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Stefanov F, McGloughlin T, Morris L. A computational assessment of the hemodynamic effects of crossed and non-crossed bifurcated stent-graft devices for the treatment of abdominal aortic aneurysms. Med Eng Phys 2016; 38:1458-1473. [PMID: 27773830 DOI: 10.1016/j.medengphy.2016.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 08/22/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
There are several issues attributed with abdominal aortic aneurysm endovascular repair. The positioning of bifurcated stent-grafts (SG) may affect SG hemodynamics. The hemodynamics and geometrical parameters of crossing or non-crossing graft limbs have not being totally accessed. Eight patient-specific SG devices and four pre-operative cases were computationally simulated, assessing the hemodynamic and geometrical effects for crossed (n= 4) and non-crossed (n= 4) configurations. SGs eliminated the occurrence of significant recirculations within the sac prior treatment. Dean's number predicted secondary flow locations with the greatest recirculations occurring at the outlets especially during the deceleration phase. Peak drag force varied from 3.9 to 8.7N, with greatest contribution occurring along the axial and anterior/posterior directions. Average resultant drag force was 20% smaller for the crossed configurations. Maximum drag force orientation varied from 1.4° to 51°. Drag force angle varied from 1° to 5° during one cardiac cycle. 44% to 62% of the resultant force acted along the proximal centerline where SG migration is most likely to occur. The clinician's decision for SG positioning may be a critical parameter, and should be considered prior to surgery. All crossed SG devices had an increased spiral flow effect along the distal legs with reductions in drag forces.
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Affiliation(s)
- Florian Stefanov
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland
| | - Tim McGloughlin
- Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Liam Morris
- Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland.
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Abstract
Peripheral arterial disease (PAD) of the lower extremities is a common and potentially life-threatening manifestation of systemic atherosclerosis. Significant PAD is identified by an ankle brachial index (ABI) <0.90; its presence is strongly associated with the major modifiable cardiac risk factors. Early detection and treatment of asymptomatic PAD is a current focus of numerous cardiovascular guideline organizations as less than a third of patients report typical claudication symptoms. This has created an ever-increasing treatment gap, whereby millions of eligible patients are inadequately treated. Risk factor management including exercise, smoking cessation, and aggressive treatment of lipids and blood pressure are essential in PAD patients. However, life-long antiplatelet therapy provides additional reductions in vascular events beyond aggressive risk factor management. The use of aspirin as well as more potent antiplatelet therapies such as thienopyridines holds promise for reducing atherothrombosis in this very high-risk population.
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Affiliation(s)
- William R Hiatt
- Department of Medicine, University of Colorado School of Medicine, Section of Vascular Medicine, Divisions of Geriatrics and Cardiology, Denver, Colorado 80203, USA.
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Aluganti Narasimhulu C, Fernandez-Ruiz I, Selvarajan K, Jiang X, Sengupta B, Riad A, Parthasarathy S. Atherosclerosis--do we know enough already to prevent it? Curr Opin Pharmacol 2016; 27:92-102. [PMID: 26974701 DOI: 10.1016/j.coph.2016.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 01/07/2023]
Abstract
In this review, we have briefly summarized the characteristics of lipids and lipoproteins and the atherosclerotic process. The development of atherosclerosis is a continuous process that involves numerous cellular and acellular processes that influence the behavior of each other. These include oxidative stress, lipoprotein modifications, macrophage polarization, macrophage lipid accumulation, generation of pro- and anti-inflammatory components, calcification, cellular growth and proliferation, and plaque rupture. The precise role(s) of many of these are unknown. Understanding the events at each particular stage might shed more light onto the process as a whole and could potentially reveal targets for intervention. Therapeutic modalities that work at one stage may have little to no influence on other stages of the disease.
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Affiliation(s)
| | - Irene Fernandez-Ruiz
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States
| | - Krithika Selvarajan
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States
| | - Xeuting Jiang
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States
| | - Bhaswati Sengupta
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States
| | - Aladdin Riad
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States
| | - Sampath Parthasarathy
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, United States.
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Marques L, Negre-Salvayre A, Costa L, Canonne-Hergaux F. Iron gene expression profile in atherogenic Mox macrophages. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1137-46. [PMID: 26972048 DOI: 10.1016/j.bbadis.2016.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023]
Abstract
RATIONALE The role of macrophage iron in the physiopathology of atherosclerosis is an open question that needs to be clarified. In atherosclerotic lesions, recruited macrophages are submitted to cytokines and oxidized lipids which influence their phenotype. An important phenotypic population driven by oxidized phospholipids is the Mox macrophages which present unique biological properties but their iron phenotype is not well described. OBJECTIVE To investigate the effect of Mox polarization by oxidized LDL (oxLDL) on macrophage iron metabolism in the absence or presence of proinflammatory stimuli. METHODS Bone marrow-derived macrophages were treated with different sources of LDL and/or LPS/IFNγ (M1 activator). Expression of ferroportin (Slc40a1, alias Fpn), heme oxygenase-1 (Hmox1), H- and L-ferritin (Fth1 and Ftl1), hepcidin (Hamp), ceruloplasmin (Cp) and interleukine-6 (Il6) was followed by quantitative PCR. FPN and HMOX1 protein expression was analyzed by immunofluorescence and in-cell-Western blotting. RESULTS Mox macrophages expressed increased Hmox1 and Fth1 levels with basal FPN protein levels despite the significant increase of Fpn mRNA. Upregulation of Hmox1 and Fpn mRNA was specific to LDL oxidative modification and mediated by NRF2. The downregulation of both Cp isoforms and the upregulation of Hamp expression observed in Mox macrophages suggest that FPN mediated iron export could be compromised. Simultaneous exposure to oxLDL and LPS/IFNγ leads to a mixed Mox/M1 phenotype that is closer to M1. CONCLUSION A microenvironment rich in oxLDL and proinflammatory cytokines could promote macrophage iron retention and lipid accumulation profiles, a specific cell phenotype that likely contributes to lesion development and plaque instability in atherosclerosis.
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Affiliation(s)
- Liliana Marques
- INSERM UMR 1043, CNRS UMR 5282, Université de Toulouse, UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France; Departamento da Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; University of Lisboa, Faculty of Sciences, BioISI - Biosystems & Integrative Sciences Institute, Campo Grande, Lisboa, Portugal
| | | | - Luciana Costa
- Departamento da Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; University of Lisboa, Faculty of Sciences, BioISI - Biosystems & Integrative Sciences Institute, Campo Grande, Lisboa, Portugal.
| | - François Canonne-Hergaux
- INSERM UMR 1043, CNRS UMR 5282, Université de Toulouse, UPS, Centre de Physiopathologie de Toulouse Purpan (CPTP), Toulouse, France; IRSD, Université de Toulouse, INSERM, INRA, INP-ENVT, Université de Toulouse 3 Paul Sabatier, Toulouse, France.
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Rahabi-Layachi H, Ourouda R, Boullier A, Massy ZA, Amant C. Distinct Effects of Inorganic Phosphate on Cell Cycle and Apoptosis in Human Vascular Smooth Muscle Cells. J Cell Physiol 2015; 230:347-55. [PMID: 24976589 DOI: 10.1002/jcp.24715] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 06/23/2014] [Indexed: 12/14/2022]
Abstract
Inorganic phosphate (Pi) is an essential nutrient to all living organisms. Nevertheless, hyperphosphatemia is now recognized as a risk factor for cardiovascular events and mortality in chronic kidney disease (CKD) patients. To our knowledge, the mechanisms by which elevated Pi alters smooth muscle cell proliferation have been poorly addressed. Therefore, in this study, we investigated the effects of Pi on cell cycle regulation and apoptosis in human aortic smooth muscle cells (HAoSMC). HAoSMC were treated with physiologic (1 mM) or high (2 and 3 mM) Pi concentrations. We showed that Pi not only decreased significantly cell viability (P < 0.001) but also induced apoptosis of HAoSMC. Moreover, Pi treatment blocked G1/S cell cycle progression by increasing cell number in G0/G1 phase up to 82.4 ± 3.4% for 3 mM vs 76.2 ± 3.1% for control (P < 0.01) while decreasing cell number in S phase. Accordingly, this was associated with a decrease protein expression of cyclin E and its associated CDK (CDK2), and phosphorylated retinoblastoma protein. Moreover, we observed an increase of protein expression of cell cycle inhibitors p15, p21, and p27. Interestingly, we also found that induction of cell cycle arrest was partially dependent on phosphate uptake. Our results demonstrated that Pi reduced HAoSMC proliferation by inducing apoptosis and cell cycle arrest. Indeed, we showed for the first time that Pi affected HAoSMC cell cycle by blocking G1/S progression. These findings would be useful for a better understanding of molecular mechanisms involved in vascular complications observed in CKD patients.
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Affiliation(s)
| | - Roger Ourouda
- HERVI EA3801, Université de Picardie Jules Verne, UFR de Médecine, Amiens, France
| | - Agnes Boullier
- Inserm U1088, Université de Picardie Jules Verne, Amiens, France
- Centre de Biologie Humaine, CHU Amiens, Amiens, France
- Laboratoire de Biochimie, CHU Amiens, Amiens, France
| | - Ziad A Massy
- Inserm U1088, Université de Picardie Jules Verne, Amiens, France
- Nephrology Division CHU Ambroise Paré, Avenue Charles de Gaulle, Boulogne-Billancourt, France
| | - Carole Amant
- HERVI EA3801, Université de Picardie Jules Verne, UFR de Médecine, Amiens, France
- Centre de Biologie Humaine, CHU Amiens, Amiens, France
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Yücel H, Zorlu A, Kaya H, Yılmaz MB. Regular blood donation improves endothelial function in adult males. Anatol J Cardiol 2015; 16:154-8. [PMID: 26467374 PMCID: PMC5336799 DOI: 10.5152/akd.2015.6093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Endothelial dysfunction, secondary to systemic inflammation and oxidative stress, is known to play a major role in the development and progression of atherosclerosis. It is hypothesized that the lower incidence of coronary artery disease in the premenopausal period in females when compared with males is associated with regular menstrual blood loss. We investigated whether regular blood donation (BD) is associated with improved endothelial function in healthy adult males. METHODS Fifty young healthy male volunteers volunteers with a mean age of 30 ± 6 years without overt cardiovascular disease were enrolled to participate in serial consecutive BDs. Serum iron levels as oxidative stress parameters, flow-mediated dilatation (FMD) for endothelial function, 24-h mean diastolic blood pressure for peripheral vascular resistance identification, and high-sensitivity C-reactive protein (hs-CRP) levels as systemic inflammatory markers were evaluated before and after BD. This study used a prospective observational cohort design. Patients with cardiovascular and inflammatory diseases were excluded. RESULTS BD was found to improve FMD steadily and significantly when compared with the baseline (mean ± SD: 9.9% ± 3.8%, 10.44% ± 3.9%, 10.65% ± 3.9%, and 10.75 ± 3.9%, respectively, p=0.15, p=0.02, p=0.006 as compared with the baseline). A steady decrease was identified in hs-CRP levels after serial BDs, although this decrease was not statistically significant in the all phases (2.96 ± 3.3 mg/L, 2.26 ± 1.5 mg/L, and 2.12 ± 1.5 mg/L, respectively, p=0.829, p=0.558). The 24-h mean diastolic blood pressures were significantly lower in the chronic phase (77 ± 9 mm Hg, 75 ± 7 mm Hg, and 72 ± 8 mm Hg, respectively, p=0.50, p=0.003), whereas there was no significant change in iron levels in the acute and chronic phases (66 ± 32 mg/dL, 72 ± 43 mg/dL, and 68 ± 33 mg/dL, respectively, p=1.000, p=1.000). CONCLUSION The results of the study indicate that regular BD improves endothelial function.
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Affiliation(s)
- Hasan Yücel
- Department of Cardiology, Faculty of Medicine, Cumhuriyet University; Sivas-Turkey.
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Gewartowska M, Olszewski WL, Buyanowskaya O, Frontczak-Baniewicz M. A novel method for long-lasting preservation of arterial grafts. J Surg Res 2015; 200:374-86. [PMID: 26323366 DOI: 10.1016/j.jss.2015.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Autologous venous grafts generally give best results for arterial bypass grafting in cases of arterial stenosis. When no suitable venous graft can be found, synthetic prosthetic graft may be an alternative. Prostheses are easily accessible but susceptible to infection. In these cases, the replacement of infected prosthesis by the human arterial allograft is the best treatment option. The question arises whether we could prepare a graft meeting mechanical conditions of an artery immunologically inert and resistant to bacterial infection. MATERIALS AND METHODS LEW and BN rat aortic segments were placed in dehydrated sodium chloride and stored for 1 to 12 mo. Then, they were transplanted orthotopically as aortic grafts for 3 to 15 mo in syngenic and allogenic combination. No immunosuppression was used. Patency, pulsation, and frequency of development of aneurysms were studied. The tensile strength and maximum intraluminal pressures were measured. Morphology of grafts was evaluated on histology and electron microscopy. The endothelial and infiltrating cells were identified. RESULTS Transplanted allogeneic aortic grafts preserved in anhydrous sodium chloride up to 12 mo remained patent for 15 mo. Hypertrophy of intima with endothelial cells lining the inner surface and single muscle cells between elastic fibers were seen. Normal structure of collagen and elastic fibers was maintained. Only minor-host mononuclear infiltrates were seen around the preserved allografts. CONCLUSIONS Rat aortas preserved in anhydrous sodium chloride retain patency and function even 15 mo after transplantation. Such grafts retain their wall structure and evoke only minor recipient reaction. Our results confirm that anhydrous sodium chloride may be used for arterial grafts preservation. Low immunogenicity is additional advantage.
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Affiliation(s)
- Magdalena Gewartowska
- Department of Surgical Research and Transplantology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland; Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
| | - Waldemar L Olszewski
- Department of Surgical Research and Transplantology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland; Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland; Department of Gastrointestinal and Transplantation Surgery and Clinical Laboratory, Central Clinical Hospital, Ministry of Internal Affairs, Warsaw, Poland
| | - Olga Buyanowskaya
- Department of Surgical Research and Transplantology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland; Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
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Kwon H, Lee JJ, Lee JH, Cho WK, Gu MJ, Lee KJ, Ma JY. Cinnamon and its Components Suppress Vascular Smooth Muscle Cell Proliferation by Up-Regulating Cyclin-Dependent Kinase Inhibitors. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2015; 43:621-36. [DOI: 10.1142/s0192415x1550038x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cinnamomum cassia bark has been used in traditional herbal medicine to treat a variety of cardiovascular diseases. However, the antiproliferative effect of cinnamon extract on vascular smooth muscle cells (VSMCs) and the corresponding restenosis has not been explored. Hence, after examining the effect of cinnamon extract on VSMC proliferation, we investigated the possible involvement of signal transduction pathways associated with early signal and cell cycle analysis, including regulatory proteins. Besides, to identify the active components, we investigated the components of cinnamon extract on VSMC proliferation. Cinnamon extract inhibited platelet-derived growth factor (PDGF)-BB-induced VSMC proliferation and suppressed the PDGF-stimulated early signal transduction. In addition, cinnamon extract arrested the cell cycle and inhibited positive regulatory proteins. Correspondingly, the protein levels of p21 and p27 not only were increased in the presence of cinnamon extract, also the expression of proliferating cell nuclear antigen (PCNA) was inhibited by cinnamon extract. Besides, among the components of cinnamon extract, cinnamic acid (CA), eugenol (EG) and cinnamyl alcohol significantly inhibited the VSMC proliferation. Overall, the present study demonstrates that cinnamon extract inhibited the PDGF-BB-induced proliferation of VSMCs through a G0/G1 arrest, which down-regulated the expression of cell cycle positive regulatory proteins by up-regulating p21 and p27 expression.
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Affiliation(s)
- Hyeeun Kwon
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Jung-Jin Lee
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Ji-Hye Lee
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Won-Kyung Cho
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Min Jung Gu
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Kwang Jin Lee
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Jin Yeul Ma
- Korean Medicine (KM) Application Center, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
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Peña-Duque MA, Romero-Ibarra JL, Gaxiola-Macías MBA, Arias-Sánchez EA. Coronary Atherosclerosis and Interventional Cardiology. Arch Med Res 2015; 46:372-8. [PMID: 26117516 DOI: 10.1016/j.arcmed.2015.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/16/2015] [Indexed: 12/21/2022]
Abstract
The atherosclerotic process in coronary arteries begins with endothelial dysfunction and may provoke thrombotic total occlusion and myocardial infarction. In this state-of-the-art review, we discuss recent evidence of atheroslerosis, vulnerable plaque, and hemodynamic changes in the coronary tree, as well as the current techniques we implement in the catheterization lab to evaluate coronary stenosis. It is clear that atherosclerosis is a chronic inflammatory condition with several consequences in the coronary tree, however, we are able now to characterize the plaque and to select the appropriate treatment for many patients.
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Affiliation(s)
- Marco Antonio Peña-Duque
- Interventional Cardiology Department, National Institute of Cardiology, Ignacio Chávez, Tlalpan, Mexico City, Mexico.
| | - José Luis Romero-Ibarra
- Interventional Cardiology Department, National Institute of Cardiology, Ignacio Chávez, Tlalpan, Mexico City, Mexico
| | | | - Eduardo A Arias-Sánchez
- Interventional Cardiology Department, National Institute of Cardiology, Ignacio Chávez, Tlalpan, Mexico City, Mexico
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Henriksson P, Lu Q, Diczfalusy U, Freyschuss A. Immediate effect of passive smoking on microcirculatory flow. Microcirculation 2015; 21:587-92. [PMID: 24698527 DOI: 10.1111/micc.12137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 03/31/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Exposure to SHS, as by passive smoking, seems to increase the incidence of cardiovascular events. It has been shown that active smoking of a single cigarette causes an immediate and significant decrease in microcirculatory blood flow velocity, whereas the acute effects of exposure to SHS on microcirculatory flow have as yet not been demonstrated. METHODS Healthy nonsmoking volunteers of both genders were studied during acute exposure to SHS of two cigarettes burning up to 10 minutes. Microvessels were examined by in vivo vital capillaroscopy (Capiflow(®)), allowing continuous assessment of CBV. RESULTS CBV decreased from 514 mm/sec (CI 383-646) at baseline to 306 mm/sec (CI 191-420) at end of SHS exposure with a further decrease to a nadir of 240 mm/sec (CI 155-325) four minutes after the end of this exposure (p < 0.0001; ANOVA). CONCLUSIONS The result of this study shows that passive inhalation of secondhand cigarette smoke induces an immediate and prolonged marked reduction in CBV in nonsmoking healthy volunteers.
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Affiliation(s)
- Peter Henriksson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Meier S, Pütz G, Massing U, Hagemeyer C, von Elverfeldt D, Meißner M, Ardipradja K, Barnert S, Peter K, Bode C, Schubert R, von zur Muhlen C. Immuno-magnetoliposomes targeting activated platelets as a potentially human-compatible MRI contrast agent for targeting atherothrombosis. Biomaterials 2015; 53:137-48. [DOI: 10.1016/j.biomaterials.2015.02.088] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 02/13/2015] [Accepted: 02/19/2015] [Indexed: 11/26/2022]
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Englund EK, Langham MC, Ratcliffe SJ, Fanning MJ, Wehrli FW, Mohler ER, Floyd TF. Multiparametric assessment of vascular function in peripheral artery disease: dynamic measurement of skeletal muscle perfusion, blood-oxygen-level dependent signal, and venous oxygen saturation. Circ Cardiovasc Imaging 2015; 8:e002673. [PMID: 25873722 PMCID: PMC4399002 DOI: 10.1161/circimaging.114.002673] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Endothelial dysfunction present in patients with peripheral artery disease may be better understood by measuring the temporal dynamics of blood flow and oxygen saturation during reactive hyperemia than by conventional static measurements. METHODS AND RESULTS Perfusion, Intravascular Venous Oxygen saturation, and T2* (PIVOT), a recently developed MRI technique, was used to measure the response to an ischemia-reperfusion paradigm in 96 patients with peripheral artery disease of varying severity and 10 healthy controls. Perfusion, venous oxygen saturation SvO2, and T2* were each quantified in the calf at 2-s temporal resolution, yielding a dynamic time course for each variable. Compared with healthy controls, patients had a blunted and delayed hyperemic response. Moreover, patients with lower ankle-brachial index had (1) a more delayed reactive hyperemia response time, manifesting as an increase in time to peak perfusion in the gastrocnemius, soleus, and peroneus muscles, and in the anterior compartment, (2) an increase in the time to peak T2* measured in the soleus muscle, and (3) a prolongation of the posterior tibial vein SvO2 washout time. Intrasession and intersession repeatability were also assessed. Results indicated that time to peak perfusion and time to peak T2* were the most reliable extracted time course metrics. CONCLUSIONS Perfusion, dynamic SvO2, and T2* response times after induced ischemia are highly correlated with peripheral artery disease severity. Combined imaging of peripheral microvascular blood flow and dynamics of oxygen saturation with Perfusion, intravascular SvO2, and T2* may be a useful tool to investigate the pathophysiology of peripheral artery disease.
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Affiliation(s)
- Erin K Englund
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.).
| | - Michael C Langham
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
| | - Sarah J Ratcliffe
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
| | - Molly J Fanning
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
| | - Felix W Wehrli
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
| | - Emile R Mohler
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
| | - Thomas F Floyd
- From the Department of Bioengineering (E.K.E.), Department of Radiology (M.C.L., F.W.W.), Department of Biostatistics & Epidemiology (S.J.R.), Department of Medicine (E.R.M.), University of Pennsylvania, Philadelphia; and Department of Anesthesiology, Stony Brook University, NY (T.F.F.)
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Chindhi S, Thakur S, Sarkar M, Negi PC. Subclinical atherosclerotic vascular disease in chronic obstructive pulmonary disease: Prospective hospital-based case control study. Lung India 2015; 32:137-41. [PMID: 25814798 PMCID: PMC4372867 DOI: 10.4103/0970-2113.152624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is an important non-communicable disease worldwide with a rising global incidence. COPD is associated with multiple co-morbidities. Patients with COPD are at increased risk of atherosclerosis and other cardiovascular events. Cardiovascular diseases are an important cause of morbidity and mortality in COPD. The present case-control study was designed to assess the relationship between sub-clinical atherosclerotic vascular diseases with COPD. Methods: It was a prospective case-control blinded observational study. There were 142 COPD patients and 124 age-and sex-matched controls without COPD and cardiovascular diseases. Frequency of sub-clinical atherosclerosis was assessed by the carotid B-mode duplex ultrasonography assessment of carotid wall intima medial thickness (IMT). Plaque was defined as IMT of more than 1.2 mm. Results: Prevalence of carotid plaqing was significantly higher amongst patients of COPD (38.7%) compared to controls (13.7%, odds ratio 3.9, P < 0.0001). Multinomial logistic regression analysis revealed COPD as an independent predictor of carotid plaqing (r = 0.85, P < 0.023). Conclusion: The frequency of carotid plaqing is high in COPD patients. Carotid plaqing may be due to shared risk factors or the presence of low-grade systemic inflammation. Presence of increased CIMT and carotid plaqing in COPD patients identifies early atherosclerotic changes and future cardiovascular risk. Hence screening of CIMT should be a part of cardiovascular assessment in patients with COPD.
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Affiliation(s)
- Sandip Chindhi
- Department of General Medicine, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Surinder Thakur
- Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Malay Sarkar
- Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Prakash C Negi
- Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Gaztanaga J, Farkouh M, Rudd JHF, Brotz TM, Rosenbaum D, Mani V, Kerwin TC, Taub R, Tardif JC, Tawakol A, Fayad ZA. A phase 2 randomized, double-blind, placebo-controlled study of the effect of VIA-2291, a 5-lipoxygenase inhibitor, on vascular inflammation in patients after an acute coronary syndrome. Atherosclerosis 2015; 240:53-60. [PMID: 25752438 DOI: 10.1016/j.atherosclerosis.2015.02.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 02/03/2015] [Accepted: 02/14/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Arachidonate 5-lipoxygenase (5-LO) is a key enzyme in the synthesis of leukotrienes. VIA-2291 is a potent 5-LO inhibitor, which has been shown to reduce hsCRP and noncalcified coronary plaque volume following an acute coronary syndrome (ACS). We aim to evaluate the effect of VIA-2291 on vascular inflammation compared to placebo using FDG-PET. METHODS A Phase II, randomized, double-blind, parallel-group study was conducted in 52 patients with recent ACS assigned 1:1 to either 100 mg VIA-2291 or placebo for 24 weeks. The primary outcome was the effect of VIA-2291 relative to placebo on arterial inflammation detected by (18)fluorodeoxyglucose positron emission tomography (FDG-PET) within the index vessel after 24 weeks of daily treatment, compared to baseline. RESULTS VIA-2291 was relatively well tolerated and was associated with a significant inhibition of the potent chemo-attractant LTB4, with a mean inhibition of activity of 92.8% (p<0.0001) at 6 weeks in the VIA-2291 group, without further significant change in inhibition at 24 weeks. However, for VIA-2291 was not associated with significant difference in inflammation (target-to-background ratio) compared to placebo at 24 weeks or 6 weeks of treatment. Further, VIA-2291 was not associated with a significant reduction in hsCRP from baseline after either 6 or 24 weeks of treatment. CONCLUSIONS VIA-2291 is well-tolerated and effectively reduces leukotriene production. However, inhibition of 5-LO with VIA-2291 is not associated with significant reductions in vascular inflammation (by FDG-PET) or in blood inflammatory markers. Accordingly, this study does not provide evidence to support a significant anti-inflammatory effect of VIA-2291 in patients with recent ACS.
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Affiliation(s)
- Juan Gaztanaga
- Department of Cardiology, Winthrop University Hospital, Mineola, NY, USA
| | - Michael Farkouh
- Mount Sinai Cardiovascular Institute, New York, NY, USA; Peter Munk Cardiac Centre and Li Ka Shing Knowledge Institute, University of Toronto, Translational and Molecular Imaging Institute and Imaging Science Laboratories, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James H F Rudd
- Division of Cardiovascular Medicine, University of Cambridge, United Kingdom
| | | | - David Rosenbaum
- Insitute of Cardiology Nutrition and Metabolism, Pitié Salpétrière Hospital, AP-HP, Paris, France
| | - Venkatesh Mani
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Todd C Kerwin
- Department of Cardiology, New York Hospital Queens, Flushing, NY, USA
| | | | | | - Ahmed Tawakol
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Zahi A Fayad
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount, New York, NY, USA.
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Lopez D, Pollak AW, Meyer CH, Epstein FH, Zhao L, Pesch AJ, Jiji R, Kay JR, DiMaria JM, Christopher JM, Kramer CM. Arterial spin labeling perfusion cardiovascular magnetic resonance of the calf in peripheral arterial disease: cuff occlusion hyperemia vs exercise. J Cardiovasc Magn Reson 2015; 17:23. [PMID: 25890198 PMCID: PMC4336689 DOI: 10.1186/s12968-015-0128-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/27/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Assessment of calf muscle perfusion requires a physiological challenge. Exercise and cuff-occlusion hyperemia are commonly used methods, but it has been unclear if one is superior to the other. We hypothesized that post-occlusion calf muscle perfusion (Cuff) with pulsed arterial spin labeling (PASL) cardiovascular magnetic resonance (CMR) at 3 Tesla (T) would yield greater perfusion and improved reproducibility compared to exercise hyperemia in studies of peripheral arterial disease (PAD). METHODS Exercise and Cuff cohorts were independently recruited. PAD patients had an ankle brachial index (ABI) between 0.4-0.9. Controls (NL) had no risk factors and ABI 0.9-1.4. Subjects exercised until exhaustion (15 NL-Ex, 15 PAD-Ex) or had a thigh cuff inflated for 5 minutes (12 NL-Cuff, 11 PAD-Cuff). Peak exercise and average cuff (Cuff mean ) perfusion were compared. Six participants underwent both cuff and exercise testing. Reproducibility was tested in 8 Cuff subjects (5 NL, 3 PAD). RESULTS Controls had greater perfusion than PAD independent of stressor (NL-Ex 74 ± 21 vs. PAD-Ex 43 ± 10, p = 0.01; NL-Cuff mean 109 ± 39 vs. PAD-Cuff mean 34 ± 17 ml/min-100 g, p < 0.001). However, there was no difference between exercise and Cuff mean perfusion within groups (p > 0.6). Results were similar when the same subjects had the 2 stressors performed. Cuff mean had superior reproducibility (Cuff mean ICC 0.98 vs. Exercise ICC 0.87) and area under the receiver operating characteristic curve (Cuff mean 0.992 vs. Exercise 0.905). CONCLUSIONS Cuff hyperemia differentiates PAD patients from controls, as does exercise stress. Cuff mean and exercise calf perfusion values are similar. Cuff occlusion hyperemia has superior reproducibility and thus may be the preferred stressor.
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Affiliation(s)
- David Lopez
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Amy W Pollak
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Craig H Meyer
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Frederick H Epstein
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Li Zhao
- Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Arthur J Pesch
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Ronny Jiji
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Jennifer R Kay
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Joseph M DiMaria
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - John M Christopher
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
| | - Christopher M Kramer
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA.
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Sharma KH, Sahoo S, Shah KH, Patel AK, Jadhav ND, Parmar MM, Patel KH. Are Gujarati Asian Indians 'older' for their 'vascular age' as compared to their 'Chronological age'? QJM 2015; 108:105-12. [PMID: 25086109 DOI: 10.1093/qjmed/hcu158] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND South Asians are known to carry higher burden of cardiovascular diseases when compared with their Caucasian counterparts. AIM This study was designed to evaluate whether vascular age is advanced for Gujarati Asian Indians as matched to their chronological age in apparently healthy, asymptomatic population. We have also assessed the contributing risk factors for premature vascular ageing. DESIGN It was cross-sectional study of 2483 individuals of Gujarat state in Western India having no past or present history of major illness including cardiovascular diseases. METHOD The vascular age of the population was calculated using Framingham vascular age calculator. A relationship between risk factor prevalence and vascular ageing was evaluated using univariate analysis of variance. RESULTS The mean chronological age of the study population was 46.8 (±10.35) years whereas mean vascular age was 53.34 (±16.05) years, and the difference (6.54±9.5) between both was statistically significant (P < 0.0001). Contributory risk factors for advanced vascular age apart from chronological age (75.4%) and male gender (66.2%) were the presence of dyslipidemia (60.4%) hypertension (57.34%) and increased waist circumference (WC) (male 39.7%, female 29%). Results of regression analysis showed that vascular age progression was highly associated with blood pressure (19.9, 95% CI: 14.34-27.63), followed by smoking (15.23, 95% CI: 8.4-27.59), and blood sugar (12.97, 95% CI: 3.48-48.25). CONCLUSION The Gujarati Asian Indians are subjected to premature vascular ageing and henceforth routine screening for vascular age and risk factors prevalence is strongly advocated in this ethnic group.
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Affiliation(s)
- K H Sharma
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - S Sahoo
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - K H Shah
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - A K Patel
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - N D Jadhav
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - M M Parmar
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
| | - K H Patel
- From the U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Asarwa, Ahmedabad, 380016, India
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Comparing velocity and fluid shear stress in a stenotic phantom with steady flow: phase-contrast MRI, particle image velocimetry and computational fluid dynamics. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 28:385-93. [PMID: 25502616 DOI: 10.1007/s10334-014-0476-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 10/12/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
Abstract
OBJECT This study aims to validate phase-contrast magnetic resonance imaging (PC-MRI) measurements of a steady flow through a severe stenotic phantom using particle image velocimetry (PIV) and computational fluid dynamics (CFD). MATERIALS AND METHODS The study was performed in an axisymmetric 87 % area stenosis model using an inlet Reynolds number (Re) of 160, corresponding to a jet Re of 444. Velocity patterns and estimated fluid shear stresses from three modalities were analyzed and compared qualitatively and quantitatively. RESULTS Visual analysis via contour subtraction and Bland-Altman plots showed good agreement for flow velocities and less agreement for maximum shear stress (MSS). The Pearson's coefficients of correlation between PC-MRI and PIV were 0.97 for the velocity field and 0.82 for the MSS. The corresponding parameters between PC-MRI and CFD were 0.96 and 0.84, respectively. CONCLUSION Findings indicate that PC-MRI can be implemented to estimate velocity flow fields and MSS; however, this method is not sufficiently accurate to quantify the MSS at regions of high shear rate.
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Sivri N, Unlu A, Palabiyik O, Budak M, Kacmaz Y, Yalta K, Sipahi T. Endothelial nitric oxide synthase intron 4a/b polymorphism in coronary artery disease in Thrace region of Turkey. BIOTECHNOL BIOTEC EQ 2014; 28:1115-1120. [PMID: 26019598 PMCID: PMC4433908 DOI: 10.1080/13102818.2014.980030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 04/12/2014] [Indexed: 11/30/2022] Open
Abstract
Coronary artery disease (CAD) is one of the frequent cardiovascular mortality causes in the world. Common risk factors explain only about half the risk of CAD. The healthy familial predisposition to CAD, combined with advances in genetic analysis, has led to a number of studies in recent years making an effort to identify the genetic factors that influence the risk. The approach taken by most studies was to examine the association of naturally occurring genetic polymorphisms in candidate genes with risk of or severity of CAD. Endothelial nitric oxide synthase (eNOS) is important for vascular and tissue protection and is found in endothelial cells that encompass the entire vasculature, including the vessels in the heart. Nitric oxide (NO) is produced in a catabolic reaction in the endothelial cells, neurons, glia and macrophages by nitric oxide synthase (NOS) isoenzymes. eNOS is a subgroup of this family of enzymes that catalyses the production of nitric oxide (NO) from L-arginine and oxygen, which leads to vascular relaxation by activating the guanylate cyclase. This finally induces smooth muscle relaxation. The aim of this study was to investigate the allelic frequency and the genotypic distribution of the variable number of tandem repeat 27 (27 VNTR) gene polymorphism in intron 4 of the eNOS (eNOS 4a/b) gene in Thrace region, to compare CAD patients with appropriate healthy controls and to correlate the genetic findings with CAD subtypes. The study group included 281 (153 subjects with CAD and 128 controls) patients. The eNOS polymorphism was identified with a polymerase chain reaction. Genotypes were defined as aa, ab and bb according to the presence of a and b alleles. In this case–control study, we found that there was sensible correlation between eNOS gene intron 4a/b VNTR polymorphism and the risk of CAD in Thrace region of Turkey. However, there was no major difference for the genotype distribution and the allelic frequency among the CAD subtypes. Further studies on the interaction of such genes are needed to clarify the association between eNOS 4a/b polymorphism and CAD patients.
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Affiliation(s)
- N Sivri
- Department of Cardiology, School of Medicine, Trakya University , Edirne , Turkey
| | - A Unlu
- Department of Biophysics, School of Medicine, Trakya University , Edirne , Turkey
| | - O Palabiyik
- Department of Biophysics, School of Medicine, Trakya University , Edirne , Turkey
| | - M Budak
- Department of Biophysics, School of Medicine, Trakya University , Edirne , Turkey
| | - Y Kacmaz
- Department of Cardiology, School of Medicine, Trakya University , Edirne , Turkey
| | - K Yalta
- Department of Cardiology, School of Medicine, Trakya University , Edirne , Turkey
| | - T Sipahi
- Department of Biophysics, School of Medicine, Trakya University , Edirne , Turkey
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The association of inflammatory markers with cerebral vasoreactivity and carotid atherosclerosis in transient ischaemic attack. Clin Biochem 2014; 47:182-6. [DOI: 10.1016/j.clinbiochem.2014.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/08/2014] [Accepted: 07/11/2014] [Indexed: 11/22/2022]
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Abstract
Patients presenting for lower extremity revascularization often have multiple systemic comorbidities, making them high-risk surgical candidates. Neuraxial anesthesia and general anesthesia are equivocal in their effect on perioperative cardiac morbidity and improved graft patency. Postoperative epidural analgesia may improve perioperative cardiac morbidity. Systemic antithrombotic and anticoagulation therapy is common among this patient population and may affect anesthetic techniques.
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Affiliation(s)
- James M Anton
- St. Luke's Medical Group, CHI St. Luke's Health, 6720 Bertner Avenue, Room 0520, MC 1-226, Houston, TX 77030, USA; Division of Cardiovascular Anesthesiology, Texas Heart Institute, Baylor St. Luke's Medical Center, 6720 Bertner Avenue, Room 0520, MC 1-226, Houston, TX 77030, USA.
| | - Marie LaPenta McHenry
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital and Clinics, 300 Pasteur Drive, Stanford, CA 94305, USA
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Thiruvengadam J, Anburajan M, Menaka M, Venkatraman B. Potential of thermal imaging as a tool for prediction of cardiovascular disease. J Med Phys 2014; 39:98-105. [PMID: 24872607 PMCID: PMC4035622 DOI: 10.4103/0971-6203.131283] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/20/2014] [Accepted: 03/21/2014] [Indexed: 01/14/2023] Open
Abstract
Vascular dysfunction is associated with onset of cardiovascular disease (CVD). Its effect is reflected as temperature change on the skin. The aim of this work was to test the potential of thermal imaging as cost effective screening tool for prediction of CVD. Thermal imaging of various parts of the subject (N = 80, male/female =44/36, aged 25-75 years) was done using noncontact infrared (IR) camera. In each subject, total cholesterol (TC; mg/dl) and high-density lipoprotein (HDL, mg/dl) were measured according to standard biochemical analysis. Based on National Cholesterol Education Program ATP III criteria, subject with known CVD (N = 16) and age- and sex- matched normal subjects (N = 21) were included in the study. The average surface temperature of various parts from head to toe was calculated and statistical analysis was performed between the groups. In the total population (N = 37), correlation study shows TC (mg/dl) was correlated with measured surface temperature of the following regions: Temporal left (r = -0.316) and right (r = -0.417), neck left (r = 0.347) and right (r = -0.410), and hand left (r = 0.387). HDL (mg/dl) was found to be correlated with measured surface temperature of the following regions: Temporal left (r = 0.445) and right (r = 0.458), hand left (r = -0.470), and foot anterior left (r = -0.332) and right (r = -0.336). Temperature asymmetry was more significant in upper extremity in CVD group. Using the surface temperature, regression models were calculated for noninvasive estimation of TC and HDL. The predictive ability of measured surface temperature for TC and HDL was 60%. The model for noninvasive estimation gave sensitivity and specificity value of 79 and 83% for TC and 78 and 81% for HDL, respectively. Thus, the surface temperature can be one of the screening tools for prediction of CVD. The limitation of the present study is also discussed under future work.
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Affiliation(s)
| | - M Anburajan
- Department of Biomedical Engineering, SRM University, Chennai, Tamil Nadu, India
| | - M Menaka
- Department of Quality Assurance Division, Indira Gandhi Centre for Atomic Research, Kalpakkam, Chennai, Tamil Nadu, India
| | - B Venkatraman
- Department of Radiological Safety and Environmental Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Chennai, Tamil Nadu, India
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Stather PW, Sylvius N, Wild JB, Choke E, Sayers RD, Bown MJ. Differential microRNA expression profiles in peripheral arterial disease. ACTA ACUST UNITED AC 2014; 6:490-7. [PMID: 24129592 DOI: 10.1161/circgenetics.111.000053] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Peripheral arterial disease (PAD) is a clinical condition caused by an atherosclerotic process affecting the arteries of the limbs. Despite major improvements in surgical endovascular techniques, PAD is still associated with high mortality and morbidity. Recently, microRNAs (miRNAs), a class of short noncoding RNA controlling gene expression, have emerged as major regulators of multiple biological processes. METHODS AND RESULTS A whole-miRNA transcriptome profiling was performed in peripheral blood from an initial sample set of patients and controls. A 12-miRNA PAD-specific signature, which includes let 7e, miR-15b, -16, -20b, -25, -26b, -27b, -28-5p, -126, -195, -335, and -363, was further investigated and validated in 2 additional sample sets. Each of these 12 miRNAs exhibited good diagnostic value as evidenced by receiver operating characteristic curve analyses. Pathway enrichment analysis using predicted and validated targets identified several signaling pathways relevant to vascular disorders. Several of these pathways, including cell adhesion molecules, were confirmed by quantifying the expression level of several candidate genes regulating the initial stages of the inflammatory atherosclerotic process. The expression level of 7 of these candidate genes exhibits striking inverse correlation with that of several, if not all, of the miRNAs of the PAD-specific miRNA signature. CONCLUSIONS These results demonstrate the potential of miRNAs for the diagnosis of PAD and provide further insight into the molecular mechanisms leading to the development of PAD, with the potential for future therapeutic targets.
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Affiliation(s)
- Philip W Stather
- Department of Cardiovascular Sciences and Department of Genetics and the NIHR Leicester Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, United Kingdom
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El Raouf SA, El Maati AAA, Chalabi N. Agreement between multi-detector-row CT angiography and US-ECD in quantification of carotid artery stenosis and plaque characterization. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2013.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Lee JJ, Kwon H, Lee JH, Kim DG, Jung SH, Ma JY. Fermented soshiho-tang with Lactobacillus plantarum enhances the antiproliferative activity in vascular smooth muscle cell. Altern Ther Health Med 2014; 14:78. [PMID: 24580756 PMCID: PMC3942327 DOI: 10.1186/1472-6882-14-78] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/24/2014] [Indexed: 11/26/2022]
Abstract
Background Soshiho-tang (SST) is a traditional medicine widely used for the treatment of chronic hepatitis. SST has been shown to confer a variety of pharmacological activities, including prevention of hepatotoxicity, promotion of liver regeneration, and modulation of liver fibrosis. In this study, we investigated the antiproliferative activity of native and fermented (FSST) formulations of SST in vascular smooth muscle cells (VSMCs) and examined the potential underlying mechanisms driving these effects. Methods SST, along with preparations fermented with Lactobacillus plantarum KFRI-144 (S-A144), L. amylophilus KFRI-161 (S-A161) and L. bulgaricus KFRI-344 (S-A344), were investigated to determine their effects on the proliferation and viability of VSMCs, along with the signalling pathways underlying these effects. Results S-A144 exhibited a strong, dose-dependent inhibition of VSMC proliferation relative to untreated controls, but the others did not affect. In addition, S-A144 significantly decreased the phosphorylation of Akt and PLCγ1 in a dose-dependent manner and induced cell cycle arrest at the G0/G1 phase characterised by decreased expression of CDKs, cyclins and PCNA. Conclusions The findings suggest that S-A144 exhibit enhanced inhibition of PDGF-BB-induced VSMC proliferation comparison to S-AOR through the suppression of cell cycle progression and expression of cell cycle-related proteins, along with the downregulation of Akt phosphorylation.
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Lee CH, Chang SH, Lin YH, Liu SJ, Wang CJ, Hsu MY, Hung KC, Yeh YH, Chen WJ, Hsieh IC, Wen MS. Acceleration of re-endothelialization and inhibition of neointimal formation using hybrid biodegradable nanofibrous rosuvastatin-loaded stents. Biomaterials 2014; 35:4417-27. [PMID: 24582553 DOI: 10.1016/j.biomaterials.2014.02.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
Abstract
Incomplete endothelialization and neointimal hyperplasia of injured arteries can cause acute and late stent thromboses. This work develops hybrid stent/biodegradable nanofibers for the local and sustained delivery of rosuvastatin to denuded artery walls. Biodegradable nanofibers were firstly prepared by dissolving poly(D,L)-lactide-co-glycolide and rosuvastatin in 1,1,1,3,3,3-hexafluoro-2-propanol. The solution was then electrospun into nanofibrous tubes, which were mounted onto commercially available bare-metal stents. The in vitro release rates of the pharmaceuticals from the nanofibers were determined using an elution method and a high-performance liquid chromatography assay. The experimental results thus obtained suggest that the biodegradable nanofibers released high concentrations of rosuvastatin for four weeks. The effectiveness of the local delivery of rosuvastatin in reducing platelets was studied. The tissue inflammatory reaction caused by the hybrid stents that were used to treat diseased arteries was also documented. The proposed hybrid stent/biodegradable rosuvastatin-loaded nanofibers contributed substantially to the local and sustainable delivery of a high concentration of drugs to promote re-endothelialization, improve endothelial function, reduce inflammatory reaction, and inhibit neointimal formation of the injured artery. The results of this work provide insight into how patients with a high risk of stent restenosis should be treated for accelerating re-endothelialization and inhibiting neointimal hyperplasia.
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Affiliation(s)
- Cheng-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan; Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan
| | - Shang-Hung Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Yu-Huang Lin
- Graduate Institute of Medical Mechatronics, Chang Gung University, Tao-Yuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
| | - Chao-Jan Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan
| | - Ming-Yi Hsu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Yung-Hsin Yeh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Wei-Jan Chen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - I-Chang Hsieh
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Ming-Shien Wen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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Wilczynska M, Rice S, Davies G, Lewis KE. Endothelial injury markers before and after nasal continuous positive airway pressure treatment for obstructive sleep apnoea hypopnoea syndrome. Sleep Breath 2013; 18:599-607. [DOI: 10.1007/s11325-013-0923-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 11/23/2013] [Accepted: 11/27/2013] [Indexed: 01/29/2023]
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Tzvetanov P, Hegde V, Al-Hashel JY, Atanasova M, Sohal APS, Rousseff RT. Abnormal levels of serum anti-elastin antibodies in patients with symptomatic carotid stenosis. Clin Neurol Neurosurg 2013; 116:9-12. [PMID: 24388508 DOI: 10.1016/j.clineuro.2013.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 09/25/2013] [Accepted: 11/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE A correlation between the levels of antibodies to alpha-elastin (alpha-AEAb) and tropoelastin (tropo-AEAb) and the corresponding peptide concentration is found in human serum in health and disease. Serum elastin peptide and anti-elastin antibodies (AEAb) levels are age-related and vary with the stages of atherosclerotic vascular damage. This study aims to determine if elastin metabolism (assessed by the ratio of tropo-AEAb to alpha-AEAb) differs in patients with symptomatic carotid stenosis versus subjects with asymptomatic stenosis. PATIENTS AND METHODS Alpha-AEAb and tropo-AEAb were measured by ELISA in blood sera of 65 patients with ultrasound verified high-grade symptomatic carotid stenosis (resulting in stroke 1-7 days before measurement) compared to 51 patients with asymptomatic stenosis. RESULTS Serum anti-alpha-elastin IgG levels are extremely increased in symptomatic versus asymptomatic carotid stenosis. The ratio of tropo-AEAb (reflecting elastin synthesis) to alpha-AEAb (a function of elastin degradation) was 3.7 in symptomatic stenosis versus 14.2 in asymptomatic stenosis (p<0.001). CONCLUSIONS There is a significant difference in elastin metabolism in patients with symptomatic carotid stenosis versus asymptomatic stenosis. The ratio of tropo-AEAb to alpha-AEAb as an index of elastin synthesis/degradation proves useful in investigation of atherosclerotic lesions and may represent a new immunologic marker for carotid plaque destabilization.
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Affiliation(s)
- Plamen Tzvetanov
- Department of Neurosciences, University Hospitals, Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Vish Hegde
- Department of Neurosciences, University Hospitals, Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Jasem Y Al-Hashel
- Department of Neurology, Ibn-Sina Hospital, pob 25427, Safat 13115, Kuwait
| | - Milena Atanasova
- Department of Biology, Medical University of Pleven, Kliment Ohridski st 1, Pleven 5800, Bulgaria
| | - Aman P S Sohal
- Department of Neurosciences, University Hospitals, Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Rossen T Rousseff
- Department of Neurology, Ibn-Sina Hospital, pob 25427, Safat 13115, Kuwait.
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79
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Honda T, Fujimoto K, Miyao Y, Koga H, Ishii M. Current cigarette smoking is an independent risk factor for subacute stent thrombosis in acute myocardial infarction patients. J Cardiol 2013; 63:358-64. [PMID: 24239276 DOI: 10.1016/j.jjcc.2013.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 09/16/2013] [Accepted: 10/06/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute myocardial infarction (AMI) is prevalent and has serious consequences including re-infarction and death. Cigarette smoking is a coronary risk factor for AMI, although a "smoker's paradox" for AMI has been reported in Western countries. On the other hand, some researchers have reported that smoking is associated with subacute stent thrombosis (SAST) after AMI. However, the occurrence of this condition is not well documented in Japan. The aim of this study was to clarify how prior smoking status may affect prognosis, including SAST, in Japanese patients with AMI. METHODS A total of 266 consecutive patients with AMI were enrolled retrospectively in the study if they had undergone emergency coronary intervention (bare metal stent) within 24h of symptom onset, and had a 5-10 month follow-up examination. The patients were divided into three groups based on their cigarette smoking status (non-smokers, past smokers, and current smokers). RESULTS Current smokers were significantly younger than the other two groups, although their levels of low density lipoprotein-cholesterol and triglyceride were significantly higher. White blood cell count and hemoglobin level on admission were also significantly higher in current smokers compared with the other two groups. The incidence of SAST was significantly higher in current smokers than in the other groups, although the occurrence of heart failure after AMI was similar in the three groups. On the other hand, improvement in left ventricular ejection fraction was observed in non-smokers and past smokers, but not in current smokers. Multiple logistic analysis revealed that current smoking was an independent risk factor for SAST (odds ratio 5.4; p<0.05). Current smokers were about five times more likely to have a SAST compared with non-smokers. CONCLUSIONS These findings indicate that current cigarette smoking predicts SAST after primary percutaneous coronary intervention for AMI in Japanese patients.
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Affiliation(s)
- Tsuyoshi Honda
- Department of Cardiology, Cardiovascular Center, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
| | - Kazuteru Fujimoto
- Department of Cardiology, Cardiovascular Center, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yuji Miyao
- Department of Cardiology, Cardiovascular Center, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Hidenobu Koga
- Department of Cardiology, Cardiovascular Center, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Masanobu Ishii
- Department of Cardiology, Cardiovascular Center, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
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Rajendran P, Rengarajan T, Thangavel J, Nishigaki Y, Sakthisekaran D, Sethi G, Nishigaki I. The vascular endothelium and human diseases. Int J Biol Sci 2013; 9:1057-69. [PMID: 24250251 PMCID: PMC3831119 DOI: 10.7150/ijbs.7502] [Citation(s) in RCA: 931] [Impact Index Per Article: 84.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/07/2013] [Indexed: 02/07/2023] Open
Abstract
Alterations of endothelial cells and the vasculature play a central role in the pathogenesis of a broad spectrum of the most dreadful of human diseases, as endothelial cells have the key function of participating in the maintenance of patent and functional capillaries. The endothelium is directly involved in peripheral vascular disease, stroke, heart disease, diabetes, insulin resistance, chronic kidney failure, tumor growth, metastasis, venous thrombosis, and severe viral infectious diseases. Dysfunction of the vascular endothelium is thus a hallmark of human diseases. In this review the main endothelial abnormalities found in various human diseases such as cancer, diabetes mellitus, atherosclerosis, and viral infections are addressed.
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Affiliation(s)
- Peramaiyan Rajendran
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
| | | | - Jayakumar Thangavel
- 2. Department of Pharmacology and Center of Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, Illinois, United States of America
| | - Yutaka Nishigaki
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
| | - Dhanapal Sakthisekaran
- 3. Department of Medical Biochemistry, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai, India 600 113
| | - Gautam Sethi
- 4. Department of Pharmacology,Yong Loo Lin School of Medicine,National University Health System, 10 Medical Drive, MD11, #05-09, Clinical Research Centre, Singapore 117597
| | - Ikuo Nishigaki
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
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81
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Mangoni AA, Stockley CS, Woodman RJ. Effects of red wine on established markers of arterial structure and function in human studies: current knowledge and future research directions. Expert Rev Clin Pharmacol 2013; 6:613-25. [PMID: 24164610 DOI: 10.1586/17512433.2013.841077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Evidence from observational studies suggests that mild-to-moderate consumption of red wine is associated with reduced cardiovascular morbidity and mortality. Various individual chemical components of red wine also show salutary effects on vascular homeostasis, that is, enhanced endothelial function and arterial distensibility, both in vitro and in animal studies. However, testing the beneficial potential of red wine in primary and secondary cardiovascular prevention on established surrogate cardiovascular markers requires further study with longer term intervention trials. This report reviews and critically appraises the published evidence for the effects of red wine on endothelium-dependent vasodilation, arterial stiffness and arterial wave reflections in healthy subjects and in patients with cardiovascular disease. Suggestions for future research directions are also provided.
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Affiliation(s)
- Arduino A Mangoni
- Discipline of Clinical Pharmacology, School of Medicine, Flinders University and Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia
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82
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Song P, Zhou Y, Coughlan KA, Dai X, Xu H, Viollet B, Zou MH. Adenosine monophosphate-activated protein kinase-α2 deficiency promotes vascular smooth muscle cell migration via S-phase kinase-associated protein 2 upregulation and E-cadherin downregulation. Arterioscler Thromb Vasc Biol 2013; 33:2800-9. [PMID: 24115035 DOI: 10.1161/atvbaha.113.301869] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) are critical events in the progression of several vasculopathologies. Adenosine monophosphate-activated protein kinase (AMPK) has been shown to play a pivotal role in cellular proliferation and migration. However, the roles of AMPK in VSMC migration and its underlying molecular mechanisms remain elusive. APPROACH AND RESULTS VSMC migration and the neointima formation were studied in cultured mouse VSMCs or in carotid artery ligation of wild-type C57BL/6J mice, AMPKα2, AMPKα1 homozygous-deficient (AMPKα2(-/-), AMPKα1(-/-)) mice. Deletion of AMPKα2, but not AMPKα1, led to increased phosphorylation of both IкB kinase α and its downstream target nuclear factor кB2/p100 at serine 866/870. Consequently, phosphor-p100 at S866/870 bound with E3 ubiquitin ligase β-transducin repeat-containing protein resulting in the proteolytic processing of the p100 precursor and nuclear factor кB2/p52 induction. Interestingly, acetylation of histone H3 at lysine 56 mediated by histone deacetylase-3 reduction was enhanced significantly in AMPKα2(-/-) VSMCs compared with wild-type or AMPKα1(-/-) VSMCs. Moreover, the augmented association of p52/acetylation of histone H3 at lysine 56 with the promoter of ubiquitin E3 ligase, S-phase kinase-associated protein 2, was shown in AMPKα2(-/-) VSMCs by chromatin immunoprecipitation assay. Furthermore, AMPKα2 deletion caused S-phase kinase-associated protein 2-mediated E-cadherin downregulation. S-Phase kinase-associated protein 2 siRNA abolished the increased migration of AMPKα2(-/-) VSMCs via E-cadherin upregulation. Finally, neointima formation after ligation of carotid artery was increased in AMPKα2(-/-), but not AMPKα1(-/-), mice. CONCLUSIONS We conclude that deletion of AMPKα2 causes aberrant VSMC migration with accelerated neointima formation in vivo.
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Affiliation(s)
- Ping Song
- From the Section of Molecular Medicine, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK (P.S., Y.Z., K.A.C., X.D., H.X., M.-H.Z.); College of Medicine, Hubei, Province Key Laboratory on Cardiovascular, Cerebrovascular, and Metabolic Disorders, Hubei University of Science and Technology, Xianning, Hubei, China (Y.Z.); College of Medicine, Yangzhou University, Yangzhou, Jiangsu, China (H.X.); Institut Cochin, Université Paris Descartes, CNRS (UMR 8104), Paris, France (B.V.); and INSERM, U1016, Paris, France (B.V.)
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83
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Soluble RAGE plasma levels in patients with coronary artery disease and peripheral artery disease. ScientificWorldJournal 2013; 2013:584504. [PMID: 24228009 PMCID: PMC3817642 DOI: 10.1155/2013/584504] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 09/12/2013] [Indexed: 11/18/2022] Open
Abstract
The objective of the present study was define in a relatively large patient population with coronary artery disease (CAD) whether the concomitant presence of peripheral artery disease (PAD), which is known to convey additional cardiovascular risk, was associated with different circulating levels of sRAGE with respect to CAD alone and control subjects. Clinical and laboratory parameters including the ankle brachial index (ABI) and sRAGE (enzyme-linked immunosorbent assay kit) were investigated in 544 patients with angiographically documented CAD and 328 control subjects. 213/554 CAD patients (39%) showed an ABI <0.9 associated with typical symptoms (group CAD + PAD), whereas 331 patients were free from PAD. The concentration of plasma sRAGE was significantly lower (P < 0.0001) in CAD population, with and without PAD, than in control subjects. Among CAD patients, those with PAD showed lower levels of sRAGE. The distribution of the three groups (CAD, CAD + PAD, and controls) according to sRAGE tertiles showed that lower levels were more frequent in patients with CAD and CAD + PAD, whereas higher levels were more frequently found in controls. CAD patients presenting with PAD have lower sRAGE levels than CAD patients without peripheral atherosclerosis showing that stable atherosclerotic lesions in different vascular districts are inversely related to soluble decoy receptor sRAGE.
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84
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Du Y, Lai PT, Leung CH, Pong PWT. Design of superparamagnetic nanoparticles for magnetic particle imaging (MPI). Int J Mol Sci 2013; 14:18682-710. [PMID: 24030719 PMCID: PMC3794803 DOI: 10.3390/ijms140918682] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 07/29/2013] [Accepted: 08/14/2013] [Indexed: 01/21/2023] Open
Abstract
Magnetic particle imaging (MPI) is a promising medical imaging technique producing quantitative images of the distribution of tracer materials (superparamagnetic nanoparticles) without interference from the anatomical background of the imaging objects (either phantoms or lab animals). Theoretically, the MPI platform can image with relatively high temporal and spatial resolution and sensitivity. In practice, the quality of the MPI images hinges on both the applied magnetic field and the properties of the tracer nanoparticles. Langevin theory can model the performance of superparamagnetic nanoparticles and predict the crucial influence of nanoparticle core size on the MPI signal. In addition, the core size distribution, anisotropy of the magnetic core and surface modification of the superparamagnetic nanoparticles also determine the spatial resolution and sensitivity of the MPI images. As a result, through rational design of superparamagnetic nanoparticles, the performance of MPI could be effectively optimized. In this review, the performance of superparamagnetic nanoparticles in MPI is investigated. Rational synthesis and modification of superparamagnetic nanoparticles are discussed and summarized. The potential medical application areas for MPI, including cardiovascular system, oncology, stem cell tracking and immune related imaging are also analyzed and forecasted.
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Affiliation(s)
- Yimeng Du
- Department of Electrical and Electronic Engineering, the University of Hong Kong, Hong Kong; E-Mails: (Y.D.); (P.T.L.); (C.H.L.)
| | - Pui To Lai
- Department of Electrical and Electronic Engineering, the University of Hong Kong, Hong Kong; E-Mails: (Y.D.); (P.T.L.); (C.H.L.)
| | - Cheung Hoi Leung
- Department of Electrical and Electronic Engineering, the University of Hong Kong, Hong Kong; E-Mails: (Y.D.); (P.T.L.); (C.H.L.)
| | - Philip W. T. Pong
- Department of Electrical and Electronic Engineering, the University of Hong Kong, Hong Kong; E-Mails: (Y.D.); (P.T.L.); (C.H.L.)
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85
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Englund EK, Langham MC, Li C, Rodgers ZB, Floyd TF, Mohler ER, Wehrli FW. Combined measurement of perfusion, venous oxygen saturation, and skeletal muscle T2* during reactive hyperemia in the leg. J Cardiovasc Magn Reson 2013; 15:70. [PMID: 23958293 PMCID: PMC3765712 DOI: 10.1186/1532-429x-15-70] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/30/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The function of the peripheral microvascular may be interrogated by measuring perfusion, tissue oxygen concentration, or venous oxygen saturation (SvO2) recovery dynamics following induced ischemia. The purpose of this work is to develop and evaluate a magnetic resonance (MR) technique for simultaneous measurement of perfusion, SvO2, and skeletal muscle T2*. METHODS Perfusion, Intravascular Venous Oxygen saturation, and T2* (PIVOT) is comprised of interleaved pulsed arterial spin labeling (PASL) and multi-echo gradient-recalled echo (GRE) sequences. During the PASL post-labeling delay, images are acquired with a multi-echo GRE to quantify SvO2 and T2* at a downstream slice location. Thus time-courses of perfusion, SvO2, and T2* are quantified simultaneously within a single scan. The new sequence was compared to separately measured PASL or multi-echo GRE data during reactive hyperemia in five young healthy subjects. To explore the impairment present in peripheral artery disease patients, five patients were evaluated with PIVOT. RESULTS Comparison of PIVOT-derived data to the standard techniques shows that there was no significant bias in any of the time-course-derived metrics. Preliminary data show that PAD patients exhibited alterations in perfusion, SvO2, and T2* time-courses compared to young healthy subjects. CONCLUSION Simultaneous quantification of perfusion, SvO2, and T2* is possible with PIVOT. Kinetics of perfusion, SvO2, and T2* during reactive hyperemia may help to provide insight into the function of the peripheral microvasculature in patients with PAD.
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Affiliation(s)
- Erin K Englund
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Michael C Langham
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Cheng Li
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Zachary B Rodgers
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Thomas F Floyd
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
| | - Emile R Mohler
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Felix W Wehrli
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
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86
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Yang Z, Ming XF. Arginase: the emerging therapeutic target for vascular oxidative stress and inflammation. Front Immunol 2013; 4:149. [PMID: 23781221 PMCID: PMC3679468 DOI: 10.3389/fimmu.2013.00149] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 05/30/2013] [Indexed: 01/28/2023] Open
Abstract
Oxidative stress and inflammation in the vascular wall are essential mechanisms of atherosclerosis and vascular dysfunctions associated with risk factors such as metabolic diseases, aging, hypertension, etc. Evidence has been provided that activation of the vascular endothelial cells in the presence of the risk factors promotes oxidative stress and vascular inflammatory responses, leading to acceleration of atherosclerotic vascular disease. Increasing number of studies from recent years demonstrates that uncoupling of endothelial nitric oxide synthase (eNOS), whereby the enzyme eNOS produces detrimental amount of superoxide anion O2− instead the vasoprotective nitric oxide (NO⋅), plays a critical role in vascular dysfunction under various pathophysiological conditions and in aging. The mechanisms of eNOS-uncoupling seem multiple and complex. Recent research provides emerging evidence supporting an essential role of increased activity of arginases including arginase-I and arginase-II in causing eNOS-uncoupling, which results in vascular oxidative stress and inflammatory responses, and ultimately leading to vascular diseases. This review article will summarize the most recent findings on the functional roles of arginases in vascular diseases and/or dysfunctions and the underlying mechanisms in relation to oxidative stress and inflammations. Moreover, regulatory mechanisms of arginases in the vasculature are reviewed and the future perspectives of targeting arginases as therapeutic options in vascular diseases are discussed.
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Affiliation(s)
- Zhihong Yang
- Vascular Biology, Division of Physiology, Department of Medicine, University of Fribourg , Fribourg , Switzerland
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87
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Jover E, Marín F, Roldán V, Montoro-García S, Valdés M, Lip GYH. Atherosclerosis and thromboembolic risk in atrial fibrillation: focus on peripheral vascular disease. Ann Med 2013; 45:274-90. [PMID: 23216106 DOI: 10.3109/07853890.2012.732702] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. It results in a 5-fold increased risk for stroke and thromboembolism and is associated with a high morbidity and mortality. AF shares several risk factors and pathophysiological features with atherosclerosis. Hence AF is often complicated by a variety of other cardiovascular conditions. Indeed, peripheral vascular disease (PVD) is highly prevalent among AF patients and associates with increased mortality. Inclusion of PVD within stroke risk scoring systems such as the CHA2DS2-VASc score improves risk stratification of AF patients. Of note, PVD has not been previously well documented nor looked for in observational studies or clinical trials. The aim of this present review article is to provide an overview of the association between atherosclerosis (with particular focus on PVD) and AF as well as its complications.
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Affiliation(s)
- Eva Jover
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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88
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Stefanov F, McGloughlin T, Delassus P, Morris L. Hemodynamic variations due to spiral blood flow through four patient-specific bifurcated stent graft configurations for the treatment of abdominal aortic aneurysms. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2013; 29:179-196. [PMID: 23255342 DOI: 10.1002/cnm.2525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 09/18/2012] [Accepted: 10/07/2012] [Indexed: 06/01/2023]
Abstract
Endovascular repair is now a recognised procedure for treating abdominal aortic aneurysms. However, post-operative complications such as stent graft migration and thrombus may still occur. To assess these complications numerically, the correct input boundary conditions, which include the full human aorta with associated branching, should be included. Four patient-specific computed tomography scanned bifurcated stent grafts (SGs) were modelled and attached onto a full human aorta, which included the ascending, aortic arch and descending aortas. Two of the SG geometries had a twisted leg configuration, while the other two had conventional nontwisted leg configurations. Computational fluid dynamics was completed for both geometries and the hemodynamics assessed. The complexity of the flow patterns and secondary flows were influenced by the inclusion of the full human aorta at the SG proximal section. During the decelerating phase significant recirculations occurred along the main body of all SG configurations. The inclusion of the full human aorta did not impact the velocity contours within the distal legs and there was no difference in drag forces with the SG containing the full human aorta and those without. A twisted leg configuration further promoted a spiral flow formation along its distal legs.
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Affiliation(s)
- Florian Stefanov
- Galway Medical Technologies Centre-GMedTech, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland
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89
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Oxygenation and flow in the limbs: Novel methods to characterize peripheral artery disease. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013; 6:150-157. [PMID: 23504569 DOI: 10.1007/s12410-013-9191-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Peripheral arterial disease (PAD) affects approximately 8 million Americans and is associated with high morbidity and increased mortality. Current therapies for PAD are limited and development of new therapeutic agents is needed. Present diagnostic methods for PAD are insensitive to the subtle microvascular and metabolic changes that occur beyond macrovacular stenosis and therefore may be less useful endpoints for clinical trials. Phosphorus-31 magnetic resonance (MR) spectroscopy, MR muscle perfusion, and MR oximetry are novel methods capable of evaluating both the macrovascular and microvascular changes that occur in PAD patients.
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90
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Monteiro DP, Britto RR, Lages ACR, Basílio ML, de Oliveira Pires MC, Carvalho MLV, Procópio RJ, Pereira DAG. Heel-rise test in the assessment of individuals with peripheral arterial occlusive disease. Vasc Health Risk Manag 2013; 9:29-35. [PMID: 23378770 PMCID: PMC3556919 DOI: 10.2147/vhrm.s39860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The heel-rise test (HRT) is a clinical instrument relevant to vascular rehabilitation that has been proposed to assess the function of the triceps surae muscle. To use HRT in the assessment of individuals with peripheral arterial occlusive disease (PAOD), its ability to detect differences in the functional performance of patients with PAOD must be verified. AIM To verify whether the test is sensitive in differentiating between individuals with PAOD with distinct functional capacities. MATERIALS AND METHODS A transversal study in which individuals with PAOD were assessed using the HRT, the Walking Impairment Questionnaire (WIQ), and the Shuttle Walk Test. The following variables were analyzed: number of plantar flexions performed in the HRT (time in seconds) and velocity (plantar flexions per second) when performing plantar flexions up to the point of volunteer fatigue, maximum distance walked in the Shuttle Walk Test, and scores obtained in each WIQ domain. RESULTS Twenty-five individuals (14 male) were included in the study, with a mean age of 63.36 ± 9.83 years. The variables number of plantar flexions and time to perform the HRT were sensitive enough to differentiate between distinct functional capacities in individuals with PAOD (P = 0.003 and P = 0.009, respectively). However, this result was not found for the variable of velocity in the HRT. The number of plantar flexions in the HRT was sensitive enough to differentiate individuals of extreme classes on the WIQ domain, stairs (P = 0.008). CONCLUSION The HRT can be applied in clinical practice as a valid assessment of the distinct function capacities of individuals with PAOD.
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Affiliation(s)
- Débora Pantuso Monteiro
- Rehabilitation Sciences of the Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil
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Xu Y, Zhou Y, Lin H, Hu H, Wang Y, Xu G. Toll-like receptor 2 in promoting angiogenesis after acute ischemic injury. Int J Mol Med 2013; 31:555-60. [PMID: 23314218 DOI: 10.3892/ijmm.2013.1240] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 12/06/2012] [Indexed: 11/06/2022] Open
Abstract
Angiogenesis is an important mechanism that protects tissue against necrosis following acute ischemic injury. The aim of this study was to investigate whether the Toll-like receptor 2 (TLR2) signaling pathway is involved in angiogenesis following ischemic injury by cell migration and lymphocyte invasion assays in vitro, and a mouse model of hindlimb ischemia by ligation in vivo, respectively. To assess the potential role of TLR2 activation in endothelial cell permeability, HUVECs were pretreated with Pam3CSK4 and analyzed using wound repair and transwell assays. The results showed that the TLR2 agonist induced human umbilical vein endothelial cell (HUVEC) migration and increased the permeability of HUVECs to lymphocyte. The lymphocyte invasion of TLR2 knockout (TLR2-/-) mice was inhibited as compared to that of wild-type (WT) mice. In the mouse model of hindlimb ischemia by ligation, blood perfusion of operated limbs was significantly lower in TLR2-/- compared to WT mice, 7 and 14 days after ligation. TLR2-/- mice showed a decreased CD31 expression in ischemic gastrocnemius at 7 and 14 days after ligation, reduced interleukin-6 (IL-6) level and lowered tumor necrosis factor-α (TNF-α) levels. These findings demonstrated that TLR2 activation promotes cell migration, cell permeability and the lymphocyte invasion of endothelial cells. TLR2 activation promotes angiogenesis in vivo, which may be associated with the serum of TNF-α levels and IL-6 release.
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Affiliation(s)
- Yifei Xu
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310009, PR China
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Cronin P, Upchurch GR, Patel HJ, Deeb GM, Kelly AM, Williams DM. Asymmetric expansion of aortic aneurysms on computed tomography imaging. J Vasc Surg 2012. [PMID: 23182153 DOI: 10.1016/j.jvs.2012.08.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate whether wall growth during aneurysm development spares the aortic wall between the intercostal or lumbar arteries or, alternatively, is uniform around the circumference. METHODS Computed tomography scans of 155 patients with aortic aneurysms (40 thoracic, 50 thoracoabdominal, and 65 abdominal) in a single hospital of a large academic institution were retrospectively inspected. Computed tomography studies of 100 control subjects (40 thoracic and 60 abdominal) were also reviewed. In all 255 patients, the ratio of the arc length between the origins of the intercostal or lumbar arteries (interbranch arc length) to the remainder of the aortic residual circumference was calculated. These ratios were compared between all subjects with aneurysms and the controls at each vertebral body level and between those with thoracic or thoracoabdominal or abdominal aneurysms and controls at each vertebral body level. RESULTS Interbranch arc lengths and residual aortic circumferences were larger in aneurysm patients than in control subjects, but the differences were statistically significant only at T4 and from T8 to L4 (P = .009 to P < .001) and from T4 to L4 (P < .001), respectively. The ratio of interbranch arc length to residual circumference in aneurysmal aortas was significantly smaller than that in controls at 12 out of 13 levels from T4 to L4 (P = .004 to P < .001). There was a statistically significant smaller ratio at 8 out of 9 levels for thoracic aneurysms (P = .006 to P < .001), 12 out of 13 levels for thoracoabdominal aneurysms (P = .008 to P < .001), and 3 out of 4 levels for abdominal aneurysms compared with controls (P = .006 to P < .001). CONCLUSIONS Wall growth in aortic aneurysms is asymmetric, with greater aneurysmal growth in the anterior aorta wall and relative sparing of the portion of aortic wall between the intercostal or lumbar arteries. The mechanisms effecting this asymmetric growth have not been fully characterized.
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Affiliation(s)
- Paul Cronin
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, Ann Arbor, MI 48109-5302, USA.
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93
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Peffer K, den Heijer M, Holewijn S, de Graaf J, Swinkels DW, Verbeek AL, Atsma F. The effect of frequent whole blood donation on ferritin, hepcidin, and subclinical atherosclerosis. Transfusion 2012; 53:1468-74. [DOI: 10.1111/j.1537-2995.2012.03916.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 08/12/2012] [Accepted: 08/12/2012] [Indexed: 11/28/2022]
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94
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Nitric oxide and geriatrics: Implications in diagnostics and treatment of the elderly. J Geriatr Cardiol 2012; 8:230-42. [PMID: 22783310 PMCID: PMC3390088 DOI: 10.3724/sp.j.1263.2011.00230] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 09/21/2011] [Accepted: 09/28/2011] [Indexed: 01/01/2023] Open
Abstract
The nation's aging population is growing rapidly. By 2030, the number of adults age 65 and older will nearly double to 70 million. Americans are living longer and older adults can now live for many years with multiple chronic illnesses but with a substantial cost to health care. Twenty percent of the Medicare population has at least five chronic conditions i.e., hypertension, diabetes, arthritis, etc. Studies in experimental models and even humans reveal that constitutive production of nitric oxide (NO) is reduced with aging and this circumstance may be relevant to a number of diseases that plague the aging population. NO is a multifunctional signaling molecule, intricately involved with maintaining a host of physiological processes including, but not limited to, host defense, neuronal communication and the regulation of vascular tone. NO is one of the most important signaling molecules in our body, and loss of NO function is one of the earliest indicators or markers of disease. Clinical studies provide evidence that insufficient NO production is associated with all major cardiovascular risk factors, such as hyperlipidemia, diabetes, hypertension, smoking and severity of atherosclerosis, and also has a profound predictive value for disease progression including cardiovascular and Alzheimers disease. Thirty plus years after its discovery and over 13 years since a Nobel Prize was awarded for its discovery, there have been no hallmark therapeutic breakthroughs or even NO based diagnostics. We will review the current state of the science surrounding NO in the etiology of a number of different diseases in the geriatric patient. From these observations, it can be concluded that enzymatic production of NO declines steadily with increasing age in healthy human subjects. Implementing strategies to diagnose and treat NO insufficiency may provide enormous benefit to the geriatric patient.
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95
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Evaluation of carotid intima-media thickness, a marker of subclinical atherosclerosis, in children with cerebral palsy. Pediatr Radiol 2012; 42:679-84. [PMID: 22450433 DOI: 10.1007/s00247-012-2361-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 10/21/2011] [Accepted: 11/06/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND Respiratory and cardiovascular diseases are the most common causes of death in children with cerebral palsy. OBJECTIVE To evaluate sonographic carotid intima-media thickness, an early marker of atherosclerosis, in children with cerebral palsy and in healthy controls. MATERIALS AND METHODS One hundred children with cerebral palsy (65 boys), mean age 6.2 (SD, 2.1) years, and 35 age-matched and sex-matched healthy controls were included. Common carotid artery intima-media thickness was measured sonographically. Differences between patients and controls were evaluated with an independent samples t-test. RESULTS Age, sex distribution and levels of serum lipids were comparable between patients and controls. Average, right and left carotid artery intima-media were thicker in patients compared with controls (mean ± SD, 0.61 ± 0.13 mm vs 0.40 ± 0.03 mm; 0.61 ± 0.14 mm vs 0.40 ± 0.03 mm; 0.61 ± 0.13 mm vs 0.40 ± 0.03 mm, respectively; all P < 0.001). CONCLUSION Carotid intima-media is sonographically thicker in children with cerebral palsy compared with healthy controls, which may express an increased risk of atherosclerotic diseases.
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96
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Matsuo Y, Takumi T, Mathew V, Chung WY, Barsness GW, Rihal CS, Gulati R, McCue ET, Holmes DR, Eeckhout E, Lennon RJ, Lerman LO, Lerman A. Plaque characteristics and arterial remodeling in coronary and peripheral arterial systems. Atherosclerosis 2012; 223:365-71. [PMID: 22721702 DOI: 10.1016/j.atherosclerosis.2012.05.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 05/07/2012] [Accepted: 05/22/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Few studies have examined plaque characteristics among multiple arterial beds in vivo. The purpose of this study was to compare the plaque morphology and arterial remodeling between coronary and peripheral arteries using gray-scale and radiofrequency intravascular ultrasound (IVUS) at clinical presentation. METHODS AND RESULTS IVUS imaging was performed in 68 patients with coronary and 93 with peripheral artery lesions (29 carotid, 50 renal, and 14 iliac arteries). Plaques were classified as fibroatheroma (VH-FA) (further subclassified as thin-capped [VH-TCFA] and thick-capped [VH-ThCFA]), fibrocalcific plaque (VH-FC) and pathological intimal thickening (VH-PIT). Plaque rupture (13% of coronary, 7% of carotid, 6% of renal, and 7% of iliac arteries; P = NS) and VH-TCFA (37% of coronary, 24% of carotid, 16% of renal, and 7% of iliac arteries; P = 0.02) were observed in all arteries. Compared with coronary arteries, VH-FA was less frequently observed in renal (P < 0.001) and iliac arteries (P < 0.006). Lesions with positive remodeling demonstrated more characteristics of VH-FA in coronary (84% vs. 25%, P < 0.001), carotid (72% vs. 20%, P = 0.001), and renal arteries (42% vs. 4%, P = 0.001) compared with those with intermediate/negative remodeling. There was positive relationship between remodeling index and percent necrotic area in all four arteries. CONCLUSIONS Atherosclerotic plaque phenotypes were heterogeneous among four different arteries; renal and iliac arteries had more stable phenotypes compared with coronary artery. In contrast, the associations of remodeling pattern with plaque phenotype and composition were similar among the various arterial beds.
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Affiliation(s)
- Yoshiki Matsuo
- The Division of Cardiovascular Disease, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Barr RG, Ahmed FS, Carr JJ, Hoffman EA, Jiang R, Kawut SM, Watson K. Subclinical atherosclerosis, airflow obstruction and emphysema: the MESA Lung Study. Eur Respir J 2012; 39:846-54. [PMID: 22034646 PMCID: PMC3616898 DOI: 10.1183/09031936.00165410] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Airflow obstruction is an independent risk factor for cardiovascular events in the general population. The affected vascular bed and contribution of emphysema to cardiovascular risk are unclear. We examined whether an obstructive pattern of spirometry and quantitatively defined emphysema were associated with subclinical atherosclerosis in the carotid, peripheral and coronary circulations. The Multi-Ethnic Study of Atherosclerosis recruited participants aged 45-84 yrs without clinical cardiovascular disease. Spirometry, carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcium (CAC) were measured using standard protocols. Percentage of emphysema-like lung was measured in the lung windows of cardiac computed tomography scans among 3,642 participants. Multiple linear regression was used to adjust for cardiac risk factors, including C-reactive protein. Decrements in forced expiratory volume in 1 s (FEV(1)) and FEV(1)/forced vital capacity ratio were associated with greater internal carotid IMT, particularly among smokers (p=0.03 and p<0.001, respectively) whereas percentage emphysema was associated with reduced ABI regardless of smoking history (p=0.004). CAC was associated with neither lung function (prevalence ratio for the presence of CAC in severe airflow obstruction 0.99, 95% CI 0.91-1.07) nor percentage emphysema. An obstructive pattern of spirometry and emphysema were associated distinctly and independently with subclinical atherosclerosis in the carotid arteries and peripheral circulation, respectively, and were not independently related to CAC.
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Affiliation(s)
- R G Barr
- Dept of Medicine, Columbia University Medical Center, New York, NY 10032, USA.
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Zamani P, Ganz P, Libby P, Sutradhar SC, Rifai N, Nicholls SJ, Nissen SE, Kinlay S. Relationship of antihypertensive treatment to plasma markers of vascular inflammation and remodeling in the Comparison of Amlodipine versus Enalapril to Limit Occurrences of Thrombosis study. Am Heart J 2012; 163:735-40. [PMID: 22520542 DOI: 10.1016/j.ahj.2011.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 12/18/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND Antihypertensive agents lower the risk of cardiovascular events, but whether they affect pathways important in inflammation and plaque remodeling in atherosclerosis is uncertain. We assessed whether 2 commonly used antihypertensive agents affected plasma biomarkers reflecting specific inflammatory and remodeling processes over 2 years in the Comparison of Amlodipine versus Enalapril to Limit Occurrences of Thrombosis (CAMELOT) study. METHODS The study was a randomized controlled trial of 2 antihypertensives (amlodipine and enalapril) compared with placebo in patients with coronary artery disease and diastolic blood pressure less than 100 mm Hg. In 196 subjects who had baseline and 2-year intravascular coronary ultrasound examinations, we measured plasma interleukin 18, interleukin 1 receptor antagonist, matrix metalloproteinase 9, neopterin, and C-reactive protein. Results for both treatment groups were pooled and compared with placebo. RESULTS Antihypertensive treatment with either agent significantly lowered diastolic blood pressure (-4.7 vs placebo 1.3 mm Hg, P = .002) and progression of coronary atheroma (Δ percent atheroma volume 0.6 vs placebo 2.1, P = .031). Antihypertensive therapy did not affect plasma biomarkers of inflammation or plaque remodeling in the 135 subjects with baseline and 2-year biomarker samples. Progression in percent atheroma volume was significantly less in subjects taking statins at baseline (-2.5%, P = .0008). CONCLUSIONS In patients with coronary artery disease and well-controlled risk factors, antihypertensive therapy lowered blood pressure and progression of coronary atherosclerosis but did not affect plasma biomarkers of inflammation and remodeling. Antihypertensives may decrease atheroma progression by mechanisms other than those reflected by these plasma biomarkers.
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The epidemiology of vascular dysfunction relating to chronic obstructive pulmonary disease and emphysema. Ann Am Thorac Soc 2012; 8:522-7. [PMID: 22052931 DOI: 10.1513/pats.201101-008mw] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Cor pulmonale has long been described in very severe chronic obstructive pulmonary disease (COPD) and emphysema. Cross-sectional results from population-based studies show that left ventricular filling and a variety of vascular measures in the systemic circulation are abnormal in preclinical COPD and emphysema and that a predominant vascular change in COPD and emphysema is endothelial and microvascular dysfunction. These findings suggest that pulmonary vascular changes may occur early in COPD and emphysema and might contribute to pathogenesis. However, longitudinal epidemiologic studies with direct measures of the pulmonary vasculature are lacking; therefore, inferences are limited at present. New imaging-based approaches to the assessment of the pulmonary vasculature are applicable to epidemiologic studies and may help in defining the relationship of pulmonary vascular damage to progression of COPD and emphysema. These measures may also provide imaging-based surrogate markers, and novel therapeutics targeted to the pulmonary vasculature might reduce symptoms and improve function in these common diseases.
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Lee JJ, Yi H, Kim IS, Kim Y, Nhiem NX, Kim YH, Myung CS. (2S)-naringenin from Typha angustata inhibits vascular smooth muscle cell proliferation via a G0/G1 arrest. JOURNAL OF ETHNOPHARMACOLOGY 2012; 139:873-878. [PMID: 22212500 DOI: 10.1016/j.jep.2011.12.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 12/16/2011] [Accepted: 12/20/2011] [Indexed: 05/31/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Typha angustata is used in traditional Chinese medicine for a variety of clinical disorders. Its pharmacological actions include beneficial effects on hyperlipidemia and myocardial infarction, as well as labor-inducing and antibacterial effects. AIM OF THE STUDY We investigated the mechanism underlying the ability of (2S)-naringenin, an active compound from Typha angustata, to inhibit the proliferation of vascular smooth muscle cells (VSMCs). MATERIALS AND METHODS After measuring the antiproliferative effect of (2S)-naringenin on VSMC proliferation using cell proliferation and viability assays, the possible involvement of a signaling pathway associated with platelet-derived growth factor receptor β (PDGF-Rβ), extracellular signal regulated kinase 1/2 (ERK1/2), phosphatidylinositol 3-kinase (PI3K)-linked protein kinase B (Akt/PKB), or phospholipase C-γ1 (PLCγ1) was investigated by immunoblotting. Moreover, the effect of (2S)-naringenin on DNA synthesis and the cell cycle was examined using a [(3)H]-thymidine incorporation assay and flow cytometry. RESULTS (2S)-Naringenin significantly inhibited PDGF-BB-induced VSMC proliferation in a concentration-dependent manner, but did not affect signaling pathways associated with PDGF-Rβ, Akt/PKB, ERK1/2, or PLCγ1. However, (2S)-naringenin suppressed DNA synthesis via a G(0)/G(1) cell cycle arrest. Accordingly, the expression of cyclins D1 and E and cyclin-dependent kinases 2 and 4 was inhibited in a concentration-dependent manner; moreover, the phosphorylation of retinoblastoma protein was suppressed. CONCLUSIONS Our results show that (2S)-naringenin inhibited the PDGF-BB-induced proliferation of VSMCs via a G(0)/G(1) arrest; thus, (2S)-naringenin may be valuable as a therapeutic agent for managing atherosclerosis and/or vascular restenosis.
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Affiliation(s)
- Jung-Jin Lee
- Department of Pharmacology, Chungnam National University College of Pharmacy, Yuseong-gu, Daejeon, Republic of Korea
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