151
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Pinheiro EA, Magdy T, Burridge PW. Human In Vitro Models for Assessing the Genomic Basis of Chemotherapy-Induced Cardiovascular Toxicity. J Cardiovasc Transl Res 2020; 13:377-389. [PMID: 32078739 PMCID: PMC7365753 DOI: 10.1007/s12265-020-09962-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/22/2020] [Indexed: 12/20/2022]
Abstract
Chemotherapy-induced cardiovascular toxicity (CICT) is a well-established risk for cancer survivors and causes diseases such as heart failure, arrhythmia, vascular dysfunction, and atherosclerosis. As our knowledge of the precise cardiovascular risks of each chemotherapy agent has improved, it has become clear that genomics is one of the most influential predictors of which patients will experience cardiovascular toxicity. Most recently, GWAS-led, top-down approaches have identified novel genetic variants and their related genes that are statistically related to CICT. Importantly, the advent of human-induced pluripotent stem cell (hiPSC) models provides a system to experimentally test the effect of these genomic findings in vitro, query the underlying mechanisms, and develop novel strategies to mitigate the cardiovascular toxicity liabilities due to these mechanisms. Here we review the cardiovascular toxicities of chemotherapy drugs, discuss how these can be modeled in vitro, and suggest how these models can be used to validate genetic variants that predispose patients to these effects.
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Affiliation(s)
- Emily A Pinheiro
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pharmacogenomics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tarek Magdy
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pharmacogenomics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paul W Burridge
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Center for Pharmacogenomics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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152
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Cardio-ankle vascular index predicts the 1-year prognosis of heart failure patients categorized in clinical scenario 1. Heart Vessels 2020; 35:1537-1544. [PMID: 32458054 DOI: 10.1007/s00380-020-01633-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/22/2020] [Indexed: 12/24/2022]
Abstract
The sudden increase in blood pressure by vascular dysfunction is associated with the development of acute decompensated heart failure (ADHF) categorized in clinical scenario (CS) 1. However, the relationship between vascular function and prognosis in ADHF patients with CS1 is unclear. 3239 consecutive ADHF patients between January 2012 and June 2018 were enrolled. ADHF patients with CS1 undergoing ankle brachial index/cardio-ankle vascular index (CAVI) were included and patients with peripheral artery disease were excluded. Finally, 113 patients were analyzed. The primary endpoint of the present study was composite endpoint at 1 year (the cardiac death or re-hospitalization by ADHF). Cox proportional hazard analysis was conducted to identify independent predictors of composite endpoint. 25 patients (22.1%) were developed composite endpoint. CAVI in patients who have composite endpoint were significantly higher than without non-composite endpoint (composite endpoint group: 9.9 ± 1.3 non-composite endpoint group 8.7 ± 1.7, P = 0.001). The composite endpoint group was elderly and had higher ejection fraction, lower hemoglobin, and less used beta blockers, and renin angiotensin aldosterone system inhibitors. After adjustment by these confounding factors, CAVI was independently associated with the occurrence of composite endpoint (hazard ratio 1.69, 95% CI 1.05-2.73, P = 0.032). A cut-off value of CAVI for predicting composite endpoint was 8.65 (sensitivity 0.444, specificity 0.920, area under the curve 0.724, 95% CI 0.614-0.834). High CAVI was associated with the occurrence of composite endpoint after CS1 ADHF.
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153
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Tomiyama H, Vlachopoulos C, Xaplanteris P, Nakano H, Shiina K, Ishizu T, Kohro T, Higashi Y, Takase B, Suzuki T, Yamazaki T, Furumoto T, Kario K, Inoue T, Koba S, Takemoto Y, Hano T, Sata M, Ishibashi Y, Node K, Tanaka A, Maemura K, Ohya Y, Furukawa T, Ito H, Ohkuma T, Ninomiya T, Chikamori T, Yamashina A, Ueda SI. Usefulness of the SAGE score to predict elevated values of brachial-ankle pulse wave velocity in Japanese subjects with hypertension. Hypertens Res 2020; 43:1284-1292. [PMID: 32457429 DOI: 10.1038/s41440-020-0472-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 11/10/2022]
Abstract
The score based on the office systolic blood pressure, age, fasting blood glucose level, and estimated glomerular filtration rate (SAGE score) has been proposed as a useful marker to identify elevated values of carotid-femoral pulse wave velocity (PWV). The present cross-sectional study was conducted to examine whether the SAGE score is also a useful marker to identify subjects with elevated brachial-ankle PWV values in Japanese subjects with hypertension. We measured the brachial-ankle PWV and calculated the SAGE score in a total of 1019 employees of a Japanese company with hypertension and 817 subjects with hypertension derived from a multicenter study cohort. The analyses in this study were based on data from these two study groups as well as on a composite population of the two (n = 1836). The receiver operating characteristic curve analysis showed that the area under the curve to identify subjects with brachial-ankle PWV values of ≥1800 cm/s was over 0.70 in each of the three study groups. Even after adjustments, a SAGE score ≥7 had a significant odds ratio for identifying subjects with brachial-ankle PWV values ≥1800 cm/s in the 1836 study subjects from the composite occupational and multicenter study cohort (odds ratio = 2.1, 95% confidence interval = 1.4-3.0, P < 0.01). Thus, in Japanese subjects with hypertension, the SAGE score may be a useful marker for identifying subjects with elevated brachial-ankle PWV values.
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Affiliation(s)
| | - Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Cyprus
| | - Panagiotis Xaplanteris
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Cyprus.,Cardiology Department, CHU Saint-Pierre, Université Libre de Bruxelles, 322 rue Haute, B-1000, Brussels, Belgium
| | - Hiroki Nakano
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takahide Kohro
- Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute, Saitama, Japan
| | - Toru Suzuki
- Cardiovascular Medicine, University of Leicester, Leicester, UK
| | - Tsutomu Yamazaki
- Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoo Furumoto
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan
| | - Yasuhiko Takemoto
- Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuzo Hano
- Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yutaka Ishibashi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Koichi Node
- Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Ohya
- The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiji Furukawa
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okinawa, Japan
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Akira Yamashina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Shin-Ichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
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154
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Morphometric, Hemodynamic, and Multi-Omics Analyses in Heart Failure Rats with Preserved Ejection Fraction. Int J Mol Sci 2020; 21:ijms21093362. [PMID: 32397533 PMCID: PMC7247709 DOI: 10.3390/ijms21093362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 12/30/2022] Open
Abstract
(1) Background: There are no successive treatments for heart failure with preserved ejection fraction (HFpEF) because of complex interactions between environmental, histological, and genetic risk factors. The objective of the study is to investigate changes in cardiomyocytes and molecular networks associated with HFpEF. (2) Methods: Dahl salt-sensitive (DSS) rats developed HFpEF when fed with a high-salt (HS) diet for 7 weeks, which was confirmed by in vivo and ex vivo measurements. Shotgun proteomics, microarray, Western blot, and quantitative RT-PCR analyses were further carried out to investigate cellular and molecular mechanisms. (3) Results: Rats with HFpEF showed diastolic dysfunction, impaired systolic function, and prolonged repolarization of myocytes, owing to an increase in cell size and apoptosis of myocytes. Heatmap of multi-omics further showed significant differences between rats with HFpEF and controls. Gene Set Enrichment Analysis (GSEA) of multi-omics revealed genetic risk factors involved in cardiac muscle contraction, proteasome, B cell receptor signaling, and p53 signaling pathway. Gene Ontology (GO) analysis of multi-omics showed the inflammatory response and mitochondrial fission as top biological processes that may deteriorate myocyte stiffening. GO analysis of protein-to-protein network indicated cytoskeleton protein, cell fraction, enzyme binding, and ATP binding as the top enriched molecular functions. Western blot validated upregulated Mff and Itga9 and downregulated Map1lc3a in the HS group, which likely contributed to accumulation of aberrant mitochondria to increase ROS and elevation of myocyte stiffness, and subsequent contractile dysfunction and myocardial apoptosis. (4) Conclusions: Multi-omics analysis revealed multiple pathways associated with HFpEF. This study shows insight into molecular mechanisms for the development of HFpEF and may provide potential targets for the treatment of HFpEF.
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155
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Åström Malm I, Alehagen U, Blomstrand P, Dahlström U, De Basso R. Higher blood pressure in elderly hypertensive females, with increased arterial stiffness and blood pressure in females with the Fibrillin-1 2/3 genotype. BMC Cardiovasc Disord 2020; 20:180. [PMID: 32303188 PMCID: PMC7165376 DOI: 10.1186/s12872-020-01454-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/29/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Elderly patients have a relatively high cardiovascular risk due to increased arterial stiffness, elevated blood pressure and decreased amounts of elastin in the arteries. The composition of the media layer in the arterial wall, comprising elastin, collagen, smooth muscle cells, proteoglycans, fibronectin and fibrillin-1, influences its mechanical properties. Mutations in the fibrillin-1 gene leads to increased aortic stiffness, elevated pulse pressure and aortic root dilatation. This study investigates whether there is a sex difference among hypertensive elderly patients regarding blood pressure, arterial stiffness and fibrillin-1 genotypes. METHODS A total of 315 hypertensive subjects (systolic blood pressure > 140 mmHg) were included in this study (155 men and 160 women aged 71-88 years). Aortic pulse wave velocity and augmentation index were determined using SphygmoCor, and brachial blood pressure was measured using an oscillometric technique. Fibrillin-1 was genotyped by polymerase chain reaction and with a capillary electrophoresis system. RESULTS Females showed a significantly higher peripheral mean arterial pressure (females; 107.20 mmHg, males 101.6 mmHg, p = 0.008), central mean arterial pressure (females; 107.2 mmHg, males 101.6 mmHg p = 0.008), central systolic blood pressure (females; 148.1 mmHg, males 139.2 mmHg, p < 0.001) and central pulse pressure (females; 68.9 mmHg, males 61.6 mmHg, p = 0.035) than males. Females with the Fibrillin-1 2/3 genotype showed a significantly higher augmentation index (FBN1 2/3; 39.9%, FBN1 2/2 35.0%, FBN1 2/4 35.8, p = 0.029) and systolic blood pressure (FBN1 2/3; 174.6 mmHg, FBN1 2/2168.9 mmHg, FBN1 2/4169.9 mmHg, p = 0.025) than females with the 2/2 and 2/4 genotypes. CONCLUSION The findings of this study may indicate that hypertensive elderly females, especially elderly females with Fibrillin-1 2/3, have increased systolic blood pressure and arterial stiffness.
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Affiliation(s)
- Ida Åström Malm
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Urban Alehagen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Peter Blomstrand
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Physiology, County Hospital Ryhov, Jönköping, Sweden
| | - Ulf Dahlström
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiology Linköping University, Linköping, Sweden
| | - Rachel De Basso
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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156
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Haarala A, Kähönen E, Koivistoinen T, Pälve K, Hulkkonen J, Tikkakoski A, Sipilä K, Raitakari OT, Lehtimäki T, Kähönen M, Aatola H, Hutri-Kähönen N. Pulse wave velocity is related to exercise blood pressure response in young adults. The Cardiovascular Risk in Young Finns Study. Blood Press 2020; 29:256-263. [DOI: 10.1080/08037051.2020.1750944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Atte Haarala
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Teemu Koivistoinen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Kristiina Pälve
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Janne Hulkkonen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
| | - Antti Tikkakoski
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Olli T. Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
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157
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Zhang Y, Lacolley P, Protogerou AD, Safar ME. Arterial Stiffness in Hypertension and Function of Large Arteries. Am J Hypertens 2020; 33:291-296. [PMID: 32060496 DOI: 10.1093/ajh/hpz193] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/28/2019] [Accepted: 02/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Arterial stiffness-typically assessed from non-invasive measurement of pulse wave velocity along a straight portion of the vascular tree between the right common carotid and femoral arteries-is a reliable predictor of cardiovascular risk in patients with essential hypertension. METHODS We reviewed how carotid-femoral pulse wave velocity increases with age and is significantly higher in hypertension (than in age- and gender-matched individuals without hypertension), particularly when hypertension is associated with diabetes mellitus. RESULTS From the elastic aorta to the muscular peripheral arteries of young healthy individuals, there is a gradual but significant increase in stiffness, with a specific gradient. This moderates the transmission of pulsatile pressure towards the periphery, thus protecting the microcirculatory network. The heterogeneity of stiffness between the elastic and muscular arteries causes the gradient to disappear or be inversed with aging, particularly in long-standing hypertension. CONCLUSIONS In hypertension therefore, pulsatile pressure transmission to the microcirculation is augmented, increasing the potential risk of damage to the brain, the heart, and the kidney. Furthermore, elevated pulse pressure exacerbates end-stage renal disease, particularly in older hypertensive individuals. With increasing age, the elastin content of vessel walls declines throughout the arterial network, and arterial stiffening increases further due to the presence of rigid wall material such as collagen, but also fibronectin, proteoglycans, and vascular calcification. Certain genes, mainly related to angiotensin and/or aldosterone, affect this aging process and contribute to the extent of arterial stiffness, which can independently affect both forward and reflected pressure waves.
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Affiliation(s)
- Yi Zhang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | | | - Athanase D Protogerou
- Cardiovascular Prevention and Research Unit, Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michel E Safar
- Diagnosis and Therapeutics Department, Hôtel-Dieu Hospital, Paris, France
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158
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Flahault A, Girard-Bock C, Fernandes RO, Cloutier A, Pastore YD, Luu TM, Nuyt AM. Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm. Thorax 2020; 75:494-502. [PMID: 32217779 DOI: 10.1136/thoraxjnl-2019-214307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Although erythropoiesis is impaired and anaemia frequent in neonates born preterm, haematopoiesis in adults born preterm has not been previously studied. OBJECTIVE We, thus, aimed to evaluate haemoglobin and erythropoietin levels in young adults born preterm, to identify neonatal events associated with erythropoiesis in adulthood and to examine the relationships of haemoglobin levels with respiratory function and blood pressure. METHODS We assessed a cohort of 101 young adults (ages 18-29) born preterm (≤29 weeks of gestation), in comparison to 105 full-term controls. We measured haemoglobin, erythropoietin levels and blood pressure. We also assessed respiratory function using spirometry. RESULTS Compared with controls, tobacco use and sex-adjusted haemoglobin levels were 5.3 (95% CI 2.9 to 7.7) g/L higher in preterm-born individuals, but erythropoietin levels were similar. Duration of oxygen supplementation in the neonatal period was independently associated with higher haemoglobin levels in the preterm group. In young adults born preterm with bronchopulmonary dysplasia, airflow limitation was associated with higher haemoglobin levels. Both systolic (SBP) and diastolic (DBP) blood pressure were increased in individuals born preterm (p=0.042 and p=0.0008, respectively). Higher haemoglobin levels were associated with higher SBP and DBP, independently of term or preterm status. Mediation analysis suggests that haemoglobin increase contributes to 37% and 32% of the effect of preterm birth on SBP and DBP, respectively. CONCLUSIONS Haemoglobin levels are higher in young adults born preterm, while erythropoietin levels are similar, especially in case of bronchopulmonary dysplasia and airflow limitation, and haemoglobin increase is associated with elevated blood pressure in this population.
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Affiliation(s)
- Adrien Flahault
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Camille Girard-Bock
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Rafael Oliveira Fernandes
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Yves D Pastore
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada.,Division of Hematology and Oncology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
| | - Thuy Mai Luu
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada.,Division of General Pediatrics, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada .,Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
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159
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Does early life programming influence arterial stiffness and central hemodynamics in adulthood? J Hypertens 2020; 38:481-488. [DOI: 10.1097/hjh.0000000000002292] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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160
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Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cardiovasc Ther 2020; 2020:7056184. [PMID: 32190121 PMCID: PMC7068147 DOI: 10.1155/2020/7056184] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/31/2019] [Accepted: 01/08/2020] [Indexed: 12/11/2022] Open
Abstract
To determine the effects of ACEIs on arterial stiffness, a meta-analysis of randomized controlled trials was conducted. Relevant articles that investigated the effects of ACEIs on arterial stiffness from PubMed, Embase, and the Cochrane library from inception to September 2018 were systematically retrieved. The investigated outcomes included brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV) by using weighted mean differences (WMDs) and 95% confidence intervals (CIs) with the random-effects model. A total of 17 RCTs including 1,458 individuals were included. The summary results indicated no significant differences between ACEIs and control for ba-PWV and cf-PWV. Also, no significant differences between ACEI and control for ba-PWV and cf-PWV were observed in hypertensive patients, while the therapeutic effects of ACEI versus placebo showed statistically significant difference. Moreover, subgroup analysis indicated that the levels of ba-PWV were significantly associated if the study was conducted in Western countries, mean age <60.0 years, percentage male ≥60.0%, compared with ARBs, baseline PWV <10.0, and high-quality study. Furthermore, the significant levels of cf-PWV in patients who received ACEIs were observed when percentage male was ≥60.0% and the studies were of high-quality. Finally, no significant differences were observed between ACEIs and other antihypertensive drugs regarding the changes of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The overall analysis suggested no significant differences between ACEIs and other antihypertensive drugs for ba-PWV and cf-PWV levels, whereas ACEIs versus placebo showed lower levels of ba-PWV and cf-PWV.
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161
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Carnevale D, Wenzel P. Mechanical stretch on endothelial cells interconnects innate and adaptive immune response in hypertension. Cardiovasc Res 2020; 114:1432-1434. [PMID: 29912294 DOI: 10.1093/cvr/cvy148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Daniela Carnevale
- Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, Via dell'Elettronica, Pozzilli, IS, Italy.,Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Philip Wenzel
- Center for Cardiology-Cardiology I, University Medical Center Mainz, Langenbeckstrasse 1, Mainz, Germany.,Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstrasse 1, Mainz, Germany.,German Center for Cardiovascular Research (DZHK)-Partner site Rhine-Main, Germany
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162
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Rafouli-Stergiou P, Ikonomidis I, Katsiki N, Kadoglou NPE, Vlachos S, Thymis J, Parissis J, Moulakakis KG, Kakisis JD. Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms. J Clin Hypertens (Greenwich) 2020; 22:187-193. [PMID: 32049424 DOI: 10.1111/jch.13825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/31/2019] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
Abstract
Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19-4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.
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Affiliation(s)
- Pinelopi Rafouli-Stergiou
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ignatios Ikonomidis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Katsiki
- First Department of Internal Medicine, Division of Endocrinology and Metabolism, Diabetes Center, Medical School, AHEPA University Hospital, Thessaloniki, Greece
| | - Nikolaos P E Kadoglou
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefanos Vlachos
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John Thymis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John Parissis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos G Moulakakis
- Department of Vascular Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John D Kakisis
- Department of Vascular Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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163
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Fidelis HG, Mageski JGA, Goes SCE, Botelho T, Marques VB, Ávila RA, Dos Santos L. Blockade of angiotensin AT 1 receptors prevents arterial remodelling and stiffening in iron-overloaded rats. Br J Pharmacol 2020; 177:1119-1130. [PMID: 31705542 DOI: 10.1111/bph.14904] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/05/2019] [Accepted: 10/05/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Damage to the vasculature caused by chronic iron-overload in both humans and animal models, is characterized by endothelial dysfunction and reduced compliance. In vitro, blockade of the angiotensin II AT1 receptors reversed functional vascular changes induced by chronic iron-overload. In this study, the effect of chronic AT1 receptor blockade on aorta stiffening was assessed in iron-overloaded rats. EXPERIMENTAL APPROACH Male Wistar rats were treated for 15 days with saline as control group, iron dextran 200 mg·kg-1 ·day-1 , 5 days a week (iron-overload group), losartan (20 mg·kg-1 ·day-1 in drinking water), and iron dextran plus losartan. Mechanical properties of the aorta were assessed in vivo. In vitro, aortic geometry and biochemical composition were assessed with morphometric and histological methods. KEY RESULTS Thoracoabdominal aortic pulse wave velocity (PWV) increased significantly, indicating a decrease in aortic compliance. Co-treatment with losartan prevented changes on PWV, β-index, and elastic modulus in iron-overloaded rats. This iron-related increase in PWV was not related to changes in aortic geometry and wall stress. but to increased elastic modulus/wall stress ratio, suggesting that a change in the composition of the wall was responsible for the stiffness. Losartan treatment also ameliorated the increase in aorta collagen content of the iron-overload group, without affecting circulating iron or vascular deposits. CONCLUSIONS AND IMPLICATIONS Losartan prevented the structural and functional indices of aortic stiffness in iron-overloaded rats, implying that inhibition of the renin-angiotensin system would limit the vascular remodelling in chronic iron-overload.
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Affiliation(s)
| | | | | | - Tatiani Botelho
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
| | | | | | - Leonardo Dos Santos
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil
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164
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Hsu BG, Chen TK, Pan YC, Wang CH, Hou JS. Low serum adiponectin level is associated with central arterial stiffness in patients undergoing peritoneal dialysis. Tzu Chi Med J 2020; 32:272-277. [PMID: 32955506 PMCID: PMC7485669 DOI: 10.4103/tcmj.tcmj_67_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/29/2019] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective: Adiponectin has antidiabetic, anti-atherosclerotic, and anti-inflammatory functions and protects against vascular damage. Carotid-femoral pulse wave velocity (cfPWV) is a noninvasive method for measuring central artery stiffness, which is known to be associated with cardiovascular disease in peritoneal dialysis (PD) patients. This study was conducted to evaluate the relationship between central arterial stiffness and serum adiponectin levels in PD patients. Materials and Methods: Fasting blood samples were obtained from 60 PD patients, and the cfPWV value was measured using a validated tonometry system. In this study, cfPWV values of >10 m/s were used to define the high arterial stiffness group according to the European Society of Hypertension and the European Society of Cardiology guidelines. Results: Among 60 patients with PD, 19 patients (31.7%) were included in the high arterial stiffness group. When compared to those in the control group, the high arterial stiffness group patients were older (P = 0.029), had longer PD vintage (P = 0.001), higher diastolic blood pressures (P = 0.030), higher fasting glucose (P = 0.014), and lower serum adiponectin levels (P = 0.001). After multivariable logistic regression analysis, serum adiponectin (odds ratio, 0.612; 95% confidence interval: 0.426–0.879; P = 0.008) was identified as an independent predictor of arterial stiffness. The multivariable regression analysis also showed that the adiponectin level (β = −0.408; adjusted R2 change = 0.183; P < 0.001) was negatively associated with cfPWV values in patients undergoing PD. Conclusion: Low serum adiponectin level is an independent marker of arterial stiffness in patients undergoing PD.
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165
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Wu S, Jin C, Li S, Zheng X, Zhang X, Cui L, Gao X. Aging, Arterial Stiffness, and Blood Pressure Association in Chinese Adults. Hypertension 2019; 73:893-899. [PMID: 30776974 DOI: 10.1161/hypertensionaha.118.12396] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Arterial stiffness and blood pressure (BP) both increase with aging synchronously. Whether elevated BP results from thickening of arterial wall or vice versa is controversial in previous studies. This study included 17 862 participants without history of myocardial infarction, stroke, atrial fibrillation or flutter, or cancer and with brachial-ankle pulse wave velocity (baPWV) and BP measurements during 2010 to 2016. Age was calculated from the self-reported birthdate to the first date of baPWV examination. Mediation analyses were applied to assess the mediation effect by baPWV in the association between age and BP. Temporal relation between baPWV and BP was assessed by cross-lagged analyses among 1508 participants with repeated assessment of baPWV. We found that systolic BP increased 0.47 (95% CI, 0.45-0.49) mm Hg per 1 year older by the mediation effect of baPWV and that the direct effect of aging on systolic BP was -0.07 (95% CI, -0.09 to -0.05) mm Hg per 1 year older. The standard regression coefficient from baseline baPWV to follow-up systolic BP was 0.09 (95% CI, 0.04-0.15), which was greater than the standard regression coefficient from baseline systolic BP to follow-up baPWV (0.01; 95% CI, -0.04 to 0.06). Arterial stiffness mediated the positive association between aging and BP, and arterial stiffness might precede elevated BP. Clinical Trial Registration- URL: http://www.chictr.org.cn . Unique identifier: ChiCTR-TNRC-11001489.
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Affiliation(s)
- Shouling Wu
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Cheng Jin
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Shanshan Li
- Clinical Epidemiology Unit, Boston University School of Medicine, MA (S.L.)
| | - Xiaoming Zheng
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Xinyuan Zhang
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China.,Department of Nutritional Sciences, Pennsylvania State University, State College (X. Zhang, X.G.)
| | - Liufu Cui
- Department of Rheumatic Disease (L.C.), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, State College (X. Zhang, X.G.)
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166
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Hoare D, Bussooa A, Neale S, Mirzai N, Mercer J. The Future of Cardiovascular Stents: Bioresorbable and Integrated Biosensor Technology. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1900856. [PMID: 31637160 PMCID: PMC6794628 DOI: 10.1002/advs.201900856] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/26/2019] [Indexed: 05/15/2023]
Abstract
Cardiovascular disease is the greatest cause of death worldwide. Atherosclerosis is the underlying pathology responsible for two thirds of these deaths. It is the age-dependent process of "furring of the arteries." In many scenarios the disease is caused by poor diet, high blood pressure, and genetic risk factors, and is exacerbated by obesity, diabetes, and sedentary lifestyle. Current pharmacological anti-atherosclerotic modalities still fail to control the disease and improvements in clinical interventions are urgently required. Blocked atherosclerotic arteries are routinely treated in hospitals with an expandable metal stent. However, stented vessels are often silently re-blocked by developing "in-stent restenosis," a wound response, in which the vessel's lumen renarrows by excess proliferation of vascular smooth muscle cells, termed hyperplasia. Herein, the current stent technology and the future of biosensing devices to overcome in-stent restenosis are reviewed. Second, with advances in nanofabrication, new sensing methods and how researchers are investigating ways to integrate biosensors within stents are highlighted. The future of implantable medical devices in the context of the emerging "Internet of Things" and how this will significantly influence future biosensor technology for future generations are also discussed.
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Affiliation(s)
- Daniel Hoare
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
| | - Anubhav Bussooa
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
| | - Steven Neale
- James Watt South BuildingSchool of EngineeringUniversity of GlasgowG12 8QQGlasgowScotland
| | - Nosrat Mirzai
- Bioelectronics UnitCollege of Medical, Veterinary & Life Sciences (MVLS)University of GlasgowG12 8QQGlasgowScotland
| | - John Mercer
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
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167
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Puyo L, Paques M, Fink M, Sahel JA, Atlan M. Waveform analysis of human retinal and choroidal blood flow with laser Doppler holography. BIOMEDICAL OPTICS EXPRESS 2019; 10:4942-4963. [PMID: 31646021 PMCID: PMC6788604 DOI: 10.1364/boe.10.004942] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/14/2019] [Accepted: 06/27/2019] [Indexed: 05/20/2023]
Abstract
Laser Doppler holography was introduced as a full-field imaging technique to measure blood flow in the retina and choroid with an as yet unrivaled temporal resolution. We here investigate separating the different contributions to the power Doppler signal in order to isolate the flow waveforms of vessels in the posterior pole of the human eye. Distinct flow behaviors are found in retinal arteries and veins with seemingly interrelated waveforms. We demonstrate a full field mapping of the local resistivity index, and the possibility to perform unambiguous identification of retinal arteries and veins on the basis of their systolodiastolic variations. Finally we investigate the arterial flow waveforms in the retina and choroid and find synchronous and similar waveforms, although with a lower pulsatility in choroidal arteries. This work demonstrates the potential held by laser Doppler holography to study ocular hemodynamics in healthy and diseased eyes.
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Affiliation(s)
- Léo Puyo
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
| | - Michel Paques
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Institut de la Vision-Sorbonne Universités, 17 rue Moreau, 75012 Paris, France
| | - Mathias Fink
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
| | - José-Alain Sahel
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Institut de la Vision-Sorbonne Universités, 17 rue Moreau, 75012 Paris, France
| | - Michael Atlan
- Institut Langevin, Centre National de la Recherche Scientifique (CNRS), Paris Sciences & Lettres (PSL University), École Supérieure de Physique et de Chimie Industrielles (ESPCI Paris) - 1 rue Jussieu, 75005 Paris, France
- Paris Adaptive Optics, Retinal Imaging, and Surgery, Paris, France
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168
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Newland N, Lowe FJ, Camacho OM, McEwan M, Gale N, Ebajemito J, Hardie G, Murphy J, Proctor C. Evaluating the effects of switching from cigarette smoking to using a heated tobacco product on health effect indicators in healthy subjects: study protocol for a randomized controlled trial. Intern Emerg Med 2019; 14:885-898. [PMID: 31049783 PMCID: PMC6722146 DOI: 10.1007/s11739-019-02090-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/16/2019] [Indexed: 12/18/2022]
Abstract
Tobacco heating products (THPs) are a potentially safer alternative to combustible cigarette smoking. Through continued use, THPs may reduce smoking-related disease risk, whilst maintaining the sensorial experience and nicotine delivery sought by smokers. While literature evidence of the biological effects of THP aerosol exposure is increasing, there remains a knowledge gap with respect to substantiation of THP reduced risk potential in longer term real-life use. This randomized, multi-centre, controlled clinical study will test the hypotheses that following a switch from combustible cigarettes to a THP for 1 year, participants will experience a sustained reduction in exposure to tobacco-related toxicants that will lead to favourable changes in health effect indicators associated with smoking-related disease development. Changes in such indicators will be contextualized against smoking cessation and never-smoker cohorts. Up to 280 participants who do not intend to quit smoking will be randomized to continued combustible smoking (arm A, up to n = 80) or a commercially available THP (arm B n = 200). Furthermore, up to 190 participants with a high intent to quit smoking will undergo smoking cessation (arm D), and 40 never smokers will serve as a control group (arm E). Recruitment numbers were determined to be sufficient to achieve n = 50 in arms A, B and D, at study end. Enrolment started in March 2018 and the trial is scheduled to be completed in March 2020. Data from this study will be a valuable addition to the growing body of evidence in the field of understanding the individual and public health impact of THPs.Clinical Trial Registration: https://www.isrctn.com/ISRCTN81075760.
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Affiliation(s)
- Nik Newland
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - Frazer John Lowe
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK.
| | - Oscar Martin Camacho
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - Mike McEwan
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - Nathan Gale
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - James Ebajemito
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - George Hardie
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - James Murphy
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
| | - Christopher Proctor
- Group Research and Development, British American Tobacco (Investments) Ltd., Regents Park Road, Southampton, SO15 8TL, UK
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169
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Abstract
Cardiovascular ageing and the atherosclerotic process begin very early in life, most likely in utero. They progress over decades of exposure to suboptimal or abnormal metabolic and hormonal risk factors, eventually culminating in very common, costly, and mostly preventable target-organ pathologies, including coronary heart disease, stroke, heart failure, aortic aneurysm, peripheral artery disease, and vascular dementia. In this Review, we discuss findings from preclinical and clinical studies showing that calorie restriction (CR), intermittent fasting, and adjusted diurnal rhythm of feeding, with adequate intake of specific macronutrients and micronutrients, are powerful interventions not only for the prevention of cardiovascular disease but also for slowing the accumulation of molecular damage leading to cardiometabolic dysfunction. Furthermore, we discuss the mechanisms through which a number of other nondietary interventions, such as regular physical activity, mindfulness-based stress-reduction exercises, and some CR-mimetic drugs that target pro-ageing pathways, can potentiate the beneficial effects of a healthy diet in promoting cardiometabolic health.
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170
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A multilocus genetic risk score is associated with arterial stiffness in hypertensive patients: the CARE NORTH study. J Hypertens 2019; 36:1882-1888. [PMID: 29878972 DOI: 10.1097/hjh.0000000000001773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Arterial stiffness is recognized as an intermediate phenotype and predictor of cardiovascular disease. Arterial stiffness is complex in origin with contributions from lifestyle and genetic factors. However, the association between single nucleotide polymorphisms (SNPs) and arterial stiffness remains unclear. OBJECTIVE The aim is to assess whether a multilocus genetic risk score (GRS), composed of selected SNPs linked to cardiovascular traits and outcomes, is associated with arterial stiffness in patients with hypertension. DESIGN AND METHODS This study included 730 participants derived from the CARE NORTH study. The arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cfPWV). An adjusted linear regression was used to evaluate the association between cfPWV and each individual SNP using multiple genetic models. The association between a constructed GRS and cfPWV was tested in an unadjusted and adjusted model. RESULTS We selected 13 SNPs found to be associated with cfPWV (P < .05): 6 SNPs in additive, 4 SNPs in recessive and 3 SNPs in dominant mode of inheritance. The GRS based on these SNPs was positively associated with cfPWV both in unadjusted and adjusted models (β = 0.2 m/s, 95% CI 0.11 - 0.29, P = 7.6 × 10 and β = 0.22 m/s, 95% CI 0.15 - 0.28, P = 1.4 × 10, respectively). The GRS explained an additional 3.6% cfPWV variance above clinical covariates. CONCLUSION We demonstrate that the GRS composed of 13 SNPs related to cardiovascular phenotypes is associated with an increased arterial stiffness in hypertensive patients. Our findings may help to clarify genetic basis of arterial stiffening and provide insight into mechanisms underlying this phenotype.
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171
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del Campo L, Sánchez‐López A, Salaices M, von Kleeck RA, Expósito E, González‐Gómez C, Cussó L, Guzmán‐Martínez G, Ruiz‐Cabello J, Desco M, Assoian RK, Briones AM, Andrés V. Vascular smooth muscle cell-specific progerin expression in a mouse model of Hutchinson-Gilford progeria syndrome promotes arterial stiffness: Therapeutic effect of dietary nitrite. Aging Cell 2019; 18:e12936. [PMID: 30884114 PMCID: PMC6516150 DOI: 10.1111/acel.12936] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/23/2019] [Accepted: 02/03/2019] [Indexed: 12/11/2022] Open
Abstract
Vascular stiffness is a major cause of cardiovascular disease during normal aging and in Hutchinson-Gilford progeria syndrome (HGPS), a rare genetic disorder caused by ubiquitous progerin expression. This mutant form of lamin A causes premature aging associated with cardiovascular alterations that lead to death at an average age of 14.6 years. We investigated the mechanisms underlying vessel stiffness in LmnaG609G/G609G mice with ubiquitous progerin expression, and tested the effect of treatment with nitrites. We also bred LmnaLCS/LCS Tie2Cre+/tg and LmnaLCS/LCS SM22αCre+/tg mice, which express progerin specifically in endothelial cells (ECs) and in vascular smooth muscle cells (VSMCs), respectively, to determine the specific contribution of each cell type to vascular pathology. We found vessel stiffness and inward remodeling in arteries of LmnaG609G/G609G and LmnaLCS/LCS SM22αCre+/tg , but not in those from LmnaLCS/LCS Tie2Cre+/tg mice. Structural alterations in aortas of progeroid mice were associated with decreased smooth muscle tissue content, increased collagen deposition, and decreased transverse waving of elastin layers in the media. Functional studies identified collagen (unlike elastin and the cytoskeleton) as an underlying cause of aortic stiffness in progeroid mice. Consistent with this, we found increased deposition of collagens III, IV, V, and XII in the media of progeroid aortas. Vessel stiffness and inward remodeling in progeroid mice were prevented by adding sodium nitrite in drinking water. In conclusion, LmnaG609G/G609G arteries exhibit stiffness and inward remodeling, mainly due to progerin-induced damage to VSMCs, which causes increased deposition of medial collagen and a secondary alteration in elastin structure. Treatment with nitrites prevents vascular stiffness in progeria.
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Affiliation(s)
- Lara del Campo
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
| | - Amanda Sánchez‐López
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
| | - Mercedes Salaices
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
- Departamento de Farmacología y Terapéutica, Facultad de Medicina, Instituto de Investigación Hospital La Paz (IdiPaz)Universidad Autónoma de MadridMadridSpain
| | - Ryan A. von Kleeck
- Center for Engineering Mechanobiology and Department of Systems Pharmacology and Translational TherapeuticsUniversity of PennsylvaniaPhiladelphiaPennsylvania
| | - Elba Expósito
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
| | - Cristina González‐Gómez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
| | - Lorena Cussó
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- Departamento de Bioingeniería e Ingeniería AeroespacialUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)Spain
| | - Gabriela Guzmán‐Martínez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- Cardiac Imaging Unit, Cardiology DepartmentHospital Universitario La PazMadridSpain
| | - Jesús Ruiz‐Cabello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Respiratorias (CIBERES)Spain
- Present address:
CIC biomaGUNE and Ikerbasque Basque Foundation for ScienceSan SebastiánSpain
- Present address:
Universidad Complutense MadridMadridSpain
| | - Manuel Desco
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- Departamento de Bioingeniería e Ingeniería AeroespacialUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)Spain
| | - Richard K. Assoian
- Center for Engineering Mechanobiology and Department of Systems Pharmacology and Translational TherapeuticsUniversity of PennsylvaniaPhiladelphiaPennsylvania
| | - Ana M. Briones
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
- Departamento de Farmacología y Terapéutica, Facultad de Medicina, Instituto de Investigación Hospital La Paz (IdiPaz)Universidad Autónoma de MadridMadridSpain
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- CIBER de Enfermedades Cardiovasculares (CIBERCV)Spain
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172
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The prevalence of obesity and metabolic abnormalities in eastern China: a cross-sectional study. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00725-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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173
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Venara A, Jaouen R, Lermite E, Le Naoures P, Casa C, Mirallié E, Duchalais E, Hamy A. The Predictive Value of Pulse Wave Velocity for Anastomotic Leakage After Colorectal Surgery. World J Surg 2019; 43:252-259. [PMID: 30109387 DOI: 10.1007/s00268-018-4757-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Arterial perfusion defects are a risk factor for anastomotic leakage (AL) following colorectal surgery. Measuring arterial stiffness using pulse wave velocity (PWV) is known to reflect the performance of the arterial network. The objective of this study was to assess the predictive value of PWV for AL after colorectal surgery. METHODS A prospective monocentric study was conducted on all consecutive patients who underwent colorectal surgery scheduled between March 1, 2016 and May 1, 2017. Patients were divided into two groups according to the PWV which was measured preoperatively using the pOpmètre® device: PWV+ (PWV > 10 m/s) and PWV- (PWV ≤ 10 m/s). We then compared the PWV+ and PWV- groups. The primary endpoint was the AL rate. RESULTS A total of 96 patients were studied, including 60 in the PWV- group and 36 in the PWV+ group. Patients in the PWV+ group were more at risk of presenting with AL than those in the PWV- group (6.25 vs 0%) (p = 0.002). There was no difference in immediate postoperative complications between the two groups apart from the length of hospital stay. PWV predicted the appearance of AL with a sensitivity of and a negative predictive value of 100%. CONCLUSION Measuring PWV could be a used as a predictive examination in the early detection of AL after colorectal surgery.
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Affiliation(s)
- A Venara
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France.
- Angers Medical University, Angers, France.
- INSERM U1235- TENS, The Enteric Nervous System in Gut and Brain Disorders, Institute of Digestive Tract Disorders, (Institut des maladies de l'appareil digestif), 1 Rue Gaston Veil 44035, Nantes, France.
| | - R Jaouen
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
| | - E Lermite
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
| | - P Le Naoures
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - C Casa
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - E Mirallié
- Department of Visceral and Endocrine Surgery, Nantes University Hospital, 1 Place Alexis Ricordeau, 44000, Nantes, France
| | - E Duchalais
- INSERM U1235- TENS, The Enteric Nervous System in Gut and Brain Disorders, Institute of Digestive Tract Disorders, (Institut des maladies de l'appareil digestif), 1 Rue Gaston Veil 44035, Nantes, France
- Department of Visceral and Endocrine Surgery, Nantes University Hospital, 1 Place Alexis Ricordeau, 44000, Nantes, France
| | - A Hamy
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
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174
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Dose–response relationship between thyroid stimulating hormone and hypertension risk in euthyroid individuals. J Hypertens 2019; 37:144-153. [DOI: 10.1097/hjh.0000000000001826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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175
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Solanki JD, Mehta HB, Panjwani SJ, Munshi HB, Shah CJ. Central hemodynamics and arterial stiffness by oscillometric pulse-wave analysis in treated Gujarati euglycemic hypertensives: A case-control study. J Family Med Prim Care 2019; 8:2047-2054. [PMID: 31334178 PMCID: PMC6618187 DOI: 10.4103/jfmpc.jfmpc_233_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Introduction Hypertension is the most prevalent noncommunicable disorder, studied in terms of brachial blood pressure. Direct parameters like central hemodynamics and arterial stiffness, though superior, are not studied much. The same can be studied by pulse-wave analysis (PWA) and we did that in euglycemic treated hypertensives. Materials and Methods A case-control study was conducted in 258 treated euglycemic hypertensives and 258 matched controls. Oscillometric PWA was accomplished by Mobil-O-Graph (IEM, Germany). Parameters were further analyzed for the effect of gender, physical activity, body mass index (BMI) (cutoff 23), blood pressure control, and duration (cutoff 5 years). Multiple linear regressions were used to find significant predictors. P < 0.05 was taken as statistically significant. Results Cases had significantly higher brachial arterial parameters (blood pressure, heart rate, rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse-wave velocity, total arterial stiffness, pulse pressure amplification), and central hemodynamics (central blood pressure, cardiac output, stroke work) compared to age, gender, and BMI-matched controls. In the case group, female gender, BMI ≥ 23, and uncontrolled blood pressure were significant factors affecting results. Heart rate and pulse pressure were major predictors of study parameters. Central pressure parameters were not predicted significantly by corresponding brachial pressure parameters. Conclusion PWA revealed the adverse profile of arterial stiffness and central hemodynamics in treated Gujarati hypertensives, associated with female gender, BMI, and blood pressure control, predicted mainly by heart rate and pulse pressure, independent of brachial blood pressure. It indicates both potential and further study of these parameters.
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Affiliation(s)
- Jayesh D Solanki
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Hemant B Mehta
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Sunil J Panjwani
- Department of Medicine, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Hirava B Munshi
- Department of Medicine, Govt. Medical College, Bhavnagar, Gujarat, India
| | - Chinmay J Shah
- Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India
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176
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Huo Y, Chen H, Kassab GS. Acute Tachycardia Increases Aortic Distensibility, but Reduces Total Arterial Compliance Up to a Moderate Heart Rate. Front Physiol 2018; 9:1634. [PMID: 30510518 PMCID: PMC6252350 DOI: 10.3389/fphys.2018.01634] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 10/29/2018] [Indexed: 12/02/2022] Open
Abstract
Background: The differential effects of rapid cardiac pacing on small and large vessels have not been well-established. The objective of this study was to investigate the effect of pacing-induced acute tachycardia on hemodynamics and arterial stiffness. Methods: The pressure and flow waves in ascending aorta and femoral artery of six domestic swine were recorded simultaneously at baseline and heart rates (HR) of 135 and 155 beats per minutes (bpm) and analyzed by the models of Windkessel and Womersley types. Accordingly, the flow waves were simultaneously measured at carotid and femoral arteries to quantify aortic pulse wave velocity (PWV). The arterial distensibility was identified in small branches of coronary, carotid and femoral arteries with diameters of 300–600 μm by ex vivo experiments. Results: The rapid pacing in HR up to 135 bpm reduced the total arterial compliance, stroke volume, systemic pulse pressure, and central systolic pressure by 36 ± 17, 38 ± 26, 29 ± 16, and 23 ± 12%, respectively, despite no statistical difference of mean aortic pressure, cardiac output, peripheral resistance, and vascular flow patterns. The pacing also resulted in a decrease of distensibility of small muscular arteries, but an increase of aortic distensibility. Pacing from 135 to 155 bpm had negligible effects on systemic and local hemodynamics and arterial stiffness. Conclusions: There is an acute mismatch in the response of aorta and small arteries to pacing from basal HR to 135 bpm, which may have important pathological implications under chronic tachycardia conditions.
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Affiliation(s)
- Yunlong Huo
- PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, China.,Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Huan Chen
- California Medical Innovations Institute, San Diego, CA, United States
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, United States
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177
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Zhang C, Tao J. Expert consensus on clinical assessment and intervention of vascular aging in China (2018). Aging Med (Milton) 2018; 1:228-237. [PMID: 31942501 PMCID: PMC6880715 DOI: 10.1002/agm2.12049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 11/11/2018] [Indexed: 12/18/2022] Open
Abstract
With the development of geriatric medicine, more and more reported research has found that as humans grow old, their blood vessels also age. Blood vessels are vital components of various organs. Vascular aging is an important physiological and pathological basis for the aging of organs and systems of the human body and is the common pathogenesis of various chronic diseases in the elderly. Early detection of vascular aging and the use of correct methods to delay and treat vascular aging are of great significance to prevent and control chronic diseases in the elderly and to deal with the increasingly serious problems of population aging. For this purpose, this consensus is formulated for use by geriatric doctors and related personnel.
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Affiliation(s)
- Cuntai Zhang
- Department of GeriatricsTongji Medical College of Huazhong University of Science and TechnologyWuhanHubeiChina
| | - Jun Tao
- Department of Hypertension and Vascular DiseaseThe First Affiliated HospitalSun Yat‐Sen UniversityGuangzhouGuangdongChina
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178
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Antza C, Doundoulakis I, Akrivos E, Stabouli S, Trakatelli C, Doumas M, Kotsis V. Early Vascular Aging Risk Assessment From Ambulatory Blood Pressure Monitoring: The Early Vascular Aging Ambulatory Score. Am J Hypertens 2018; 31:1197-1204. [PMID: 30239585 DOI: 10.1093/ajh/hpy115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study compared the diagnostic accuracy of blood pressure (BP) measurement methods, office BP, ambulatory BP monitoring (ABPM), and home BP, in the identification of early vascular aging (EVA) and developed a score to predict the risk of EVA in hypertensive patients. METHODS Two-hundred eighty-two consecutive subjects (39.7% male) aged 56.8 ± 15.8 years were included. Office and out-of-office BP measurements including ABPM on a usual working day and 7 days home BP monitoring were performed. Carotid-femoral pulse wave velocity (c-f PWV) was measured in all patients. EVA was defined as c-f PWV values higher than the expected for age average values according to European population data. RESULTS In univariate analysis, EVA was significantly correlated with office systolic BP, average 24-hour systolic and diastolic BP, and average 24-hour and office heart rates. The area under the curve for predicting EVA was 0.624 (95% CI 0.551 to 0.697), 0.559 (95% CI 0.484 to 0.635) and 0.565 (95% CI 0.49 to 0.641), for daytime, home, and office systolic BP, respectively. Ambulatory BP variables, age, sex, body mass index, diabetes mellitus (yes/no), and estimated glomerular filtration rate were used to develop a new score for EVA providing a total accuracy of 0.82, 0.84 sensitivity, and 0.78 specificity. CONCLUSIONS In conclusion, the new risk score, Early Vascular Aging Ambulatory score, may accurately identify hypertensive patients with EVA using ABPM values and classic cardiovascular risk factors.
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Affiliation(s)
- Christina Antza
- 3rd Department of Internal Medicine, Hypertension-24h Ambulatory Blood Pressure Monitoring Center, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Ioannis Doundoulakis
- 3rd Department of Internal Medicine, Hypertension-24h Ambulatory Blood Pressure Monitoring Center, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Evagelos Akrivos
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Medical School, Aristotle University of Thessaloniki and 2nd Department of Internal Medicine, Thessaloniki, Greece
| | - Stella Stabouli
- 1st Department of Pediatrics, Hippokration Hospital, Aristotle University, Thessaloniki, Greece
| | - Christina Trakatelli
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michael Doumas
- Veterans Affairs Medical Center, George Washington University, Washington, DC, USA
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine, Hypertension-24h Ambulatory Blood Pressure Monitoring Center, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
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179
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Vargas-Uricoechea H, Cáceres-Acosta MF. Blood pressure control and impact on cardiovascular events in patients with type 2 diabetes mellitus: A critical analysis of the literature. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2018; 31:31-47. [PMID: 30274771 DOI: 10.1016/j.arteri.2018.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/07/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022]
Abstract
High blood pressure in individuals with type2 diabetes mellitus increases the risk of cardiovascular events. The international management guidelines recommend starting pharmacological treatment with blood pressure values >140/90mmHg. However, there is no optimal cut-off point from which cardiovascular events can be reduced without causing adverse events. A blood pressure range of >130/80 to <140/90mmHg seems to be adequate. These values can be achieved through non-pharmacological (diet, exercise) and pharmacological interventions (using drugs that have been shown to reduce cardiovascular events). The choice of one or several drugs must be individualised, according to factors including, ethnicity, age, and associated comorbidities, among others.
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Affiliation(s)
- Hernando Vargas-Uricoechea
- Grupo de estudio de enfermedades metabólicas, Facultad Ciencias de la Salud, Departamento de Medicina Interna, Universidad del Cauca, Popayán, Cauca, Colombia.
| | - Manuel Felipe Cáceres-Acosta
- Grupo de estudio de enfermedades metabólicas, Facultad Ciencias de la Salud, Departamento de Medicina Interna, Universidad del Cauca, Popayán, Cauca, Colombia
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180
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Martinez-Quinones P, McCarthy CG, Watts SW, Klee NS, Komic A, Calmasini FB, Priviero F, Warner A, Chenghao Y, Wenceslau CF. Hypertension Induced Morphological and Physiological Changes in Cells of the Arterial Wall. Am J Hypertens 2018; 31:1067-1078. [PMID: 29788246 DOI: 10.1093/ajh/hpy083] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/14/2018] [Indexed: 12/17/2022] Open
Abstract
Morphological and physiological changes in the vasculature have been described in the evolution and maintenance of hypertension. Hypertension-induced vascular dysfunction may present itself as a contributing, or consequential factor, to vascular remodeling caused by chronically elevated systemic arterial blood pressure. Changes in all vessel layers, from the endothelium to the perivascular adipose tissue (PVAT), have been described. This mini-review focuses on the current knowledge of the structure and function of the vessel layers, specifically muscular arteries: intima, media, adventitia, PVAT, and the cell types harbored within each vessel layer. The contributions of each cell type to vessel homeostasis and pathophysiological development of hypertension will be highlighted.
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Affiliation(s)
- Patricia Martinez-Quinones
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Cameron G McCarthy
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Stephanie W Watts
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan, USA
| | - Nicole S Klee
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Amel Komic
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Fabiano B Calmasini
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Fernanda Priviero
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Alexander Warner
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Yu Chenghao
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Camilla F Wenceslau
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
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181
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Vargas-Uricoechea H, Cáceres-Acosta MF. Control of Blood Pressure and Cardiovascular Outcomes in Type 2 Diabetes. Open Med (Wars) 2018; 13:304-323. [PMID: 30140748 PMCID: PMC6104200 DOI: 10.1515/med-2018-0048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/22/2018] [Indexed: 02/07/2023] Open
Abstract
High blood pressure in patients with diabetes mellitus results in a significant increase in the risk of cardiovascular events and mortality. The current evidence regarding the impact of intervention on blood pressure levels (in accordance with a specific threshold) is not particularly robust. Blood pressure control is more difficult to achieve in patients with diabetes than in non-diabetic patients, and requires using combination therapy in most patients. Different management guidelines recommend initiating pharmacological therapy with values >140/90 mm/Hg; however, an optimal cut point for this population has not been established. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90mmHg, and that values approaching 130/80mmHg should be recommended. Initial treatment of hypertension in diabetes should include drug classes demonstrated to reduce cardiovascular events; i.e., angiotensin converting-enzyme inhibitors, angiotensin receptor blockers, diuretics, or dihydropyridine calcium channel blockers. The start of therapy must be individualized in accordance with the patient's baseline characteristics, and factors such as associated comorbidities, race, and age, inter alia.
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Affiliation(s)
| | - Manuel Felipe Cáceres-Acosta
- Metabolic Diseases Study Group, Division of Endocrinology and Metabolism, Department of Internal Medicine, Universidad del Cauca, Popayán, Cauca, Colombia
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182
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Abstract
PURPOSE OF REVIEW Increased arterial stiffness, an abnormal structural and functional change in the vascular wall, is a precursor for hypertension, coronary heart disease, stroke, and associated cardiovascular disease (CVD). The aim of this paper is to review the etiology of arterial stiffening and potential therapeutic approaches to modulate arterial fibrosis and stiffness. RECENT FINDINGS The Framingham Heart Study demonstrated that arterial stiffness is an independent predictor of CVD and related morbidity and mortality. Dysfunction of endothelial cells, vascular smooth muscle cells, extracellular matrix, and other functional elements of the vessel wall contribute to underlying pathophysiology of increased arterial stiffness. An activated renin-angiotensin-aldosterone system, oxidative stress, abnormal peri-vascular adipose tissue, inflammation, and increased sympathetic nervous system activity are associated with the development and progression of arterial fibrosis, stiffening, and associated CVD. In this review, we will discuss the structural and function changes and mechanisms of the vessel wall in arterial stiffness and provide potential therapeutic strategies.
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183
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Dumor K, Shoemaker-Moyle M, Nistala R, Whaley-Connell A. Arterial Stiffness in Hypertension: an Update. Curr Hypertens Rep 2018; 20:72. [DOI: 10.1007/s11906-018-0867-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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184
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Sabia L, Avenatti E, Cesareo M, Leone D, Tosello F, Veglio F, Milan A. Evaluation of aortic stiffness by a new simplified 2D speckle tracking analysis. Int J Cardiovasc Imaging 2018; 34:1753-1760. [PMID: 29931554 DOI: 10.1007/s10554-018-1400-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/15/2018] [Indexed: 01/13/2023]
Abstract
Arterial stiffness is a marker of cardiovascular damage and an independent predictor of major cardiovascular events, usually assessed via Carotid-Femoral Pulse Wave Velocity (cfPWV). The aim of this study was to test the feasibility and usefulness of aortic strain analysis using a simplified transthoracic echocardiography (TTE) speckle-tracking (ST) based method. 60 consecutive patients with normal blood pressure and aortic dimensions underwent TTE and cfPWV evaluation. Strain analysis was performed on the largest section of the ascending aorta (aA) with a dedicated software; three couples of speckles were identified within the anterior and posterior aortic wall and transverse segments connecting each couple traced. Peak ascending Aorta Strain (PaAS) was defined as the averaged peak percentage deformation of these segments during the cardiac cycle; aortic stiffness index β2 was defined as 100 × Ln(SBP/DBP)/PaAS. 17 patients were excluded for suboptimal TTE images. In the 43 analyzed individuals (male 58%, age 63 years) PaAS was 5.5 [3.7-8.6] % with excellent inter and intra observer reproducibility (ICC 95% for both). PaAS showed significant correlation with age (r = - 0.64), aA diameter (r = - 0.45), cfPWV (r = - 0.41), stroke volume (r = - 0.41) and heart rate (r = - 0.49). Age remained the only independent determinant of PaAS in a multivariate analysis. β2 (10.8 [5.9-15.0]) showed significant direct correlation with age, Pulse pressure, aA diameter and cfPWV. A simplified strain analysis of the ascending aorta is technically feasible with good reproducibility; PaAS and β2 index correlate well with established parameters of arterial stiffness and might represent a new index in evaluating vascular biomechanics.
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Affiliation(s)
- Luca Sabia
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Eleonora Avenatti
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Marco Cesareo
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Dario Leone
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Francesco Tosello
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Franco Veglio
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy
| | - Alberto Milan
- Internal Medicine and Hypertension Division, Department of Medical Sciences, AOU Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy.
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185
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Tripepi G, Agharazii M, Pannier B, D’Arrigo G, Mallamaci F, Zoccali C, London G. Pulse Wave Velocity and Prognosis in End-Stage Kidney Disease. Hypertension 2018; 71:1126-1132. [DOI: 10.1161/hypertensionaha.118.10930] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/09/2018] [Accepted: 03/23/2018] [Indexed: 01/23/2023]
Abstract
High pulse wave velocity (PWV) is a hallmark of end-stage kidney disease (ESKD) where it is considered useful for risk stratification. We investigated whether PWV adds meaningful prognostic information to 2 simple, well-validated, clinical risk scores specific to ESKD (the Annualized Rate of Occurrence scores) for predicting all-cause and cardiovascular mortality by applying state-of-the-art prognostic tests including discrimination (Harrell C-index), risk reclassification (integrated discrimination improvement), and calibration. We performed these analyses in the 2 largest ESKD cohorts with available PWV data, the Manhes-Hospital cohort in Paris (n=287 patients) and the Quebec Research Center cohort in Canada (n=246 patients). The Harrell C-index of the 2 clinical risk scores was consistently higher than that by PWV both for all-cause (Manhes cohort, 77.5% versus 73.7%; Quebec cohort, 61.5% versus 58.9%) and cardiovascular mortality (Manhes cohort, 77.9% versus 77.2%; Quebec cohort, 63.8% versus 60.3%). Furthermore, PWV provided a very modest increase in discriminatory power over and above clinical risk scores by Harrell C-index (from 0.5% to 1.8%) and in risk reclassification by Integrated Discrimination Improvement (from 0.9% to 5.1%) and actually worsened models calibration. In patients with ESKD, PWV has a prognostic power for all-cause and cardiovascular mortality inferior to that by simple clinical risk scores and only modestly improves the risk discrimination and reclassification by the same risk scores and worsens models calibration. Clinicians may better rely on available clinical risk scores rather than on PWV for risk stratification in the ESKD population.
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Affiliation(s)
- Giovanni Tripepi
- From the Institute of Clinical Physiology (IFC-CNR), Research Unit of Reggio Calabria, Reggio di Calabria, Italy (G.T., G.D’A., F.M., C.Z.)
| | - Mohsen Agharazii
- CHU de Québec Research Center, L’Hôtel-Dieu de Québec Hospital, Quebec, Quebec, Canada (M.A.)
| | - Bruno Pannier
- Centre Hospitalier F.H. Manhes, Fleury Merogis, France (B.P.)
| | - Graziella D’Arrigo
- From the Institute of Clinical Physiology (IFC-CNR), Research Unit of Reggio Calabria, Reggio di Calabria, Italy (G.T., G.D’A., F.M., C.Z.)
| | - Francesca Mallamaci
- From the Institute of Clinical Physiology (IFC-CNR), Research Unit of Reggio Calabria, Reggio di Calabria, Italy (G.T., G.D’A., F.M., C.Z.)
| | - Carmine Zoccali
- From the Institute of Clinical Physiology (IFC-CNR), Research Unit of Reggio Calabria, Reggio di Calabria, Italy (G.T., G.D’A., F.M., C.Z.)
| | - Gerard London
- and INSERM U970, Hopital Européen Georges Pompidou, Paris, France (G.L.)
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186
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Haley AP, Oleson S, Pasha E, Birdsill A, Kaur S, Thompson J, Tanaka H. Phenotypic heterogeneity of obesity-related brain vulnerability: one-size interventions will not fit all. Ann N Y Acad Sci 2018; 1428:89-102. [PMID: 29741211 DOI: 10.1111/nyas.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/10/2018] [Accepted: 02/17/2018] [Indexed: 01/07/2023]
Abstract
Intact memory and problem solving are key to functional independence and quality of life in older age. Considering the unprecedented demographic shift toward a greater number of older adults than children in the United States in the next few decades, it is critically important for older adults to maintain work productivity and functional independence for as long as possible. Implementing early interventions focused on modifiable risk factors for cognitive decline at midlife is a strategy with the highest chance of success at present, bearing in mind the current lack of dementia cures. We present a selective, narrative review of evidence linking nutrition, body composition, vascular health, and brain function in midlife to highlight the phenotypic heterogeneity of obesity-related brain vulnerability and to endorse the development of individually tailored lifestyle modification plans for primary prevention of cognitive decline.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas.,Imaging Research Center, The University of Texas at Austin, Austin, Texas
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Evan Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
| | - Alex Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Sonya Kaur
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Janelle Thompson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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187
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Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040659. [PMID: 29614802 PMCID: PMC5923701 DOI: 10.3390/ijerph15040659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/25/2018] [Accepted: 03/27/2018] [Indexed: 12/12/2022]
Abstract
As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population have been reported. Therefore, we conducted an epidemiological study among 2141 Thai enterprise employees (858 men and 1283 women) who were free from any diagnosed cardiovascular disease. Work stress was measured using Karasek’s Job Demand–Control model for job strain (a combination of high demand and low control). Arterial stiffness was evaluated by a non-invasive approach using pulse-wave analysis based on a finger photoplethysmogram. Multivariable linear regression was applied to examine associations between job strain and arterial stiffness. In men, job strain was significantly associated with arterial stiffness (β = 0.078, 95% confidence interval = 0.026 to 0.130), after accounting for sociodemographic, behavioral, dietary and biomedical factors. However, the association in women was not significant. As the first study in Thailand on work stress and cardiovascular risk, we found that job strain might be an important risk factor for cardiovascular disease among Thai working men. Further studies with longitudinal design are warranted.
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188
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Affiliation(s)
- Chantal M Boulanger
- From the INSERM UMR-S 970, Paris-Cardiovascular Research Center (PARCC) and Université Paris Descartes, Sorbonne Paris Cité, 56 rue Leblanc, France.
| | - Jean-Sébastien Silvestre
- From the INSERM UMR-S 970, Paris-Cardiovascular Research Center (PARCC) and Université Paris Descartes, Sorbonne Paris Cité, 56 rue Leblanc, France
| | - Alain Tedgui
- From the INSERM UMR-S 970, Paris-Cardiovascular Research Center (PARCC) and Université Paris Descartes, Sorbonne Paris Cité, 56 rue Leblanc, France
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189
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Ikäheimo TM. Cardiovascular diseases, cold exposure and exercise. Temperature (Austin) 2018; 5:123-146. [PMID: 30377633 DOI: 10.1080/23328940.2017.1414014] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 12/11/2022] Open
Abstract
Both acute and prolonged cold exposure affect cardiovascular responses, which may be modified by an underlying cardiovascular disease. In addition, exercise in a cold environment increases cardiovascular strain further, but its effects among persons with cardiovascular diseases are not well known. Controlled studies employing whole-body or local cold exposure demonstrate comparable or augmented increase in cardiac workload, but aggravated cutaneous vasoconstriction in persons with mild hypertension. A strong sympathetic stimulation of a cold pressor test, increases cardiac workload in persons with coronary artery disease (CAD), but does not markedly differ from those with less severe disease or healthy. However, cold exposure reduces myocardial oxygen supply in CAD, which may lead to ischemia. Exercise in cold often augments cardiac workload in persons with CAD more than when performed in thermoneutral conditions. At the same time, reduced myocardial perfusion may lead to earlier ischemia, angina and impaired performance. Also having a heart failure deteriorates submaximal and maximal performance in the cold. Antianginal medication is beneficial in the cold in lowering blood pressure, but does not affect the magnitude of cold-related cardiovascular responses in hypertension. Similarly, the use of blood pressure lowering medication improves exercise performance in cold both among persons with CAD and heart failure. Both the acute and seasonal effects of cold and added with exercise may contribute to the higher morbidity and mortality of those with cardiovascular diseases. Yet, more controlled studies for understanding the pathophysiological mechanisms behind the adverse cold-related health effects are warranted.
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Affiliation(s)
- Tiina M Ikäheimo
- Center For Environmental and Respiratory Health Research, University of Oulu, FI-90014 University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, FI-90029 OYS, Oulu, Finland
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