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Lim MW, Setjiadi D, Dobbin SJ, Lang NN, Delles C, Connelly PJ. Nailfold video-capillaroscopy in the study of cardiovascular disease: a systematic review. Blood Press Monit 2023; 28:24-32. [PMID: 36281701 PMCID: PMC9815820 DOI: 10.1097/mbp.0000000000000624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/21/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Nailfold video-capillaroscopy (NVC) is an inexpensive method of assessing microcirculation. We reviewed the literature to assess whether changes to the nailfold capillaries exist in patients with cardiovascular disease (CVD). METHODS We searched PubMed, Scopus and Cochrane Library databases for original research articles relating to the use of noninvasive microvascular assessment in patients with CVD. Methodological quality was assessed with the 'Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.' The results obtained from NVC were analysed qualitatively and compared with other forms of microvascular assessment. RESULTS In total 2759 articles were screened, of which 22 studies involving 562 patients (~40% women) with CVD were included. Mean age ranged between 3.7-68.4 years (cases) and 4.0-58.0 years (controls). Reduced capillary density and increased capillary dimensions were seen in patients with pulmonary arterial hypertension (PAH). Among patients with systemic sclerosis, advanced scleroderma patterns can be used to identify patients with or at risk of developing PAH. Functional nailfold changes precede structural changes in patients with hypertension. However, the studies were heterogeneous in the diagnosis of disease and the measurement of nailfold parameters. Most studies did not exclude conditions with altered nailfold features, and only one study performed a power calculation. Furthermore, abnormal nailfold findings are present in patients without systemic disease. CONCLUSIONS Structural and functional changes to the nailfold are a feature of established CVD and precede the development of PAH. However, heterogeneity in measurement and abnormal findings in healthy participants limit their use in the wider population.
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Affiliation(s)
- Matthew W.S. Lim
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Dellaneira Setjiadi
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Stephen J.H. Dobbin
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Ninian N. Lang
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Christian Delles
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul J. Connelly
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Macro- and microhemodynamic disorders as cardiovascular risk factors in overweight young people. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.6.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Obesity is associated with a high risk of cardiovascular diseases. Therefore, an urgent task of preventive medicine is to search for markers indicating the early development of cardiovascular pathology in young people in order to develop preventive measures.The aim of the study. To study macro- and microhemodynamics in young people with normal and elevated body mass index (BMI).Methods. After receiving informed consent, we evaluated microhemodynamics using Doppler ultrasound (Angiodin-PC (BIOSS, Russia); 16 MHz sensor) and macrohemodynamics by daily blood pressure monitoring (MnSDP-3 (BPLab, Peter Telegin LLC, Russia)) in students (20.05 ± 1.46 years old) who did not play sports in the period from 2019 to 2021. The subjects were divided into 2 groups according to their BMI: group 1 (control) – BMI ≤ 25 (average age 20.5 ± 0.7 years; average weight 59.47 ± 8.26 kg); group 2 – BMI ≥ 25 (average age 20.12 ± 1.73 years; average weight 83.8 ± 9.59 kg).Results. It has been proven that already at a young age, an increased BMI adversely affects the elasticity of the vascular wall. We registered a statistically significant increase in the peripheral resistance index (RI; Purcello index) (p = 0.022,) and the Stewart index (SD) (p = 0.0034) which are reflecting vascular wall remodeling. There is also a statistically significant increase in average blood pressure per day, day/night against the background of increased BMI. An insufficient degree of nocturnal decrease in systolic blood pressure is revealed, as well as an increase in pressure load and blood pressure variability.Conclusion. Since changes in the structure and function of the vessels of the microcirculatory bed are a precursor to preclinical disorders of systemic blood flow, the introduction of high-frequency Doppler ultrasound into the protocol of examination of people having metabolic syndrome will allow us to assess the functional status of large and small arteries and to identify early vascular disorders.
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Schnorbus B, Jurk K, Lackner KJ, Welk C, Münzel T, Gori T. Effects of Clopidogrel, Prasugrel and Ticagrelor on Microvascular Function and Platelet Reactivity in Patients With Acute Coronary Syndrome Undergoing Coronary Artery Stenting. A Randomized, Blinded, Parallel Group Trial. Front Cardiovasc Med 2021; 8:780605. [PMID: 34966798 PMCID: PMC8710519 DOI: 10.3389/fcvm.2021.780605] [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] [Received: 09/21/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: In this pre-specified analysis of the "endothelium, stent and antiplatelet therapy" study, we investigate the impact of antiplatelet therapies on microvascular function in patients undergoing stenting for an acute coronary syndrome. Methods and Results: Fifty-six patients [age: 63(55-67) years, males, 10 diabetics, 27 non-ST-elevation myocardial infarction] were randomized to receive clopidogrel, ticagrelor or prasugrel in form of oral loading 2 h before stenting followed by oral therapy. Investigators were blinded to the allocation. Laser-Doppler microvascular function and ADP-induced platelet aggregation capacity were measured at baseline, 2 h after oral antiplatelet loading, and 1 day, 1 week and 1 month after stenting during chronic therapy with the same antiplatelet agent. Platelet aggregation decreased in all groups 2 h after oral loading, with a significantly larger effect in the prasugrel group (P = 0.009). Similarly, prasugrel and ticagrelor loading was followed by an increase in microvascular reactive hyperemia (P = 0.007 and P = 0.042 compared to clopidogrel). This effect disappeared one day after coronary intervention, with a significant decrease in the prasugrel group (P = 0.026). Similarly, analysis of microvascular conductance showed a larger increase in the prasugrel group 2 h after loading (P = 0.022 among groups), and a decrease in all groups after stenting. Conclusions: Oral loading with prasugrel (and less consistently ticagrelor) is associated with improved microvascular function and stronger platelet inhibition in acute coronary syndrome patients. The microvascular effect was however lost 1 day after stenting and during subsequent follow-up. Further studies are necessary to clarify the the long-term effects and potential benefits of P2Y12 inhibitors on microvascular damage. ClINICALTRIALS.gov N°: NCT01700322 EUDRACT-N°: 2011-005305-73.
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Affiliation(s)
- Boris Schnorbus
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, Universitätsmedizin Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Kerstin Jurk
- Center for Thrombosis and Hemostasis, Universitätsmedizin Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsmedizin Mainz, Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Caroline Welk
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tommaso Gori
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany.,Deutsches Zentrum für Herz Kreislauf-Forschung (DZHK), Standort Rhein-Main, Partnereinrichtung Mainz, Mainz, Germany
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Xing X, Li D, Chen S, Wang L, Li Z, He L. Evaluation of left ventricular systolic function in patients with different types of ischemic heart disease by two-dimensional speckle tracking imaging. J Cardiothorac Surg 2020; 15:325. [PMID: 33148298 PMCID: PMC7640713 DOI: 10.1186/s13019-020-01345-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate left ventricular systolic function in patients with different types of ischemic heart disease using two-dimensional speckle tracking imaging (2D-STI). METHODS We retrospectively studied patients who were admitted to Peking University Third Hospital from January 2011 to December 2017 due to chest tightness and chest pain. Two hundred forty-two patients were divided into control group, CMD group and obstructive CAD group. The main coronary artery stenosis was confirmed by coronary angiography or coronary computed tomography and coronary flow reserve (CFR) in patients was measured by transthoracic Doppler echocardiography. Left ventricular strain and strain rate (SR) measured by 2D-STI. Cardiac structure and function were measured by conventional echocardiography. RESULTS Conventional echocardiography showed that there was no significant difference in cardiac structure and function among the three groups (P > 0.05). Moreover, the longitudinal strain (LS) of each ventricular wall in CMD group was notably lower than that in control group (P < 0.01). In addition, global longitudinal SR and longitudinal SR in CMD group and obstructive CAD group were obviously lower than those in control group (P < 0.01). GLS, endocardial LS and epicardial LS were negatively correlated with CFR (P < 0.01). CONCLUSIONS Early left ventricular systolic dysfunction was found in patients with CMD and patients with obstructive CAD, with similar degree. CFR is an independent influencing factor of GLS. GLS and stratified LS have certain diagnostic value for CMD.
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Affiliation(s)
- Xing Xing
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Dan Li
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Shaomin Chen
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Lingli Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Zhaoping Li
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
| | - Liyun He
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
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Tremblay A, Clinchamps M, Pereira B, Courteix D, Lesourd B, Chapier R, Obert P, Vinet A, Walther G, Chaplais E, Bagheri R, Baker JS, Thivel D, Drapeau V, Dutheil F. Dietary Fibres and the Management of Obesity and Metabolic Syndrome: The RESOLVE Study. Nutrients 2020; 12:nu12102911. [PMID: 32977595 PMCID: PMC7650763 DOI: 10.3390/nu12102911] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/12/2023] Open
Abstract
Objectives: This study was performed to evaluate the long-term maintenance of nutritional changes promoted during an intensive initial intervention to induce body weight loss. The ability of these changes to predict long-term health outcomes was also examined. Methods: Nutritional variables, body composition, and metabolic markers collected in the RESOLVE project were analyzed before and after a 3-week intensive diet–exercise intervention (Phase 1), and during a subsequent supervision under free living conditions, of 12 months (Phase 2). Results: As expected, the macronutrient composition of the diet was modified to promote a negative energy balance during Phase 1. The decrease in carbohydrates imposed during this phase was maintained during Phase 2 whereas the increase in protein intake returned to baseline values at the end of the program. Dietary fiber intake was almost doubled during Phase 1 and remained significantly greater than baseline values throughout Phase 2. Moreover, fiber intake was the only nutritional variable that systematically and significantly predicted variations of health outcomes in the study. Conclusion: The adequacy of dietary fiber intake should be a matter of primary consideration in diet-based weight reduction programs.
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Affiliation(s)
- Angelo Tremblay
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- Department of Kinesiology, Université Laval, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +418-656-7294; Fax: +418-656-3044
| | - Maëlys Clinchamps
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.C.); (F.D.)
| | - Bruno Pereira
- Biostatistics, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | - Bruno Lesourd
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | | | - Philippe Obert
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Agnes Vinet
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Guillaume Walther
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Elodie Chaplais
- Laboratory “Development, Adaption and Disability” (DevAH-EA 3450), Université de Lorraine, 54000 Nancy, France;
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan 81746-73441, Iran;
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong;
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
- Physical Institut, Universitaire de France, 75000 Paris, France
| | - Vicky Drapeau
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.C.); (F.D.)
- Physiological and Psychosocial Stress, LaPSCo, CNRS, University Clermont Auvergne, 63000 Clermont-Ferrand, France
- Witty Fit, 75000 Paris, France
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