber as well. This fiber increment corresponded to 47% of soluble and 19% of insoluble
fibers. However, a negative impact onbread volume was observed: a reduction of 1.5% of diameter, 17 – 19% of volume,
18 – 24% of height, 9 – 12% of porosity and 6–11% of elasticity. But surprisingly, the bread life time increased 100%,
i.e., the rolls looked as fresh as just baked, the day after.

The Role of Cardiology in Search of a Paradigm of Psychiatry S.V. Rosman L.V. Lebedeva

Abstract: The paper proposes a new integrated approach to the search for a paradigm of psychiatry, is based on a
thorough study of entropy neuron-glial networks of the brain using a unique research method, the variance of the
amplitude-frequency characteristics of the alpha rhythm of the EEG, which merged to form a new unit with modern
methods of monitoring cardiovascular activity of heart rate variability and dispersion parameters of ECG.

The Characteristics of Chronic Heart Failure in Rheumatoid Arthritis Harutyun S. Hovhannisyan  

Abstract: In recent times there is an emerging evidence about the increased risk of cardiovascular disease (CVD) and
rheumatic conditions. This review has been focused on the multiple relationships between rheumatoid arthritis (RA) and
heart failure (HF) features.
Cardiovascular (CV) system involvement is an extra-articular complication of RA and is a major cause of morbidity and
mortality. All heart structures may be affected in RA and different clinical manifestations may be seen.
HF is a complex clinical syndrome which represents universal end-stage of nearly every form of heart disease and has a
poor prognosis. Patients with RA have almost 2-fold higher risk of HF development than non RA-subjects and this high
risk is not explained entirely by traditional CV risk factors. RA patients with HF appear to have a more subtle
presentation of HF, compared to HF patients without RA, while mortality from HF is significantly higher. In RA HF mostly
is manifested by diastolic dysfunction (DD) which is revealed by echocardiography. In general, brain natriuretic peptide
(BNP) is an important clinical and prognostic marker of HF, but there are no final data concerning its screening value in
Nevertheless, up to date HF is still being poorly revealed in most RA-patients, especially on early stages of the disease,
which leads to HF treatment delay, thus contributing to mortality.
These findings emphasize the role and need of further larger studies in this field, which will bring to early identification
and treatment of RA-subjects with HF and a decrease in mortality rates.

Statins and Malignancies in Cardiovascular Practice Wilhelm P. Mistiaen  

Abstract: Statins have a proven efficacy in lowering of plasma cholesterol and reduction of atherosclerotic
cardiovascular disease. They also have anti-inflammatory, pro-apoptotic and anti-angiogenic effects which can be
derived from their biochemical activity. The cell cycle could also be arrested at several stages. However, an early
concern was the possibility of increase in malignancy. The first reports were conflicting.
A search in Web of Science has been made with the terms “statins AND malignancy”, from 2012 to 2017.
Twenty of 119 manuscripts were considered as useful. Manuscripts dealing with in-vitro and animal experiments were
excluded, as well as reviews and manuscripts not related to the topic. There was a variety of malignancies under
scrutiny. Most series showed a favorable result on either reduction of incidence in malignancy or, if a malignancy was
diagnosed and improvement in overall or cancer specific survival. Reduction in symptoms and improvement in
inflammatory response after adjuvant chemo and radiotherapy were documented in a few reports.
Elimination of bias has been attempted by taking into account confounding factors or by using a propensity analysis or a
multivariate regression. Interpreting these results is difficult due to the differences in study designs. This precluded a
meta-analysis. The disentangling of the effect of statins on malignancy, plasma cholesterol and changes of this level in
these patients requires a large multicenter prospective trial which might encounter ethical and logistical difficulties.

Dyslipidemia in Metabolic Syndrome: an Overview of Lipoprotein- Related Disorders S. Asha Devi B. Jyothi

Abstract: The significance of plasma levels of total cholesterol (TC), triglycerides (TG) and each lipoprotein class
namely chylomicrons, low density lipoproteins (LDL), very low density lipoproteins (VLDL), and high density lipoproteins
(HDL) has been tested time and again for their reliability as diagnostic markers of dyslipidemia. The prevalence of
dyslipidemia-related metabolic syndrome is associated with the risk of cardiovascular disease (CVD) and diabetes. This
review will focus on the characteristics of major classes of lipoproteins (LPs) and their coexistence with TG and
apolipoprotein as estimates of the intensity of metabolic syndrome. It will deal with the suitability of animal models for
dyslipidemic studies that match with clinical conditions of diabetes, atherosclerosis and obesity. It also sums up
published research and clinical case studies in support of the conceptual paradigm shift from the use of simple lipids to
oxidized LDL (OxLDL) and apolipoproteins as diagnostic markers of dyslipidemia. Further, it briefly discusses the use of
non-pharmacological approach such as exercise and diet as an effective means of management of dyslipidemia in
human as well as subhuman species. Finally, it presents evidence for treatment of dyslipidemia with specific targets, LP
and TG as the appropriate therapy only when non-pharamacological means fail to accomplish the standard lipid profile.

Hibernation of Myocardium in the Case of Neuroleptic Cardiomyopathy: A Statistical Analysis V.P. Volkov*  

Abstract: Aim: The purpose of the present study is to summarize and interpret the data, which has been received
earlier, in order to prove the development of the hibernation of myocardium (HM) in cases of the neuroleptic
cardiomyopathy (NCMP).
Methods: Morphometric methods of research were used which meets modern requirements of the evidence based
medicine. The studied micromorphometric parameters describe the condition of three structural components of
myocardium (vasculature, intercellular matrix, and parenchyma). Such parameters as zone of pericapillary diffusion
(ZPD), Kernogan index (KI), Stromal-parenchymatous ratio (SPR), rate of interstitial edema (RIE) were calculated.
Karyometry and cytometry of cardiomyocytes (CMCs) were performed, the specific volumes of hypertrophied CMCs
(SVHC), of atrophied CMCs (SVAC) and – by the method of polarization microscopy – the specific volume of dystrophic
CMCs (SDVC) were determined.
Results: In the absence of NCMP, the changes, which have an acute character, develop in the case of sudden cardiac
death (SCD) and malignant neuroleptic syndrome (NMS) and reflect the statistically significant (p<0.05) shifts of the respective quantitative parameters. When NCMP is present, the only parameter, which is significantly changed in connection with SCD and NMS, is SVDC (p<0.05). Conclusion: NCMP causes irreversible damages in myocardium, it leads to its insensitivity, practically almost fully prevents it from reacting to any influences, particularly in the presence of SCD and/or development of NMS. The morphofunctional state of cardiac muscle in the case of NCMP is an independent proof of state of hibernation of myocardium which appears during the process of morphogenesis of NCMP.

Cardiac Development and Expression of Some Transcription Factors María Luz Gunturiz  

Abstract: Cardiac embryogenesis is the result of multiple, highly dynamic processes and with a high degree of
heterogeneity in their gene expression that occurs at different stages of myocardial development and in the fully formed
heart. The aim of this review is to illustrate the different patterns of expression of some gene families of transcription
factors which are expressed specifically in the different stages of the heart formation and provide information on the
progress and results of the function and role of the Transcription Factor associated with microphthalmia MITF, obtained
in the doctoral thesis of the author in the National Institute of Health of Colombia. The knowledge of the molecular
mechanisms that control the specific expression of tissue, the regulatory factors and the interactions which allow the
expression directed to a particular tissue compartment, constitutes the basis for clinical applications. Within the families
of genes with specific expression patterns in the heart contractile proteins, ion channels, and transcription factors whose
study will allow to clarify the association between gene deregulation, and the high incidence of cardiovascular disease.
Necessary to mention that this review focused exclusively in the families of transcription factors which are expressed in a
more widespread way during each stages of the cardiac development and by the design targeted initially, it does not
include studies of gene expression at the level of contractile proteins and calcium regulators of the heart metabolism,
that are as important as the above factors of transcription before mentioned. In conclusion transcription factors such as
MITF-H may be involved not only in the pathogenesis of cardiovascular diseases but early stages of cardiac

Cardiopulmonary Microcirculation and Gas Exchange in Acute Adrenaline-Induced Injury A.B. Semerjyan N.F. Krasnikov

Abstract: Microcirculatory alterations lead to cell and organ dysfunction. High levels of catecholamines induce
tachycardia, coronary vasospasm, microcirculatory disruption, hypoxia, ventricular fibrillation. Hypercatecholaminemia
increases pulmonary capillary resistance and permeability as well.
Aim of this research is to study adrenaline-induced alterations in myocardial and lung microcirculation, and gas
exchange parameters in rats.
Experiments were performed in male Wistar rats divided into 2 groups: control (n=11), and animals (n=12) treated with
histotoxic-dose adrenaline. Anesthetized animals were exposed to mechanical lung ventilation at a frequency of 40
breaths/min and were sacrified 20 min after adrenaline injection. Paraffin-embedded myocardial and lung tissues were
stained by hematoxylin and eosin. Myocardial and pulmonary microcirculation was studied by Sisakyan and Chilingaryan
methods for revealing intraorganic MCB based on detection of phosphatase enzymes’ activities (acid phosphatase and
Ca2+-ATP-ase, respectively) in the vessel walls. Mean capillary diameter (MCD) was calculated using ocular-micrometer.
Partial pressures of arterial blood O2, CO2 and pH were measured.
Histological studies showed that adrenaline induced contraction band lesions of cardiomyocytes, diffuse pulmonary
infiltrations, hemorrhages. Myocardial and lung microcirculation studies revealed inhomogeneous and less intensive
staining, tortuous course of capillary walls and their destructive changes. Blood gas analysis data indicated hypoxemia
and hypercapnia developing along with acidosis following adrenaline injection.
In conclusion, high-dose adrenaline induces acute myocardial and lung injuries, manifested in inflammatory and
microcirculatory alterations, disorders of pulmonary gas exchange that may aggravate further development of
cardiopulmonary pathology. The data achieved in present study may allow further adjustment of treatment strategies for
stress-induced myocardial injury considering the role of lung microcirculation and gas exchange disorders in the given

Consumption of Tree Nuts in the Prevention of Coronary Heart and Cardiovascular Disease Ryszard Amarowicz  

Abstract: Emerging research from epidemiologic studies and clinical trials is demonstrating that tree nuts promote
satiety and weight maintenance. Moreover, tree nuts contain a plethora of nutrients, natural phenolic antioxidants, and
other bioactive compounds (e.g., phytosterols), which are now being recognized for bestowing health benefits. As will be
discussed in this review, tree nuts have been linked to improving heart health, lowering low-density lipoprotein
cholesterol levels, and reducing inflammation. The strongest evidence that tree nuts are cardio-protective foodstuffs
comes from epidemiological observations indicating a consistent and well-defined inverse association between the
frequency of nut consumption and development of coronary heart disease, and several short-term clinical trials
demonstrating the beneficial effects of nut intake on lipid profiles as well as other intermediate markers of heart disease.
In this review research findings from the existing literature published within the last 15 years have been compiled and
summarised. Three bases: SCOPUS, Web Science, and PubMed were used for search.

Specific of Myocardial Perfusion Scintigraphy Compared to Invasive Coronary Angiography N. Noroozian P. Parekh

Abstract: Purpose: The NICE guidance has placed non-invasive ischaemia testing as the primary role for assessing
patients with moderate pre test probability for obstructive coronary artery disease. Functional tests like MPI, have led to
a reduced role for invasive coronary angiography (ICA) in initial patient assessment. Aim of our audit was to assess the
specificity of our nuclear service compared with ICA retrospectively. The standard was set at a false positive rate of no
more than 73%.
Methods: A search was conducted (between Aug2012-Feb2013). MPIs were reported by a radiologist and a cardiologist.
A standard 17-segment model was used for MPI interpretation. Coronary angiograms were interpreted for the
absence/presence of epicardial luminal narrowing >50% by referencing the clinical report on the patient electronic
record. The cases which were positive enough to warrant recommendation for ICA the true positive and false positive
rate was determined.
Results: This cross –sectional study included 51 cases.33 had a stenosis in a major coronary artery of>50% giving a true
positive rate of 65%. There were18 false positive studies (35%). 5 cases were regarded as having evidence of transient
ischaemic dilatation (TID), all of which had a subsequent negative angiogram.3 studies had notable artefact due to
patient body habitus, or inability to position the patient optimally. The percentage of myocardium defects was determined
for each case at stress. The average percentage in the true positive studies was 17%, in the false positive studies it
was7%, excluding those regarding as having TID.
Conclusions: MPI studies deemed sufficiently abnormal to justify a coronary angiogram have a moderate likelihood of
predicting a significant stenosis being present on ICA. False positive scans are frequent when only TID and significant
artefacts are present. It is likely that CT calcium scoring with MPI will increase the specifity of this imaging. It will also
allow CT coronary angiography to be used in cases where artefact is present and the calcified atheroma burden is low.
The audit standard was not met. Suggested changes in practice. 1. Greater caution in recommending ICA for cases
where the only evidence for ischaemia is transient ischaemic cardiomyopathy. 2. Increased use of CT to determine
cases where significant reversible ischaemia is present in the context of none or low burden of coronary calcification.
Clinical Relevance/Application: MPI assesses myocardial perfusion by using radiotracers injected under stress/rest

Effect of Doxorubicin on Cardiac Myocytes: Role of Apoptosis, Autophagy and other Proteolytic Pathways Wilhelm P Mistiaen  

Abstract: Doxorubicin is a very effective chemotherapeutic agent. However, its use is limited by serious cardiac side
effects, including long-term irreversible cardiac failure which is often fatal. These effects are related to the cumulative
dose but other factors also play a role. Through a systematic search in an electronic database, manuscripts dealing with
this matter were included. Exposure of the heart to doxorubicin s result in three types of stress: 1] genotoxic, 2] energetic
and 3] oxidative stress. These effects are closely related with the dependence of the heart on oxidative phosphorylation,
its low defenses against reactive oxygen species and with the peculiarities of mitochondria, which are abundantly
present in cardiac tissue. In most manuscripts, the cellular effects of doxorubicin are documented by changes in
enzymatic pathways within cardiomyocytes. These pathways have mutual influences, which complicate the interpretation
of results. These pathways often result in proteolysis, cellular damage and apoptotic cell death. Necrosis and autophagy
are also involved as mechanisms. Most of the included manuscripts deal with in-vitro experiments with anti-oxidant
agents, using cardiomyoblasts and H9c2 cell lines as well as in-vivo short-term murine models. However, long-term
animal models are lacking. Clinical articles and experiments with cells other than cardiomyocytes are few. The effects of
doxorubicin on the extracellular matrix also needs further exploration. These areas need further exploration.

Morphogenesis of a Neuroleptic Cardiomyopathy:A Morphometric Study V.P. Volkov  

Abstract: Aim: A comparative morphometric study of heart condition on various organizational levels (organ, tissue, and
cellular one) in each clinical stage of neuroleptic cardiomyopathy.
Methods and results: Morphometric methods of research were used which meet modern requirements of the evidencebased
medicine. For analysis of data from organometry of heart an own original method was used. For this analysis the
outer volume of heart without atria (V) was determined and two relative parameters (both in percent) were calculated: 1)
Cv - coefficient of volume, this coefficient shows a part of the total volume of heart (without atria), and this part falls on
the volume of cavities of ventricles; and 2) Cl - coefficient of the left ventricle, this coefficient shows the volume size of
the left ventricle with respect to the total volume of both ventricles. In addition, two other parameters were calculated
which use a gravimetric characteristic of the heart (m): mass-volume ratio (MVR) and index of density of myocardium
It was found that on the organ level the process of cardiac remodeling ends during the latent stage of the disease.
Progression of myocardial dysfunction is connected with changes of myocardium microstructure.
The studied micromorphometric parameters describe the condition of three structural components of myocardium
(vasculature, intercellular matrix, and parenchyma). Such parameters as zone of pericapillary diffusion (ZPD), Kernogan
index (KI), SPR, RIE were calculated. Karyometry and cytometry of cardiomyocytes (CMCs) were performed, the specific
volumes of hypertrophied CMCs (SVHC), of atrophied ones (SVAC), and – by the method of polarization microscopy –
the specific volume of dystrophic ones (SVDC) were determined.
In the latent stage the microcirculatory disorders prevail. In the full-scale stage the damages of intercellular matrix come
to the forefront. For the terminal stage the atrophic and dystrophic-degenerative changes of cardiomyocytes are
Conclusion: In the course of morphogenesis of a neuroleptic cardiomyopathy a certain staging of clinical manifestations
of the disease is observed; this staging corresponds to an observed cardiac remodeling on the organ level and to an
observed chain of interconnected pathologic shifts in all microstructures of myocardium.

Non-Alcoholic Fatty Liver Disease as Risk of Cardiovascular Disease: Myth or Reality? Hamayak Sisakian Ani Kocharyan

Abstract: Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver conditions ranging from simple
steatosis to nonalcoholic steatohepatitis (NASH) and advanced hepatic fibrosis. Taking into account that NAFLD shares
many common risk factors with cardiovascular diseases, it is evident that NAFLD may promote to increased
cardiovascular morbidity and mortality.
Cumulative evidence suggests that NAFLD is linked to atherosclerosis, coronary artery disease, obesity, type 2 diabetes,
and also predicts the clustering of risk factors for cardiovascular diseases.
To our opinion, the role of NAFLD in the prediction of cardiovascular risks should be investigated for coronary artery
disease (CAD) prognosis assessment
This review focuses on the pathophysiologic relationships between NAFLD and cardiovascular diseases, subclinical and
clinical cardiovascular manifestations in NAFLD.

Focus on Pitavastatin Angelo Michele Carella Teresa Marinelli

Abstract: Currently, different statins are available for the treatment of dyslipidemia: Atorvastatin, Simvastatin,
Rosuvastatin, Lovastatin, Pravastatin, and Fluvastatin; the newest entry in this class of drugs is Pitavastatin.
The purpose of the present study was to examine the latest evidences on Pitavastatin, more than 10 years after its first
marketing and focuses on the most recent evidence regarding its differences with other available statins. A literature
review of the last 3 years (January 2013 - January 2016) has been carried out via Pub Med. 193 obtained items were
Pitavastatin has been studied against other drugs in its class and has demonstrated high potency in reducing LDLCholesterol
levels and increasing HDL-Cholesterol. Pitavastatin has demonstrated a significant reduction in
atherosclerotic plaque volumes and several pleiotropic effects, which suggest its potential benefits in reducing
cardiovascular risk.
At present, Pitavastatin don’t seem to have adverse effects on glucose metabolism; it has no adverse effects on renal
function and currently there is no clinical evidence of Pitavastatin-induced hepatotoxicity. Pitavastatin has favorable
pharmacokinetic and safety profiles and its characteristic structure provides significant efficacy at low doses.

Tissue Engineered Heart Valve for Aortic Valve Disease. Quo Vadis, Again? Wilhelm P. Mistiaen  

Abstract: Introduction: Heart valve tissue engineering has been presented as a “promising” solution” for over 20 years.
These living devices are supposed to have the capacity to grow, heal and repair or remodel. This would avoid structural
valve degeneration of currently used biological heart valve prostheses or the need for life-long anticoagulation or
mechanical devices. Especially for patients with stenotic aortic valve disease, which is the third most common
cardiovascular condition in Western societies, this solution might be useful.
Methods: A literature search has been performed for the years 2010-2014 with focus for results of tissue engineered
valves of in-vitro, in-vivo animal and patient studies
Results: Most experiments were still in-vitro. Especially those experiments which focus on synthetic biodegradable
scaffolds have not left the laboratory, because these cannot withstand systemic pressures. The animal studies involved
scaffolds of biologic origin with or without reseeding with cells. Cells were harvested from vascular, embryonal tissues or
from bone marrow. Large animal studies (ovine, porcine) dealt with implantations in pulmonary position and right
ventricular reconstruction, which might be useful in the treatment of congenital heart defects. Implantation in the
systemic – high pressure – circulation were only performed in small animals (rat model). One goat model showed some
remarkable results, but only on very short time.
Conclusions: Tissue engineered valves seemed very promising, a promise that will not be fulfilled soon. Synthetic
bioresorbable scaffolds have not left the laboratory yet. Scaffolds of biologic origin already have been tested in animals,
mostly in pulmonary origin. It is by no means certain that behavior of tissue engineered valves in animals reflect the
clinical situation, which is much more demanding. Also non-scientific hurdles such as official registration and
commercialization of such devices have to be taken.

Statin Therapy for Stroke Prevention: Current Status and Controversies Adrià Arboix Gabriel Rosselló-Vicens

Abstract: Statin therapy has become one of the most widely prescribed medications in the world because of its efficacy
in the primary and secondary prevention of cardiovascular mortality and stroke. Current cardiovascular guidelines
recommend statin use in all patients with stroke due to atherosclerosis (non-cardioembolic stroke). Statin therapy at
stroke onset is associated with good functional outcome and reduced risk of cardiovascular events after stroke via
different mechanisms. These include lipid-lowering effects, platelet aggregation, improved endothelial function, antiinflammation
activity, neuroprotective action, and stabilization of atherosclerotic plaques. Nevertheless, the effects of
statin therapy following major stroke are uncertain and data on the optimal dose and intensity are limited. Statins may
potentially increase the incidence of overall stroke and fatal stroke in patients with a history of renal transplantation, or
regular hemodialysis. There is a need for additional studies since statins benefits do not extend across all etiologic
subtypes of ischemic stroke: they are indicated for thrombotic strokes and some, but not all, lacunar, cardioembolic or
essential strokes, and they are not suitable for ischemic strokes of unusual etiology.

To a Problem of a Neuroleptic Cardiomyopathy: Brief Review of a Literature and of Own Researches V.P. Volkov  

Abstract: Introduction: Neuroleptic cardiomyopathy (NCMP) belongs to secondary specific metabolic dilated
cardiomyopathies. It is caused by side cardiotoxic effect of antipsychotic drugs. Many aspects of epidemiology,
pathogenesis, morphology, clinical picture and diagnostics of NCMP still remain insufficiently explored.
Results: NCMP passes through 3 stages in its development: 1) a latent one, 2) a full-scale one, and 3) a terminal one.
Each stage has clinical features, electrocardiograph signs and certain morphology.
Lethal termination in a latent and in a full-scale stage either takes place because of intercurrent diseases or it is a
sudden cardiac death of arrythmogenic genesis. In the terminal stage, the direct cause of death is, as a rule, a
progressive congestive chronic cardiac failure.
On the macroscopic level, NCMP is characterized by a moderate cardiomegaly; by a noticeable dilatation of heart
ventricles; by absence of evident coronary atherosclerosis.
On the microscopic level, all structural components of myocardium (microvasculature, intercellular matrix,
cardiomyocytes) are deeply damaged. These pathologic changes are a physical basis of a contractile myocardial
Conclusion: On the basis of the summarizing of the data, which were received in a series of studies, we singled out and
proved clinical and morphological criteria of diagnostics of NCMP.
Taking the described clinical and morphologic peculiarities of NCMP into account, it is advisable and quite logic to singleout
this pathology into an independent nosologic unit.

Intra-aortic Balloon Pump: Reviewing its Role in Cardiogenic Shock Bruno Robalinho Cavalcanti Barbosa Alfredo Augusto Eyer-Rodrigues

Abstract: Cardiogenic shock is a high-mortality condition caused, mostly, by ST-elevation myocardial infarction. When
the adequate therapy is implemented in a timely fashion, recovery can be achieved. Treatment is based on intensive
care measures, vasoactive drugs, early revascularization and the use of assist circulatory devices. In this review, the
authors aim to discuss the available evidence on the use of intra-aortic balloon pump (IABP) in this clinical setting.

First Diagnosed Heart Failure Due to Churg-Strauss Syndrome. A Case Report Konstantinos M. Lampropoulos

Abstract: Churg Strauss Syndrome (CSS) is an autoimmune condition that causes inflammation of small and mediumsized
blood vessels. It is a non-infectious systemic vasculitis, which affects mainly the lungs but also other tissues and
organs. CSS is considered a highly variable condition in terms of its presentation and its course. The most serious
complication of the vasculitic stage is congestive heart failure with reduced ejection fraction. We present a case with first
diagnosed heart failure because of CSS and review of the literature.

Anthropometric and Lipid Profile in Medical Students. Influence of a Physical Exercise Program Diana María García-Cardona Pedro Luis Campos Rodríguez

Abstract: Introduction: Most students in health programs do not practice physical exercise due to the high level of stress
involved in their curriculum, a condition that makes them a population at high cardiovascular risk.
Objective: Determine the influence of an exercise program on anthropometric and lipid profile of medical students.
Methods: Acommunity trial type quasi-experimental study, through a 12-week exercise intervention, was made. Athletes
and people doing regular exercise, or with altered lipid profile results were excluded. The anthropometric assessment
was performed as directed by the International Society for the Advancement of Kinanthropometry.
Results: We studied 50 subjects, distributed in 33 women, 17 men, and average age 20 ± 2.7 years. Weight, waist
circumference, bone percentage, residual percentage and BMI were not significantly different after exercise. While the
waist-hip ratio, muscle percentage, skin percentage and fat percentage were significantly different after exercise. Highdensity
lipoproteins decreased and other profile variables increased significantly.
Conclusion: This study showed that the exercise program positively influences physical structure, given that it increased
muscle percentage and decreased fat percentage, but not enough to positively change the lipid profile of the studied
population. Further it suggests the need for intervention programs on healthy habits (healthy foods, appropriate rest and
sleep intervals) for medical students.

Xenografts and Tissue Engineered Heart Valve in Pediatric Cardiac Surgery. Quo Vadis, Once More? Wilhelm P. Mistiaen  

Abstracts: Introduction: Many attempts have been undertaken for surgical correction of congenital heart defects.
Reconstruction of the right ventricular outflow tract (RVOT) is a main component of many procedures. Homograft
devices are considered as benchmark, but these are in short supply. Xenografts and tissue engineered heart valves
(TEHV) have been proposed as solution. This review aims to explore what progress has been made for these two
Methods: A systematic search for TEHV and the commonly used xenograft (Matrix P / P+, Shelhigh and Contegra)
devices through ISI web of Knowledge was performed. The SynerGraft homograft was also included.
Results: Contegra, Shelhigh and Matrix P / Matrix P+ have been used with varying success. The problems are foreign
body reaction, with inflammation, stenosis of the conduit or more distally in the pulmonary arteries and regurgitation. In
spite of efforts during more than 20 years, TEHV has not left the laboratory: there is still an ongoing search for the ideal
scaffold, adequate cell sources for cellular repopulation and culture media. There are no long-term animal models for the
latter device.
Conclusions: To treat patients with congenital heart disease, reconstruction can be performed with xenograft devices,
but their limitations have to be taken into account. Matrix P and P+ as well as Shelhigh suffer from inflammation with
stenosis. The alternative, TEHV, will not be available for the foreseeable future. In any case, any TEHV device has to
compete against more established values.

Serum Concentration and Polymorphisms of Apolipoproteins A-I and B, and Risk of Coronary Artery Disease Johanny Aguillón Nelsy Loango

Abstract: Introduction: Variations in the apoprotein apoA-I and apoB genes have been associated with their serum
concentration, and thus with Coronary Artery Disease (CAD). This study determined the relationship between
polymorphism and the serum concentration of apoA-I and apoB in a group of patients with angiographically documented
Materials and methods: Polymorphic sites, XbaI (in apoB), and MspI (in apo A-I) and serum concentrations in these
lipoproteins were determined in a population of 231patients classified into two groups: patients with significant CAD
(coronary obstruction 􀀁50%) and patients with mild CAD (coronary obstruction <50%); the apoB/apoA-I ratio was then calculated. Results: It was found that the M2 allele in the apoA-I acts as a risk factor for coronary artery disease, odds ratio=1.78(confidence interval: 1.21 – 2.61), p =0.002. Nosignificant differences were found between the apoA-I concentration values and the corresponding MspI polymorphism genotypes in the two study groups. Meanwhile, the apoB concentration presented significant differences among the XbaI (p=0.027) polymorphism genotypes, with greater values for the heterozygous genotype in patients with CAD􀀁50%. Likewise, a significantly abnormal difference was evident in the apoB/apoA-I ratio among the two groups, with a greater value for patients with mild CAD. Conclusion: the data showed that the M2allele may be a risk factor for CAD in this population. Additionally, it showed that there is a relationship between apoB serum concentration and XbaI polymorphism; relationship which manifests itself more strongly in patients with CAD. There was no relationship established between the MspI polymorphism of apoA-I and its serum concentration. Other studies are necessary in order to establish the anomalous behavior of the apoB/apoA-I relation in this population.

Effects of Physical Activity on The Inflammatory Process Related to Insulin Resistance and Obesity Aline Marcadenti Francisca Mosele

Abstract: Atherosclerosis, the pathophysiological substrate for cardiovascular disease (CVD), is the final stage of an
inflammatory cascade. During the process, endothelial dysfunction ensues and the inflammatory state is perpetuated. A
number of traditional risk factors, as obesity and insulin resistance/type 2 diabetes, are characterized by a
proinflammatory state as well, with increased levels of cytokines, interleukins, vasoactive peptides and enhanced
expression of specific cellular receptors. The anti-inflammatory properties of physical exercise and its positive effects as
a strategy for obesity and insulin resistance have already been shown in terms of cardiovascular protection and survival.

Cardiac Amyloidosis : Mini Review and a Case Report Athanasios I. Triantafyllou

Abstract: Amyloidosis is a rare heterogeneous group of systemic disorders, which result due to extra cellular deposition
of an insoluble, amorphous, eosinophilic, substance known as amyloid. The disease is often characterized by a
restrictive cardiomyopathy with a poor prognosis and survival. The treatment of cardiac amyloidosis depends on the
underlying etiology. However, the diagnosis of the type of cardiac amyloidosis is not always straightforward. We present
here a case of cardiac amyloidosis and we discuss the different forms.

Diet and Inflammation: Effects of Macronutrients and Dietary Patterns Aline Marcadenti Francisca Mosele

Abstract: Cardiovascular disease (CVD) has already been demonstrated to be related to a chronic and complex
inflammatory process, in which the loss of endothelial protective properties - the so-called endothelial dysfunction - plays
a central role. A number of different approaches, both pharmacological and non-pharmacological, have been tested with
inconclusive results so far. One field of special interest is the impact of the different macronutrients and dietary patterns
in the inflammatory response that, ultimately, leads to endothelial dysfunction and increased cardio-metabolic risk.
Although apparently simple, interventions regarding dietary habits have complex implications and involve a number of
covariates that may interfere in the final results. To date, results about the protective effects of diet - in general -
regarding cardio-metabolic risk remain to be fully proven.

Transient Global Amnesia and Takosubo Syndrome: A Case Report. C. Kavouras R. Tsatovidou

Abstract: Broken heart syndrome, also called apical ballooning syndrome or Takotsubo cardiomyopathy, is
characterized by an acute, transient systolic dysfunction of the apical and mid segments of the left ventricle. There have
been reports showing an association with neurologic disorders. In this article, we present the case of a female patient,
who suffered from an episode of transient global amnesia followed by takotsubo cardiomyopathy.

Complex Atheromatosis of the Aortic Arch: An Emerging Diagnosis in Cerebral Ischemia of Unknown Cause Adrià Arboix Mireia García-Batanero

Abstract: Complex atheromatosis of the aortic arch has been increasignly recognized as a cause of cerebral infarction
in patients with stroke of uncertain etiology. The incorporation of transesophageal echocardiographic studies in routine
clinical practice allows direct visualization of cardiac and vascular structures previously innaccessible, including
atherosclerotic plaques in the aortic arch. Large atheromatous plaques, which protrude strikingly into the aortic arch
lumen and have obvious mobile components are associated with a high probability of being the etiology of embolism.
Aortic arch atheromatosis should be considered a dynamic process entailing a non-negligible risk of recurrent
cardiovascular events. Therefore, adequate diagnosis and optimal treatment is mandatory for secondary prevention of
cerebral ischemic infarction and progression of aortic arch atheromas.

Predictive Value of Circulating SPARC-Related protein Osteonectin in Patients with Symptomatic Moderate-to-Severe Ischemic- Induced Chronic Heart Failure Alexander E. Berezin Alexander A. Kremzer

Abstract: Aim: To evaluate the prognostic value of circulating osteonectin for cumulative survival and hospitalization in
patients with ischemic chronic heart failure (CHF).
Methods: One hundred fifty four patients with ischemic symptomatic moderate-to-severe CHF were prospectively
enrolled at discharge from the hospital. Observation period was up to 3 years (156 weeks). Blood samples for
hematology, chemistry, and biomarker measurements were collected at baseline prior to study entry. ELISA method for
measurement of circulating osteonectin (OSN) was used.
Results: During a median follow-up of 2.18 years we identified 21 deaths and 106 readmissions. Medians of circulating
levels of OSN in survivors patient and subjects who died were 670.96 ng/mL (95% confidence interval [CI] = 636.53-
705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02-937.60 ng/mL). Receive Operation Characteristic curve analysis has
shown the best balanced cutoff point of OSN concentration for cumulative survival equal 845.15 ng/mL. A significantly
divergence of Kaplan-Meier survival curves constructed for patients with high (> 845.15 ng/mL) and low (<845.15 ng/mL) concentrations of OSN was found. Circulating OSN independently predicted all-cause mortality (OR = 1.23; 95% CI = 1.10–1.36; P < 0.001), CHF-related death (OR = 1.46; 95% CI 1.22–1.80; P < 0.001), and also CHF-related readmission (OR = 1.92; 95% CI = 1.77 – 2.45; P<0.001) within 3 year of follow-up period. Conclusion: Increased circulating SPARC family member OSN associates with increased 3-year CHF-related death, allcause mortality, and risk for readmission due to CHF

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