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van der Laan KWF, Reesink KD, Lambrichts S, Bitsch NJJE, van der Taelen L, Foulquier S, Delhaas T, Spronck B, Giudici A. Effect of rapid cooling, frozen storage, and thawing on the passive viscoelastic properties and structure of the rat aorta. J Biomech 2024; 171:112190. [PMID: 38897049 DOI: 10.1016/j.jbiomech.2024.112190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/21/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024]
Abstract
Biological tissues decay over time after harvesting, which alters their biomechanical properties. This poses logistical challenges for studies investigating passive arterial biomechanics as tissues need to be characterized shortly after excision. Freezing and cryopreservation methods can help alleviate the need for biomechanical testing of fresh tissue in human ex vivo studies. However, these methods tend to eliminate or reduce arterial cell functionality and affect passive biomechanics. Furthermore, their impact on dynamic arterial biomechanics remains unknown despite arterial viscoelastic properties being an integral component contributing to arterial stiffness under in vivo loading conditions. The present study aims to investigate the impact of rapid cooling and subsequent storage at -80 °C on the passive viscoelastic properties of arterial tissue and aid in ascertaining whether this is a suitable method to delay tissue analysis for studies investigating passive arterial biomechanics. Control and frozen abdominal rat aorta segments were quasi-statically and dynamically tested using a biaxial testing set-up. The results were modeled using a constituent-based quasi-linear viscoelastic modeling framework, yielding directional stiffness parameters, individual constituent biomechanical contributions, and a quantification of viscoelastic stiffening under dynamic pressurization conditions. Frozen samples displayed significantly decreased wall thickness, viscoelastic dissipation, viscoelastic stiffening, and significantly decreased circumferential deformation with changes in luminal pressure. Furthermore, frozen samples displayed significantly increased circumferential stiffness, pulse wave velocity, and collagen load bearing. Consequently, these changes should be considered when utilizing this tissue preservation method to delay biomechanical characterization of rat aortic tissue.
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Affiliation(s)
- Koen W F van der Laan
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Koen D Reesink
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Sara Lambrichts
- Department of Pharmacology & Toxicology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; MHENS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Laura van der Taelen
- Department of Pharmacology & Toxicology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Sébastien Foulquier
- Department of Pharmacology & Toxicology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; MHENS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Bart Spronck
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Alessandro Giudici
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
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Cunha J, Chan MV, Nkambule BB, Thibord F, Lachapelle A, Pashek RE, Vasan RS, Rong J, Benjamin EJ, Hamburg NM, Chen MH, Mitchell GF, Johnson AD. Trends among platelet function, arterial calcium, and vascular function measures. Platelets 2023; 34:2238835. [PMID: 37609998 PMCID: PMC10947606 DOI: 10.1080/09537104.2023.2238835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/26/2023] [Accepted: 07/14/2023] [Indexed: 08/24/2023]
Abstract
Arterial tonometry and vascular calcification measures are useful in cardiovascular disease (CVD) risk assessment. Prior studies found associations between tonometry measures, arterial calcium, and CVD risk. Activated platelets release angiopoietin-1 and other factors, which may connect vascular structure and platelet function. We analyzed arterial tonometry, platelet function, aortic, thoracic and coronary calcium, and thoracic and abdominal aorta diameters measured in the Framingham Heart Study Gen3/NOS/OMNI-2 cohorts (n = 3,429, 53.7% women, mean age 54.4 years ±9.3). Platelet reactivity in whole blood or platelet-rich plasma was assessed using 5 assays and 7 agonists. We analyzed linear mixed effects models with platelet reactivity phenotypes as outcomes, adjusting for CVD risk factors and family structure. Higher arterial calcium trended with higher platelet reactivity, whereas larger aortic diameters trended with lower platelet reactivity. Characteristic impedance (Zc) and central pulse pressure positively trended with various platelet traits, while pulse wave velocity and Zc negatively trended with collagen, ADP, and epinephrine traits. All results did not pass a stringent multiple test correction threshold (p < 2.22e-04). The diameter trends were consistent with lower shear environments invoking less platelet reactivity. The vessel calcium trends were consistent with subclinical atherosclerosis and platelet activation being inter-related.
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Affiliation(s)
- Jason Cunha
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Melissa V. Chan
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Bongani B. Nkambule
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Florian Thibord
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Amber Lachapelle
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Robin E. Pashek
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | - Ramachandran S. Vasan
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- Cardiology and Preventive Medicine Sections, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Evans Center for Interdisciplinary Biomedical Research, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Whitaker Cardiovascular Institute, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Schools of Public Health and Medicine, Departments of Population Health and Medicine, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Jian Rong
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Emelia J. Benjamin
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- Cardiology and Preventive Medicine Sections, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Evans Center for Interdisciplinary Biomedical Research, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Whitaker Cardiovascular Institute, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Naomi M. Hamburg
- Whitaker Cardiovascular Institute, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Ming-Huei Chen
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
| | | | - Andrew D. Johnson
- National Heart, Lung and Blood Institute’s the Framingham Heart Study, Boston University and National Heart, Framingham, MA, USA
- National Heart, Lung and Blood Institute, Population Sciences Branch, Framingham, MA, USA
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Fatemi S, Acosta S, Zarrouk M, Nilsson PM, Gottsäter A. A population-based study on hyperinsulinaemia and arterial stiffness in men with and without abdominal aortic aneurysm. Cardiovasc Endocrinol Metab 2023; 12:e0290. [PMID: 37731907 PMCID: PMC10508446 DOI: 10.1097/xce.0000000000000290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/10/2023] [Indexed: 09/22/2023]
Abstract
Objectives Patients with type 2 diabetes mellitus (DM) run lower risk for abdominal aortic aneurysm (AAA, aortic diameter ≥ 30 mm) and its complications. We aimed to evaluate associations between disturbances in glucose metabolism and arterial stiffness, AAA, and abdominal aortic diameter in 65-year-old men. Methods Forty-eight 65-year-old men with screening-detected AAA and 115 men with normal abdominal aortic diameter underwent examination of glucose metabolism and arterial stiffness. Results Men with AAA had higher BMI, waist-hip ratio (WHR), frequency of DM, haemoglobin A1c, smoking exposure, and plasma insulin levels at 0, 60 and 120 min during OGTT compared to those without. The increase in p-insulin (P < 0.001) after OGTT was also higher in men with AAA, adjusted for smoking, WHR, and nadir value of p-insulin. In analyses adjusted for smoking, use of lipid-lowering agents, and WHR, the increase in p-insulin at 2-hours (P = 0.006) after OGTT and p-homocysteine were associated with abdominal aortic diameter. There were no differences between groups in aortic stiffness or skin autofluorescence Advanced Glycation End products. Conclusion In this population-based study hyperinsulinaemia as a marker of insulin resistance, but not hyperglycaemia or aortic stiffness, was associated with AAA and abdominal aortic diameter in 65-year-old men.
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Affiliation(s)
- Shahab Fatemi
- Department of Clinical Sciences, Lund University, Malmö
- Department of Medicine, Trelleborg Hospital
| | - Stefan Acosta
- Department of Clinical Sciences, Lund University, Malmö
- Departments of Cardiothoracic and Vascular Surgery
| | - Moncef Zarrouk
- Department of Clinical Sciences, Lund University, Malmö
- Departments of Cardiothoracic and Vascular Surgery
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Malmö
- Internal and Emergency Medicine, Skåne University Hospital, Malmö, Sweden
| | - Anders Gottsäter
- Department of Clinical Sciences, Lund University, Malmö
- Internal and Emergency Medicine, Skåne University Hospital, Malmö, Sweden
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Lelis DDF, Cunha RS, Santos RD, Sposito AC, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Association Between Triglycerides, High-Density Lipoprotein Cholesterol, and Their Ratio With the Pulse Wave Velocity in Adults From the ELSA-Brasil Study. Angiology 2023; 74:822-831. [PMID: 35972851 DOI: 10.1177/00033197221121434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atherogenic dyslipidemia is a risk factor for cardiovascular diseases. The present study aimed to evaluate the association between triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the triglycerides to high-density lipoprotein (TG/HDL-C) ratio with carotid-femoral pulse wave velocity (cf-PWV), a marker of vascular stiffness. Anthropometric, biochemical, and clinical data from 13,732 adults were used to assess this association. Individuals within the third TG/HDL-C tertile presented worse anthropometric, biochemical, and clinical profiles as compared with the participants in the lower TG/HDL-C tertile. There was a linear association between TG, HDL-C, and TG/HDL-C ratio and cf-PWV in both men and women (stronger in women). After adjustment for confounders, lower levels of HDL-C were associated with increased cf-PWV in men (9.63 ± .02 m/s) and women (8.90 ± .03 m/s). However, TG was not significantly associated with cf-PWV after adjustment, regardless of sex. An increased TG/HDL-C ratio is associated with higher cf-PWV only in women (9.01 ± .03 m/s), but after adjustment for HDL-C levels, the association was non-significant (8.99 ± .03 m/s). These results highlight the stronger association of HDL-C with arterial stiffness, and that the association of TG/HDL-C with cf-PWV is dependent on HDL-C.
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Affiliation(s)
- Deborah de Farias Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Raul D Santos
- Lipid Clinic Heart Institute (Incor) University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | | | - Maria Inês Schmidt
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruce B Duncan
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
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Chen C, Bao W, Chen C, Chen L, Wang L, Gong H. Association between estimated pulse wave velocity and all-cause mortality in patients with coronary artery disease: a cohort study from NHANES 2005-2008. BMC Cardiovasc Disord 2023; 23:412. [PMID: 37605157 PMCID: PMC10441734 DOI: 10.1186/s12872-023-03435-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Arterial stiffness has been shown to be an independent risk factor for adverse events and all-cause mortality in patients. Although PWV is the gold standard for pulse wave velocity, its application in clinical practice is limited by the high cost and complexity. ePwv is a new, simple, non-invasive indicator of arterial stiffness. The aim of this study was to assess the relationship between ePwv and all-cause mortality in patients with coronary artery disease. METHODS This is a cohort study, selected from NHANES 2005 to 2008, 402 patients with coronary artery disease were included. The ePWV was divided into two groups and KM survival curves were used to calculate cumulative mortality in patients with coronary artery disease. Restricted cubic spline were used to represent the relationship between ePWV and all-cause mortality in patients with coronary artery disease. Cox regression was used to diagnose the relationship between ePwv and all-cause mortality. RESULTS The mean age of the study subjects was 68.5 ± 11.8 years, of which 282 (70.1%) were men and 120 (29.9%) were women. During 180 months of follow-up, 160 all-cause mortality occurred. KM survival curves indicated that all-cause mortality increased with increasing ePWV. The relationship between ePWV and all-cause mortality in patients with coronary artery disease was verified by cox models. Patients in higher ePWV tertile tended to have higher all-cause mortality. After complete multivariate adjustment, an increase in ePWV was positively associated with all-cause mortality (HR = 1.180, 95% confidence interval (CI): 1.056-1.320). The multivariate-adjusted HR and 95% CI for the highest ePWV tertile was 1.582 (95% CI: 0.968-2.587) compared to the lowest tertile. In addition, the association between ePWV and mortality was visualized employing restricted spline curves, in which we found curves indicating a possible threshold for the effect of ePWV on all-cause mortality, with HR less than 1 when ePWV was less than 11.15 m/s; thereafter, there was a tendency for HR to increase with enhanced ePWV. Subgroup analysis showed that the correlation between ePWV and mortality persisted in population subgroups. CONCLUSION Our findings suggest that higher ePWV is associated with increased all-cause mortality in patients with coronary artery disease, particularly when ePWV exceeds 11.15 m/s.
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Affiliation(s)
- Chunwei Chen
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Bao
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chengwen Chen
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lingyao Chen
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Liudi Wang
- Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Haibin Gong
- XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
- Xuzhou Cardiovascular Disease Institute, Xuzhou, Jiangsu, China.
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Augmentation Index in Patients with Thoracic Aortic Aneurysm: A Matched Case-Control Study. J Cardiovasc Dev Dis 2022; 10:jcdd10010006. [PMID: 36661901 PMCID: PMC9861448 DOI: 10.3390/jcdd10010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
Thoracic aortic aneurysms (TAA) may be associated with complications such as rupture and dissection, which can lead to a fatal outcome. Increased central arterial stiffness has been proposed to be present in patients with TAA compared to unmatched controls. We aimed to assess whether wall properties in patients with TAA are also altered when compared to a matched control group. Applanation tonometry was performed in 74 adults with TAA and 74 sex, age, weight, height, and left ventricular ejection fraction matched controls. Subsequently analysis of the pulse wave was done using the SphygmoCor System. For comparing the two groups, AIx was adjusted to a heart rate of 75/min (AIx@75). 148 1-to-1 matched participants were included in the final model. There was no significant difference in the Alx@75 between the TAA group and the matched control group [mean (SD) of 24.7 (11.2) % and 22.8 (11.2) %, p = 0.240]. Adjusted for known cardiovascular risk factors, there was no association between TAA and AIx@75. Patients with TAA showed comparable arterial wall properties to cardiovascular risk factor matched controls. Since higher arterial stiffness is associated with TAA progression, it remains to be investigated if increased central arterial stiffness is a relevant factor of TAA emergence.
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Haley JE, Woodly SA, Daniels SR, Falkner B, Ferguson MA, Flynn JT, Hanevold CD, Hooper SR, Ingelfinger JR, Khoury PR, Lande MB, Martin LJ, Meyers KE, Mitsnefes M, Becker RC, Rosner BA, Samuels J, Tran AH, Urbina EM. Association of Blood Pressure-Related Increase in Vascular Stiffness on Other Measures of Target Organ Damage in Youth. Hypertension 2022; 79:2042-2050. [PMID: 35762327 PMCID: PMC9378473 DOI: 10.1161/hypertensionaha.121.18765] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hypertension-related increased arterial stiffness predicts development of target organ damage (TOD) and cardiovascular disease. We hypothesized that blood pressure (BP)-related increased arterial stiffness is present in youth with elevated BP and is associated with TOD. METHODS Participants were stratified by systolic BP into low- (systolic BP <75th percentile, n=155), mid- (systolic BP ≥80th and <90th percentile, n=88), and high-risk BP categories (≥90th percentile, n=139), based on age-, sex- and height-specific pediatric BP cut points. Clinic BP, 24-hour ambulatory BP monitoring, anthropometrics, and laboratory data were obtained. Arterial stiffness measures included carotid-femoral pulse wave velocity and aortic stiffness. Left ventricular mass index, left ventricular systolic and diastolic function, and urine albumin/creatinine were collected. ANOVA with Bonferroni correction was used to evaluate differences in cardiovascular risk factors, pulse wave velocity, and cardiac function across groups. General linear models were used to examine factors associated with arterial stiffness and to determine whether arterial stiffness is associated with TOD after accounting for BP. RESULTS Pulse wave velocity increased across groups. Aortic distensibility, distensibility coefficient, and compliance were greater in low than in the mid or high group. Significant determinants of arterial stiffness were sex, age, adiposity, BP, and LDL (low-density lipoprotein) cholesterol. Pulse wave velocity and aortic compliance were significantly associated with TOD (systolic and diastolic cardiac function and urine albumin/creatinine ratio) after controlling for BP. CONCLUSIONS Higher arterial stiffness is associated with elevated BP and TOD in youth emphasizing the need for primary prevention of cardiovascular disease.
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Affiliation(s)
| | - Shalayna A Woodly
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | | | | | - Joseph T Flynn
- Department of Pediatrics, University of Washington, Seattle, WA (J.T.F., C.D.H.)
- Division of Nephrology, Seattle Children's Hospital, Seattle, WA (J.T.F., C.D.H.)
| | - Coral D Hanevold
- Department of Pediatrics, University of Washington, Seattle, WA (J.T.F., C.D.H.)
- Division of Nephrology, Seattle Children's Hospital, Seattle, WA (J.T.F., C.D.H.)
| | | | | | - Philip R Khoury
- Rady Children's Hospital San Diego, CA (J.E.H.)
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | - Marc B Lande
- University of Rochester Medical Center, Rochester, NY (M.B.L.)
| | - Lisa J Martin
- Rady Children's Hospital San Diego, CA (J.E.H.)
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | - Mark Mitsnefes
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | | | - Joshua Samuels
- University of Texas Health Sciences Center, Houston (J.S.)
| | - Andrew H Tran
- Nationwide Children's Hospital, Columbus, OH (A.H.T.)
| | - Elaine M Urbina
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
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8
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Gkousioudi A, Yu X, Ferruzzi J, Qian J, Wainford RD, Seta F, Zhang Y. Biomechanical Properties of Mouse Carotid Arteries With Diet-Induced Metabolic Syndrome and Aging. Front Bioeng Biotechnol 2022; 10:862996. [PMID: 35392404 PMCID: PMC8980683 DOI: 10.3389/fbioe.2022.862996] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/07/2022] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome increases the risk of cardiovascular diseases. Arteries gradually stiffen with aging; however, it can be worsened by the presence of conditions associated with metabolic syndrome. In this study, we investigated the combined effects of diet-induced metabolic syndrome and aging on the biomechanical properties of mouse common carotid arteries (CCA). Male mice at 2 months of age were fed a normal or a high fat and high sucrose (HFHS) diet for 2 (young group), 8 (adult group) and 18-20 (old group) months. CCAs were excised and subjected to in vitro biaxial inflation-extension tests and the Cauchy stress-stretch relationships were determined in both the circumferential and longitudinal directions. The elastic energy storage of CCAs was obtained using a four-fiber family constitutive model, while the material stiffness in the circumferential and longitudinal directions was computed. Our study showed that aging is a dominant factor affecting arterial remodeling in the adult and old mice, to a similar extent, with stiffening manifested with a significantly reduced capability of energy storage by ∼50% (p < 0.05) and decreases in material stiffness and stress (p < 0.05), regardless of diet. On the other hand, high fat high sucrose diet resulted in an accelerated arterial remodeling in the young group at pre-diabetic stage by affecting the circumferential material stiffness and stress (p < 0.05), which was eventually overshadowed by aging progression. These findings have important implications on the effects of metabolic syndrome on elastic arteries in the younger populations.
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Affiliation(s)
- Anastasia Gkousioudi
- Department of Mechanical Engineering, Boston University, Boston, MA, United States
| | - Xunjie Yu
- Department of Mechanical Engineering, Boston University, Boston, MA, United States
| | - Jacopo Ferruzzi
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, United States
| | - Juncheng Qian
- Department of Mechanical Engineering, Boston University, Boston, MA, United States
| | - Richard D. Wainford
- Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Francesca Seta
- Vascular Biology Section, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Yanhang Zhang
- Department of Mechanical Engineering, Boston University, Boston, MA, United States
- Division of Materials Science and Engineering, Boston University, Boston, MA, United States
- Department of Biomedical Engineering, Boston University, Boston, MA, United States
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9
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Aydemir D, Salman N, Karimzadehkhouei M, Alaca BE, Turan B, Ulusu NN. Evaluation of the Effects of Aging on the Aorta Stiffness in Relation with Mineral and Trace Element Levels: an Optimized Method via Custom-Built Stretcher Device. Biol Trace Elem Res 2021; 199:2644-2652. [PMID: 32918713 DOI: 10.1007/s12011-020-02380-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/07/2020] [Indexed: 01/03/2023]
Abstract
Aortic stiffness represents the major cause of aging and tightly associated with hypertension, atherosclerosis, cardiovascular diseases, and increased mortality. Mechanical characteristics of the aorta play a vital role in the blood flow, circulation, systolic pressure, and aortic stiffness; however, the correlation of trace element and mineral levels with aortic stiffness has not been studied before. Balance in the trace elements and minerals is vital for the biological functions; however, natural aging may alter this balance. Thus, after measuring aortic stiffness of aged and young rat aortas by a custom-built stretcher device, trace element and mineral levels were evaluated via ICP-MS. Also, biomarkers of aging including blood pressure, arterial pressure glucose, insulin levels, and histochemical parameters were investigated as well. Aortic stiffness, blood glucose, plasma insulin, systolic, diastolic, and mean arterial pressure significantly increased by aging in the aorta of aged rats compared with the young ones. Also, Fe, Al, Co, Ni, Zn, Sr, Na, Mg, and K levels increased in the aged aorta samples compared with the young aorta samples of rats. Increased levels of the indicated elements may be correlated with the development and progression of aortic stiffness and vascular complications. Thus, possible mechanisms correlating aortic stiffness with the imbalance in the trace element and mineral levels should be further investigated.
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Affiliation(s)
- Duygu Aydemir
- School of Medicine, Department of Medical Biochemistry, Koç University, Sariyer, 34450, Istanbul, Turkey
- Koç University Research Center for Translational Medicine (KUTTAM), Sariyer, 34450, Istanbul, Turkey
| | - Naveed Salman
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - Mehrdad Karimzadehkhouei
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - B Erdem Alaca
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
- Surface Science and Technology Center (KUYTAM), Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - Belma Turan
- Faculty of Medicine, Department of Biophysics, Ankara University, 06100, Ankara, Turkey
| | - Nuriye Nuray Ulusu
- School of Medicine, Department of Medical Biochemistry, Koç University, Sariyer, 34450, Istanbul, Turkey.
- Koç University Research Center for Translational Medicine (KUTTAM), Sariyer, 34450, Istanbul, Turkey.
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10
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Zhou Z, Xing AJ, Zhang JN, Xia WH, Su C, Xu SY, Zhang XY, Chen SH, Huang Z, Qian XX, Wu SL, Tao J. Hypertension, Arterial Stiffness, and Clinical Outcomes: A Cohort Study of Chinese Community-Based Population. Hypertension 2021; 78:333-341. [PMID: 34120451 DOI: 10.1161/hypertensionaha.121.17131] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Zhe Zhou
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Ai-Jun Xing
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jian-Ning Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Wen-Hao Xia
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Chen Su
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shi-Yue Xu
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Xiao-Yu Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shuo-Hua Chen
- Health Care Center, Kailuan Group, Tangshan, China (S.-H.C.)
| | - Zhe Huang
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Xiao-Xian Qian
- Department of Cardiology, Third Affiliated Hospital (X.-X.Q.), Sun Yat-Sen University, Guangzhou, China
| | - Shou-Ling Wu
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jun Tao
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
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11
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Park KH, Park WJ, Kim HS, Jo SH, Kim SA, Choi HM, Suh SW. Association between 10-Year Atherosclerotic Cardiovascular Disease Risk and Vascular Endothelial Function in Patients with Vasospastic Angina. Cardiology 2021; 146:281-287. [PMID: 33849014 DOI: 10.1159/000513141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 11/13/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Endothelial dysfunction is a predictor of atherosclerotic cardiovascular disease (ASCVD) and plays an important role in vasospastic angina (VA). OBJECTIVES This study evaluated whether flow-mediated dilation (FMD) is also a good marker of 10-year ASCVD risk (10Y-ASCVDR) in patients with VA. METHODS Based on their clinical history and coronary artery diameter stenosis (DS), patients were retrospectively enrolled into VA (DS <50% and positive ergonovine provocation), minor coronary artery disease (mCAD, DS <30%), and significant coronary artery disease (sCAD, DS ≥50%) groups. Endothelial function was evaluated by FMD. RESULTS Each group contained 50 patients. The 10Y-ASCVDR was significantly higher in the sCAD group than in the VA and mCAD groups (10.86 ± 7.30, 4.71 ± 4.04, and 4.77 ± 4.30, respectively, p < 0.001). The FMD was significantly higher in the mCAD group than in the VA and sCAD groups (6.37 ± 4.25, 3.10 ± 2.23, and 3.07 ± 1.89, respectively, p < 0.001). A significant correlation was found between the FMD and 10Y-ASCVD in the mCAD group (r = -0.622, p < 0.001) and the sCAD group (r = -0.557, p < 0.001) but not in the VA group (r = -0.193, p = 0.179). After adjusting for potential confounders such as BMI, C-reactive protein, maximal coronary stenosis, and brachial-ankle pulse wave velocity, multivariate analysis showed that FMD was independently associated with 10Y-ASCVDR in all patients. However, when looking only at the VA group, FMD did not correlate independently with 10Y-ASCVDR. CONCLUSIONS Unlike mCAD and sCAD, we found no correlation between 10Y-ASCVDR and endothelial function in VA. Thus, our results support that FMD is not a good marker of atherosclerotic cardiovascular risk in VA.
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Affiliation(s)
- Kyoung-Ha Park
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Woo Jung Park
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Hyun-Sook Kim
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Sang Ho Jo
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Sung-Ai Kim
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Hong-Mi Choi
- Division of Cardiovacular Disease, Hallym University Medical Center, Anyang, Republic of Korea
| | - Sang Won Suh
- Department of Physiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
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12
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The Acute Effect of Exercise on Arterial Stiffness in Healthy Subjects: A Meta-Analysis. J Clin Med 2021; 10:jcm10020291. [PMID: 33466830 PMCID: PMC7831005 DOI: 10.3390/jcm10020291] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 01/02/2023] Open
Abstract
Arterial stiffness has been shown to be a subclinical marker associated with cardiovascular disease. Meanwhile, long-term exercise has been demonstrated to reduce arterial stiffness, providing a decrease in cardiovascular risk. However, the acute effect of exercise on arterial stiffness is unclear. This systematic review and meta-analysis aimed to assess the acute effect of exercise interventions on arterial stiffness in healthy adults. We searched the Cochrane Central Register of Controlled Trials, MEDLINE (via Pubmed), Scopus, and Web of Science databases, from their inception to 30 June 2020. A meta-analysis was performed to evaluate the acute effect of exercise on arterial stiffness using random-effects models to calculate pooled effect size estimates and their corresponding 95% CI. Pulse wave velocity was measured as an arterial stiffness index. The 30 studies included in the meta-analysis showed that pulse wave velocity was not modified immediately after exercise (0 min post) (ES: 0.02; 95% CI: −0.22, 0.26), but subsequently decreased 30 min after exercise (ES: −0.27; 95% CI: −0.43, −0.12). Thereafter, pulse wave velocity increased to its initial value 24 h after exercise (ES: −0.07; 95% CI: −0.21, 0.07). Our results show that, although there is a significant reduction in pulse wave velocity 30 min after exercise, the levels of arterial stiffness return to their basal levels after 24 h. These findings could imply that, in order to achieve improvements in pulse wave velocity, exercise should be performed on a daily basis.
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13
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Bhandari V, Sharma K, Shah P, Khan E, Desai HD, Vora T, Bhalla S, Gadhiya D, Bansal M, Kasliwal RR. Predictors of Arterial Stiffness Amongst the 24-Hour Ambulatory Blood Pressure Variables in Hypertensive Patients. Cureus 2020; 12:e12207. [PMID: 33500849 PMCID: PMC7818675 DOI: 10.7759/cureus.12207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective The objective of the study is to identify the predominant determinants of arterial stiffness as assessed by pulse-wave-velocity (PVW) amongst various 24-hour ambulatory blood pressure monitoring (ABPM) parameters in Indian hypertensive subjects. Method Subjects of both genders between 18-60 years with hypertension and who were either drug naïve or on stable anti-hypertensive treatment for at least three months were included in the study. All subjects underwent clinical evaluation with a medical history, biochemical investigations, and assessment of arterial stiffness by PWV along with 24-hour ABPM. Results We found the males were younger than females amongst hypertensive cohort (41.53 ± 10.89 years vs. 52.2 ± 5.17 years, respectively; p=0.001) and had shorter duration of hypertension (41.42 ± 49.14 months vs. 87.8 ± 74.55 months, respectively; p=0.012) and had lower 24-hour average pulse pressure (aPP; 49.1 ± 7.8 mm Hg vs. 57.83 ± 8.92 mm Hg, respectively; p=0.001) at baseline. Younger people (<40-years) as compared to those >40-years of age had the lower carotid-femoral (cf) PWV (972.8 ± 125.0 cm/sec vs. 1165.0 ± 208.4 cm/sec, respectively; p=0.001) and average brachial-ankle (ba) PWV (1413.7 ± 160.4 cm/sec and 1640.0 ± 227.1 cm/sec, respectively; p=0.001). Bivariate analysis revealed that amongst all the 24-hour ABPM parameters, 24-hour aPP had the strongest correlation (r=0.414, p=0.003) with arterial stiffness as assessed by PWV. Also, statistically significant correlation was found in age group <40 years between cf-PWV and both 24-hour aPP (r=0.54, p=0.025) as well as night-time aPP (r=0.59, p=0.013) Conclusion We conclude that 24-hour aPP showed the strongest correlation with arterial stiffness parameters and best correlated with arterial stiffness variables amongst 24-hour ABPM parameters, especially amongst subjects <40 years of age. The pulsatile blood pressure (BP) was a better predictor of aortic PWV than the continuous part of BP.
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Affiliation(s)
- Vishal Bhandari
- Interventional Cardiology, Tagore Hospital and Heart Care Center, Jalandhar, IND
| | - Kamal Sharma
- Cardiology Department, U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, IND
| | - Purva Shah
- Medicine, B.J. Medical College, Ahmedabad, IND
| | - Erum Khan
- Medicine, B.J. Medical College, Ahmedabad, IND
| | - Hardik D Desai
- Internal Medicine, Gujarat Adani Institute of Medical Sciences, Krantiguru Shyamji Krishna Verma (KSKV) University, Bhuj, IND
| | - Tanisha Vora
- Graduate Medical Education, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND
| | - Sukriti Bhalla
- Cardiology, Akash Healthcare - Super Speciality Hospital, New Delhi, IND
| | - Dhruvkumar Gadhiya
- Graduate Medical Education, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND
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14
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Influence of noninvasive central blood pressure devices for afterload monitoring with aortic velocity-pressure Loop in anesthetized patients. Blood Press Monit 2020; 25:184-194. [PMID: 32433117 DOI: 10.1097/mbp.0000000000000445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Global afterload angle (GALA) is a parameter derived from velocity-pressure loop (VP Loop), for continuous assessment of cardiac afterload in the operating room. It has been validated with invasive measure of central pressure. The aim of this study was to evaluate the feasibility of noninvasive VP Loop obtained with central pressure measured with two different noninvasive tonometers. METHODS A prospective, observational, monocentric study was conducted in 51 patients under general anesthesia. Invasive central pressure (cPINV) was measured with a fulfilled intravascular catheter, and noninvasive central pressure signals were obtained with two applanation tonometry devices: radial artery tonometry (cPSHYG: Sphygmocor tonometer) and carotid tonometry (cPCOMP: Complior tonometer). Three VP Loops were built: VP LoopINV, VP LoopSPHYG and VP LoopCOMP. Patients were separated according to cardiovascular risk factors. RESULTS In the 51 patients under general anesthesia, cPSHYG was adequately obtained in 48 patients (89%) but, compared to cPINV, SBP was underestimated (-4 ± 6 mmHg, P < 0.0001), augmentation index (AIXSPHYG) and a GALASPHYG were overestimated (+13 ± 19%, P = 0.0077 and +4 ± 8°, P = 0.0024, respectively) with large limit of agreement (LOA) (-21 to 47% and -13 to 21° for AIXSPHYG and GALASPHYG, respectively). With the Complior, the failure rate of measurement for cPCOMP was 41%. SBP was similar (3 ± 17 mmHg, P = 0.32), AIXCOMP was underestimated (-11 ± 19%, P = 0.0046) and GALACOMP was similar but with large LOA (-50 to 26% and -20 to 18° for AIXCOMP and GALACOMP, respectively). CONCLUSION In anesthetized patient, the reliability of noninvasive central pressure monitoring by tonometry seems too limited to monitor cardiac afterload with VP Loop.
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Abstract
OBJECTIVE Hyperglycemia and diabetes mellitus associate with arterial stiffness. This observational study aimed to investigate such links in two related generations from a population-based study. METHODS Data from 2640 participants in the ongoing Malmö Offspring Study, Sweden, was used. The participants were direct descendants, that is, parents (median age 52.5 years) and children (26.9 years). In linear regressions, arterial stiffness measured through carotid--femoral pulse wave velocity was associated with markers of glucose metabolism (fasting glucose, glycated hemoglobin, skin autoflourescence of Advanced Glycation End products), adjusted for age, sex, smoking, BMI, lipids, SBP and antihypertensive medication. Analysis was first performed in all participants and then separately in each generation. T-tests with diabetes mellitus as the grouping variable were performed for all participants and per generation. RESULTS In all participants, pulse wave velocity was significantly associated with glucose (β = 0.007, P = 0.018) and hemoglobin (β = 0.017, P < 0.001), but not with autoflourescence. Stratified by generation, arterial stiffness was associated with glucose (β = 0.013, P = 0.008) and glycated hemoglobin (β = 0.022, P < 0.001) only in parents. Mean pulse speed differed between participants with and without diabetes in the total group (mean difference 1.7 m/s, P < 0.001), as well as within each generation (parents: 1.3 m/s; P < 0.001, and children: 0.7 m/s; P = 0.040). CONCLUSION Impaired glucose metabolism and arterial stiffness were significantly associated only in the parental generation, indicating the influence of hyperglycemia on vascular aging. However, carotid--femoral pulse wave velocity differed significantly between participants with or without diabetes mellitus in both generations, suggesting that diabetes might negatively affect arterial stiffness also at a younger age.
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16
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Saz-Lara A, Álvarez-Bueno C, Martínez-Vizcaíno V, Notario-Pacheco B, Sequí-Dominguez I, Cavero-Redondo I. Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186936. [PMID: 32972023 PMCID: PMC7559442 DOI: 10.3390/ijerph17186936] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 12/22/2022]
Abstract
Evidence exists regarding the association between advanced glycation end products and different cardiovascular disease subclinical processes, such as arterial stiffness and atherosclerosis. With this systematic review and meta-analysis, we aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with skin autofluorescence. A systematic search was performed using: MEDLINE (PubMed), SCOPUS, and Web of Science, until 30 March 2020. Cross-sectional studies or baseline data from prospective longitudinal studies were considered. The DerSimonian and Laird method was used to calculate the pooled estimates of correlation coefficients and the corresponding 95% confidence intervals (CI) for the association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. Twenty-five studies were included in the systematic review and meta-analysis, including 6306 subjects. The pooled correlation coefficient was 0.25 (95% CI: 0.18, 0.31) for pulse wave velocity and skin autofluorescence, and 0.31 (95% CI: 0.25, 0.38) for carotid intima media thickness and skin autofluorescence. This systematic review and meta-analysis provide a synthesis of the evidence showing a positive weak association of pulse wave velocity and carotid intima media thickness with skin autofluorescence.
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Affiliation(s)
- Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Universidad Politécnica y Artística del Paraguay, 001518 Asuncion, Paraguay
- Correspondence:
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile
| | - Blanca Notario-Pacheco
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Irene Sequí-Dominguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16171 Cuenca, Spain; (A.S.-L.); (V.M.-V.); (B.N.-P.); (I.S.-D.); (I.C.-R.)
- Universidad Politécnica y Artística del Paraguay, 001518 Asuncion, Paraguay
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17
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Steppan J, Jandu S, Savage W, Wang H, Kang S, Narayanan R, Nyhan D, Santhanam L. Restoring Blood Pressure in Hypertensive Mice Fails to Fully Reverse Vascular Stiffness. Front Physiol 2020; 11:824. [PMID: 32792976 PMCID: PMC7385310 DOI: 10.3389/fphys.2020.00824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/19/2020] [Indexed: 12/28/2022] Open
Abstract
Background Hypertension is a well-established driver of vascular remodeling and stiffening. The goal of this study was to evaluate whether restoring normal blood pressure (BP) fully restores vascular stiffness toward that of normotensive controls. Methods C57Bl6/J male mice received angiotensin II (angII; 1 μg/kg/min) via infusion pump for 8 weeks (hypertension group: HH), angII for 4 weeks (hypertension group: H4), angII for 4 weeks followed by 4 weeks of recovery (reversal group: HN), or sham treatment (normotensive group: NN). BP, heart rate, and pulse wave velocity (PWV) were measured longitudinally. At the end of the study period, aortas were harvested for testing of vasoreactivity, passive mechanical properties, and vessel structure. Results The HH group exhibited a sustained increase in BP and PWV over the 8-week period (p < 0.01). In the HN group, BP and PWV increased during the 4-week angII infusion, and, though BP was restored during the 4-week recovery, PWV exhibited only partial restoration (p < 0.05). Heart rate was similar in all cohorts. Compared to NN controls, both HH and HN groups had significantly increased wall thickness (p < 0.05 HH vs. NN, p < 0.01 HN vs. NN), mucosal extracellular matrix accumulation (p < 0.0001 HH vs. NN, p < 0.05 HN vs. NN), and intralamellar distance (p < 0.001 HH vs. NN, p < 0.01 HN vs. NN). Both intact and decellularized vessels were noted to have significantly higher passive stiffness in the HH and H4 cohorts than in NN controls (p < 0.0001). However, in the HN cohort, intact vessels were only modestly stiffer than those of NN controls, and decellularized HN vessels were identical to those from the NN controls. Compared to NN controls, the HH and HN cohorts exhibited significantly diminished phenylephrine-induced contraction (p < 0.0001) and endothelium-dependent vasodilation (p < 0.05). Conclusion Hypertension causes a significant increase in in vivo aortic stiffness that is only partially reversible after BP normalization. Although hypertension does lead to matrix stiffening, restoration of BP restores matrix mechanics to levels similar to those of normotensive controls. Nevertheless, endothelial and vascular smooth muscle cell dysfunction persist after restoration of normotension. This dysfunction is, in part, responsible for augmented PWV after restoration of BP.
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Affiliation(s)
- Jochen Steppan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Sandeep Jandu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - William Savage
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Huilei Wang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Sara Kang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Roshini Narayanan
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Daniel Nyhan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Lakshmi Santhanam
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
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18
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Yuan Y, Mu JJ, Chu C, Zheng WL, Wang Y, Hu JW, Ma Q, Yan Y, Liao YY, Chen C. Effect of metabolically healthy obesity on the development of arterial stiffness: a prospective cohort study. Nutr Metab (Lond) 2020; 17:50. [PMID: 32625239 PMCID: PMC7330959 DOI: 10.1186/s12986-020-00474-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/25/2020] [Indexed: 01/14/2023] Open
Abstract
Background Metabolically healthy obesity (MHO) has been reported to be associated with the development of vascular damage by the carotid intima-media thickness, but the relationship between metabolic health and obesity phenotypes and arterial stiffness is still unknown. Our hypothesized that different metabolic health and obesity phenotypes might be associated with the development of arterial stiffness, and that subjects in MHO phenotype might not have increased risks of arterial stiffness compared with those in metabolically healthy nonobesity phenotype (MHNO), while metabolic unhealthy individuals might have increased risks of arterial stiffness. Methods A prospective cohort of 2076 participants (aged 36-48 years) who were enrolled in the Hanzhong Adolescent Hypertension Cohort Study in 2017 was analyzed in a cross-sectional analysis. A subgroup of 202 participants from 2005 to 2017 was selected by an isometric sampling method and was included in the final longitudinal analysis. Results We identified four metabolic health and obesity phenotypes for both the cross-sectional and longitudinal analyses as follows: MHNO, metabolically unhealthy nonobesity (MUNO), MHO, and metabolically unhealthy obesity (MUO). In the cross-sectional analysis, individuals with the MHO phenotype had the lowest brachial-ankle pulse wave velocity (baPWV) levels of the four phenotypes (P < 0.001), and participants with the MHO phenotype had a similar risk of arterial stiffness after fully adjustment [odds ratio (OR) = 0.99 (0.61-1.60)] as the MUNO subjects. Subjects with metabolically unhealthy status had a significantly higher risk of arterial stiffness than the MHNO individuals, particularly females (P < 0.005). In the longitudinal analysis, subjects with the MUNO and MUO phenotypes had a significantly higher risk of arterial stiffness than the MHNO individuals after adjustment for age and sex [OR = 5.21 (2.26-12.02), OR = 3.32 (1.18-9.32), respectively]. Conclusions The MHO phenotype did not significantly increase the progression of arterial stiffness. Metabolically unhealthy individuals (MUNO, MUO), regardless of obesity status, showed a worse effect for the development of arterial stiffness, particularly females. Trial registration NCT02734472. Registered 12 April 2016 - Retrospectively registered, http:www.clinicaltrials.gov.
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Affiliation(s)
- Yue Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Ling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jia-Wen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chen Chen
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Street, Xi'an, 710061 China.,Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
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Sun ZJ, Hsiao HJ, Cheng HJ, Chou CY, Lu FH, Yang YC, Wu JS, Chang CJ. Relationship between Kidney Stone Disease and Arterial Stiffness in a Taiwanese Population. J Clin Med 2020; 9:jcm9061693. [PMID: 32498283 PMCID: PMC7355902 DOI: 10.3390/jcm9061693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022] Open
Abstract
Previous studies examining the association between kidney stone disease (KSD) and arterial stiffness have been limited. Both age and gender have been found to have an impact on KSD, but their influence on the relationship between KSD and increased arterial stiffness is unclear. This study included 6694 subjects from October 2006 to August 2009. The diagnosis of kidney stone was based on the results of ultrasonographic examination. Increased arterial stiffness was defined as right-sided brachial-ankle pulse wave velocity (baPWV) ≥ 14 m/s. Associations between KSD and increased arterial stiffness were analyzed using multiple logistic regression models. KSD was positively related to increased arterial stiffness in both male and female groups (males: odds ratio [OR], 1.306; 95% confidence interval [CI], 1.035–1.649; females: OR, 1.585; 95% CI, 1.038–2.419) after adjusting for confounding factors. Subgroup analysis by age group (<50 and ≥50 years) showed a significant positive relationship only in the groups ≥ 50 years for both genders (males: OR, 1.546; 95% CI, 1.111–2.151; females: OR, 1.783; 95% CI, 1.042–3.054), but not in the groups < 50 years. In conclusion, KSD is associated with a higher risk of increased arterial stiffness in individuals aged ≥ 50 years, but not in those aged < 50 years for both genders.
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Affiliation(s)
- Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
| | - Hsuan-Jung Hsiao
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Chieh-Ying Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No.539, Zhongxiao Rd., East Dist., Chiayi 60002, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
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20
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Chaix I, Manquat E, Liu N, Casadio MC, Ludes P, Tantot A, Lopes J, Touchard C, Mateo J, Mebazaa A, Gayat E, Vallée F. Impact of hypotension on cerebral perfusion during general anesthesia induction: A prospective observational study in adults. Acta Anaesthesiol Scand 2020; 64:592-601. [PMID: 31883375 DOI: 10.1111/aas.13537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION During anesthesia, decreases in mean arterial pressure (MAP) are common but the impact on possible cerebral hypoperfusion remains a matter of debate. We evaluated cerebral perfusion in patients with or without cardiovascular comorbidities (Hi-risk vs Lo-risk) during induction of general anesthesia and during hypotensive episodes. METHODS Patients scheduled for neuroradiology procedure using standardized target-controlled Propofol-Remifentanil infusion were prospectively included. Monitoring included Transcranial Doppler (TCD) measuring mean blood velocity of the middle cerebral artery (Vm), Bispectral Index with burst suppression ratio (SR) and cerebral Near-Infrared Spectroscopy (NIRS). Hypotensive episodes were treated with a 10 µg bolus of Norepinephrine. RESULTS Eighty-one patients were included, 37 Hi-risk and 44 Lo-risk. During induction of anesthesia, MAP and Vm decreased in all patients, with greater changes observed in Hi-risk patients compared to Lo-risk patients (-34 [38-29]% vs -17 [25-8]%, P < .001 and -39 [45-29]% vs -28 [34-19]%, P < .01 respectively). In Hi-risk patients, the MAP-decrease correlated with the Vm-decrease (r = .48, P < .01), and was associated with more frequent occurrences of SR (21 vs 5 patients, P < .01 for Hi-risk vs Lo-risk). For the MAP-increase induced by norepinephrine, the Vm-increase was greater in Hi-risk than in Lo-risk patients (+15 [8-21]% vs +4 [1-11]%, P < .01). During induction and norepinephrine boluses, NIRS values did not follow acute changes of Vm. CONCLUSION Our results showed that Hi-risk patients had a higher decrease in MAP and Vm, and a higher occurrence of SR during induction of anesthesia than Lo-risk patients. Correction of MAP with norepinephrine increased Vm mainly in Hi-rik patients.
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Affiliation(s)
- Isabelle Chaix
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Elsa Manquat
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Ngai Liu
- Department of Anesthesiology Hopital Foch Suresnes France
- Outcomes Research Consortium Cleveland Clinic Cleveland OH USA
| | - Maria Chiara Casadio
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Pierre‐Olivier Ludes
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Audrey Tantot
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Jean‐Paul Lopes
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Cyril Touchard
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
| | - Joaquim Mateo
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
- Inria Paris France
| | - Alexandre Mebazaa
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
- Inria Paris France
| | - Etienne Gayat
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
- Inria Paris France
| | - Fabrice Vallée
- Department of Anesthesiology and Critical Care Lariboisière University Hospital, DMU Parabol, AP-HP Nord & University of ParisParis France
- UMR-S 942 "MASCOT" Inserm Paris France
- Inria Paris France
- LMS, CNRS Institut Polytechnique de ParisEcole Polytechnique Palaiseau France
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21
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Tandon R, Bansal M, Bansal N, Goyal A, Singh B, Chabbra S, Aslam N, Mohan B, Wander G. Comparison of traditional and novel markers of subclinical atherosclerosis for evaluating cardiovascular risk in asymptomatic population. JOURNAL OF THE INDIAN ACADEMY OF ECHOCARDIOGRAPHY & CARDIOVASCULAR IMAGING 2020. [DOI: 10.4103/jiae.jiae_10_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Association of serum carbohydrate antigen 19-9 level with arterial stiffness and coronary artery calcification in middle-aged and older adults. J Hypertens 2020; 38:95-101. [DOI: 10.1097/hjh.0000000000002217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Mangoni AA, Tommasi S, Zinellu A, Sotgia S, Bassu S, Piga M, Erre GL, Carru C. Methotrexate and Vasculoprotection: Mechanistic Insights and Potential Therapeutic Applications in Old Age. Curr Pharm Des 2019; 25:4175-4184. [DOI: 10.2174/1381612825666191112091700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023]
Abstract
Increasing age is a strong, independent risk factor for atherosclerosis and cardiovascular disease. Key
abnormalities driving cardiovascular risk in old age include endothelial dysfunction, increased arterial stiffness,
blood pressure, and the pro-atherosclerotic effects of chronic, low-grade, inflammation. The identification of
novel therapies that comprehensively target these alterations might lead to a major breakthrough in cardiovascular
risk management in the older population. Systematic reviews and meta-analyses of observational studies have
shown that methotrexate, a first-line synthetic disease-modifying anti-rheumatic drug, significantly reduces
cardiovascular morbidity and mortality in patients with rheumatoid arthritis, a human model of systemic
inflammation, premature atherosclerosis, and vascular aging. We reviewed in vitro and in vivo studies
investigating the effects of methotrexate on endothelial function, arterial stiffness, and blood pressure, and the
potential mechanisms of action involved. The available evidence suggests that methotrexate might have beneficial
effects on vascular homeostasis and blood pressure control by targeting specific inflammatory pathways,
adenosine metabolism, and 5' adenosine monophosphate-activated protein kinase. Such effects might be
biologically and clinically relevant not only in patients with rheumatoid arthritis but also in older adults with high
cardiovascular risk. Therefore, methotrexate has the potential to be repurposed for cardiovascular risk
management in old age because of its putative pharmacological effects on inflammation, vascular homeostasis,
and blood pressure. However, further study and confirmation of these effects are essential in order to adequately
design intervention studies of methotrexate in the older population.
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Affiliation(s)
- Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
| | - Sara Tommasi
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Sotgia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Stefania Bassu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Matteo Piga
- Rheumatology Unit, University Clinic and AOU of Cagliari, Cagliari, Italy
| | - Gian L. Erre
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University Hospital (AOUSS) and University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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24
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Choi YM, Kwon HS, Choi KM, Lee WY, Hong EG. Short-Term Effects of Beraprost Sodium on the Markers for Cardiovascular Risk Prediction in Type 2 Diabetic Patients with Microalbuminuria. Endocrinol Metab (Seoul) 2019; 34:398-405. [PMID: 31884740 PMCID: PMC6935783 DOI: 10.3803/enm.2019.34.4.398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/31/2019] [Accepted: 11/25/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To evaluate the changes in cardiovascular risk markers including pulse wave velocity (PWV), microalbuminuria, inflammatory cytokines, and adhesion molecules after treatment with beraprost sodium (BPS) in patients with diabetic nephropathy. METHODS This was a multicenter, prospective, randomized, double-blind, placebo-controlled trial. Type 2 diabetes mellitus patients with microalbuminuria were included. The primary endpoints were changes in microalbuminuria in spot urine and PWV after BPS or placebo (PCB) treatment for 24 weeks. The secondary endpoints were changes in clinical and metabolic parameters. RESULTS A total of 52 patients completed the 24-week trial. Changes in PWV were not different significantly in the BPS and PCB groups (right, P=0.16; left, P=0.11). Changes in microalbuminuria were 14.2±157.0 and 34.5±146.6 (μg/mg Cr) in the BPS and PCB groups, respectively (P=0.63). Subgroup analysis in the high blood pressure (BP) group (baseline systolic BP >120 mm Hg and diastolic BP >80 mm Hg), showed that microalbuminuria decreased by ?47.6 in the BPS group compared with an increase by 116.4 (μg/mg Cr) in the PCB group (P=0.04). Also, in the large waist circumference group (>95 cm), microalbuminuria decreased significantly in the BPS group (P=0.04). CONCLUSION Short-term treatment of BPS for patients with diabetic nephropathy did not show significant improvement in various cardiovascular risk factors. However, BPS significantly decreased microalbuminuria in study subjects with higher cardiovascular risk such as high BP or large waist circumference.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hyuk Sang Kwon
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Mook Choi
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Won Young Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Gyoung Hong
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
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Hong A, Joachim J, Buxin C, Levé C, Le Gall A, Millasseau S, Mateo J, Civelli V, Serrano J, Mebazaa A, Gayat E, Vallée F. Using velocity-pressure loops in the operating room: a new approach of arterial mechanics for cardiac afterload monitoring under general anesthesia. Am J Physiol Heart Circ Physiol 2019; 317:H1354-H1362. [PMID: 31674813 DOI: 10.1152/ajpheart.00362.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac afterload is usually assessed in the ascending aorta and can be defined by the association of peripheral vascular resistance (PVR), total arterial compliance (Ctot), and aortic wave reflection (WR). We recently proposed the global afterload angle (GALA) and β-angle derived from the aortic velocity-pressure (VP) loop as continuous cardiac afterload monitoring in the descending thoracic aorta. The aim of this study was to 1) describe the arterial mechanic properties by studying the velocity-pressure relations according to cardiovascular risk (low-risk and high-risk patients) in the ascending and descending thoracic aorta and 2) analyze the association between the VP loop (GALA and β-angle) and cardiac afterload parameters (PVR, Ctot, and WR). PVR, Ctot, WR, and VP loop parameters were measured in the ascending and descending thoracic aorta in 50 anesthetized patients. At each aortic level, the mean arterial pressure (MAP), cardiac output (CO), and PVR were similar between low-risk and high-risk patients. In contrast, Ctot, WR, GALA, and β-angle were strongly influenced by cardiovascular risk factors regardless of the site of measurement along the aorta. The GALA angle was inversely related to aortic compliance, and the β-angle reflected the magnitude of wave reflection in both the ascending and descending aortas (P < 0.001). Under general anesthesia, the VP loop can provide new visual insights into arterial mechanical properties compared with the traditional MAP and CO for the assessment of cardiac afterload. Further studies are necessary to demonstrate the clinical utility of the VP loop in the operating room.NEW & NOTEWORTHY Our team recently proposed the global afterload angle (GALA) and β-angle derived from the aortic velocity-pressure (VP) loop as continuous cardiac afterload monitoring in the descending thoracic aorta under general anesthesia. However, the evaluation of cardiac afterload at this location is unusual. The present study shows that VP loop parameters can describe the components of cardiac afterload both in the ascending and descending thoracic aorta in the operating room. Aging and cardiovascular risk factors strongly influence VP loop parameters. The VP loop could provide continuous visual additional information on the arterial system than the traditional mean arterial pressure and cardiac output during the general anesthesia.
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Affiliation(s)
- A Hong
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Inserm, UMRS-942, Paris Diderot University, Paris, France
| | - J Joachim
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Inserm, UMRS-942, Paris Diderot University, Paris, France
| | - C Buxin
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France
| | - C Levé
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France
| | - A Le Gall
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine, Inria, Université Paris-Saclay, Palaiseau, France.,Solid Mechanics Laboratory, Ecole Polytechnique, Centre National de la Recherche Scientifique, Palaiseau, France
| | - S Millasseau
- Pulse Wave Consulting, Saint-Leu-La-Forêt, France
| | - J Mateo
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France
| | - V Civelli
- Department of Neuroradiology, Lariboisière Hospital, Paris, France
| | - J Serrano
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France
| | - A Mebazaa
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Inserm, UMRS-942, Paris Diderot University, Paris, France
| | - E Gayat
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Inserm, UMRS-942, Paris Diderot University, Paris, France
| | - F Vallée
- Department of Anesthesiology and Intensive Care, Lariboisière-Saint Louis Hospitals, Paris, France.,Inserm, UMRS-942, Paris Diderot University, Paris, France.,Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine, Inria, Université Paris-Saclay, Palaiseau, France.,Solid Mechanics Laboratory, Ecole Polytechnique, Centre National de la Recherche Scientifique, Palaiseau, France
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26
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Lee J, Yang S, Lee S, Kim HC. Analysis of Pulse Arrival Time as an Indicator of Blood Pressure in a Large Surgical Biosignal Database: Recommendations for Developing Ubiquitous Blood Pressure Monitoring Methods. J Clin Med 2019; 8:E1773. [PMID: 31653002 PMCID: PMC6912522 DOI: 10.3390/jcm8111773] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/16/2019] [Accepted: 10/22/2019] [Indexed: 01/03/2023] Open
Abstract
As non-invasive continuous blood pressure monitoring (NCBPM) has gained wide attraction in the recent decades, many pulse arrival time (PAT) or pulse transit time (PTT) based blood pressure (BP) estimation studies have been conducted. However, most of the studies have used small homogeneous subject pools to generate models of BP based on particular interventions for induced hemodynamic change. In this study, a large open biosignal database from a diverse group of 2309 surgical patients was analyzed to assess the efficacy of PAT, PTT, and confounding factors on the estimation of BP. After pre-processing the dataset, a total of 6,777,308 data pairs of BP and temporal features between electrocardiogram (ECG) and photoplethysmogram (PPG) were extracted and analyzed. Correlation analysis revealed that PAT or PTT extracted from the intersecting-tangent (IT) point of PPG showed the highest mean correlation to BP. The mean correlation between PAT and systolic blood pressure (SBP) was -0.37 and the mean correlation between PAT and diastolic blood pressure (DBP) was -0.30, outperforming the correlation between BP and PTT at -0.12 for SBP and -0.11 for DBP. A linear model of BP with a simple calibration method using PAT as a predictor was developed which satisfied international standards for automatic oscillometric BP monitors in the case of DBP, however, SBP could not be predicted to a satisfactory level due to higher errors. Furthermore, multivariate regression analyses showed that many confounding factors considered in previous studies had inconsistent effects on the degree of correlation between PAT and BP.
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Affiliation(s)
- Joonnyong Lee
- Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea.
| | - Seungman Yang
- Interdisciplinary Program in Bioengineering, Seoul National University Graduate School, Seoul 03080, Korea.
| | - Saram Lee
- Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea.
| | - Hee Chan Kim
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Korea.
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Korea.
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Elias Neto J, Ferreira A, Futuro G, Santos LCD, Heringer Filho N, Gomes F, Mill JG. Influences on the Functional Behavior of Great Arteries during Orthostasis. Arq Bras Cardiol 2019; 113:1072-1081. [PMID: 31508691 PMCID: PMC7021262 DOI: 10.5935/abc.20190182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/13/2019] [Indexed: 11/28/2022] Open
Abstract
Background Arterial compliance reduction has been associated with aging and hypertension in supine position. However, the dynamic effects of orthostatism on aortic distensibility has not been defined. Objective We sought to determine the orthostatic influence and the interference of age, blood pressure (BP) and heart rate (HR) on the great arteries during gravitational stress. Methods Ninety-three healthy volunteers (age 42 ± 16 years). Carotid-femoral pulse wave velocity (PWV) assumed as aortic stiffness was assessed in supine position (basal phase), during tilt test (TT) (orthostatic phase) and after return to supine position (recovery phase). Simultaneously with PWV acquisition, measures of BP and HR rate were recorded. Results PWV during TT increased significantly compared to the basal and recovery phases (11.7 ± 2.5 m/s vs. 10.1 ± 2.3 m/s and 9.5 ± 2.0 m/s). Systolic BP (r = 0.55, r = 0.46 and r = 0.39) and age (r = 0.59, r = 0.63 and r = 0.39) correlated with PWV in all phases. The significance level for all tests was established as α = 0.05. Conclusion We conclude that there is a permanent increase in PWV during orthostatic position that was returned to basal level at the recovery phase. This dynamic pattern of PWV response, during postural changes, can be explained by an increase in hydrostatic pressure at the level of abdominal aorta which with smaller radius and an increased elastic modulus, propagates the pulse in a faster way. Considering that it could increase central pulse reflection during the orthostatic position, we speculate that this mechanism may play a role in the overall adaptation of humans to gravitational stress.
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Affiliation(s)
- Jorge Elias Neto
- Vitória Apart Hospital, Serra, ES - Brazil.,Universidade Federal do Espirito Santo, Vitória, ES - Brazil
| | | | | | | | | | - Fernando Gomes
- Universidade Federal do Espirito Santo, Vitória, ES - Brazil
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A multilocus genetic risk score is associated with arterial stiffness in hypertensive patients: the CARE NORTH study. J Hypertens 2019; 36:1882-1888. [PMID: 29878972 DOI: 10.1097/hjh.0000000000001773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Arterial stiffness is recognized as an intermediate phenotype and predictor of cardiovascular disease. Arterial stiffness is complex in origin with contributions from lifestyle and genetic factors. However, the association between single nucleotide polymorphisms (SNPs) and arterial stiffness remains unclear. OBJECTIVE The aim is to assess whether a multilocus genetic risk score (GRS), composed of selected SNPs linked to cardiovascular traits and outcomes, is associated with arterial stiffness in patients with hypertension. DESIGN AND METHODS This study included 730 participants derived from the CARE NORTH study. The arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cfPWV). An adjusted linear regression was used to evaluate the association between cfPWV and each individual SNP using multiple genetic models. The association between a constructed GRS and cfPWV was tested in an unadjusted and adjusted model. RESULTS We selected 13 SNPs found to be associated with cfPWV (P < .05): 6 SNPs in additive, 4 SNPs in recessive and 3 SNPs in dominant mode of inheritance. The GRS based on these SNPs was positively associated with cfPWV both in unadjusted and adjusted models (β = 0.2 m/s, 95% CI 0.11 - 0.29, P = 7.6 × 10 and β = 0.22 m/s, 95% CI 0.15 - 0.28, P = 1.4 × 10, respectively). The GRS explained an additional 3.6% cfPWV variance above clinical covariates. CONCLUSION We demonstrate that the GRS composed of 13 SNPs related to cardiovascular phenotypes is associated with an increased arterial stiffness in hypertensive patients. Our findings may help to clarify genetic basis of arterial stiffening and provide insight into mechanisms underlying this phenotype.
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Zhu H, Gao Y, Cheng H, Lu Y, Cheang I, Xu D, Yao W, Xu T, Zhou F, Zhou Y, Xu F, Kong X, Li X, Zhang H. Comparison of arterial stiffness indices measured by pulse wave velocity and pulse wave analysis. Blood Press 2019; 28:206-213. [PMID: 30924384 DOI: 10.1080/08037051.2019.1598254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hongyan Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuan Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huiling Cheng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yichao Lu
- Department of Cardiology, The Affiliated Jiangyin People’s Hospital of Southeast University Medical College, Jiangyin, China
| | - IokFai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dongxu Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tianbao Xu
- Department of Cardiology, The People’s Hospital of Kizilsu Kirghiz Autonomous Prefecture, Xinjiang, China
| | - Fang Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fang Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Haifeng Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Cardiology, The People’s Hospital of Kizilsu Kirghiz Autonomous Prefecture, Xinjiang, China
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Pulse wave velocity and its gender-related associations with cardiovascular risk factors in a high cardiovascular risk population. ARCHIVES OF MEDICAL SCIENCES. ATHEROSCLEROTIC DISEASES 2019; 3:e99-e105. [PMID: 30775598 PMCID: PMC6374584 DOI: 10.5114/amsad.2018.76919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 06/18/2018] [Indexed: 11/17/2022]
Abstract
Introduction Associations found between pulse wave velocity (PWV) and cardiovascular risk factors (CVrF) are diverse. We aimed to evaluate whether differences in PWV and its associations with CVrF in a high cardiovascular risk population exist between genders and between the whole population (WHgr) and groups of apparently healthy (AHgr) and those of hypertensive, obese or diabetics (Rgr). Material and methods Pulse wave velocity measured by Arteriograph was investigated in 805 adults aged 20-65, randomly selected from the Tallinn Population Register. Results Pulse wave velocity was the highest in Rgr and no differences were found between genders of the same group. In women of WHgr and AHgr age and SBP with addition of BMI and apolipoprotein B (ApoB) were associated with 54% and 48%, and without ApoB in Rgr with only 30% of PWV values. In men aged ≥ 50 of WHgr with elevated SBP odds ratios for increased PWV were 25.3 and 3.5, in Rgr 21.2 and 2.2, in those aged ≥ 50 AHgr 28.4. In women aged ≥ 50 of WHgr with elevated SBP and diabetes odds ratios were 5.5, 4.9 and 4.0, in Rgr with elevated SBP and diabetes 3.6 and 3.7, in those aged ≥ 50 AHgr 29.3. Conclusions The associations of ApoB and BMI with PWV and diabetes with elevated PWV indicative of increased aortic stiffness were unique for women. Aging and SBP were related to PWV even in AHgr, although age ≥ 50 years in Rgr women and normal SBP in AHgr were not associated with elevated PWV.
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Cavero-Redondo I, Tudor-Locke C, Álvarez-Bueno C, Cunha PG, Aguiar EJ, Martínez-Vizcaíno V. Steps per Day and Arterial Stiffness. Hypertension 2019; 73:350-363. [DOI: 10.1161/hypertensionaha.118.11987] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Iván Cavero-Redondo
- From the Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain (I.C.-R., C.A.-B., V.M.-V.)
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts Amherst, MA (C.T.-L., E.J.A.)
| | - Celia Álvarez-Bueno
- From the Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain (I.C.-R., C.A.-B., V.M.-V.)
| | - Pedro G. Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Guimarães, Portugal (P.G.C.)
| | - Elroy J. Aguiar
- Department of Kinesiology, University of Massachusetts Amherst, MA (C.T.-L., E.J.A.)
| | - Vicente Martínez-Vizcaíno
- From the Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain (I.C.-R., C.A.-B., V.M.-V.)
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Aristizábal-Ocampo D, Espíndola-Fernández D, Gallo-Villegas J. Pulse wave velocity reference values in 3,160 adults referred to a hypertension clinic for 24-hour ambulatory blood pressure monitoring. Clin Exp Hypertens 2018; 41:759-765. [PMID: 30501425 DOI: 10.1080/10641963.2018.1545853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Carotid-femoral pulse wave velocity (PWV) is a direct measure of aortic stiffness used in the stratification of cardiovascular risk. Its clinical application in Latin America has been limited by the absence of reference values. The objective of this study was to establish PWV reference values among adults referred to a specialized cardiology center for 24-hour ambulatory blood pressure monitoring (ABPM) in Medellín, Colombia.Methods: A descriptive study of 3,160 records of adult (older than 18 years) patients without pharmacological treatment assessed for PWV using a Mobil-O-Graph® 24-hour PWA device (IEM, Stolberg, Germany) and 24-hour ABPM with hemodynamic parameters based on suspected hypertension or hypotension was conducted. Patient records were categorized by decade of age and sub-divided based on the following 24-hour ABPM categories: normal (< 130/80 mmHg), grade I hypertension (between 130-150/80-90 mmHg), and grade II hypertension (> 150/90 mmHg).Results: PWV increased with age (r = 0,894; p < 0,001) and blood pressure category (ρ = 0,081; p < 0,001); the age-related increase was more pronounced among the patients in the higher blood pressure categories. Measures of central tendency and dispersion regarding PWV are presented, and reference values are proposed from the 90th percentile based on the age and 24-hour ABPM categories.Conclusions: PWV is directly related to age and blood pressure and can be predicted using a simple equation that includes these two variables. To stratify the cardiovascular risk of patients and make clinical decisions, the 90th percentile based on the age and 24-hour ABPM categories is recommended as a cut-off.
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Affiliation(s)
- Dagnovar Aristizábal-Ocampo
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Medellín, Colombia
| | - Diego Espíndola-Fernández
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Medellín, Colombia
| | - Jaime Gallo-Villegas
- Centro Clínico y de Investigación SICOR, Soluciones Integrales de Conocimiento en Riesgo Cardiovascular, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Modena BD, Bellahsen O, Nikzad N, Chieh A, Parikh N, Dufek DM, Ebner G, Topol EJ, Steinhubl S. Advanced and Accurate Mobile Health Tracking Devices Record New Cardiac Vital Signs. Hypertension 2018; 72:503-510. [PMID: 29967036 PMCID: PMC6044460 DOI: 10.1161/hypertensionaha.118.11177] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 03/28/2018] [Accepted: 05/18/2018] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease remains the leading cause of death and disease worldwide. As demands on an already resource-constrained healthcare system intensify, disease prevention in the future will likely depend on out-of-office monitoring of cardiovascular risk factors. Mobile health tracking devices that can track blood pressure and heart rate, in addition to new cardiac vital signs, such as physical activity level and pulse wave velocity (PWV), offer a promising solution. An initial barrier is the development of accurate and easily-scalable platforms. In this study, we made a customized smartphone app and used mobile health devices to track PWV, blood pressure, heart rate, physical activity, sleep duration, and multiple lifestyle risk factors in ≈250 adults for 17 continual weeks. Eligible participants were identified by a company database and then were consented and enrolled using only a smartphone app, without any special training given. Study participants reported high overall satisfaction, and 73% of participants were able to measure blood pressure and PWV, <1 hour apart, for at least 14 of 17 weeks. The study population's blood pressure, PWV, heart rate, activity levels, sleep duration, and the interrelationships among these measurements were found to closely match either population averages or values obtained from studies performed in a controlled setting. As a proof-of-concept, we demonstrated the accuracy and ease, as well as many challenges, of using mHealth technology to accurately track PWV and new cardiovascular vital signs at home.
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Affiliation(s)
- Brian D Modena
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Otmane Bellahsen
- Division of Digital Health, Withings, Paris, France (O.B., A.C.)
| | - Nima Nikzad
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Angela Chieh
- Division of Digital Health, Withings, Paris, France (O.B., A.C.)
| | - Nathan Parikh
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Danielle Marie Dufek
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Gail Ebner
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Eric J Topol
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
| | - Steven Steinhubl
- From the Research Division of the Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA (B.D.M., N.N., N.P., D.M.D., G.E., E.J.T., S.S.)
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Łoboz-Rudnicka M, Jaroch J, Kruszyńska E, Bociąga Z, Rzyczkowska B, Dudek K, Szuba A, Łoboz-Grudzień K. Gender-related differences in the progression of carotid stiffness with age and in the influence of risk factors on carotid stiffness. Clin Interv Aging 2018; 13:1183-1191. [PMID: 29983553 PMCID: PMC6027709 DOI: 10.2147/cia.s161711] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In recent years, there has been growing interest in the impact of gender-related factors on the function and structure of the arterial tree. The aim of our study was to identify gender-specific differences in the progression of carotid stiffness parameters with age and in the impact of risk factors on carotid stiffness. Subjects and methods The study group included 256 subjects (mean age: 54.7 years): 134 women (52%) and 122 men (48%) with cardiovascular risk factors: hypertension, type 2 diabetes mellitus, dyslipidemia, smoking, and obesity. Local parameters of carotid stiffness: β stiffness index (β), Peterson’s elastic modulus (Ep), pulse wave velocity β (PWV-β) and arterial compliance (AC) were determined with ultrasound echo-tracking software application. Results Women were characterized by lower AC than men (women: 0.57 mm2/kPa vs men: 0.69 mm2/kPa, p < 0.001) and the subanalysis in three age groups revealed that the difference in AC value between genders became significant over the age of 45 years. Although no significant difference in the value of β, Ep and PWV-β were found between genders in the whole study group, women <45 years were characterized by lower values of β and Ep than their men counterparts (β: women: 5.4 vs men: 6.6, p = 0.002; Ep: women: 72 kPa vs men: 84 kPa, p = 0.015). Among analyzed risk factors, the significant determinants of carotid stiffness were age, blood pressure components (pulse pressure and mean arterial pressure), type 2 diabetes mellitus and heart rate. The relationship between carotid stiffness and pulse pressure was observed only in women and between carotid stiffness and heart rate – only in men. Conclusion There are gender-related differences in the progression of carotid stiffness parameters with age and in the influence of risk factors on carotid stiffness.
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Affiliation(s)
| | - Joanna Jaroch
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland,
| | - Ewa Kruszyńska
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland,
| | - Zbigniew Bociąga
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland,
| | | | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Wrocław University of Technology, Wrocław, Poland
| | - Andrzej Szuba
- Division of Angiology, Wrocław Medical University, Wrocław, Poland
| | - Krystyna Łoboz-Grudzień
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland, .,Public Health Department, Wrocław Medical University, Wrocław, Poland
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Comparison of pulse wave velocity and pulse pressure amplification in association with target organ damage in community-dwelling elderly: The Northern Shanghai Study. Hypertens Res 2018. [PMID: 29535455 DOI: 10.1038/s41440-018-0027-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study aimed to investigate the discrepancy between pulse wave velocity (PWV) and pulse pressure amplification (PPA) in association with hypertensive target organ damage (TOD) in the elderly. From June 2014 to August 2015, 1599 participants aged >65 years old from communities located in northern Shanghai were recruited. Carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TOD indicators, including the ratio of the early ventricular filling velocity (E) to the peak velocity of the tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (CIMT), estimated glomerular filtration rate (eGFR), and urinary albumin-creatinine ratio (ACR), were determined for each participant. PPA was defined as the peripheral-to-central pulse pressure ratio. In multivariable linear regression analysis, cfPWV was significantly associated with CIMT (β = 12.83 ± 4.28 μm per SD; P = 0.003) and eGFR (β = -1.85 ± 0.69 ml/min/1.73 m2 per SD; P = 0.007), whereas PPA was significantly associated with E/Ea (β = -0.25 ± 0.10 per SD; P = 0.01) and LVMI (β = -3.00 ± 0.78 g/m2 per SD; P < 0.001). Similarly, in multivariable logistic regression analysis, cfPWV was significantly associated with arterial plaque (odds ratio [OR], 1.21 [95% confidence interval [CI], 1.05-1.39]; P = 0.007), peripheral artery disease (OR, 1.22 [95% CI, 1.06-1.42]; P = 0.007), chronic kidney diseases (OR, 1.24 [95% CI, 1.01-1.54]; P = 0.04) and microalbuminuria (OR, 1.21 [95% CI, 1.07-1.37]; P = 0.002), while PPA was tightly associated with left ventricular hypertrophy (OR, 0.85 [95% CI, 0.72-0.99]; P = 0.04) and diastolic dysfunction (OR, 0.78 [95% CI, 0.64-0.96]; P = 0.02). In conclusion, cfPWV is a vessel-related and renal-related biomarker, while PPA is a cardiac-related biomarker in community-based elderly.
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Li G, Wu HK, Wu XW, Cao Z, Tu YC, Ma Y, Wang WQ, Cheng J, Zhou ZH. Small dense low density lipoprotein-cholesterol and cholesterol ratios to predict arterial stiffness progression in normotensive subjects over a 5-year period. Lipids Health Dis 2018; 17:27. [PMID: 29433526 PMCID: PMC5810050 DOI: 10.1186/s12944-018-0671-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Small dense low density lipoprotein-cholesterol (sdLDL-C), cholesterol ratios and carotid-femoral pulse wave velocity (cf-PWV) impart risk for all-cause morbidity and mortality independently of conventional cardiovascular disease (CVD) risk factors. This study was designed to identify feasible indicators for predicting arterial stiffness progression. METHODS We followed up 816 normotensive participants without diabetes or CVD for nearly 5.0 years. Cholesterol parameters, ratios and other clinical and laboratory data were collected at baseline. cf-PWV were measured at baseline and the end of follow-up. RESULTS PWV progression subjects had higher levels of PWV parameters, sdLDL-C and TG/HDL-C ratio. sdLDL-C and TG/HDL-C were significantly correlated with all PWV parameters. Multiple regression models showed that sdLDL-C was closely associated with follow-up PWV (β = 0.222, p < 0.001) and △PWV (β = 0.275, p < 0.001). TG/HDL-C was only one cholesterol ratios that associated with all PWV parameters. sdLDL-C (OR = 2.070, 95%CI: 1.162 to 3.688, p = 0.014) and TG/HDL-C (OR = 1.355, 95%CI: 1.136 to 1.617, p = 0.001) could significantly determine the progression of PWV after correction for covariates. High sd-LDL-C quantiles subjects were more likely to develop arterial stiffness progression than low quantiles (Tertiles 3 vs Tertiles1, RR = 2.867, 95%CI: 1.106 to 7.434, p = 0.03). CONCLUSION We founded that sdLDL-C and TG/HDL-C ratio can independently predict arterial stiffness progression in normotensive subjects, and high level sdLDL-C and TG/HDL-C ratio were associated with a higher risk of arterial stiffness.
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Affiliation(s)
- Gang Li
- Emergency Department, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, China.,Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China
| | - Hui-Kun Wu
- Department of Hepatology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.,Institute of Hepatology, Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China
| | - Xiao-Wei Wu
- Department of Thoracic Surgery, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Zhe Cao
- Department of Cardiology, The Central Hospital of Wuhan, Wuhan, China
| | - Yuan-Chao Tu
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan, China.
| | - Yi Ma
- Emergency Department, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, China
| | - Wei-Qing Wang
- Emergency Department, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, China
| | - Jian Cheng
- Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wuhan, China
| | - Zi-Hua Zhou
- Institute of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Son WM, Kim DY, Kim YS, Ha MS. Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women. Osong Public Health Res Perspect 2017; 8:369-372. [PMID: 29354393 PMCID: PMC5749481 DOI: 10.24171/j.phrp.2017.8.6.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/02/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022] Open
Abstract
Objectives Our study aims to provide basic scientific data on the importance of obesity management in middle-aged Korean women by analyzing its effects on blood pressure and arterial stiffness. In addition, we examined the correlations of these two parameters. Methods The study participants were 40 middle-aged female volunteers, who were classified into obesity group (n = 20) and normal weight group (n = 20). Statistical analysis was performed using independent t-test and the Pearson correlation coefficient was used to correlate blood pressure and arterial stiffness. Results This study evaluated the systolic blood pressure, diastolic blood pressure, and pulse wave velocity (PWV). These results were higher in the obesity group than the normal weight group. Furthermore, blood pressure and arterial stiffness (PWV, augmentation pressure) were static correlated. Conclusion Obesity is closely related to blood pressure and arterial stiffness. Therefore, indices for blood pressure and arterial stiffness may play a vital role in predicting and preventing obesity and its sequelae.
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Affiliation(s)
- Won-Mok Son
- Department of Physical Education, Pusan National University, Busan, Korea
| | - Do-Yeon Kim
- Department of Physical Education, Pusan National University, Busan, Korea
| | - You-Sin Kim
- Department of Leisure Sports, Jung-Won University, Chungbuk, Korea
| | - Min-Seong Ha
- Department of Physical Education, Pusan National University, Busan, Korea
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Banerjee P. Heart failure: a story of damage, fatigue and injury? Open Heart 2017; 4:e000684. [PMID: 29081980 PMCID: PMC5652497 DOI: 10.1136/openhrt-2017-000684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/29/2017] [Accepted: 09/26/2017] [Indexed: 12/16/2022] Open
Abstract
Heart failure has been recognised for years but the complete picture has been difficult to clearly understand. This article aims to try and put forward a proposed mechanistic explanation to encompass all that we see within the clinical heart failure syndrome using supporting published evidence. The aim of the article is to link, using published evidence, all the known varieties of heart failure into a spectrum that is explained by simple interlinked processes. In addition, the concept of routinely looking for reversibility of left ventricular dysfunction is introduced.
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Affiliation(s)
- Prithwish Banerjee
- Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry, UK
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
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Oh JY, Allison MA, Barrett-Connor E. Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults: the Rancho Bernardo Study. J Hypertens 2017; 35:55-62. [PMID: 27906837 DOI: 10.1097/hjh.0000000000001145] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading cause of death in the United States and worldwide. We aimed to observe the association of HTN and diabetes mellitus with all-cause and CVD mortality in older white adults. METHODS All community-dwelling Rancho Bernardo Study participants who were at least 55 years old and had carefully measured blood pressure and plasma glucose from 75-g oral glucose tolerance test at the baseline visit (1984-1987, n = 2186) were followed up until death or the last clinic visit in 2013 (median 14.3 years, interquartile range 8.4-21.3). RESULTS In unadjusted analyses, diabetes mellitus was associated with all-cause mortality [hazard ratio 1.40, 95% confidence interval (CI) 1.23-1.60] and CVD mortality (hazard ratio 1.67, 95% CI 1.39-2.00); HTN with all-cause mortality [hazard ratio 1.93 (1.73-2.15)] and CVD mortality [hazard ratio 2.45 (2.10-2.93)]. After adjustment for cardiovascular risk factors, including age, BMI, triglycerides, HDL-cholesterol, smoking, exercise, and alcohol consumption, diabetes mellitus was associated with CVD mortality only (hazard ratio 1.25, P = 0.0213). Conversely, HTN was associated with both all-cause (hazard ratio 1.34, P < 0.0001) and CVD mortality (hazard ratio 1.40, P = 0.0003). Having both diabetes mellitus and HTN was associated with all-cause (hazard ratio 1.38, P = 0.0002) and CVD mortality (hazard ratio 1.70, P < 0.0001). CONCLUSION We report the novel finding that HTN is more strongly associated with all-cause and CVD mortality than diabetes mellitus. Having both confers a modest increase in the hazards for these types of mortality.
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Affiliation(s)
- Jee-Young Oh
- aDepartment of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South KoreabDepartment of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
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Zócalo Y, Curcio S, García-Espinosa V, Chiesa P, Giachetto G, Bia D. Comparative Analysis of Arterial Parameters Variations Associated with Inter-Individual Variations in Peripheral and Aortic Blood Pressure: Cross-Sectional Study in Healthy Subjects Aged 2-84 years. High Blood Press Cardiovasc Prev 2017; 24:437-451. [PMID: 28948506 DOI: 10.1007/s40292-017-0231-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/12/2017] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The association between arterial parameters and blood pressure (BP) interindividual variations could depend on the arterial segment, BP component (systolic, SBP; diastolic, DBP; pulse pressure, PP) and/or on whether central (cBP) or peripheral (pBP) BP variations are considered. AIM To assess and compare arterial parameters variations associated with interindividual variations in cBP and pBP. METHODS Healthy subjects (n = 923; 488 males, 2-84 years) were included. pBP and cBP waves were obtained (Mobil-O-Graph; SphygmoCor). Arterial diameter, intima-media thickness, local elastic modulus (carotid, CEM; brachial, BEM; femoral, FEM) and regional (carotid-radial and carotid-femoral pulse wave velocity; crPWV and cfPWV) arterial stiffness were determined. Associations between BP and arterial parameters interindividual variations were analyzed and compared (correlations; linear regressions; slopes comparisons) considering data transformed into z-scores. RESULTS Given a variation in z-cSBP or z-pSBP, z-CEM, z-FEM and z-cfPWV (stiffness indexes), were among the parameters with major BP-associated variations. z-crPWV and z-cfPWV, rather than local stiffness indexes were the parameters with major variations associated with z-DBP variations. z-cPP or z-pPP were associated with z-CEM and z-FEM variations, but not with brachial or regional stiffness variations. Most of the arterial parameters-BP slopes did not show significant differences when considering a variation in z-cSBP and z-pSBP. z-CEM and z-FEM were mainly associated with z-cPP and z-pPP variations, respectively. CONCLUSION Disregard of age and sex, the variations in arterial parameters associated with BP interindividual variations showed differences depending on whether variations were central or peripheral; in SBP, DBP or PP and depending on the arterial segment considered.
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Affiliation(s)
- Yanina Zócalo
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
| | - Santiago Curcio
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - Victoria García-Espinosa
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
| | - Pedro Chiesa
- Servicio de Cardiología Pediátrica, Centro Hospitalario Pereira Rossell, ASSE-Ministry of Public Health, Boulevard Artigas 1550, 11600, Montevideo, Uruguay
| | - Gustavo Giachetto
- Clínica Pediátrica "C", Centro Hospitalario Pereira Rossell, ASSE, Republic University, Boulevard Artigas 1550, 11600, Montevideo, Uruguay
| | - Daniel Bia
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay
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Evaluation of local carotid stiffness and inflammatory biomarkers in stable angina pectoris. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2017; 13:122-129. [PMID: 28798782 PMCID: PMC5545659 DOI: 10.5114/pwki.2017.68046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 02/07/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Arterial stiffness (AS) is a well-accepted and reliable predictor of atherosclerotic diseases. Inflammation plays an important role in the development of AS. AIM To evaluate local carotid stiffness (CS) together with fibrinogen and high-sensitivity C-reactive protein (hsCRP) levels in stable angina pectoris (SAP) patients. MATERIAL AND METHODS The study consisted of 353 consecutive patients with SAP. All underwent coronary angiography (CAG) after the evaluation of local CS parameters and carotid intima-media thickness (IMT) from both common carotid arteries by a real-time echo-tracking system. Baseline inflammatory biomarkers, serum hsCRP and fibrinogen levels were measured. Based on CAG findings, the patients were classified into 4 groups: control subjects with normal coronary arteries (group 1, n = 86), single-vessel disease (group 2, n = 104), double-vessel disease (group 3, n = 95) and triple-vessel disease (group 4, n = 68). RESULTS The mean carotid pulse wave velocity (PWV) in patients with angiographically confirmed coronary artery disease (CAD) was significantly higher than that in patients with normal coronary arteries (7.82 ±1.76 vs. 6.51 ±0.85 cm/s, p = 0.001). The mean carotid IMT was detected to be significantly higher in group 4 patients compared to those in group 1 (p < 0.001) and group 2 (p = 0.001). Significant correlations were observed between both inflammatory biomarkers and the number of diseased vessels and carotid PWV. Using multi-variate analysis, carotid stiffness, carotid IMT, hsCRP and fibrinogen were independently associated with the presence and extent of CAD. CONCLUSIONS Local CS, carotid IMT, hsCRP and fibrinogen levels are significant predictors of atherosclerotic burden and they may facilitate the identification of high-risk patients for the early diagnosis and prompt treatment of CAD.
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Melatonin attenuates thiocyanate-induced vasoconstriction in aortic rings. Saudi Pharm J 2017; 25:993-998. [PMID: 29158705 PMCID: PMC5681314 DOI: 10.1016/j.jsps.2017.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 03/24/2017] [Indexed: 01/15/2023] Open
Abstract
Cigarette smoking not only has a carcinogenic effect but also leads to an increase in arterial blood pressure. Besides its main components, i.e. nicotine, tar, and carbon monoxide, cigarette smoke also contains thiocyanate. Thiocyanate anions (SCN-) arise from the detoxification of hydrogen cyanide and its plasma concentrations were found to correlate significantly with cigarette consumption. There is also evidence that atherosclerotic disease progression is much more rapid when serum SCN- levels are increased. Melatonin, a non-toxic indolamine with various physiologic functions, is believed to protect against inflammatory processes and oxidative stress. It has been demonstrated that melatonin serves as free radical scavenger and represents a potent antioxidant. Therefore, it is believed that melatonin with its atheroprotective effects may be useful either as a sole therapy or in conjunction with others. The aim of this study was to quantify the thiocyanate-induced vasomotor response in aortic tissue and further to examine the potential of melatonin in affecting the generated vasoreactivity. Aortic rings of adult male normotensive Wistar rats were cut into 4-mm rings. Following the administration of thiocyanate in various concentrations, vasomotor response of aortic vessel segments was measured. To assess the effect of melatonin on vasomotor activity, organ bath concentrations were modulated from 60 to 360 pM, which corresponds to physiologic plasma up to the levels of patients with regular oral intake of 3 mg of melatonin as a supplement. Thirty-six rat aortic rings were studied. When exposed to thiocyanate, vessel segments revealed vasoconstriction in a concentration-dependent manner. In rings which were preincubated with melatonin at a concentration of 360 pM, a 56.5% reduction of effect size could be achieved (4.09 ± 1.22 mN versus 9.41 ± 1.74 mN, P < 0.0001). Additionally, administration of 360 pM melatonin at a norepinephrine concentration of 80 mM resulted in a relaxation of 10.9 ± 2.2%. The vasodilatatory effect of melatonin was significantly reduced to 1.3 ± 0.5% when concentration of norepinephrine was doubled (P < 0.002). This study indicates that vessel segments that were exposed to thiocyanate responded with a dose-dependent vasoconstriction. The effect could be markedly attenuated in segments preincubated in melatonin.
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Gaudio A, Fiore V, Rapisarda R, Sidoti MH, Xourafa A, Catalano A, Tringali G, Zanoli L, Signorelli SS, Fiore CE. Sclerostin is a possible candidate marker of arterial stiffness: Results from a cohort study in Catania. Mol Med Rep 2017; 15:3420-3424. [PMID: 28339088 DOI: 10.3892/mmr.2017.6390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/13/2017] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis and cardiovascular disease are worldwide public health issues. Recent evidence indicates a possible role of the canonical Wnt/β-catenin signalling pathway as a common mediator between these two diseases. The aim of the present study was to investigate the relationship between serum concentrations of sclerostin and Dkk1, two extracellular inhibitors of Wnt/β-catenin signalling, with carotid intima-media thickness (CIMT) and with arterial stiffness, evaluated by measuring the pulse wave velocity (PWV) in an ambulatory population of adults. To this aim, 67 subjects were recruited in the 'Atherosclerosis and osteoporosis: identification of common pathogenetic factors' investigation. Serum sclerostin levels correlated positively with CIMT (r=0.314, p=0.03) and inversely with the augmentation index, a marker of arterial stiffness (r=-0.286, p<0.05), whereas Dkk1 did not. Moreover, in a multivariate linear regression model, sclerostin [β -0.1472; p=0.0023; standard error (SE)=0.04620] was an independent predictor of PWV in the study subjects. Our study shows that, following adjustment for confounders, sclerostin is an independent predictor of arterial stiffness in an ambulatory population, whereas Dkk1 is not.
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Valerio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Rosario Rapisarda
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Maria Helga Sidoti
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Anastasia Xourafa
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, I-98125 Messina, Italy
| | - Giovanni Tringali
- Medical and Environmental Research Institute (IRMA), I-95024 Acireale, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | | | - Carmelo Erio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
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Su HM, Lee KT, Chu CS, Lee MY, Lin TH, Voon WC, Sheu SH, Lai WT. Effects of Heart Rate on Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Pressure Index in Patients Without Significant Organic Heart Disease. Angiology 2016; 58:67-74. [PMID: 17351160 DOI: 10.1177/0003319706295481] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the effects of heart rate (HR) on brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI). Thirty-two patients without significant organic heart disease underwent elective cardiac catheterization or electrophysiologic study, and were then enrolled in right atrial pacing (RAP; 11 men, 9 women; aged 48 ∓15 years) or right ventricular pacing (RVP; 6 men, 6 women, aged 45 ∓13 years) studies. Three different HR levels (90, 100, and 110 beats per minute) were paced in random order. By stepwise, multiple linear regression analysis, age, systolic blood pressure (SBP), and pulse pressure (PP) correlated positively with baseline baPWV. In the RAP group, as HR increased, baPWV and left brachial diastolic blood pressure increased significantly (p ≤0.015), while ABI, left ankle SBP, left brachial PP, and left ankle PP decreased significantly (p ≤0.013). In the RVP group, as HR increased, baPWV also increased significantly (p=0.001), while ABI, left ankle SBP, and PP decreased significantly (p ≤ 0.034). Values of baPWV and ABI may be influenced by HR in young and middle-aged patients without significant organic heart disease. When these values are used to evaluate and follow up cardiovascular risk in patients, HR changes should be considered.
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Affiliation(s)
- Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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Achimastos AD, Efstathiou SP, Christoforatos T, Panagiotou TN, Stergiou GS, Mountokalakis TD. Arterial Stiffness: Determinants and Relationship to the Metabolic Syndrome. Angiology 2016; 58:11-20. [PMID: 17351153 DOI: 10.1177/0003319706295477] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study aimed to investigate independent determinants of arterial stiffness and evaluate the association of arterial stiffness with the presence of metabolic syndrome (MS). Demographic characteristics, hemodynamic parameters, and cardiovascular (CV) risk factors were assessed in Greek food industry employees with no history of diabetes or CV disease in order to isolate multiple correlates of arterial stiffness as assessed by pulse wave velocity (PWV). Subsequently, logistic regression analysis was performed using as end point the presence of MS, defined according to the National Cholesterol Education Program. Data from 424 participants (mean age 45.3 ∓15.5 years, 298 [70.3%] males, average PWV 8.5 ∓3.6 m/s) were analyzed. PWV was higher in men (8.8 ∓3.1 m/s) compared to women (7.7 ∓2.9 m/s, p<0.01). Age, systolic blood pressure, and heart rate were isolated as multivariate determinants of PWV (adjusted R2 0.511 [p<0.0001] in men and 0.538 [p<0.0001] in women). The overall prevalence of the MS was 14.6%, being similar in both genders. Four variables were shown to be independent predictors of the presence of MS: waist circumference >102 cm (men)/88 cm (women) (OR 8.6, [95% CI 2.8, 20.6], p<0.001), insulin resistance (homeostasis model assessment >4) (6.3, [2.1, 17.6], p<0.001), total cholesterol >240 mg/dL (5.5, [1.7, 12.4], p<0.01), PWV >9 m/s (4.1, [1.5, 9.9], p<0.01). High PWV, which was found to be mostly determined by advanced age, elevated systolic BP, and accelerated heart rate, appeared to exhibit a strong independent association with the presence of MS together with adiposity and insulin resistance. This index should be considered as a useful marker for CV risk stratification.
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Affiliation(s)
- Apostolos D Achimastos
- Third Department of Medicine, Athens University, Medical School, Sotiria General Hospital, Athens, Greece
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Kingue S, Walinjom J, Menanga A, Mintom P, Ngweth MN, Betrand F, Muna W. Arterial compliance in a group of normotensive and untreated hypertensive Cameroonian subjects in Yaounde. Pan Afr Med J 2016; 24:162. [PMID: 27795760 PMCID: PMC5072824 DOI: 10.11604/pamj.2016.24.162.7526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/06/2015] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Arterial compliance is an independent predictor of cardiovascular events. It decreases with age and this decrease is accelerated by hypertension. The objectives were to determine the arterial compliance in a group of normotensive and untreated hypertensive stage 1, 2 and 3 Cameroonian subjects. METHODS A cross-sectional study was conducted from August 2012 to February 2013 in Yaoundé. Our sample size was 88 participants. The PulsePen® device was used to determine cfPWV (carotid-femoral Pulse Wave Velocity) and central Augmentation Index % (AIx). Other measurements obtained were: blood pressure (BP), body mass index (BMI), fasting glycaemia, lipid profile and serum creatinine. RESULTS Our sample's mean age was 35.48 years and ranged from 20 to 60 years. The means of: cfPWV, SBP, DBP, Pulse Pressure (PP) and Heart Rate (HR) showed a statistically significant increase (p-value < 0.05) across the groups from normotensive to severely hypertensive patients. cfPWV was significantly correlated (p-value< 0.05) to: Age, Central SBP, Central DBP, Central PP, HR, BMI and central Augmentation index (AIx). Furthermore, cfPWV was significantly dependent on LVH (p-value <0.05). CONCLUSION This study suggests that arterial compliance decreases with increase severity of hypertension, indicating a higher risk of developing cardiovascular events in severely hypertensive patients.
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Affiliation(s)
- Samuel Kingue
- Medical & cardiology Unit, General Hospital Yaoundé, Cameroon
| | - Joshua Walinjom
- Faculty of Medicine and Biomedical sciences, University of Yaoundé I, Cameroon
| | - Alain Menanga
- Medical & cardiology Unit, General Hospital Yaoundé, Cameroon
| | - Pierre Mintom
- Medical & cardiology Unit, General Hospital Yaoundé, Cameroon
| | | | - Fesuh Betrand
- National Advanced School of Engineering, Department of mathematics, Physics and Applied Statistics, University of Yaoundé 1, Cameroon
| | - Walinjom Muna
- Medical & cardiology Unit, General Hospital Yaoundé, Cameroon
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Wang Y, Yang Y, Wang A, An S, Li Z, Zhang W, Liu X, Ruan C, Liu X, Guo X, Zhao X, Wu S. Association of long-term blood pressure variability and brachial-ankle pulse wave velocity: a retrospective study from the APAC cohort. Sci Rep 2016; 6:21303. [PMID: 26892486 PMCID: PMC4759569 DOI: 10.1038/srep21303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/21/2016] [Indexed: 11/09/2022] Open
Abstract
We investigated associations between long-term blood pressure variability (BPV) and brachial-ankle pulse wave velocity (baPWV). Within the Asymptomatic Polyvascular Abnormalities Community (APAC) study, we retrospectively collected long-term BPV and baPWV measures. Long-term BPV was calculated using the mean and standard deviation of systolic blood pressure (SBP) across 4 years based on annual values of SBP. In total, 3,994 subjects (2,284 men) were eligible for inclusion in this study. We stratified the study population into four SBP quartiles. Left and right baPWV was higher in participants with long-term SBPV in the fourth quartile compared with the first quartile (left: 1,725 ± 488 vs. 1,461 ± 340 [p < 0.001]; right: 1,722 ± 471 vs. 1,455 ± 341 [p < 0.001], respectively). We obtained the same result for total baPWV (fourth vs. first quartile: 1,772 ± 429 vs. 1,492 ± 350 [p < 0.001]). Furthermore, there was a trend for gradually increased baPWV (≥1,400 cm/s) with increased SBPV (p < 0.001). After multivariable adjustment, baPWV was positively correlated with long-term BPV (p < 0.001). In conclusion, long-term BPV is significantly associated with arterial stiffness as assessed by baPWV.
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Affiliation(s)
- Yang Wang
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Yuling Yang
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Shasha An
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Zhifang Li
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Wenyan Zhang
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Xuemei Liu
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Chunyu Ruan
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Xiaoxue Liu
- Department of Cardiology,Tangshan People's Hospital, Tangshan, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
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Asayama K, Ohkubo T, Hoshide S, Kario K, Ohya Y, Rakugi H, Umemura S. From mercury sphygmomanometer to electric device on blood pressure measurement: correspondence of Minamata Convention on Mercury. Hypertens Res 2016; 39:179-82. [PMID: 26818650 DOI: 10.1038/hr.2015.158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Umemura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Yokohama, Japan
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El Hraiech A, Abdennebi K, Amah G. [Short-term impact of an ambulatory cardiac rehabilitation program on arterial rigidity]. Ann Cardiol Angeiol (Paris) 2015; 64:210-5. [PMID: 26047872 DOI: 10.1016/j.ancard.2015.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND If the positive impact of cardiac rehabilitation on metabolic profile and exercise tolerance is well documented in the literature, very few studies evaluated the impact of these rehabilitation programs on arterial rigidity. PURPOSE The main objective of this study was to determine if a short and intense 4-week cardiac rehabilitation program could yield a positive impact on arterial rigidity. METHOD A cohort study was performed on Leopold Bellan Foundation. All patients referred for cardiac rehabilitation program after an acute event (surgery, technical gesture or acute decompensate heart failure) were included in this study. Our CR program consists of four sessions per week for five weeks (total of 20 sessions) and includes both exercise and health and nutrition education sessions. In addition to clinical and therapeutic data collection, biochemical analysis for carbohydrate and lipid metabolism and exercise capacity measurements, carotid femoral pulse wave velocity (PWV) were measured in a quiet room in the morning of their first and last day prior to any exercise. RESULTS One hundred and ninety-eight cardiac patients have participated in this study, of which 79% were male, mean age 60 ± 10, 50 (25%) were diabetic, 103 (52%) were hypertensive, 60 (30%) were current smokers, 98 (50%) had dyslipidemia, and 140 (71%) were referred for cardiac rehabilitation after acute coronary syndrome. Arterial stiffness is defined by a VPWV value greater or equal to 10. At the beginning, 59% of our patients have rigid arteries. After 20 sessions of cardiac rehabilitation, this number is significantly reduced to 51% (P=0.12). Patients with arterial stiffness have accumulated more major cardiovascular risk factors, and have had less exercise capacity than others. However they benefit similarly from the cardiovascular rehabilitation program. CONCLUSION In the present study, we observed that arterial stiffness, as reflected by the PWV, tends to decrease after short-term ambulatory cardiac rehabilitation program.
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Affiliation(s)
- A El Hraiech
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France.
| | - K Abdennebi
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France
| | - G Amah
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France
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Hao G, Wang Z, Zhang L, Chen Z, Wang X, Guo M, Tian Y, Shao L, Zhu M. Thresholds of Central Systolic Blood Pressure in a Normotensive Chinese Middle-Aged Population. Angiology 2015; 67:174-9. [PMID: 25934007 DOI: 10.1177/0003319715584134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An increasing body of evidence has emerged showing that the central systolic blood pressure (CSBP) is more relevant to the risk of cardiovascular (CV) diseases than brachial blood pressure. However, there are no agreed CSBP threshold values above which the risk of CV disease is increased. The aim of our study was to define the threshold values of the CSBP in a normotensive Chinese population; 10 012 adults 35 to 65 years of age were eligible for analysis. We excluded 3765 participants with hypertension, and the final normotensive reference sample consisted of 6247 participants. We defined abnormally high CSBP as exceeding the 90th percentile age- and sex-specific values in the normotensive population. The 90th percentile cutoff value for CSBP in the reference sample was 125 mm Hg in men and 126 mm Hg in women. The CSBP was significantly higher in participants with diabetes, history of CV disease, and hyperlipidemia (P < .001). The CSBP values increased with age (P < .001). We established that the 90th percentile of the CSBP threshold value in normotensive Chinese middle-aged population is 125 mm Hg for men and 126 mm Hg for women.
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Affiliation(s)
- Guang Hao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Min Guo
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Ye Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lan Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Manlu Zhu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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