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Endothelial Dysfunction and Irritable Bowel Disorder

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Int J Cardiol. 2016 Aug 8;223:176-181

Is activation in inflammatory bowel diseases associated with further impairment of coronary microcirculation?

Caliskan Z1Keles N2Gokturk HS1Ozdil K3Aksu F4Ozturk O3Kahraman R3Kostek O5Tekin AS4Ozgur GT1Caliskan M4.

  • 1Baskent University Department of Gastroenterology, Konya, Turkey.
  • 2Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey. Electronic address:
  • 3Umraniye Training and Research Hospital Department of Gastroenterology, Istanbul,Turkey.
  • 4Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
  • 5Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.


BACKGROUND: Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary Flow Reserve [CFR] reflects coronary microvascular circulation. Coronary microvasculardysfunction may be defined as a predictor of CV outcome combined with previous described atherosclerotic risk factors. The present study was purposed to further evaluate whether or not CFR in the left anterior descending artery [LAD] is disturbed in IBD patients with activation in comparison to remission and healthy subjects.

METHODS: 62 patients with IBD and 39 healthy volunteers were enrolled into the study. Patients’ demographics were recorded. CFR evaluation of patients with IBD in both activation and remission period and control group were performed with transthoracic echocardiography. RESULTS:CFR was significantly lowest in the active period of the IBD [2.26 [2.08-2.55] vs. 2.55 [2.18-3.00] and 3.10 [2.85-3.29] p 0.001]. CFR is negatively correlated with disease activity scores of IBD.


This study showed that CFR is more prominently disturbed in patients with IBD in activation. The activation of disease may have a major role in the progression of coronary microcirculatory dysfunctionand future cardiovascular events.
Eye (Lond). 2016 Aug 19

Microvascular endothelial function and severity of primary open angle glaucoma.

Bukhari SM1Kiu KY1Thambiraja R1Sulong S2Rasool AH3Liza-Sharmini AT1.

  • 1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
  • 2Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
  • 3Pharmacology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.


PurposeThe role of microvascular endothelial dysfunction on severity of primary open angle glaucoma (POAG) was investigated in this study.Patients and methodsA prospective cohort study was conducted. One hundred and fourteen ethnically Malay patients (114 eyes) with POAG treated at the eye clinic of Hospital University Sains Malaysia between April 2012 and December 2014 were recruited. Patients aged between 40 and 80 years with two consecutive reliable and reproducible Humphrey visual field 24-2 analyses were selected. Patients who were diagnosed with any other type of glaucoma, previous glaucoma-filtering surgery, or other surgeries except uncomplicated cataract and pterygium surgery were excluded. Humphrey visual field analysis 24-2 was used to stratify the severity of glaucoma using Advanced Glaucoma Intervention Study (AGIS) score at the time of recruitment. Microvascular endothelial function was assessed using Laser Doppler fluximetry and iontophoresis. Iontophoresis process with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and -independent vasodilatation, respectively.ResultsBased on the AGIS score, 55 patients showed mild glaucoma, with 29 moderate and 30 severe. There was statistically significant difference in microvascular endothelial function (ACh% and AChmax) between mild and moderate POAG cases (P=0.023) and between mild and severe POAG cases (P<0.001). there=”” was=”” negative=”” correlation=”” between=”” microvascular=””>endothelial function and severity of POAG (r=-0.457, P<>


Microvascular endothelial dysfunction may have a role in influencing the severity of POAG in Malay patients.Eye advance online publication, 19 August 2016; doi:10.1038/eye.2016.185.



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