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PubMed2006

Daily polyphenol intake in France from fruit and vegetables.

The objective of this study was to create a French database on the polyphenol content of fruit and vegetables as uncooked fruits and vegetables and then to evaluate polyphenol intake through fruit and vegetable consumption in France. To achieve this, we used the Folin-Ciocalteu method adapted to fruit and vegetable polyphenol quantitation (1). Vegetables with the highest polyphenol concentration were artichokes, parsley, and brussels sprouts [>250 mg of gallic acid equivalent (GAE)/100 g fresh edible portion (FEP)]; fruits with the highest concentrations were strawberries, lychees, and grapes (>180 mg of GAE/100 g FEP). Conversely, melons (Cantaloupe cv.) and avocados had the lowest polyphenol concentration for fruits and vegetables, respectively. Based on fruit consumption data, apples and strawberries are the main sources of polyphenols in the French diet, whereas potatoes, lettuces, and onions are the most important vegetable sources. Total polyphenol intake from fruit is about 3 times higher than from vegetables, due to the lower polyphenol concentration in vegetables. The calculation of polyphenol intake, based on both assessment methods used [(Société d'Etudes de la Communication, Distribution et Publicité (SECODIP) and Supplémentation en Vitamines et Minéraux Antioxydants (SUVIMAX)], showed that apples and potatoes provide approximatively half of the total polyphenol intake from fruit and vegetables in the French diet.

Allium↗

PubMed1986

Carotenoid intake, vegetables, and the risk of lung cancer among white men in New Jersey.

A population-based incident case-control study of lung cancer in white males was conducted during 1980-1981 in six high-risk areas in New Jersey. Interviews were completed for 763 cases and 900 controls. To assess whether dietary intake of carotenoids, preformed retinol, or total vitamin A influences the risk of lung cancer, the authors asked the respondents about the usual frequency of consumption, approximately four years earlier, of 44 food items which provide 83% of the vitamin A in the US diet and about the use of vitamin supplements. The men in the lowest quartile of carotenoid intake had a relative risk of 1.3 compared with those in the highest quartile after adjusting for smoking. No increase in risk was associated with low consumption of retinol or total vitamin A. Intake of vegetables, dark green vegetables, and dark yellow-orange vegetables showed stronger associations than did the carotenoid index; the smoking-adjusted risks of those in the lowest quartiles of consumption of these food groups reached relative risks of 1.4-1.5 compared with the risks of those in the highest quartiles. The protective effect of vegetables was limited to current and recent cigarette smokers; the smoking-adjusted relative risks for low consumers reached 1.7, 1.8, and 2.2 compared with the risks for high consumers for vegetables, dark green vegetables, and dark yellow-orange vegetables, respectively. The reduction in risk with vegetable intake was most apparent for squamous cell carcinomas, but it extended to adenocarcinomas and most other cell types when only current and recent smokers were analyzed. This protection among current and recent smokers is consistent with the model that vegetable intake prevents a late-stage event of carcinogenesis. Consumption of dark yellow-orange vegetables was consistently more predictive of reduced risk than consumption of any other food group or the total carotenoid index, possibly because of the high content of beta-carotene relative to other carotenoids in this particular food group.

Adult↗

PubMed1997

Reliability and comparability of three dietary assessment methods for estimating fruit and vegetable intakes.

Although fruits and vegetables have been evaluated in numerous epidemiologic studies, few validation studies have examined fruits and vegetables. We examined the reproducibility and comparability of fruit and vegetable intakes estimated by diet records, food frequency questionnaires, and modules (brief food frequency questionnaires) in 101 control participants of a 1-year diet intervention trial. For each method, mean intakes at baseline and 3 months were generally within 0.3 serving per day for juice, fruits, vegetables, and total fruits and vegetables. In addition, Pearson correlations for the two time periods generally exceeded 0.55 for these four groups for each method. We evaluated comparability of intakes for 15 days of diet records, 1-year food frequency questionnaires, and modules, respectively. Mean total fruit and vegetable intakes were 6.3, 6.5, and 3.8 servings per day for diet records, food frequency questionnaires, and modules. For each pair-wise combination of methods, Pearson correlations exceeded 0.45 for juice, fruits, and total fruits and vegetables; correlations were lower for vegetables. Exact agreement in quintile assignment was less than 45%, however. These results indicate that estimates of fruit and vegetable intakes and disease associations may differ depending on the method used to assess fruit and vegetable intake.

Adenoma↗

PubMed2006

Vegetable and fruit intake and mortality from chronic disease in New Zealand.

OBJECTIVE: To estimate mortality attributable to inadequate vegetable and fruit intake in New Zealand in 1997, and the burden of disease that could be avoided in 2011 if modest increases in vegetable and fruit intake were to occur. METHODS: Comparative risk assessment methodology was used to estimate both attributable and avoidable mortality due to inadequate vegetable and fruit consumption (< 600 g/day). Vegetables and fruit were defined as all fresh, frozen, canned, dried or juiced vegetables and fruit, except potatoes, nuts, seeds and pulses. Disease outcomes assessed were mortality from ischaemic heart disease, ischaemic stroke, and lung, oesophageal, stomach and colorectal cancers. RESULTS: In 1997, mean vegetable and fruit intake was 420 g/day in males and 404 g/day in females. Inadequate vegetable and fruit intake is estimated to have contributed to 1,559 deaths (6% of all deaths) in that year, including 1,171 from ischaemic heart disease, 179 from ischaemic stroke and 209 from cancer. Modest increases in vegetable and fruit intake (40 g/day above the historic trend) could prevent 334 deaths each year from 2011, mostly from ischaemic heart disease. CONCLUSIONS: Inadequate vegetable and fruit intake is an important cause of mortality in New Zealand. Small increases in vegetable and fruit intake could have a major impact on population health within a decade.

Adult↗

PubMed2005

Association of vegetable intake with urinary 6-sulfatoxymelatonin level.

Melatonin is present in plants consumed as vegetables; however, only a limited number of vegetables have been tested for melatonin. The antiproliferative, antioxidative, and immunostimulatory effects of melatonin have been reported from laboratory studies. The potential protective effects of vegetable against cancer and cardiovascular disease may be partially attributable to an increased melatonin intake from vegetables. As a first step to test this hypothesis, we evaluated whether vegetable intake is associated with an increased urinary melatonin in 289 community-dwelling Japanese women. Diet, including vegetable consumption, was assessed with a validated 169-item semiquantitative food-frequency questionnaire. Urinary 6-sulfatoxymelatonin (aMT6-s) was measured in the first-void morning urines. There was a significant positive association between vegetable intake and urinary aMT6-s levels. The mean urinary aMT6-s was 16% higher in women with the highest quartile of vegetable intake than it was in those with the lowest quartile of intake. This association may be explained by the melatonin contained in vegetables. However, data should be regarded as preliminary because it is impossible to estimate dietary melatonin intake from vegetables and or from the entire diet because of incomplete data for melatonin in plants.

Adult↗

PubMed2005

Fruit and vegetable consumption and risk of epithelial ovarian cancer: the European Prospective Investigation into Cancer and Nutrition.

OBJECTIVE: The association between consumption of fruit and vegetables and risk of ovarian cancer is still unclear from a prospective point of view. METHODS: Female participants (n = 325,640) of the European Prospective Investigation into Cancer and Nutrition study, free of any cancer at baseline, were followed on average for 6.3 years to develop ovarian cancer. During 2,049,346 person-years, 581 verified cases of primary, invasive epithelial ovarian cancer were accrued. Consumption of fruits and vegetables as well as subgroups of vegetables, estimated from validated dietary questionnaires and calibrated thereafter, was related to ovarian cancer incidence in multivariable hazard regression models. Histologic subtype specific analyses were done. RESULTS: Total intake of fruit and vegetables, separately or combined, as well as subgroups of vegetables (fruiting, root, leafy vegetables, cabbages) was unrelated to risk of ovarian cancer. A high intake of garlic/onion vegetables was associated with a borderline significant reduced risk of this cancer. The examination by histologic subtype indicated some differential effects of fruit and vegetable intake on ovarian cancer risk. CONCLUSION: Overall, a high intake of fruits and vegetables did not seem to protect from ovarian cancer. Garlic/onion vegetables may exert a beneficial effect. The study of the histologic subtype of the tumor warrants further investigation.

Adult↗

PubMed2006

Fruit and vegetable consumption and incidence of gastric cancer: a prospective study.

BACKGROUND: Whether fruit and vegetable consumption may confer protection from gastric cancer remains controversial. METHODS: We prospectively investigated the association between consumption of fruits and vegetables and the incidence of gastric cancer among participants from two population-based cohort studies: 36,664 women in the Swedish Mammography Cohort and 45,338 men in the Cohort of Swedish Men. Participants completed a food-frequency questionnaire in 1997 and were followed up for cancer incidence through June 2005. Cox proportional hazards models were used to estimate multivariate hazard ratios (HR) and 95% confidence intervals (95% CI). RESULTS: During a mean follow-up of 7.2 years, we ascertained 139 incident cases of gastric cancer. Vegetable consumption was inversely associated with risk of gastric cancer, whereas no significant association was observed for fruit consumption. After controlling for age and other risk factors, women and men who consumed > or =2.5 servings/d of vegetables had a HR of 0.56 (95% CI, 0.34-0.93) for developing gastric cancer compared with those who consumed <1 serving/d. The respective HR for fruit consumption was 0.86 (95% CI, 0.52-1.43). Among specific subgroups of vegetables, consumption of green leafy vegetables and root vegetables was inversely associated with risk of gastric cancer; the multivariate HRs comparing > or =3 servings/wk with <0.5 serving/wk were 0.64 (95% CI, 0.42-0.99) for green leafy vegetables and 0.43 (95% CI, 0.27-0.69) for root vegetables. CONCLUSIONS: Frequent consumption of vegetables may reduce the risk of gastric cancer.

Aged↗

PubMed2006

Fruit and vegetables in cancer prevention.

Our aim was to review the epidemiological literature on possible cancer-preventive effects of the consumption of fruits and vegetables in humans, to quantify the effect of high versus low consumption of fruits and vegetables, and to give an overall assessment of the existing evidence. We based our work on an expert meeting conducted by the International Agency for Research on Cancer in 2003. A qualitative reading and evaluation of relevant articles on the cancer-preventive effect of the consumption of fruits and vegetables was made followed by the calculation of the mean relative risk and range for cohort and case-control studies separately. The possible population-preventable fraction for modifying diet in relation to fruit and vegetable consumption was calculated as well as an overall statement about the degree of evidence for the cancer-preventive effect of fruit and vegetable consumption for each cancer site. There is limited evidence for a cancer-preventive effect of the consumption of fruits and vegetables for cancer of the mouth and pharynx, esophagus, stomach, colon-rectum, larynx, lung, ovary (vegetables only), bladder (fruit only), and kidney. There is inadequate evidence for a cancer-preventive effect of the consumption of fruits and vegetables for all other sites. Applying this range of risk difference to the range of prevalence of low intake, the preventable fraction for low fruit and vegetable intake would fall into the range of 5-12%. It is important to recognize that this is only a crude range of estimates and that the proportion of cancers that might be preventable by increasing fruit and vegetable intake may vary beyond this range for specific cancer sites and across different regions of the world.

Case-Control Studies↗

PubMed2006

The impact of cost on the availability of fruits and vegetables in the homes of schoolchildren in Birmingham, Alabama.

OBJECTIVES: Fruit and vegetable cost is a presumed barrier to intake. We sought to determine whether fruit and vegetable cost and consumers' race and income would predict availability of fruits and vegetables in homes of schoolchildren in the Birmingham, Ala, area. METHODS: Data on availability of 27 fruit and vegetable items were obtained from homes of 1355 children (32% African American) in the Birmingham area. Fruit and vegetable costs were obtained from the US Department of Agriculture. We used discrete choice analysis with the dependent variable represented as presence or absence of the fruit or vegetable item. Explanatory variables included fruit and vegetable price per serving; child's gender, race, and age; and parent's body mass index and income. RESULTS: Higher cost was inversely related to fruit and vegetable availability. Higher income, African American race, and female gender were positively related to availability. Cost per serving was stratified into 3 categories-low, medium, and high. Relative to low-cost items, only high-cost items decreased the odds of availability significantly. CONCLUSIONS: Fruit and vegetable cost does impact availability and has the greatest impact for high-cost items. Although cost was inversely related to availability, African Americans reported higher fruit and vegetable availability than Whites. Additional studies are needed to determine whether food items of lower nutritive value and comparable cost impact availability.

Black or African American↗

PubMed2004

The polyphenol content and antioxidant activities of the main edible vegetables in northern Vietnam.

Oxidized low-density lipoprotein (LDL) is considered a risk factor in atherosclerosis, and polyphenols are the potential agents to inhibit the oxidation of LDL. We determined the polyphenol contents and the antioxidant activities of commonly consumed vegetables in Vietnam and assessed the quantity of the polyphenol intake from vegetables in the current Vietnamese diet. The polyphenol contents in 30 kinds of vegetables was determined by the Folin-Ciocalteu method. The antioxidant activities of vegetables were evaluated by measuring the oxidation of LDL and the reduction of the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical. In this study, some herbs and edible wild vegetables possessed high contents of polyphenols and antioxidant activities. Among green vegetables, sweet potato leaves showed both a high polyphenol content and antioxidant activity. The mean polyphenol daily intake of the Vietnamese was a 595 mg catechin equivalent. Water spinach, a kind of green vegetable, contributed the highest amount (45%) of the total polyphenol intake, followed by other green vegetables. Neither herbs nor edible wild vegetables contributed significantly to the total polyphenol intake due to their low consumption. Green vegetables are therefore considered very important sources of polyphenol intake for the Vietnamese.

Antioxidants↗

PubMedDate not supplied

Spousal similarities in fruit and vegetable consumption.

PURPOSE: To explore similar patterns of fruit and vegetable consumption between health center employees and their spouses. DESIGN: Cross-sectional mailed survey assessing frequency of fruit and vegetable consumption, as well as demographics and knowledge, attitudes, access, and social support related to fruit and vegetable consumption. SETTING: Six Massachusetts health centers. SUBJECTS: Two hundred eleven health center employee/spouse pairs (422 individuals). MEASURES: The kappa statistic measured agreement in fruit and vegetable consumption between employees and spouses. The Spearman rho coefficient measured correlations for individual responses. Multiple Linear Regression Models examined variables that explained fruit and vegetable consumption level differences. RESULTS: Response rate was 59%. Mean fruit and vegetable daily intake was 4.68 and 4.30 servings for employees and spouses, respectively. Over 75% of employee and spouse estimates measuring fruit and vegetable consumption-related information, on average, were within one survey response category of each other. Knowledge, attitudes, and access indices were significantly correlated with fruit and vegetable consumption for both employees and spouses. The social support index was significantly correlated with fruit and vegetable consumption only for the spouses. Differences in knowledge, attitudes, and access indices between employees and spouses helped to explain different fruit and vegetable consumption levels. Nonresponse, selection, recall, and seasonal reporting biases may limit the findings' generalizability. CONCLUSIONS: The effectiveness of worksite nutrition interventions may be improved by involving family/household members.

Adult↗

PubMed2003

[Studies on use and residue levels of pesticides in fruit and vegetable in Tianjin Area and its control measures].

OBJECTIVE: To investigate pesticide abuse on fruits and vegetables in Tianjin Area, to detect pesticide residues in fruits and vegetables, to study the methods for reducing pesticide residues in fruits and vegetables. METHODS: (1) A questionnaire on the pesticide application during growing fruit and vegetable was administered to 185 farmers in Tianjin Area. (2) According to the information from the questionnaire survey, fruit and vegetable samples were collected in four seasons around the year and measured for organophosphorus pesticide residues by gas chromatography. (3) Fruit and vegetable samples contained pesticide residue were treated by scald, immersion in 0.15% and 0.30% detergent solution, immersion in pure water, peeling and cutting root and pesticide residues were measured before and after the treatment. RESULTS: The percentage of pesticide abuse in growing fruit and vegetable was 65.00% in Tianjin area, and 31.60% of the fruits and vegetable samples collected in summer were positive for high toxic organophosphorus pesticides. Significant decrease of pesticide residue in fruit and vegetable was found by scald, immersion in 0.15% and 0.30% detergent solution, as well as peeling and cutting root, and over 80.00% pesticide residue in the samples could be reduced by scald. CONCLUSIONS: It is necessary to strengthen pesticide abuse control and market surveillance and inspection, in order to reduce the harmful effects of pesticide residue in fruit and vegetables to human health.

Chromatography, Gas↗

PubMed2004

Effects of cruciferous vegetable consumption on urinary metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in singapore chinese.

Vegetable consumption, including cruciferous vegetables, is protective against lung cancer, but the mechanisms are poorly understood. The purpose of this study was to investigate the effects of cruciferous vegetable consumption on the metabolism of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers. The study was carried out in Singapore Chinese, whose mean daily intake of cruciferous vegetables is three times greater than that of people in the United States. Eighty-four smokers provided urine samples and were interviewed about dietary habits using a structured questionnaire, which included questions on consumption of nine commonly consumed cruciferous vegetables. Samples of these vegetables obtained in Singapore markets at three different times of year were analyzed for glucosinolates. Urine was analyzed for metabolites of NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAL-Glucs). Glucobrassicins, which release indole-3-carbinols on chewing, were the major glucosinolates in seven of the nine cruciferous vegetables, accounting for 70.0% to 93.2% of all glucosinolates in these vegetables. There was a significant correlation (P = 0.01) between increased consumption of glucobrassicins and decreased levels of NNAL in urine after adjustment for number of cigarettes smoked per day; similar trends were observed for NNAL-Glucs (P = 0.08) and NNAL plus NNAL-Glucs (P = 0.03). These results are consistent with those of previous studies, which demonstrate that indole-3-carbinol decreases levels of urinary NNAL probably by inducing hepatic metabolism of NNK. The results are discussed with respect to the known chemopreventive activity of indole-3-carbinol against lung tumorigenesis by NNK in mice and the effects of isothiocyanates, which are also formed on consumption of cruciferous vegetables, on NNK metabolism. The results of this study demonstrate the complexities in assessing effects of cruciferous vegetables on carcinogen metabolism.

Aged↗

PubMed2003

Increasing fruit and vegetable intake in homebound elders: the Seattle Senior Farmers' Market Nutrition Pilot Program.

INTRODUCTION: Diets that are high in fruits and vegetables lower an individual's risk of chronic disease and contribute to healthy aging. Homebound seniors often have low intake of fruits and vegetables and limited access to fruits and vegetables with the most protective nutrients and phytochemicals. From June through October 2001, the Seattle Senior Farmers' Market Nutrition Pilot Program delivered bi-weekly market baskets that included a variety of fresh, locally grown produce to 480 low-income Meals on Wheels participants. The purpose of this study was to determine if the program increased fruit and vegetable intake in individuals who received the baskets. METHODS: One hundred basket recipients were recruited to complete a telephone survey before and at the end of the farmers' market basket season. Fifty-two low-income homebound seniors who lived outside the project service area were recruited to serve as control respondents. Fruit and vegetable intake was determined with modified versions of the 6 fruits and vegetables questions in the Behavior Risk Factor Surveillance System. RESULTS: Seniors who received the baskets reported consuming an increase of 1.04 servings of fruits and vegetables. The difference between the mean servings in the seniors who received the baskets compared to the controls was 1.31 (95% CI, 0.68-1.95, P < .001). At baseline, 22% of the basket recipients were consuming 5 or more servings of fruits and vegetables per day, but by the end of the season, 39% reported consuming 5 or more per day. CONCLUSION: Home delivery of fruits and vegetables is an effective way to increase fruit and vegetable intake in homebound seniors.

Aged↗

PubMed1998

Vegetable and fruit consumption and prostate cancer risk: a cohort study in The Netherlands.

The association between 21 vegetables and eight fruits and prostate cancer risk was assessed in the Netherlands Cohort Study among 58,279 men of ages 55-69 years at baseline in 1986. After 6.3 years of follow-up, 610 cases with complete vegetable data and 642 cases with complete fruit data were available for analysis. In multivariate case-cohort analyses, the following rate ratios (RRs) and 95% confidence intervals (CIs) for vegetable consumption were found (comparing highest versus lowest quintile): total vegetables (RR, 0.80; CI, 0.57-1.12); prepared vegetables (RR, 0.85; CI, 0.61-1.19); and raw vegetables (RR, 0.96; CI, 0.69-1.34). For vegetables categorized in botanical groups, no associations were found except for consumption of pulses (RR, 0.71; CI, 0.51-0.98; P for trend, 0.01). The RRs for total fruit and citrus fruit were 1.31 (CI, 0.96-1.79) and 1.27 (CI, 0.93-1.73), respectively; the corresponding Ps for trend were 0.02 and 0.01, respectively. In a continuous model, no association for total fruit was observed. Individual vegetables and fruits were evaluated as continuous variables (g/day). Nonsignificant inverse associations (RRs per increment of 25 g/day) were found for consumption of kale (RR, 0.74), raw endive (RR, 0.72), mandarins (RR, 0.75), and raisins or other dried fruit (RR, 0.49). Observed positive associations were significant for consumption of leek (RR, 1.38) and oranges (RR, 1.07) and nonsignificant for sweet peppers (RR, 1.60) and mushrooms (RR, 1.49). Results in subgroups of cases were more or less consistent with the overall results. From our study, we cannot conclude that vegetable consumption is important in prostate cancer etiology, but for certain vegetables or fruits, an association cannot be excluded.

Age Distribution↗

PubMed2005

Linking riparian dynamics and groundwater: an ecohydrologic approach to modeling groundwater and riparian vegetation.

The growing use of global freshwater supplies is increasing the need for improved modeling of the linkage between groundwater and riparian vegetation. Traditional groundwater models such as MODFLOW have been used to predict changes in regional groundwater levels, and thus riparian vegetation potential attributable to anthropogenic water use. This article describes an approach that improves on these modeling techniques through several innovations. First, evapotranspiration from riparian/wetland systems is modeled in a manner that more realistically reflects plant ecophysiology and vegetation complexity. In the authors' model programs (RIP-ET and PRE-RIP-ET), the single, monotonically increasing evapotranspiration flux curve in traditional groundwater models is replaced with a set of ecophysiologically based curves, one for each plant functional group present. For each group, the curve simulates transpiration declines that occur both as water levels decline below rooting depths and as waters rise to levels that produce anoxic soil conditions. Accuracy is further improved by more effective spatial handling of vegetation distribution, which allows modeling of surface elevation and depth to water for multiple vegetation types within each large model cell. The use of RIP-ET in groundwater models can improve the accuracy of basin scale estimates of riparian evapotranspiration rates, riparian vegetation water requirements, and water budgets. Two case studies are used to demonstrate that RIP-ET produces significantly different evapotranspiration estimates than the traditional method. When combined with vegetation mapping and a supporting program (RIP-GIS), RIP-ET also enables predictions of riparian vegetation response to water use and development scenarios. The RIP-GIS program links the head distribution from MODFLOW with surface digital elevation models, producing moderate- to high-resolution depth-to-groundwater maps. Together with information on plant rooting depths, these can be used to predict vegetation response to water allocation decisions. The different evapotranspiration outcomes produced by traditional and RIP-ET approaches affect resulting interpretations of hydro-vegetation dynamics, including the effects of groundwater pumping stress on existing habitats, and thus affect subsequent policy decisions.

Ecosystem↗

PubMed2002

The importance of secondary mitral valve involvement in primary aortic valve endocarditis; the mitral kissing vegetation.

AIMS: Secondary involvement of the mitral valve is well documented in primary aortic valve endocarditis. A poorly considered, but probably important causative mechanism, involving both left-sided valves, is 'mitral kissing vegetation'. This results from large aortic vegetations prolapsing into the left ventricular outflow tract and making contact with the ventricular aspect of the anterior mitral leaflet thus causing secondary infection. METHODS AND RESULTS: In 192 consecutive patients with aortic valve endocarditis, two to 18 (7.6+/-2.6) serial transoesophageal echocardiographic examinations were analysed per patient to demonstrate the development of mitral kissing vegetation on initially competent, morphologically normal mitral leaflets. In 19 patients (9.9%) with aortic valve endocarditis, mitral kissing vegetation was diagnosed within 11.6+/-9.0 (range 1-31) days following primary transoesophageal echocardiography. In all patients with mitral kissing vegetation, vegetations attached to aortic cusps were >6 mm. On hospital admission, patients with aortic valve endocarditis plus mitral kissing vegetation presented more often with a positive sepsis score, embolic events, renal failure and had larger aortic valve vegetations (9.9+/-3.3 vs 5.7+/-2.3 mm). Prognosis of aortic valve endocarditis plus mitral kissing vegetation was unfavourable (P<0.005) when compared to patients with aortic valve endocarditis alone. CONCLUSION: In aortic valve endocarditis early echocardiographic detection of mitral kissing vegetation and timely surgery may preserve the mitral valve apparatus, and favourably influence the long-term prognosis.

Adolescent↗

PubMed1999

Acetylsalicylic acid reduces vegetation bacterial density, hematogenous bacterial dissemination, and frequency of embolic events in experimental Staphylococcus aureus endocarditis through antiplatelet and antibacterial effects.

BACKGROUND: Platelets are integral to cardiac vegetations that evolve in infectious endocarditis. It has been postulated that the antiplatelet aggregation effect of aspirin (ASA) might diminish vegetation evolution and embolic rates. METHODS AND RESULTS: Rabbits with Staphylococcus aureus endocarditis were given either no ASA (controls) or ASA at 4, 8, or 12 mg. kg-1. d-1 IV for 3 days beginning 1 day after infection. Vegetation weights and serial echocardiographic vegetation size, vegetation and kidney bacterial densities, and extent of renal embolization were evaluated. In addition, the effect of ASA on early S aureus adherence to sterile vegetations was assessed. In vitro, bacterial adherence to platelets, fibrin matrices, or fibrin-platelet matrices was quantified with either platelets exposed to ASA or S aureus preexposed to salicylic acid (SAL). ASA at 8 mg. kg-1. d-1 (but not at 4 or 12 mg. kg-1. d-1) was associated with substantial decreases in vegetation weight (P<0.05), echocardiographic vegetation growth (P<0.001), vegetation (P<0.05) and renal bacterial densities and renal embolic lesions (P<0.05) versus controls. Diminished aggregation resulted when platelets were preexposed to ASA or when S aureus was preexposed to SAL (P<0.05). S aureus adherence to sterile vegetations (P<0.05) or to platelets in suspension (P<0.05), fibrin matrices (P<0.05), or fibrin-platelet matrices (P<0.05) was significantly reduced when bacteria were preexposed to SAL. CONCLUSIONS: ASA reduces several principal indicators of severity and metastatic events in experimental S aureus endocarditis. These benefits involve ASA effects on both the platelet and the microbe.

Animals↗