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Kasaoka S. Evolved role of the cardiovascular intensive care unit (CICU). J Intensive Care 2017; 5:72. [PMID: 29299313 PMCID: PMC5741934 DOI: 10.1186/s40560-017-0271-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/12/2017] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular intensive care refers to special systemic management for the patients with severe cardiovascular disease (CVD), which consists of heart disease and vascular disease. CVD is one of the leading causes of death in the world. In order to prevent death due to CVDs, an intensive care unit for severe CVD patients, so-called cardiovascular intensive care unit (CICU), has been developed in many general hospitals. The technological developments of clinical cardiology, such as invasive hemodynamic monitoring and intracoronary interventional procedures and devices, have resulted in evolution of intensive care for CVDs. Subsequently, severe CVD patients admitted to CICU are increasing year by year. Dedicated medical staff is required for CICU in order to perform best patient management. It is necessary for optimal patient care to select effective means from various hemodynamic tools and to adjust the usage according to the clinical situation such as cardiogenic shock and acute heart failure. Furthermore, the patients in the CICU often have various complications such as respiratory failure and renal failure. Therefore, medical staffs who work at CICU are required to have the ability to practice systemic intensive care.
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Affiliation(s)
- Shunji Kasaoka
- Department of Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556 Japan
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152
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Wu J, Dong M, Santos S, Rigatto C, Liu Y, Lin F. Lab-on-a-Chip Platforms for Detection of Cardiovascular Disease and Cancer Biomarkers. SENSORS 2017; 17:s17122934. [PMID: 29258216 PMCID: PMC5751502 DOI: 10.3390/s17122934] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 11/30/2017] [Accepted: 12/13/2017] [Indexed: 12/17/2022]
Abstract
Cardiovascular disease (CVD) and cancer are two leading causes of death worldwide. CVD and cancer share risk factors such as obesity and diabetes mellitus and have common diagnostic biomarkers such as interleukin-6 and C-reactive protein. Thus, timely and accurate diagnosis of these two correlated diseases is of high interest to both the research and healthcare communities. Most conventional methods for CVD and cancer biomarker detection such as microwell plate-based immunoassay and polymerase chain reaction often suffer from high costs, low test speeds, and complicated procedures. Recently, lab-on-a-chip (LoC)-based platforms have been increasingly developed for CVD and cancer biomarker sensing and analysis using various molecular and cell-based diagnostic biomarkers. These new platforms not only enable better sample preparation, chemical manipulation and reaction, high-throughput and portability, but also provide attractive features such as label-free detection and improved sensitivity due to the integration of various novel detection techniques. These features effectively improve the diagnostic test speed and simplify the detection procedure. In addition, microfluidic cell assays and organ-on-chip models offer new potential approaches for CVD and cancer diagnosis. Here we provide a mini-review focusing on recent development of LoC-based methods for CVD and cancer diagnostic biomarker measurements, and our perspectives of the challenges, opportunities and future directions.
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Affiliation(s)
- Jiandong Wu
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Meili Dong
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
- Institute of Applied Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230088, China.
| | - Susy Santos
- Victoria General Hospital and River Heights/Fort Garry Community Areas, Winnipeg, MB, R3T 2E8, Canada.
| | | | - Yong Liu
- Institute of Applied Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230088, China.
| | - Francis Lin
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
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Predictors of early adulthood hypertension during adolescence: a population-based cohort study. BMC Public Health 2017; 17:915. [PMID: 29183297 PMCID: PMC5706303 DOI: 10.1186/s12889-017-4922-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/16/2017] [Indexed: 01/03/2023] Open
Abstract
Background Some longitudinal studies have shown that blood pressure tracks from adolescence to adulthood, yet there is limited evidence regarding the predictive factors of adulthood hypertension during adolescence. This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) to investigate the role of some factors in adolescence, measured in the first examination (1999–2001), to predict adulthood hypertension in the 4th examination (2009–2011). Methods Overall, 1579 subjects, aged 10–19 years, were used for the analysis of the current study. Mean age (SD) of participants at the baseline was 14.2 (2.5) years and 55% of them were female. A forward stepwise approach (p-value <0.2 for enter and >0.05 for removal) was considered to keep significant covariates among common variables including gender, body mass index, waist circumference, wrist and hip circumferences, fasting blood sugar, triglycerides, high density lipoprotein cholesterol, total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP). Variance inflation factor (VIF) showed some multicollinearity for anthropometric variables (VIFs between 3.5 and 10). Multivariable logistic regression revealed that gender, blood pressure, wrist circumference and total cholesterol in adolescents are important predictors for adulthood hypertension. Results The risk increased by 4% and 39% per each 10 mmHg and 1 mmol/L increase in SBP/DBP and TC, respectively; additionally, females had a 70% lower risk. Among anthropometric variables, wrist circumference remained in the model, with 50% per centimeter increase in the risk of hypertension. Conclusions Wrist circumferences and TC had significant roles in predicting hypertension through adolescence to adulthood. Electronic supplementary material The online version of this article (10.1186/s12889-017-4922-3) contains supplementary material, which is available to authorized users.
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154
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Di Bernardo S, Mivelaz Y, Epure AM, Vial Y, Simeoni U, Bovet P, Estoppey Younes S, Chiolero A, Sekarski N. Assessing the consequences of gestational diabetes mellitus on offspring's cardiovascular health: MySweetHeart Cohort study protocol, Switzerland. BMJ Open 2017; 7:e016972. [PMID: 29138200 PMCID: PMC5695409 DOI: 10.1136/bmjopen-2017-016972] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/24/2017] [Accepted: 08/17/2017] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis. METHODS AND ANALYSIS This is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2-7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned. ETHICS AND DISSEMINATION Ethical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016-00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (clinicaltrials.gov/ct2/show/NCT02872974).
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Affiliation(s)
- Stefano Di Bernardo
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Yvan Mivelaz
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Adina Mihaela Epure
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Yvan Vial
- Obstetrics and Gynaecology Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- DOHaD Laboratory, Paediatrics Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Sandrine Estoppey Younes
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicole Sekarski
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
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155
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Mendizábal B, Urbina EM. Subclinical Atherosclerosis in Youth: Relation to Obesity, Insulin Resistance, and Polycystic Ovary Syndrome. J Pediatr 2017; 190:14-20. [PMID: 28712518 DOI: 10.1016/j.jpeds.2017.06.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/08/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Brenda Mendizábal
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, Cincinnati, OH
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, Cincinnati, OH.
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Petersen SE, Sanghvi MM, Aung N, Cooper JA, Paiva JM, Zemrak F, Fung K, Lukaschuk E, Lee AM, Carapella V, Kim YJ, Piechnik SK, Neubauer S. The impact of cardiovascular risk factors on cardiac structure and function: Insights from the UK Biobank imaging enhancement study. PLoS One 2017; 12:e0185114. [PMID: 28973022 PMCID: PMC5626035 DOI: 10.1371/journal.pone.0185114] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/05/2017] [Indexed: 12/21/2022] Open
Abstract
Aims The UK Biobank is a large-scale population-based study utilising cardiovascular magnetic resonance (CMR) to generate measurements of atrial and ventricular structure and function. This study aimed to quantify the association between modifiable cardiovascular risk factors and cardiac morphology and function in individuals without known cardiovascular disease. Methods Age, sex, ethnicity (non-modifiable) and systolic blood pressure, diastolic blood pressure, smoking status, exercise, body mass index (BMI), high cholesterol, diabetes, alcohol intake (modifiable) were considered important cardiovascular risk factors. Multivariable regression models were built to ascertain the association of risk factors on left ventricular (LV), right ventricular (RV), left atrial (LA) and right atrial (RA) CMR parameters. Results 4,651 participants were included in the analysis. All modifiable risk factors had significant effects on differing atrial and ventricular parameters. BMI was the modifiable risk factor most consistently associated with subclinical changes to CMR parameters, particularly in relation to higher LV mass (+8.3% per SD [4.3 kg/m2], 95% CI: 7.6 to 8.9%), LV (EDV: +4.8% per SD, 95% CI: 4.2 to 5.4%); ESV: +4.4% per SD, 95% CI: 3.5 to 5.3%), RV (EDV: +5.3% per SD, 95% CI: 4.7 to 5.9%; ESV: +5.4% per SD, 95% CI: 4.5 to 6.4%) and LA maximal (+8.6% per SD, 95% CI: 7.4 to 9.7%) volumes. Increases in SBP were associated with higher LV mass (+6.8% per SD, 95% CI: 5.9 to 7.7%), LV (EDV: +4.5% per SD, 95% CI: 3.6 to 5.4%; ESV: +2.0% per SD, 95% CI: 0.8 to 3.3%) volumes. The presence of diabetes or high cholesterol resulted in smaller volumes and lower ejection fractions. Conclusions Modifiable risk factors are associated with subclinical alterations in structure and function in all four cardiac chambers. BMI and systolic blood pressure are the most important modifiable risk factors affecting CMR parameters known to be linked to adverse outcomes.
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Affiliation(s)
- Steffen E. Petersen
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
- * E-mail:
| | - Mihir M. Sanghvi
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Nay Aung
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Jackie A. Cooper
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - José Miguel Paiva
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Filip Zemrak
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Kenneth Fung
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Elena Lukaschuk
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Aaron M. Lee
- William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Valentina Carapella
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Young Jin Kim
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Stefan K. Piechnik
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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157
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Ouyang H, Tian J, Sun G, Zou Y, Liu Z, Li H, Zhao L, Shi B, Fan Y, Fan Y, Wang ZL, Li Z. Self-Powered Pulse Sensor for Antidiastole of Cardiovascular Disease. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2017; 29:1703456. [PMID: 28863247 DOI: 10.1002/adma.201703456] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/27/2017] [Indexed: 05/21/2023]
Abstract
Cardiovascular diseases are the leading cause of death globally; fortunately, 90% of cardiovascular diseases are preventable by long-term monitoring of physiological signals. Stable, ultralow power consumption, and high-sensitivity sensors are significant for miniaturized wearable physiological signal monitoring systems. Here, this study proposes a flexible self-powered ultrasensitive pulse sensor (SUPS) based on triboelectric active sensor with excellent output performance (1.52 V), high peak signal-noise ratio (45 dB), long-term performance (107 cycles), and low cost price. Attributed to the crucial features of acquiring easy-processed pulse waveform, which is consistent with second derivative of signal from conventional pulse sensor, SUPS can be integrated with a bluetooth chip to provide accurate, wireless, and real-time monitoring of pulse signals of cardiovascular system on a smart phone/PC. Antidiastole of coronary heart disease, atrial septal defect, and atrial fibrillation are made, and the arrhythmia (atrial fibrillation) is indicative diagnosed from health, by characteristic exponent analysis of pulse signals accessed from volunteer patients. This SUPS is expected to be applied in self-powered, wearable intelligent mobile diagnosis of cardiovascular disease in the future.
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Affiliation(s)
- Han Ouyang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jingjing Tian
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Guanglong Sun
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China
| | - Yang Zou
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhuo Liu
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Hu Li
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Luming Zhao
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Bojing Shi
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yubo Fan
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yifan Fan
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing Key Laboratory of Hypertension, Beijing, 100020, China
| | - Zhong Lin Wang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, 30332-0245, USA
| | - Zhou Li
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, 100083, China
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
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158
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Song T, Yao Y, Wang T, Huang H, Xia H. Tanshinone IIA ameliorates apoptosis of myocardiocytes by up-regulation of miR-133 and suppression of Caspase-9. Eur J Pharmacol 2017; 815:343-350. [PMID: 28867607 DOI: 10.1016/j.ejphar.2017.08.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 12/14/2022]
Abstract
To explore the potential protective effect of Tanshinone ⅡA on myocardial cell apoptosis and elucidate the underlying molecular mechanisms. The rat heart cell H9c2 was treated by either H2O2 or doxorubicin (DOX) to mimic oxidative stress and DNA damage conditions in vivo. Cell growth was monitored by optical microscope observation or CCK-8 counting kit. The relative expression of miR-133 and U6 snoRNA was semi-quantitated by RT-PCR or real-time PCR. Cell apoptosis was analyzed by flow cytometry with Annexin V/PI double staining. The microRNA binding sites were predicted by online bioinformatics tools. The regulatory effect of miR-133 on caspase-9 was measured by luciferase reporter assay. Apoptosis pathway factors were analyzed by immunoblotting. Our data demonstrated that Tanshinone ⅡA significantly ameliorated myocardial apoptosis induced by either H2O2 or DOX. The protective effect was likely mediated by up-regulation of miR-133. We further identified Caspase-9 as the target of miR-133. Tanshinone ⅡA treatment significantly reversed down-regulation of miR-133 under harsh conditions and in turn suppressed evoking of Caspase-9 and related apoptotic effectors, which consequently contributed to the improvement of myocardial injury. In conclusion, Tanshinone ⅡA ameliorated myocardial apoptosis via restoration of miR-133 and suppression Caspase-9 signaling cascade, which underlies its well-proven clinical benefit and warrants larger scale clinical applications.
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Affiliation(s)
- Tao Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060 Wuhan, PR China.
| | - Yuan Yao
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060 Wuhan, PR China
| | - Teng Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060 Wuhan, PR China
| | - He Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060 Wuhan, PR China
| | - Hao Xia
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060 Wuhan, PR China
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159
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Cheng M, An S, Li J. CDKN2B - AS may indirectly regulate coronary artery disease-associated genes via targeting miR - 92a. Gene 2017; 629:101-107. [DOI: 10.1016/j.gene.2017.07.070] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/20/2017] [Accepted: 07/27/2017] [Indexed: 12/27/2022]
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160
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Chithra PK, Jayalekshmy A, Helen A. Petroleum ether extract of Njavara rice (Oryza sativa) bran upregulates the JAK2-STAT3-mediated anti-inflammatory profile in macrophages and aortic endothelial cells promoting regression of atherosclerosis. Biochem Cell Biol 2017; 95:652-662. [PMID: 28700834 DOI: 10.1139/bcb-2017-0090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
"Njavara" (Oryza sativa L.) is a unique rice variety grown in Kerala that is reported to have significantly higher antioxidant, anti-inflammatory, chemical indices, and bioactive components compared with staple rice varieties. However, the role of NBE in reversing the atherosclerosis development remains unclear. The present study aimed to elucidate the role of NBE in promoting atherosclerotic regression. Male New Zealand white breed rabbits were divided into three groups. Group I was the control, group II was the regression control, and group III was NBE treated (100 mg/kg body mass). Serum and tissue lipids, CRP, antioxidant enzyme activities, mRNA, and protein expression of genes of RTC and mRNA expression of cytokines were studied. The current study showed that hypercholesterolemic rabbits treated with NBE decreased the serum and tissue lipids concentrations, ApoB expression, and CRP levels and enhanced the activities of antioxidant enzymes and PON1expression, JAK2, STAT3, ABCA1, and ApoA. Our results indicate that NBE attenuates proinflammatory cytokine production (IL-1β), enhanced expression and interactions of ABCA1/ApoA1 leading to JAK2/STAT3 activation in macrophages switching to an anti-inflammatory milieu in the system, and enhanced expression of IL-10 and decreased expression of ApoB, indicating that treatment with NBE facilitates plaque regression.
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Affiliation(s)
- Pushpan K Chithra
- a Department of Biochemistry, University of Kerala, Kariavattom, Thiruvananthapuram, Kerala 695581, India
| | - Ananthasankaran Jayalekshmy
- b Chemical Sciences and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR), Industrial Estate PO, Papanamcode, Thiruvananthapuram, Kerala 695019, India
| | - Antony Helen
- a Department of Biochemistry, University of Kerala, Kariavattom, Thiruvananthapuram, Kerala 695581, India
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161
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Borderline personality features, interpersonal correlates, and blood pressure response to social stressors: Implications for cardiovascular risk. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017; 113:38-47. [DOI: 10.1016/j.paid.2017.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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162
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Tran DMT, Zimmerman LM, Kupzyk KA, Shurmur SW, Pullen CH, Yates BC. Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:158-167. [PMID: 27911653 DOI: 10.1080/07448481.2016.1266638] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. PARTICIPANTS The final sample that responded to recruitment consisted of 158 college students from a midwestern university. METHODS A cross-sectional, descriptive study was performed using convenience sampling. RESULTS College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. CONCLUSIONS High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.
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Affiliation(s)
- Dieu-My T Tran
- a School of Nursing , University of Nevada , Las Vegas , Las Vegas , Nevada , USA
| | - Lani M Zimmerman
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Kevin A Kupzyk
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Scott W Shurmur
- c School of Medicine , Texas Tech University Health Sciences Center , Lubbock , Texas , USA
| | - Carol H Pullen
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
| | - Bernice C Yates
- b College of Nursing , University of Nebraska Medical Center , Lincoln , Nebraska , USA
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163
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Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study. PLoS One 2017; 12:e0173393. [PMID: 28323823 PMCID: PMC5360240 DOI: 10.1371/journal.pone.0173393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 02/20/2017] [Indexed: 01/23/2023] Open
Abstract
Background The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. Methods Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. Results Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. Conclusion Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters.
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164
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Chen KY, Zannino D, Curtis N, Cheung M, Burgner D. Increased aortic intima-media thickness following Kawasaki disease. Atherosclerosis 2017; 260:75-80. [PMID: 28359981 DOI: 10.1016/j.atherosclerosis.2017.03.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/02/2017] [Accepted: 03/17/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The cardiovascular risk following Kawasaki disease (KD), especially in those without coronary artery changes or with regressed coronary artery lesions, is unclear. We assessed markers of early atherosclerosis in individuals following KD, including those with and without coronary artery abnormalities. METHODS We performed a cross-sectional case-control study of 60 patients (25 with always normal coronary arteries and 35 with abnormalities) and 60 controls, at least two years after KD. Non-invasive assessment of arterial structure (carotid and aortic intima-media thickness (IMT)) and function (pulse wave velocity, carotid artery distensibility and diameter compliance) was done. Analyses were adjusted for traditional cardiovascular risk factors. RESULTS Kawasaki disease patients had increased aortic IMT compared to controls (0.53 mm (95% CI 0.51-0.56) versus 0.49 (95% CI 0.47-0.52), p = 0.04), largely driven by those with abnormal coronary arteries. There were no differences in carotid IMT. Kawasaki disease patients with coronary artery abnormalities had reduced carotid distensibility compared to controls (15.16% (95% CI 13.67-16.65) versus 17.50 (95% CI 16.43-18.58), p = 0.02). CONCLUSIONS Patients with KD have increased aortic IMT and reduced carotid distensibility, indicating heightened cardiovascular risk, especially in those with coronary artery abnormalities. In our study, we used validated surrogates for cardiovascular disease risk. Our findings, therefore, warrant follow-up investigations in KD patients.
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Affiliation(s)
- Katherine Yh Chen
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia
| | - Diana Zannino
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Nigel Curtis
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia
| | - Michael Cheung
- Department of Paediatrics, University of Melbourne, Victoria, Australia; Heart Research Group, Murdoch Childrens Research Institute and Department of Cardiology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - David Burgner
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Department of Paediatrics, Monash University, Victoria, Australia.
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165
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Hoffman JB, Petriello MC, Hennig B. Impact of nutrition on pollutant toxicity: an update with new insights into epigenetic regulation. REVIEWS ON ENVIRONMENTAL HEALTH 2017; 32:65-72. [PMID: 28076319 PMCID: PMC5489226 DOI: 10.1515/reveh-2016-0041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/09/2016] [Indexed: 05/03/2023]
Abstract
Exposure to environmental pollutants is a global health problem and is associated with the development of many chronic diseases, including cardiovascular disease, diabetes and metabolic syndrome. There is a growing body of evidence that nutrition can both positively and negatively modulate the toxic effects of pollutant exposure. Diets high in proinflammatory fats, such as linoleic acid, can exacerbate pollutant toxicity, whereas diets rich in bioactive and anti-inflammatory food components, including omega-3 fatty acids and polyphenols, can attenuate toxicant-associated inflammation. Previously, researchers have elucidated direct mechanisms of nutritional modulation, including alteration of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling, but recently, increased focus has been given to the ways in which nutrition and pollutants affect epigenetics. Nutrition has been demonstrated to modulate epigenetic markers that have been linked either to increased disease risks or to protection against diseases. Overnutrition (i.e. obesity) and undernutrition (i.e. famine) have been observed to alter prenatal epigenetic tags that may increase the risk of offspring developing disease later in life. Conversely, bioactive food components, including curcumin, have been shown to alter epigenetic markers that suppress the activation of NF-κB, thus reducing inflammatory responses. Exposure to pollutants also alters epigenetic markers and may contribute to inflammation and disease. It has been demonstrated that pollutants, via epigenetic modulations, can increase the activation of NF-κB and upregulate microRNAs associated with inflammation, cardiac injury and oxidative damage. Importantly, recent evidence suggests that nutritional components, including epigallocatechin gallate (EGCG), can protect against pollutant-induced inflammation through epigenetic regulation of proinflammatory target genes of NF-κB. Further research is needed to better understand how nutrition can modulate pollutant toxicity through epigenetic regulation. Therefore, the objective of this review is to elucidate the current evidence linking epigenetic changes to pollutant-induced diseases and how this regulation may be modulated by nutrients allowing for the development of future personalized lifestyle interventions.
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Affiliation(s)
- Jessie B Hoffman
- Superfund Research Center, University of Kentucky, Lexington, KY 40536
- Department of Pharmacology and Nutritional Sciences, College of Medicine, University of Kentucky, Lexington, KY 40536
| | - Michael C Petriello
- Superfund Research Center, University of Kentucky, Lexington, KY 40536
- Department of Animal and Food Sciences, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40536
| | - Bernhard Hennig
- Superfund Research Center, University of Kentucky, Lexington, KY 40536
- Department of Animal and Food Sciences, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40536
- Correspondence should be directed to: Bernhard Hennig, 900 S. Limestone Street, Superfund Research Center, University of Kentucky, Lexington, KY 40536, USA. Tel.: +1 859-218-1343; fax: +1 859-257-1811;
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Bulant CA, Blanco PJ, Lima TP, Assunção AN, Liberato G, Parga JR, Ávila LFR, Pereira AC, Feijóo RA, Lemos PA. A computational framework to characterize and compare the geometry of coronary networks. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e02800. [PMID: 27169829 DOI: 10.1002/cnm.2800] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/08/2016] [Accepted: 04/26/2016] [Indexed: 06/05/2023]
Abstract
This work presents a computational framework to perform a systematic and comprehensive assessment of the morphometry of coronary arteries from in vivo medical images. The methodology embraces image segmentation, arterial vessel representation, characterization and comparison, data storage, and finally analysis. Validation is performed using a sample of 48 patients. Data mining of morphometric information of several coronary arteries is presented. Results agree to medical reports in terms of basic geometric and anatomical variables. Concerning geometric descriptors, inter-artery and intra-artery correlations are studied. Data reported here can be useful for the construction and setup of blood flow models of the coronary circulation. Finally, as an application example, similarity criterion to assess vasculature likelihood based on geometric features is presented and used to test geometric similarity among sibling patients. Results indicate that likelihood, measured through geometric descriptors, is stronger between siblings compared with non-relative patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- C A Bulant
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - P J Blanco
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - T P Lima
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - A N Assunção
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - G Liberato
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - J R Parga
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - L F R Ávila
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - A C Pereira
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
| | - R A Feijóo
- National Laboratory for Scientific Computing, LNCC/MCTI, Av. Getúlio Vargas 333, Quitandinha, Petrópolis, 25651-075, Brazil
- National Institute of Science and Technology in Medicine Assisted by Scientific Computing, INCT-MACC, Petrópolis, Brazil
| | - P A Lemos
- Heart Institute, University of São Paulo Medical School, INCOR-FM-USP, Av. Dr. Eneas de Carvalho Aguiar, 44, 3rd floor, São Paulo-SP, 05403-000, Brazil
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Cockcroft EJ, Williams CA, Jackman SR, Bassi S, Armstrong N, Barker AR. A single bout of high-intensity interval exercise and work-matched moderate-intensity exercise has minimal effect on glucose tolerance and insulin sensitivity in 7- to 10-year-old boys. J Sports Sci 2017; 36:149-155. [PMID: 28282751 DOI: 10.1080/02640414.2017.1287934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to assess the acute effect of high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on glucose tolerance, insulin sensitivity and fat oxidation in young boys. Eleven boys (8.8 ± 0.8 y) completed three conditions: 1) HIIE; 2) work-matched MIE; and 3) rest (CON) followed by an oral glucose tolerance test (OGTT) to determine glucose tolerance and insulin sensitivity (Cederholm index). Fat oxidation was measured following the OGTT using indirect calorimetry. There was no effect for condition on plasma [glucose] and [insulin] area under the curve (AUC) responses following the OGTT (P > 0.09). However, there was a "trend" for a condition effect for insulin sensitivity with a small increase after HIIE (P = 0.04, ES = 0.28, 9.7%) and MIE (P = 0.07, ES = 0.21, 6.5%) compared to CON. There was an increase in fat oxidation AUC following HIIE (P = 0.008, ES = 0.79, 38.9%) compared to CON, but with no differences between MIE and CON and HIIE and MIE (P > 0.13). In conclusion, 7- to 10-year-old boys may have limited scope to improve insulin sensitivity and glucose tolerance after a single bout of HIIE and MIE. However, fat oxidation is augmented after HIIE but not MIE.
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Affiliation(s)
- Emma J Cockcroft
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Craig A Williams
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Sarah R Jackman
- b Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Shikhar Bassi
- b Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Neil Armstrong
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Alan R Barker
- a Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
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Nauman J, Nes BM, Lavie CJ, Jackson AS, Sui X, Coombes JS, Blair SN, Wisløff U. Prediction of Cardiovascular Mortality by Estimated Cardiorespiratory Fitness Independent of Traditional Risk Factors: The HUNT Study. Mayo Clin Proc 2017; 92:218-227. [PMID: 27866655 DOI: 10.1016/j.mayocp.2016.10.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/23/2016] [Accepted: 10/11/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the predictive value of estimated cardiorespiratory fitness (eCRF) and evaluate the additional contribution of traditional risk factors in cardiovascular disease (CVD) mortality prediction. PARTICIPANTS AND METHODS The study included healthy men (n=18,721) and women (n=19,759) aged 30 to 74 years. A nonexercise algorithm estimated cardiorespiratory fitness. Cox proportional hazards models evaluated the primary (CVD mortality) and secondary (all-cause, ischemic heart disease, and stroke mortality) end points. The added predictive value of traditional CVD risk factors was evaluated using the Harrell C statistic and net reclassification improvement. RESULTS After a median follow-up of 16.3 years (range, 0.04-17.4 years), there were 3863 deaths, including 1133 deaths from CVD (734 men and 399 women). Low eCRF was a strong predictor of CVD and all-cause mortality after adjusting for established risk factors. The C statistics for eCRF and CVD mortality were 0.848 (95% CI, 0.836-0.861) and 0.878 (95% CI, 0.862-0.894) for men and women, respectively, increasing to 0.851 (95% CI, 0.839-0.863) and 0.881 (95% CI, 0.865-0.897), respectively, when adding clinical variables. By adding clinical variables to eCRF, the net reclassification improvement of CVD mortality was 0.014 (95% CI, -0.023 to 0.051) and 0.052 (95% CI, -0.023 to 0.127) in men and women, respectively. CONCLUSION Low eCRF is independently associated with CVD and all-cause mortality. The inclusion of traditional clinical CVD risk factors added little to risk discrimination and did not improve the classification of risk beyond this simple eCRF measurement, which may be proposed as a practical and cost-effective first-line approach in primary prevention settings.
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Affiliation(s)
- Javaid Nauman
- K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarne M Nes
- K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA
| | - Andrew S Jackson
- Department of Health and Human Performance, University of Houston, Houston, TX
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Ulrik Wisløff
- K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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169
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Caswell JM. Prevalence of reported high blood pressure in Canada: investigation of demographic and spatial trends. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-016-0761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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170
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Eick GN, Kowal P, Barrett T, Thiele EA, Snodgrass JJ. Enzyme-Linked Immunoassay-Based Quantitative Measurement of Apolipoprotein B (ApoB) in Dried Blood Spots, a Biomarker of Cardiovascular Disease Risk. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:116-130. [PMID: 28521623 DOI: 10.1080/19485565.2017.1283582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Apolipoprotein B (ApoB) is a strong predictor of cardiovascular disease, which remains the leading cause of mortality in both higher and lower income countries. Here, we adapted an enzyme-linked immunosorbent assay (ELISA) development kit for quantitative determination of ApoB levels in serum and plasma for use with dried blood spots (DBS). After confirming the dilution linearity of the assay for DBS, we measured ApoB in 208 venous DBS samples. Then, using Passing-Bablok regression analysis and Spearman rank correlation analysis, we evaluated the correspondence in ApoB values between matched plasma and finger-prick DBS samples from 40 individuals who had ApoB values spanning the range of ApoB values observed in the 208 vDBS samples. We also evaluated assay precision and recovery, the effects of hematocrit, number of freeze-thaw cycles, and different storage temperatures on ApoB levels in DBS. There was a strong, significant correlation between plasma and DBS ApoB levels with little bias. Assay precision and recovery were within the range recommended by the U.S. government's industry guidelines for bioanalytical assay validation. The assay was not affected by the DBS matrix or physiological hematocrit levels. This DBS-based ELISA assay will facilitate population-scale assessment of cardiovascular risk in previously unexplored populations.
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Affiliation(s)
- Geeta N Eick
- a Department of Anthropology , University of Oregon , Eugene , Oregon , USA
| | - Paul Kowal
- a Department of Anthropology , University of Oregon , Eugene , Oregon , USA
- b World Health Organization Study on Global Ageing and Adult Health (SAGE) , Geneva , Switzerland
- c University of Newcastle Research Centre for Generational Health and Ageing , New Lambton Heights , Australia
| | - Tyler Barrett
- d Department of Anthropology , Northwestern University , Evanston , Illinois , USA
| | - Elizabeth A Thiele
- e Department of Biology , Vassar College , Poughkeepsie , New York , USA
| | - J Josh Snodgrass
- a Department of Anthropology , University of Oregon , Eugene , Oregon , USA
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Association between three-dimensional vessel geometry and the presence of atherosclerotic plaques in the left anterior descending coronary artery of high-risk patients. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2016.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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172
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Fawwad A, Moin H, Siddiqui IA, Hydrie MZI, Basit A. Framingham risk score in impaired glucose tolerant population: A sub analysis of Diabetes Prevention and Awareness Program of Pakistan. Pak J Med Sci 2016; 32:1121-1125. [PMID: 27882006 PMCID: PMC5103118 DOI: 10.12669/pjms.325.10448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: To assess the 10-year risk of coronary artery disease (CAD) in subjects with impaired glucose tolerance (IGT) using Framingham risk score. Methods: Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent. Information regarding social-demography, dietary habits and physical activities were obtained by a designed questionnaire on one-to-one based interview. Framingham risk score (FRS) was used to assess risk of developing CAD. Results: A total of 315 subjects with IGT were recruited for the study. Mean age of subjects was 44.1 ± 9.8 years and mean BMI was 27.3 ± 5.0 kg/m2. Overall, 31.4% of the participants were at risk of having CAD. Males were 6.4 times and hypertensive subjects were 2.44 times more likely to have CAD in next 10 years. Conclusion: According to the findings of the study, male and hypertensive IGT subjects were more likely to develop CAD in next 10 years. Community based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce the risk of IGT and CAD.
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Affiliation(s)
- Asher Fawwad
- Asher Fawwad, PhD. Associate Professor, Baqai Medical University, Senior Research Scientist, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Hassan Moin
- Hassan Moin, M.Sc. Statistician, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Iftikhar Ahmed Siddiqui
- Iftikhar Ahmed Siddiqui, PhD. Chairman & Professor of Biochemistry, Department of Biochemistry, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Muhammad Zafar Iqbal Hydrie
- Muhammad Zafar Iqbal Hydrie, PhD, Postdoc. Assistant Professor, Department of Biochemistry, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan
| | - Abdul Basit
- Abdul Basit, FRCP. Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
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Tomsa A, Klinepeter Bartz S, Krishnamurthy R, Krishnamurthy R, Bacha F. Endothelial Function in Youth: A Biomarker Modulated by Adiposity-Related Insulin Resistance. J Pediatr 2016; 178:171-177. [PMID: 27546204 DOI: 10.1016/j.jpeds.2016.07.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/08/2016] [Accepted: 07/13/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the physical and metabolic determinants of endothelial dysfunction, an early marker of subclinical atherosclerosis, in normal weight and overweight adolescents with and without type 2 diabetes mellitus. STUDY DESIGN A cross-sectional study of 81 adolescents: 21 normal weight, 25 overweight with normal glucose tolerance, 19 overweight with impaired glucose regulation, and 16 with type 2 diabetes mellitus underwent evaluation of reactive hyperemia index (RHI) and augmentation index (AIx) at heart rate 75 bpm by peripheral arterial tonometry; oral glucose tolerance test, lipid profile, and hyperinsulinemic-euglycemic clamp to measure insulin sensitivity; and dual energy X-ray absorptiometry scan and abdominal magnetic resonance imaging for percentage of body fat and abdominal fat partitioning. RESULTS Participants across tertiles of RHI (1.2 ± 0.02, 1.5 ± 0.02, and 2.0 ± 0.05, P < .001) had similar age, sex, race, lipid profile, and blood pressure. Body mass index z-score, percentage body fat, abdominal fat, and hemoglobin A1c decreased, and insulin sensitivity increased from the first to third tertile. RHI was inversely related to percentage body fat (r = -0.29, P = .008), total (r = -0.37, P = .004), subcutaneous (r = -0.39, P = .003), and visceral (r = -0.26, P = .04) abdominal fat. AIx at heart rate 75 bpm was higher (worse) in the lower RHI tertiles (P = .04), was positively related to percentage body fat (r = 0.26, P = .021), and inversely related to age, insulin sensitivity, and inflammatory markers (tumor necrosis factor-α and plasminogen activator inhibition-1). CONCLUSIONS Childhood obesity, particularly abdominal adiposity, is associated with endothelial dysfunction manifested by worse reactive hyperemia and higher AIx. Insulin resistance appears to mediate this relationship.
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Affiliation(s)
- Anca Tomsa
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Sara Klinepeter Bartz
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Rajesh Krishnamurthy
- Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Ramkumar Krishnamurthy
- Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Fida Bacha
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
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Dayem SMAE, Battah AA, El Bohy AEM. Assessment of Increase in Aortic and Carotid Intimal Medial Thickness in Type 1 Diabetic Patients. Open Access Maced J Med Sci 2016; 4:630-635. [PMID: 28028403 PMCID: PMC5175511 DOI: 10.3889/oamjms.2016.118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 10/14/2016] [Accepted: 10/15/2016] [Indexed: 01/18/2023] Open
Abstract
AIM To assess aortic and carotid intima-media thickness (aIMT and cIMT) in diabetic patients. PATIENTS AND METHODS The study included 75 type 1 diabetic patients and 30 age and sex matched healthy volunteer. A blood sample was taken for analysis of HbA1 and lipid profile and the urine sample was taken for analysis of albumin/creatinine ratio. aIMT and cIMT via ultrasound were also done. RESULTS cIMT & aIMT were significantly higher in diabetics. aIMT was found to be significantly higher than cIMT in diabetic patients (0.72 ± 0.11 vs. 0.52 ± 0.06, P = 0.0001). Ten of our patients (14%) with normal cIMT revealed significantly increased aIMT. aIMT had a significant positive correlation with age of patients, waist/hip ratio & cIMT. CONCLUSION Diabetic patients had increased aIMT and cIMT with a relatively greater increase in the aIMT than in the cIMT. Because atherosclerosis begins first in the intima of the aorta, these data suggest that the aIMT might provide the best currently available noninvasive marker of preclinical atherosclerosis in children. We recommend frequent follow up of diabetic patients for early detection of diabetic complication.
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Affiliation(s)
| | - Ahmed A Battah
- Critical Care Department, Cairo University, Cairo, Egypt
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175
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Oxidative Stress and Salvia miltiorrhiza in Aging-Associated Cardiovascular Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:4797102. [PMID: 27807472 PMCID: PMC5078662 DOI: 10.1155/2016/4797102] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/15/2016] [Indexed: 12/13/2022]
Abstract
Aging-associated cardiovascular diseases (CVDs) have some risk factors that are closely related to oxidative stress. Salvia miltiorrhiza (SM) has been used commonly to treat CVDs for hundreds of years in the Chinese community. We aimed to explore the effects of SM on oxidative stress in aging-associated CVDs. Through literature searches using Medicine, PubMed, EMBASE, Cochrane library, CINAHL, and Scopus databases, we found that SM not only possesses antioxidant, antiapoptotic, and anti-inflammatory effects but also exerts angiogenic and cardioprotective activities. SM may reduce the production of reactive oxygen species by inhibiting oxidases, reducing the production of superoxide, inhibiting the oxidative modification of low-density lipoproteins, and ameliorating mitochondrial oxidative stress. SM also increases the activities of catalase, manganese superoxide dismutase, glutathione peroxidase, and coupled endothelial nitric oxide synthase. In addition, SM reduces the impact of ischemia/reperfusion injury, prevents cardiac fibrosis after myocardial infarction, preserves cardiac function in coronary disease, maintains the integrity of the blood-brain barrier, and promotes self-renewal and proliferation of neural stem/progenitor cells in stroke. However, future clinical well-designed and randomized control trials will be necessary to confirm the efficacy of SM in aging-associated CVDs.
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176
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Bulant CA, Blanco PJ, Pereira A, Lima TP, Assunção AN, Liberato G, Bezerra CG, Parga JR, Ávila LF, Feijóo RA, Lemos PA. On the search of arterial geometry heritability. Int J Cardiol 2016; 221:1013-21. [DOI: 10.1016/j.ijcard.2016.07.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
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177
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Assessment of the carotid artery intima-media complex through ultrasonography and the relationship with Pathobiological Determinants of Atherosclerosis in Youth. Cardiol Young 2016; 26:1333-42. [PMID: 26555565 DOI: 10.1017/s1047951115002541] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the presence of carotid thickening and its relationship with the Pathobiological Determinants of Atherosclerosis in Youth score. METHODS We carried out a cross-sectional study involving 512 brazilian adolescents. Variables such as sex, body mass index, concentrations of non-high-density lipoprotein and high-density lipoprotein cholesterol, blood pressure, blood glucose and glycated haemoglobin A1c levels that make up the score, and carotid thickening through the intima-media complex measured by ultrasound were evaluated. We adopted two cut-off points to evaluate carotid thickening, being considered altered for those higher or equal to the z-score 2+ and ⩾75th percentile. The association was assessed using the χ2 test and univariate and multivariate logistic regression analyses. RESULTS High cardiovascular risk was present in 10.2% of the adolescents; carotid thickness was present in 4.3% determined by the z-score 2+ and in 25.0% determined by the 75th percentile. When measured by the z-score, carotid thickening was associated with high systolic blood pressure (p=0.024), high-non-high density lipoprotein cholesterol (p=0.039), and high cardiovascular risk assessed by the score and by the 75th percentile, with body mass index >30 (p=0.005). In the multivariate analysis, high cardiovascular risk was found to be independently associated with the presence of carotid thickness evaluated by the z-score, with risk four times greater (p=0.010) of presenting with this condition compared with individuals with low risk, and this fact was not observed when factors were analysed alone. CONCLUSION The presence of high cardiovascular risk in adolescents assessed by the Pathobiological Determinants of Atherosclerosis in Youth score was associated with marked thickening of the carotid artery in healthy adolescents.
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178
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Periodontitis, cardiovascular disease and pregnancy outcome--focal infection revisited? Br Dent J 2016; 217:467-74. [PMID: 25342358 DOI: 10.1038/sj.bdj.2014.903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 01/17/2023]
Abstract
Over the last two decades there has been a renewed interest around the possible effects of periodontal disease on both cardiovascular health and pregnancy outcome (among other diseases), a topic which has interested science for hundreds of years. These have led to a range of studies, workshops and consensus documents being published, with corresponding coverage in general and professional media. In this article the authors summarise the history and supporting theories behind such associations, whether clinical studies have been able to confirm these and what this might mean for general practitioners who are questioned on this topic by patients.
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179
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Hanvey AN, Clifford SA, Mensah FK, Wake M. Which body composition measures are associated with cardiovascular function and structure in adolescence? ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.obmed.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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180
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Exploring spatial trends in Canadian incidence of hospitalization due to myocardial infarction with additional determinants of health. Public Health 2016; 140:136-143. [PMID: 27523784 DOI: 10.1016/j.puhe.2016.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/05/2016] [Accepted: 07/09/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To explore the presence of spatial trends among rates of hospitalization due to myocardial infarction across health regions of Canada and the associated role of additional health determinants. STUDY DESIGN An ecological study was conducted using aggregate data from the Canadian Institute for Health Information for age-standardized rates of myocardial infarction hospitalizations by health region in 2013. METHODS Exploratory spatial data analyses were applied to myocardial infarction hospitalization rates including Moran's I for detecting global spatial autocorrelation. Local spatial dependence was examined using local indicators of spatial autocorrelation (LISA) to better identify the location of potential regional clusters. Linear and spatial regressions were applied to examine the role of additional health determinants. RESULTS Significant spatial autocorrelation was observed for hospitalizations due to myocardial infarction for both sexes, independently and combined. This was largely present in the form of geographic disparities with cold spot clusters of low rates in the west, particularly British Columbia, and hot spot clusters of high rates moving east, especially in Ontario, Quebec, and New Brunswick. Additional disparities were observed with high rates clustered in Northern Ontario compared to clusters of low rates in Southern Ontario. Significant predictors included smoking, average income, education, and overweight or obesity and, after controlling for these, the central cold spot of low rates shifted east to Saskatchewan. CONCLUSIONS The identification of spatial homogeneity suggests a necessity for better geographic-based preventive measures as determined by the varied needs of particular regions' communities. The demonstration that space matters in this context further indicates that spatial dependence should be included in additional investigations of myocardial infarction incidence and associated hospitalizations.
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181
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Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, Urbina E, Van Horn LV, Zachariah JP. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e236-55. [PMID: 27515136 DOI: 10.1161/cir.0000000000000441] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided.
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Øygarden H, Fromm A, Sand KM, Kvistad CE, Eide GE, Thomassen L, Naess H, Waje-Andreassen U. A Family History of Stroke Is Associated with Increased Intima-Media Thickness in Young Ischemic Stroke - The Norwegian Stroke in the Young Study (NOR-SYS). PLoS One 2016; 11:e0159811. [PMID: 27504830 PMCID: PMC4978409 DOI: 10.1371/journal.pone.0159811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 07/10/2016] [Indexed: 01/11/2023] Open
Abstract
Background and Purpose Positive family history (FH+) of cardiovascular disease (CVD) is a risk factor for own CVD. We aimed to analyze the effect of different types of FH (stroke, coronary heart disease (CHD), peripheral artery disease (PAD) on carotid intima-media thickness (cIMT) in young and middle-aged ischemic stroke patients. Methods First-degree FH of CVD was assessed in ischemic stroke patients ≤ 60y using a standardized interview. Carotid ultrasound was performed and far wall cIMT in three carotid artery segments was registered, representing the common carotid (CCA-IMT), carotid bifurcation (BIF-IMT) and the internal carotid artery (ICA-IMT). Measurements were compared between FH+ and FH negative groups and stepwise backward regression analyses were performed to identify factors associated with increased cIMT. Results During the study period 382 patients were enrolled, of which 262 (68%) were males and 233 (61%) reported FH of CVD. Regression analyses adjusting for risk factors revealed age as the most important predictor of cIMT in all segments. The association between FH+ and cIMT was modified by age (p = 0.014) and was significant only regarding ICA-IMT. FH+ was associated with increased ICA-IMT in patients aged < 45y (p = 0.001), but not in patients ≥ 45y (p = 0.083). The association with ICA-IMT was present for a FH of stroke (p = 0.034), but not a FH+ of CHD or PAD. Conclusions FH of stroke is associated with higher ICA-IMT in young ischemic stroke patients. Subtyping of cardiovascular FH is important to investigate heredity in young ischemic stroke patients. Trial Registration ClinicalTrials.gov NCT01597453
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Affiliation(s)
- Halvor Øygarden
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- * E-mail:
| | - Annette Fromm
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | | | - Christopher Elnan Kvistad
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Geir Egil Eide
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
- Lifestyle Epidemiology Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Lars Thomassen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Halvor Naess
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Ulrike Waje-Andreassen
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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Alkholy UM, Ahmed IA, Karam NA, Ali YF, Yosry A. Assessment of left ventricular mass index could predict metabolic syndrome in obese children. J Saudi Heart Assoc 2016; 28:159-66. [PMID: 27358533 PMCID: PMC4917708 DOI: 10.1016/j.jsha.2015.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/02/2015] [Accepted: 06/10/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Childhood obesity is a major risk factor for cardiovascular diseases in children and adults. OBJECTIVES The purpose of this study was to evaluate the serum leptin level and the cardiac changes in normotensive obese children and to study the relationship between left ventricular mass index (LVMI) and serum leptin with the parameters of metabolic syndrome (MS) in obese children. METHODS This study was conducted in al Jeddani Hospital and Ibn Sina College Hospital in Saudi Arabia in the period from July 2012 to December 2013, and included 82 obese children. Their mean age was 10.2 ± 2.8 years; they were divided into 25 obese children with MS and 57 obese children without MS, and 40 healthy age- and sex-matched children were also included in the study as a control group. All children were subjected to clinical assessment including standing height, body weight, body mass index (BMI), waist circumference (WC), and blood pressure measurements. All children received an echocardiographic examination (2-dimensional, M-mode, Doppler, and tissue Doppler echocardiograpy) and laboratory assessment of serum leptin level, fasting glucose, fasting insulin, the homeostatic model assessment for insulin resistance (HOMA) index, total cholesterol, triglycerides, and high- and low-density lipoprotein profile. RESULTS BMI, BMI standard deviation score, WC, fasting glucose, fasting insulin, HOMA index and the serum leptin level were significantly higher in obese children compared to control group (p < 0.05). The LVMI were increased in the obese compared to the control group (p < 0.001) while left ventricle systolic and diastolic functions did not differ in obese versus control group (p > 0.05). There was a significant positive correlation between both LVMI and serum leptin level in comparison to BMI, WC, fasting glucose, fasting insulin, HOMA, triglycerides, and low-density lipoprotein in all obese children, especially the MS group. However, there was a significant negative correlation between both LVMI and serum leptin level in comparison to high-density lipoprotein. CONCLUSION Assessment of LVMI as routine echocardiographic examinations and serum leptin level might be a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood that can predict metabolic syndrome and insulin resistance.
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Affiliation(s)
| | - Ihab A. Ahmed
- Department of Pediatrics, Zagazig University, Zagazig, aEgypt
| | - Nehad A. Karam
- Department of Pediatrics, Zagazig University, Zagazig, aEgypt
| | | | - Ahmed Yosry
- Department of Cardiology, Zagazig University, Zagazig, bEgypt
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184
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Makover ME, Schloss M. The very high residual degree of death and disease from atherosclerosis needs new approaches. J Clin Lipidol 2016; 10:466-8. [DOI: 10.1016/j.jacl.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 12/30/2015] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
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185
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Bariatric and Metabolic Surgery in Adolescents: a Path to Decrease Adult Cardiovascular Mortality. Curr Atheroscler Rep 2016. [PMID: 26208618 DOI: 10.1007/s11883-015-0532-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obesity is a major health problem across all age groups and has escalated to pandemic proportions. The proportion of children with overweight or obesity has risen rapidly over recent decades, and it is recognized that most obese children become obese adults. Furthermore, BMI is the strongest CV risk factor to track from childhood into adulthood. As well as BMI, multiple CV risk factors begin in childhood and strong associations between these factors and BMI are evident. Clear evidence exists for the CV benefits of reversing obesity in adults, much of which examines the effects of bariatric surgery. The capacity of bariatric surgery to reliably achieve safe and lasting improvement in BMI is unparalleled, and the emerging evidence base in adolescent bariatric surgery has so far concurred. In the absence of effective alternatives, it appears that the increase in use of bariatric surgery in adolescents will continue.
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186
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Donovan A, Finner N, O'Connor C, Quinn A, O'Gorman CS. Review of cardiometabolic risk factors in a cohort of paediatric type 1 diabetes mellitus patients. Ir J Med Sci 2016; 186:427-432. [PMID: 27083452 DOI: 10.1007/s11845-016-1440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is a recognised risk factor for cardiometabolic disease. Other risk factors include age, gender, family history, glycaemic control, dyslipidaemia, weight, and activity levels. AIMS To estimate the point prevalence of cardiometabolic risk factors in a paediatric population with T1DM. METHODS Eighty-one patients with T1DM aged between 10 and 16 years attended during the study and 56 (69.1 %) patients agreed to participate. Mixed methods data collection included a questionnaire developed for this study, supplemented by retrospective and prospective data collected from the patient records. RESULTS Of 56 subjects with T1DM, aged 12.7 ± 1.7 years (10-16 years) 26 were male and 30 were female. Mean HbA1c was 72 ± 14 mmol/mol. 53 subjects (94.6 %) had at least one additional cardiometabolic risk factor. CONCLUSIONS Cardiometabolic risk factors are present in this population with T1DM. Identifying cardiometabolic risk factors in adolescent T1DM patients is the first step in prevention of future morbidity and mortality.
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Affiliation(s)
- A Donovan
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland. .,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland.
| | - N Finner
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - C O'Connor
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - A Quinn
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - C S O'Gorman
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.,Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
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187
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Barton M, Husmann M, Meyer MR. Accelerated Vascular Aging as a Paradigm for Hypertensive Vascular Disease: Prevention and Therapy. Can J Cardiol 2016; 32:680-686.e4. [PMID: 27118295 DOI: 10.1016/j.cjca.2016.02.062] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 12/21/2022] Open
Abstract
Aging is considered the most important nonmodifiable risk factor for cardiovascular disease and death after age 28 years. Because of demographic changes the world population is expected to increase to 9 billion by the year 2050 and up to 12 billion by 2100, with several-fold increases among those 65 years of age and older. Healthy aging and prevention of aging-related diseases and associated health costs have become part of political agendas of governments around the world. Atherosclerotic vascular burden increases with age; accordingly, patients with progeria (premature aging) syndromes die from myocardial infarctions or stroke as teenagers or young adults. The incidence and prevalence of arterial hypertension also increases with age. Arterial hypertension-like diabetes and chronic renal failure-shares numerous pathologies and underlying mechanisms with the vascular aging process. In this article, we review how arterial hypertension resembles premature vascular aging, including the mechanisms by which arterial hypertension (as well as other risk factors such as diabetes mellitus, dyslipidemia, or chronic renal failure) accelerates the vascular aging process. We will also address the importance of cardiovascular risk factor control-including antihypertensive therapy-as a powerful intervention to interfere with premature vascular aging to reduce the age-associated prevalence of diseases such as myocardial infarction, heart failure, hypertensive nephropathy, and vascular dementia due to cerebrovascular disease. Finally, we will discuss the implementation of endothelial therapy, which aims at active patient participation to improve primary and secondary prevention of cardiovascular disease.
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Affiliation(s)
- Matthias Barton
- Molecular Internal Medicine, University of Zürich, Zürich, Switzerland.
| | - Marc Husmann
- Division of Angiology, University Hospital Zürich, Zürich, Switzerland
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Abstract
BACKGROUND Digital tonometry is designed to non-invasively screen for endothelial dysfunction by the detection of impaired flow-induced reactive hyperaemia in the fingertip. We determined whether digital reactive hyperaemia correlated with risk factors for atherosclerosis in two groups of children at increased risk for endothelial dysfunction. METHODS A total of 15 obese children and 23 non-obese, dyslipidaemic children, 8-21 years of age, were enrolled, and their medical histories, anthropometric measurements, carotid wall thickness by means of ultrasonography, and fasting blood samples for cardiovascular risk factors were obtained. The standard endoPAT index of digital reactive hyperaemia was modified to reflect the true peak response or the integrated response of the entire post-occlusion period. In each group, age, sex, pubertal status, carotid wall thickness, and multiple cardiovascular risk factors were tested as predictors of endothelial dysfunction. RESULTS In the non-obese, dyslipidaemic group, but not in the obese group, both indices strongly correlated with height (r=0.55, p=0.007, by peak response) followed by weight, waist circumference, and age. In both groups, neither index of reactive hyperaemia significantly correlated with any other cardiovascular risk factor. CONCLUSIONS Contrary to the known age-related increase in atherosclerosis, digital reactive hyperaemia increased with age and its correlates in non-obese, dyslipidaemic children and was not related to other cardiovascular risk factors in either group. The reason for the lack of this relationship with age in obese children is unknown. The age-dependent physiology of digital microvascular reactivity and the endothelium-independent factors controlling the peak hyperaemic response need further study in children with a wide age range.
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189
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Bulut C, Helvaci A, Adas M, Ozsoy N, Bayyigit A. The relationship between left ventricular mass and insulin resistance in obese patients. Indian Heart J 2016; 68:507-12. [PMID: 27543473 PMCID: PMC4990728 DOI: 10.1016/j.ihj.2015.11.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/06/2015] [Accepted: 11/18/2015] [Indexed: 01/19/2023] Open
Abstract
Objective In this study, we investigated the relationship between left ventricular mass and insulin resistance in obese patients. Methods A total of 90 subjects, 66 women, and 24 men, with an age range from 24 to 56 years, were enrolled in the study. Forty-nine patients were in the obesity group whose body mass index (BMI) was >29.9 kg/m2 and 41 subjects were in the control group with a BMI <25 kg/m2. All of them were normotensive, nondiabetic, and did not have any cardiovascular disease. They were not taking any medication. Weight, height, and waist circumference were measured and BMI was calculated. Plasma glucose, insulin, serum total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and triglyceride levels were measured, and insulin resistance was calculated via homeostasis model of assessment-estimated insulin resistance (HOMA-IR). Subjects were examined by echocardiography and left ventricular mass (LVM) and index (LVMI) were calculated with Devereux formula. Results Insulin levels, HOMA-IR, LVM, and LVMI were significantly higher in obesity group (p < 0.01). Fasting glucose, triglyceride, fasting insulin levels, and waist circumference did not correlate with LVMI. Conclusion In conclusion, though findings of the present study suggest increased left ventricular hypertrophy (LVH) in obese subjects compared to controls, it appears that the increased LVM or LVH is not linked to BMI and insulin resistance in this study population.
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Affiliation(s)
- Cengiz Bulut
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Aysen Helvaci
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Mine Adas
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Neslihan Ozsoy
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Akif Bayyigit
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey.
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190
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Gidding SS, Rana JS, Prendergast C, McGill H, Carr JJ, Liu K, Colangelo LA, Loria CM, Lima J, Terry JG, Reis JP, McMahan CA. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age: The CARDIA Study. Circulation 2016; 133:139-46. [PMID: 27028434 PMCID: PMC4817359 DOI: 10.1161/circulationaha.115.018042] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/23/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND We explored whether, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary and abdominal risk scores measured at 18 to 30 years of age and changes in these scores would more strongly predict coronary artery calcium (CAC) and abdominal aortic calcium (AAC) assessed 25 years later, than scores measured 25 years later. METHODS AND RESULTS In the Coronary Artery Risk Development in Young Adults (CARDIA) study, 3008 participants had measurements of risk score components at 5-year intervals beginning at 18 to 30 years of age. CAC and AAC were assessed at 43 to 55 years of age. Odds ratios (ORs) for the presence and extent of CAC/AAC per/point higher score and c-statistics for predicting CAC/AAC were calculated. The prevalence of CAC was 28% and AAC was 53%. For each 1 point higher PDAY score, the odds of CAC were higher using baseline scores than year 25 scores (OR, 1.29; 95% confidence interval [CI], 1.25-1.33 versus OR, 1.12; 95% CI, 1.11-1.14). For AAC, ORs at years 0 and 25 were similar (OR, 1.29; 95% CI, 1.24-1.34 versus OR, 1.22; 95% CI, 1.19-1.26). C-statistic for CAC prediction was higher at year 0 than year 25 (0.731 versus 0.705) but similar at years 0 and 25 for AAC (0.665 versus 0.670). ORs for CAC were highest at baseline, and, for AAC, ORs were highest at year 10. Including change in PDAY scores with baseline scores improved prediction. CONCLUSIONS Atherosclerosis risk and change in risk assessed in young adulthood years before subclinical atherosclerosis imaging provide strong prediction of future subclinical atherosclerosis. CAC and AAC reflect chronic risk exposure in addition to risk measured at the time of study.
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Affiliation(s)
- Samuel S Gidding
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.).
| | - Jamal S Rana
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Christopher Prendergast
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Henry McGill
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - J Jeffery Carr
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Kiang Liu
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Laura A Colangelo
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Catherine M Loria
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Joao Lima
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - James G Terry
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - Jared P Reis
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
| | - C Alex McMahan
- From Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE (S.S.G.); Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland, (J.S.R.); Department of Medicine, University of California, San Francisco (J.S.R.); Division of Pediatric Cardiology, Vanderbilt University, Nashville, TN (C.P.); Department of Pathology, University of Texas Health Sciences Center, San Antonio (H.M., C.A.M.); Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, Nashville, TN (J.J.C., J.G.T.); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (K.L., L.A.C.); Division of Cardiovascular Science, National Heart Lung and Blood Institute, Bethesda, MD (C.M.L., J.P.R.); and Department of Internal Medicine, Johns Hopkins University Hospital, Baltimore, MD (J.L.)
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191
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Nicolson GL, de Mattos GF, Settineri R, Costa C, Ellithorpe R, Rosenblatt S, La Valle J, Jimenez A, Ohta S. Clinical Effects of Hydrogen Administration: From Animal and Human Diseases to Exercise Medicine. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ijcm.2016.71005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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192
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Obesity, Vascular Changes, and the Development of Atherosclerosis. J Pediatr 2016; 168:5-6. [PMID: 26490129 DOI: 10.1016/j.jpeds.2015.09.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 09/23/2015] [Indexed: 11/23/2022]
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193
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Farah BQ, Christofaro DGD, Balagopal PB, Cavalcante BR, de Barros MVG, Ritti-Dias RM. Association between resting heart rate and cardiovascular risk factors in adolescents. Eur J Pediatr 2015; 174:1621-8. [PMID: 26101052 DOI: 10.1007/s00431-015-2580-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/02/2015] [Accepted: 06/08/2015] [Indexed: 01/30/2023]
Abstract
UNLABELLED This cross-sectional study was performed in 2011 and included 4619 Brazilian adolescents (14-19 years old) to analyze the association between elevated resting heart rate (RHR) and cardiovascular risk factors in boys and girls. RHR and blood pressure were measured using an oscillometric monitor. Overweight was assessed by body mass index and abdominal obesity by waist circumference. Physical activity levels and sedentary behaviors were obtained using a questionnaire. The effect of clustering of cardiovascular risk factors on RHR was analyzed. For boys, abdominal obesity (b = 0.106, p = 0.003), high sedentary behavior (b = 0.099, b < 0.001), physical inactivity (b = 0.049, p = 0.034), and high blood pressure (b = 0.160, p < 0.001) were associated with RHR, whereas for girls, only high blood pressure was associated with RHR (b = 0.259, p < 0.001), after adjustment for age, period of the day, and other cardiovascular risk factors. Boys with five risk factors presented significantly higher (p < 0.05) RHR values (82.5 ± 13.4 beats min(-1)) than those for boys without any cardiovascular risk factors (68.8 ± 10.4 beats min(-1)). The girls with five risk factors presented a mean RHR value of 89.8 ± 9.9 beats min(-1) that was higher (p < 0.05) than that for girls who had no risk factors (79.6 ± 10.9 beats min(-1)). CONCLUSIONS Our study demonstrated that while RHR was associated with cardiovascular risk factors in both sexes, the clustering of risk factors amplified the elevation of RHR in a gender-dependent fashion. WHAT IS KNOWN • Resting heart rate is a marker of cardiovascular disease and mortality in adults and associated with risk factor such as higher levels of blood pressure, triglycerides, glucose, and obesity in children and adolescents. WHAT IS NEW • The data from the current study suggest that the risk factor clustering is associated with elevated resting heart rate in adolescents and that the clustering of risk factors amplifies the elevation of resting heart rate in a gender-dependent fashion.
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Affiliation(s)
- Breno Quintella Farah
- Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil.
| | - Diego Giulliano Destro Christofaro
- Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, University of Paulista State (UNESP), Presidente Prudente, SP, Brazil.
| | - P Babu Balagopal
- Nemours Children's Clinic and Mayo Clinic College of Medicine, Jacksonville, FL, USA.
| | | | | | - Raphael Mendes Ritti-Dias
- Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil. .,Albert Einstein Hospital, Albert Einstein Avenue, 627, 05652-900, Sao Paulo, SP, Brazil.
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194
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Kelly RK, Thomson R, Smith KJ, Dwyer T, Venn A, Magnussen CG. Factors Affecting Tracking of Blood Pressure from Childhood to Adulthood: The Childhood Determinants of Adult Health Study. J Pediatr 2015; 167:1422-8.e2. [PMID: 26342719 DOI: 10.1016/j.jpeds.2015.07.055] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/26/2015] [Accepted: 07/28/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the modifiable factors that alter the trajectory of blood pressure (BP) from childhood to adulthood. STUDY DESIGN This study investigated the BP of 798 participants (53% female) from the Childhood Determinants of Adult Health Study who had BP measured when aged 9, 12, or 15 years, and at follow-up 20 years later. BP was classified as normal or elevated (prehypertensive or hypertensive) in childhood and adulthood. BP trajectory groups (persistently normal, resolution, incident elevated, persistently elevated) were established according to these classifications. Potentially modifiable factors measured at both examinations included body mass index, fruit and vegetable intake, physical activity, cardiorespiratory fitness, alcohol consumption, smoking, and socioeconomic status. RESULTS Spearman correlation coefficients for BP tracking from childhood to adulthood were 0.31 (P < .001) for systolic BP and 0.16 (P < .001) for diastolic BP. Children with elevated BP had a 35% increased risk of elevated BP in adulthood compared with those with normal BP (relative risk 1.35, 95% CI 1.18-1.55, P < .001). Relative to those with persistently elevated BP, participants in the resolution group significantly decreased their body mass index z-score, decreased their alcohol consumption z-score, and increased their vegetable consumption z-score between childhood and adulthood. The proportion of participants with upwardly mobile socioeconomic status was significantly higher in the resolution group (41.2%) compared with the persistently elevated group (27.5%). CONCLUSIONS Resolution of elevated BP in the transition from childhood to adulthood appeared to be partially determined by modifiable factors associated with a healthy lifestyle.
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Affiliation(s)
- Rebecca K Kelly
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Russell Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The George Institute for Global Health/Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
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195
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Boutry CM, Nguyen A, Lawal QO, Chortos A, Rondeau-Gagné S, Bao Z. A Sensitive and Biodegradable Pressure Sensor Array for Cardiovascular Monitoring. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2015; 27:6954-61. [PMID: 26418964 DOI: 10.1002/adma.201502535] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/06/2015] [Indexed: 05/23/2023]
Abstract
An array of highly sensitive pressure sensors entirely made of biodegradable materials is presented, designed as a single-use flexible patch for application in cardiovascular monitoring. The high sensitivity in combination with fast response time is unprecedented when compared to recent reports on biodegradable pressure sensors (sensitivity three orders of magnitude higher), as illustrated by pulse wave velocity measurements, toward hypertension detection.
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Affiliation(s)
- Clementine M Boutry
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
| | - Amanda Nguyen
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
| | - Qudus Omotayo Lawal
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
| | - Alex Chortos
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
| | - Simon Rondeau-Gagné
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
| | - Zhenan Bao
- Shriram Center Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, CA, 94305-4125, USA
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196
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Association between anthropometric indices and cardiometabolic risk factors in pre-school children. BMC Pediatr 2015; 15:170. [PMID: 26546280 PMCID: PMC4636828 DOI: 10.1186/s12887-015-0500-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 11/02/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The world health organization (WHO) and the Identification and prevention of dietary- and lifestyle-induced health effects in children and infants- study (IDEFICS), released anthropometric reference values obtained from normal body weight children. This study examined the relationship between WHO [body mass index (BMI) and triceps- and subscapular-skinfolds], and IDEFICS (waist circumference, waist to height ratio and fat mass index) anthropometric indices with cardiometabolic risk factors in pre-school children ranging from normal body weight to obesity. METHODS A cross-sectional study with 232 children (aged 4.1 ± 0.05 years) was performed. Anthropometric measurements were collected and BMI, waist circumference, waist to height ratio, triceps- and subscapular-skinfolds sum and fat mass index were calculated. Fasting glucose, fasting insulin, homeostasis model analysis insulin resistance (HOMA-IR), blood lipids and apolipoprotein (Apo) B-100 (Apo B) and Apo A-I were determined. Pearson's correlation coefficient, multiple regression analysis and the receiver-operating characteristic (ROC) curve analysis were run. RESULTS 51% (n = 73) of the boys and 52% (n = 47) of the girls were of normal body weight, 49% (n = 69) of the boys and 48% (n = 43) of the girls were overweight or obese. Anthropometric indices correlated (p < 0.001) with insulin: [BMI (r = 0.514), waist circumference (r = 0.524), waist to height ratio (r = 0.304), triceps- and subscapular-skinfolds sum (r = 0.514) and fat mass index (r = 0.500)], and HOMA-IR: [BMI (r = 0.509), waist circumference (r = 0.521), waist to height ratio (r = 0.296), triceps- and subscapular-skinfolds sum (r = 0.483) and fat mass index (r = 0.492)]. Similar results were obtained after adjusting by age and sex. The areas under the curve (AUC) to identify children with insulin resistance were significant (p < 0.001) and similar among anthropometric indices (AUC > 0.68 to AUC < 0.76). CONCLUSIONS WHO and IDEFICS anthropometric indices correlated similarly with fasting insulin and HOMA-IR. The diagnostic accuracy of the anthropometric indices as a proxy to identify children with insulin resistance was similar. These data do not support the use of waist circumference, waist to height ratio, triceps- and subscapular- skinfolds sum or fat mass index, instead of the BMI as a proxy to identify pre-school children with insulin resistance, the most frequent alteration found in children ranging from normal body weight to obesity.
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197
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Bloetzer C, Bovet P, Suris JC, Simeoni U, Paradis G, Chiolero A. Screening for cardiovascular disease risk factors beginning in childhood. Public Health Rev 2015; 36:9. [PMID: 29450037 PMCID: PMC5804494 DOI: 10.1186/s40985-015-0011-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 10/02/2015] [Indexed: 02/08/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide. Individual detection and intervention on CVD risk factors and behaviors throughout childhood and adolescence has been advocated as a strategy to reduce CVD risk in adulthood. The U.S. National Heart, Lung, and Blood Institute (NHLBI) has recently recommended universal screening of several risk factors in children and adolescents, at odds with several recommendations of the U.S. Services Task Force and of the U.K. National Screening committee. In the current review, we discuss the goals of screening for CVD risk factors (elevated blood pressure, abnormal blood lipids, diabetes) and behaviors (smoking) in children and appraise critically various screening recommendations. Our review suggests that there is no compelling evidence to recommend universal screening for elevated blood pressure, abnormal blood lipids, abnormal blood glucose, or smoking in children and adolescents. Targeted screening of these risk factors could be useful but specific screening strategies have to be evaluated. Research is needed to identify target populations, screening frequency, intervention, and follow-up. Meanwhile, efforts should rather focus on the primordial prevention of CVD risk factors and at maintaining a lifelong ideal cardiovascular health through environmental, policy, and educational approaches.
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Affiliation(s)
- Clemens Bloetzer
- 1Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- 2Division of Chronic Diseases, Institute of social and preventive medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan-Carles Suris
- 1Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland.,2Division of Chronic Diseases, Institute of social and preventive medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- 1Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland
| | - Gilles Paradis
- 3Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Arnaud Chiolero
- 2Division of Chronic Diseases, Institute of social and preventive medicine, Lausanne University Hospital, Lausanne, Switzerland.,3Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
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198
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Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol 2015; 9:S1-122.e1. [DOI: 10.1016/j.jacl.2015.09.002] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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199
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Al-Rawahi A, Lee P. Applicability of the Existing CVD Risk Assessment Tools to Type II Diabetics in Oman: A Review. Oman Med J 2015; 30:315-9. [PMID: 26421110 DOI: 10.5001/omj.2015.65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Patients with type II diabetes (T2DM) have an elevated risk for cardiovascular disease (CVD), and it is considered to be a leading cause of morbidity and premature mortality in these patients. Many traditional risk factors such as age, male sex, hypertension, dyslipidemia, glycemic control, diabetes duration, renal dysfunction, obesity, and smoking have been studied and identified as independent factors for CVD. Quantifying the risk of CVD among diabetics using the common risk factors in order to plan the treatment and preventive measures is important in the management of these patients as recommended by many clinical guidelines. Therefore, several risk assessment tools have been developed in different parts of the world for this purpose. These include the tools that have been developed for general populations and considered T2DM as a risk factor, and the tools that have been developed for T2DM populations specifically. However, due to the differences in sociodemographic factors and lifestyle patterns, as well as the differences in the distribution of various CVD risk factors in different diabetic populations, the external applicability of these tools on different populations is questionable. This review aims to address the applicability of the existing CVD risk models to the Omani diabetic population.
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Affiliation(s)
| | - Patricia Lee
- School of Public Health, Griffith University, Queensland, Australia
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200
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Hegele RA, Gidding SS, Ginsberg HN, McPherson R, Raal FJ, Rader DJ, Robinson JG, Welty FK. Nonstatin Low-Density Lipoprotein-Lowering Therapy and Cardiovascular Risk Reduction-Statement From ATVB Council. Arterioscler Thromb Vasc Biol 2015; 35:2269-80. [PMID: 26376908 DOI: 10.1161/atvbaha.115.306442] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 08/28/2015] [Indexed: 12/15/2022]
Abstract
Pharmacological reduction of low-density lipoprotein (LDL) cholesterol using statin drugs is foundational therapy to reduce cardiovascular disease (CVD) risk. Here, we consider the place of nonstatin therapies that also reduce LDL cholesterol in prevention of CVD. Among conventional nonstatins, placebo-controlled randomized clinical trials showed that bile acid sequestrants, niacin, and fibrates given as monotherapy each reduce CVD end points. From trials in which patients' LDL cholesterol was already well controlled on a statin, adding ezetimibe incrementally reduced CVD end points, whereas adding a fibrate or niacin showed no incremental benefit. Among emerging nonstatins, monoclonal antibodies against proprotein convertase subtilisin kexin type 9 added to a statin and given for ≤78 weeks showed preliminary evidence of reductions in CVD outcomes. Although these promising early findings contributed to the recent approval of these agents in Europe and in North America, much larger and longer duration outcomes studies are ongoing for definitive proof of CVD benefits. Other nonstatin agents recently approved in the United States include lomitapide and mipomersen, which both act via distinctive LDL receptor independent mechanisms to substantially reduce LDL cholesterol in homozygous familial hypercholesterolemia. We also address some unanswered questions, including measuring alternative biochemical variables to LDL cholesterol, evidence for treating children with monitoring of subclinical atherosclerosis, and potential risks of extremely low LDL cholesterol. As evidence for benefit in CVD prevention accumulates, we anticipate that clinical practice will shift toward more assertive LDL-lowering treatment, using both statins and nonstatins initiated earlier in appropriately selected patients.
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Affiliation(s)
- Robert A Hegele
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.).
| | - Samuel S Gidding
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Henry N Ginsberg
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Ruth McPherson
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Frederick J Raal
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Daniel J Rader
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Jennifer G Robinson
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
| | - Francine K Welty
- From the Department of Medicine, Robarts Research Institute, Schulich School of Medicine, Western University, London, Ontario, Canada (R.A.H.); Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, DE (S.S.G.); Irving Institute for Clinical and Translational Research, Department of Medicine, Columbia University, New York, NY (H.N.G.); Department of Medicine and Biochemistry, Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (R.M.); Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa (F.J.R); Department of Genetics (D.J.R.) and Division of Translational Medicine and Human Genetics, Department of Medicine (D.J.R.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Department of Epidemiology and Medicine, University of Iowa, Iowa City (J.G.R.); and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.K.W.)
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