Congestive nephropathy: a neglected entity? Proposal for diagnostic criteria and future perspectives
Platelets Get Trapped In Lungs In PH Patients With Heart Failure: Study
Platelets, or cell fragments in blood that help stop or prevent bleeding, tend to cluster in lung blood vessels of people with decompensated pulmonary hypertension (PH), a lung disease characterized by sudden worsening of clinical signs of right heart failure, followed by other severe complications, a study has found.
This clustering, or aggregation, is associated with low platelet counts in these patients, increasing their risk of bleeding.
Normally, most platelets travel unimpeded through the tiny blood vessels of the lungs. However, "the vascular, endothelial and immune abnormalities associated with PH may contribute to platelets trapping within lung capillaries [tiny blood vessels]," scientists wrote. The endothelium is a cell layer lining the inner side of blood vessels.
The study, "Platelet aggregates in lung capillaries in severely decompensated pulmonary hypertension" was published in Thorax.
In PH, or high blood pressure in the pulmonary arteries that supply the lungs, acute decompensation is characterized by rapid worsening symptoms of right heart failure, which can lead to other life-threatening complications such as failure of multiple organs.
20% of PH patients develop thrombocytopenia, or low platelet levelsAbout 20% of PH patients develop thrombocytopenia, or low platelet levels in the blood. Platelets are produced from precursor cells called megakaryocytes. Acute PH decompensation alters blood flow and the endothelium, while also promoting inflammation. All these changes may promote inflammation.
The study aimed to determine whether platelet aggregation in the lungs could explain the low platelet count in patients with decompensated PH. The data were retrospectively collected from patients who underwent high-priority lung transplants between July 2012 and July 2022.
All patients studied had decompensated PH, treated with catecholamines (a type of chemical made by nerve cells and used in cell communication) when they were admitted to the intensive care unit before their lung transplant. Most had pulmonary arterial hypertension.
The researchers narrowed their study to 16 patients, dividing them into two groups of eight: one with low platelet counts and the other with normal platelet counts. Also included were seven participants who had other chronic lung diseases and had undergone a lung transplant.
Results showed PH patients with low platelet counts had significantly more platelet aggregates in their lung tissue samples compared to the control group. The number of megakaryocytes was also higher in the patients with thrombocytopenia, though the difference was not statistically significant.
In addition, the study found significant correlations between platelet counts, megakaryocytes, and platelet aggregates. "The number of lung platelet aggregates and megakaryocytes correlated with the severity of thrombocytopenia," the team wrote.
Platelet counts returned to normal after lung transplantOnce the patients underwent their lung transplant, their platelet blood counts returned to normal.
According to the scientists, one explanation for these findings is that in PH, as lung blood pressure is higher and blood flow is altered, the formation of platelet aggregates may be promoted, further obstructing blood flow. This potentially creates "a vicious circle of PH-related flow disturbances, platelet aggregation, lumen [blood vessel] obstruction and further flow disturbances," the researchers wrote.
Another possible mechanism involves megakaryocytes, which were higher in patients and may trigger a compensatory response by lowering platelet counts, the scientists suggested.
The inclusion of different PH types is a noteworthy study limitation. "Including only pulmonary arterial hypertension would have been more compelling, but such patients are rare," the researchers wrote. Additionally, the technique used to quantify platelet aggregates provides only an estimate.
"Our study suggests that platelets may aggregate within the lungs during acute PH decompensation," the investigators concluded, which could affect treatment decisions about platelet transfusion. They suggested platelet transfusion should be used cautiously, only in cases of active bleeding or early in lung transplant procedures, as it may be harmful in other circumstances.
Can High Triglycerides Cause Fatigue?
Triglycerides are an important source of energy, but high triglyceride levels increase the risk of cardiovascular diseases, some of which can cause fatigue.
Triglycerides are a type of fat, or "lipid," that circulate in the blood. They derive from fats in the foods a person eats and from excess calories that the body stores in fat cells.
High triglycerides do not directly cause fatigue, but a diet high in triglycerides raises a person's risk of serious cardiovascular conditions.
Nutrition resourcesFor more science-backed resources on nutrition, visit our dedicated hub.
However, uncontrolled high blood triglyceride levels can increase a person's risk of coronary heart disease (CHD), a condition in which the blood vessels supplying the heart become narrowed and blocked.
Cardiovascular health resourcesVisit our dedicated hub for more research-backed information and in-depth resources on cardiovascular health.
Heart failure and fatigue
As the American Heart Association (AHA) explains, heart failure is a condition in which the heart cannot pump enough blood to meet the body's blood and oxygen requirements.
To compensate, the body diverts blood away from less vital tissues, such as the muscles in the limbs, and sends it to vital organs, including the heart and brain.
This may cause symptoms of tiredness and fatigue, especially after eating and during physical exertion.
Stroke and fatigue
According to a 2019 review, up to 40% of people who have had a stroke report fatigue as either their worst or one of their worst symptoms.
The American Stroke Association (ASA), notes that most people with post-stroke fatigue report that the symptom occurs without warning and interferes with their ability to carry out daily activities.
Factors that may cause or contribute to post-stroke fatigue include:
As the NHLBI explains, triglyceride levels in adults will fall into one of the following categories:
A doctor will diagnose high blood triglycerides if a person's fasting blood triglyceride levels regularly reach or exceed 150 milligrams mg/dL.
As the NHLBI explains, a diet high in triglycerides can increase a person's risk of a range of health issues, including:
According to the NHLBI, extremely high blood triglyceride levels exceeding 1,500 mg/dL can lead to a condition called multifactorial chylomicronemia syndrome (MCS).
This is where the body stops breaking down fats. MCS can lead to potentially life threatening acute pancreatitis and swelling of the liver and spleen.
As the NHLBI explains, triglycerides come from fats in foods, such as oils, and dairy products like butter and cheese.
Importantly, triglycerides also come from extra calories that the body does not need to use straight away. The body stores these unused calories as triglycerides in fat cells.
Below are some answers to frequently asked questions about high triglyceride levels.
What organ is affected by high triglycerides?
High blood triglycerides can affect various organs in the body, most notably the heart and brain.
This is because high blood triglycerides can cause coronary artery disease, which can in turn lead to heart disease and stroke.
Can high triglycerides cause brain fog?
As a 2023 review explains, "brain fog" is a term that people generally use to describe one or more of the following:
A 2021 review found an association between high triglyceride levels and cognitive impairment.
One possible reason for this is that high blood triglycerides can cause metabolic issues, which then increase a person's risk of vascular dementia.
This type of dementia occurs as a result of impaired blood flow to the brain.
Can you recover from high triglycerides?
A person with high blood triglycerides can lower their triglyceride levels so that they fall within a healthy range.
As the NLA explains, the best way to do this is to limit intake of fatty foods and foods that can increase triglyceride levels, such as:
Triglycerides are fats in the blood that provide energy, but high levels can increase the risk of cardiovascular diseases, which may cause fatigue.
Extremely high levels can lead to serious conditions like multifactorial chylomicronemia syndrome (MCS). Reducing fatty, sugary, and starchy foods, along with getting regular exercise, can help lower triglyceride levels.
'Holiday Heart Syndrome': Tips To Avoid A Dangerous Condition
Binge drinking during the holidays could lead to an irregular heartbeat.
SAN ANTONIO — The holidays are fast approaching and for most of us that means family, friends, food and drinking. Doctors are warning about a heart problem connected to drinking too much.
We're talking about holiday heart syndrome, which is the increase in cases of atrial fibrillation or an irregular heartbeat. The condition often revolves around binge drinking during the holidays.
"The dangerous part about it is it increases your risks of stroke and increases your risk of developing a blood clot within the heart that can spread through your body," said Dr. David Lim, the Medical Director of Baptist Health System's Emergency Departments.
Holiday heart syndrome results from a combination excessive alcohol, high stress and dehydration. The combination of those three could cause an irregular heartbeat, also known as an arrhythmia. The main cause is the alcohol which does not allow the heart to contract properly, disrupting the heart's ability to distribute blood throughout the body.
"The heart loses some of the augmented flow. It's a little bit like having a four cylinder engine lose the turbo. So you don't get such good function," said Dr. Allen Anderson, a professor and chief of the Division of Cardiology at UT Health San Antonio, and director of the UT/University Health Heart & Vascular Institute.
The most common holiday heart syndrome symptoms are those over 65 years of age, certain health conditions like diabetes, obesity and heart failure, drinking a lot of alcohol, family history of AFib or heart disease, recent surgery on the esophagus, heart or lungs and a substance use disorder.
"There is definitely an association between diabetes and increased cardiovascular risks. And diabetes causes certain changes in the heart that this condition won't necessarily help," Dr. Anderson added.
Dr Lim told us, "Drinking in moderation. Be careful how much you drink during the holidays. I know we all want to have fun, but it's important that you kind of pace how much you're drinking and not not drink too much over the holidays. "
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