SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted The Relationship between Depression, Stress-Related Neurobiology, and Incident Heart Failure: Understanding the Neurobiological Mechanisms Underlying Exercise as a Preventive Measure(Saudi Digital Library, 2023-04) Alhamam, Abdulaziz Arif Abdulaziz; Tawakol, AhmedBackground: Depression is associated with risk of developing heart failure (HF). Also, higher stress-related neural activity (SNA) associates with subsequent risk of cardiovascular disease. We investigated whether depression predicts subsequent HF through heightened SNA. Methods: Individuals (N=102,028; median age 57 years; 42.6% male) enrolled in the Mass General Brigham Biobank were identified to study the association of depression and incident HF, subset of 1,227 who underwent clinically indicated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging were retrospectively identified. SNA was measured using validated methods, as amygdalar metabolic activity corrected for regulatory brain (i.e., medial prefrontal cortical) activity. Depression and subsequent development of HF was determined via medical record review using International Classification of Diseases 10 (ICD-10) codes. Survival analyses using Cox and Kaplan-Meier models were performed. Results: Over a median follow-up period of 3.5 (IQR 2.0-5.0) years, 2,631 (2.6%) individuals developed HF (717 Heart failure with reduced ejection fraction (HFrEF), 1,214 Heart failure with preserved ejection fraction (HFpEF)). Individuals with subsequent HF (versus no HF) had higher baseline SNA (mean Z-score 0.19 ± 1.07 versus -0.08 ± 0.99; p=0.005, adjusted for age and sex). SNA associated with subsequent HF when divided into tertiles (Figure 2B) and as a continuous measure (standardized HR [95% CI]: 1.40 [1.13-1.74], p=0.002, adjusted for age, sex, hypertension, hyperlipidemia, diabetes, and smoking). The association between depression and HF subtype was stronger for HFpEF (1.46 [1.28-1.65], p<0.001) than for HFrEF (1.09 [0.92 -1.3], p=0.32). Conclusion: In this retrospective study of individuals with depression have higher risk of incident HF through heightened SNA with a somewhat stronger association for HFpEF. Understanding the link between depression and subsequent HF may provide important insights into better HF prevention and management strategies.16 0Item Restricted THE EFFECT OF SODIUM BICARBONATE ON ACUTE KIDNEY INJURY MARKERS DURING PHYSICAL WORK IN THE HEAT(Saudi Digital Library, 2023-07-28) Masoud, Abdulaziz; Amorim, FabianoSodium bicarbonate supplementation (NaHCO3) before physical work in the heat may reduce the risk of developing acute kidney injury (AKI). Purpose: To determine the effects of NaHCO3 supplementation before a prolonged bout of physical work in the heat on AKI markers and kidney function. Method: A randomized, cross-over, double blinded design was conducted on 8 participants (3 females) who consumed NaHCO3 (0.2 g/kg body weight) or placebo (CON) before prolonged (120 minutes) moderate intensity (~65% of maximal heart rate) physical work in the heat (40℃ and 23% relative humidity (RH)). Blood and urine samples were collected pre, post, and 1hr post exercise. Core temperature (Tc) and heart rate (HR) were measured every three minutes, and perceptual variables [i.e., rating of perceived exertion (RPE), thermal sensation (TS), and comfort scale (CS)] were measured every 6 minutes. Gastrointestinal discomfort (GI) was evaluated pre- and post NaHCO3 or placebo (CON) ingestion, within 1hr of the physical work, post physical work, and 1hr post physical work. Urine flow rate (UFR) was calculated pre and 1hr post physical work. Urine osmolality (Uosm) and creatinine (uCr) and plasma osmolality (Posm) were assessed pre, post, and 1hr post physical work. Insulin-like growth factor binding protein 7 (IGFBP7), tissue inhibitor of metalloproteinase 2 (TIMP-2), and neutrophil gelatinase-associated lipocalin (NGAL) were measured in the urine pre and 1hr post physical work. Results: Physiological, perceptual, and GI parameters increased over time (p < 0.05), but they were not different between conditions (p > 0.05). Uosm was higher in CON compared to NaHCO3 (p = 0.011) post exercise. UFR was lower in CON compared to NaHCO3 at 1 hour post exercise (p = 0.042). Urine TIMP-2 corrected for UFR was higher in CON compared to NaHCO3 (p =0.040). IGFBP-7 × TIMP-2 corrected for UFR trended to be lower in NaHCO3 (p = 0.062). Conclusion: NaHCO3 72 ingestion pre-physical work in the heat reduced markers of AKI and increased UFR suggesting less stress to the kidneys.24 0