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Miura M, Kohzuki M, Saito C, Sakai S, Sugaya H, Koyama S, Matsui Y, Sakuma T, Ito O, Yamagata K. Systemic Capillary Responses to Acute Exercise in Hypertensive Seniors: Insights from a Single-Center Pilot Study. J Clin Med 2024; 13:2818. [PMID: 38792358 PMCID: PMC11122561 DOI: 10.3390/jcm13102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Objective: The aim of this study was to investigate nailfold capillary parameters in community-dwelling individuals aged over 60 years who have hypertension and do not exercise regularly. Furthermore, the study examined the correlations between capillary function and other health-related indicators. DESIGN This study was a single- center pilot trial. SETTING The study took place in the Faculty of Health, Tsukuba University of Technology, Japan. PARTICIPANTS Hypertensive community-dwelling elderly people took part in the study. INTERVENTION Microcirculation was observed before and 1 min after an arm-curl exercise by means of capillary microscopy of the non-exercised limb. Additionally, we examined other health-related indicators. Methods: We measured the acute effects of reperfusion on nailfold density, flow, and diameters. Secondary outcomes included the correlations between microvascular parameters and other health-related indicators. We hypothesized that brief exercise could enhance microcirculation reperfusion and correlate with other health-related parameters. Results: There were 20 participants with a mean (SD) age of 67.1 (5.8) years. The capillary flow rate changed from 2.3 ± 6.7 to 2.7 ± 0.2 log µm/s (p < 0.01), and the capillary density changed from 0.8 ± 0.2 to 0.9 ± 0.1 log/mm (p < 0.01), which included a significant increase in the non-exercising limb. Significant correlations were observed between the nailfold capillary diameter and body fat mass, the capillary diameter and physical activity, and the capillary density and bone mineral density. Conclusions: The acute effects of exercise on high-risk elderly individuals can be safe, and even 1 of min exercise can potentially improve their nailfold capillary function, despite the brief time, compared to no exercise. The results indicate that capillaries have an impact on the function of the whole body. Thus, they may be a useful diagnostic tool for assessing nailfold capillaries.
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Affiliation(s)
- Misa Miura
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Masahiro Kohzuki
- Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan;
| | - Chie Saito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan; (C.S.); (K.Y.)
| | - Satoshi Sakai
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Hisashi Sugaya
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Shingo Koyama
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Yasushi Matsui
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Tohru Sakuma
- Faculty of Health Sciences, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba 305-8521, Japan; (S.S.); (H.S.); (S.K.); (Y.M.); (T.S.)
| | - Osamu Ito
- Division of General Medicine and Rehabilitation, Faculty of Medicine, Tohoku Medical Pharmaceutical University, Sendai 981-8558, Japan;
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan; (C.S.); (K.Y.)
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Ronicke M, Berking C, Erfurt-Berge C. Occlusive cutaneous vasculopathies as cause of chronic ulcers. J Dtsch Dermatol Ges 2024; 22:553-567. [PMID: 38379266 DOI: 10.1111/ddg.15276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/15/2023] [Indexed: 02/22/2024]
Abstract
The term occluding vasculopathies covers a large number of different conditions. These often manifest as skin ulcers. Occluding vasculopathies should be considered in the differential diagnosis of leg ulcers. The term "occlusive vasculopathies" encompasses pathophysiologically related entities that share structural or thrombotic obliteration of small cutaneous vessels. In this article, we will focus on livedoid vasculopathy with and without antiphospholipid syndrome and calciphylaxis with differentiation from hypertonic leg ulcer as the most relevant differential diagnoses of leg ulcer. The term also includes vascular occlusion, for example due to oxalate or cholesterol embolism, and septic vasculopathy. This often leads to acral ulceration and is therefore not a differential diagnosis with classic leg ulcers. It will not be discussed in this article. Occlusive vasculopathy may be suspected in the presence of the typical livedo racemosa or (non-inflammatory) retiform purpura as a sign of reduced cutaneous perfusion in the wound area. Inflammatory dermatoses, especially vasculitides, must be differentiated. This is achieved by histopathological evaluation of a tissue sample of sufficient size and depth taken at the appropriate time. In addition, specific laboratory parameters, particularly coagulation parameters, can support the diagnosis.
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Affiliation(s)
- Moritz Ronicke
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Cornelia Erfurt-Berge
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Ronicke M, Berking C, Erfurt-Berge C. Okkludierende kutane Vaskulopathien als Ursachen chronischer Unterschenkelulzerationen. J Dtsch Dermatol Ges 2024; 22:553-568. [PMID: 38574010 DOI: 10.1111/ddg.15276_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/15/2023] [Indexed: 04/06/2024]
Abstract
ZusammenfassungUnter den Begriff der okkludierenden Vaskulopathien fällt eine Reihe unterschiedlicher Krankheitsbilder. Diese manifestieren sich an der Haut häufig mit Ulzerationen. Gerade bei Ulzerationen der Unterschenkel sollten okkludierende Vaskulopathien in die differenzialdiagnostischen Überlegungen einbezogen werden. Der Begriff „okkludierende Vaskulopathien“ umfasst pathophysiologisch verwandte Entitäten, die eine strukturelle oder thrombotische Obliteration von kleinsten Hautgefäßen gemein haben. In diesem Artikel wird vor allem auf die Livedovaskulopathie mit und ohne Antiphospholipidsyndrom sowie die Calciphylaxie mit Abgrenzung zum Ulcus cruris hypertonicum als die relevantesten Differenzialdiagnosen von Unterschenkelulzerationen eingegangen. Der Begriff umfasst auch Gefäßverschlüsse, beispielsweise durch Oxalat oder Cholesterinembolie, sowie die septische Vaskulopathie. Diese führt häufig zu akralen Ulzerationen und stellt somit keine Differenzialdiagnose zum klassischen Ulcus cruris dar. Sie wird daher in diesem Artikel nicht behandelt.Der Verdacht einer okkludierenden Vaskulopathie kann über die typische Livedo racemosa beziehungsweise die (nichtinflammatorische) retiforme Purpura als Zeichen der kutanen Minderdurchblutung in der Wundumgebung gestellt werden. Entzündliche Dermatosen, insbesondere Vaskulitiden, müssen differenzialdiagnostisch abgegrenzt werden. Dies geschieht zum Teil klinisch und durch die histopathologische Beurteilung einer Gewebeprobe, die in ausreichender Größe und Tiefe sowie zum richtigen Zeitpunkt entnommen werden muss. Ergänzend können spezifische Laborparameter, insbesondere die Gerinnungsdiagnostik, die Diagnosestellung unterstützen.
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Affiliation(s)
- Moritz Ronicke
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Carola Berking
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Cornelia Erfurt-Berge
- Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
- Deutsches Zentrum für Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
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Koh S, Kim SJ, Lee S. Associations between central pulse pressure, microvascular endothelial function, and fluid overload in peritoneal dialysis patients. Clin Exp Hypertens 2023; 45:2267192. [PMID: 37842909 DOI: 10.1080/10641963.2023.2267192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Microcirculatory endothelial dysfunction is a complex phenomenon that contributes to the development of cardiovascular disease. However, the relationship between microcirculatory endothelial dysfunction and macrovascular disease remains incompletely understood. Fluid overload is a risk factor for cardiovascular mortality in patients undergoing peritoneal dialysis. Therefore, we investigated the effects of chronic fluid overload on both the microcirculation and macrocirculation in these patients. METHODS Thirty patients undergoing peritoneal dialysis were included in this cross-sectional study. We measured their central blood pressure and pulse wave velocity, assessed their microvascular endothelial function using drug-induced iontophoresis with laser Doppler flowmetry, and determined the amount of fluid overload using bioimpedance. We conducted a Spearman correlation analysis, univariate analysis, and stepwise multivariate regression models to determine the associations among the hemodynamic parameters. RESULTS Acetylcholine-induced iontophoresis with laser Doppler flowmetry showed a correlation with both brachial and central pulse pressure (PP), but not with pulse wave velocity. Fluid overload was associated with both central and brachial PP and remained an independent predictor of central PP even after adjusting for multiple factors. However, fluid overload was not associated with microcirculatory endothelial function. CONCLUSION In peritoneal dialysis patients, we observed a significant association between central PP and microvascular endothelial function, indicating a connection between macrocirculation and microcirculation. However, conclusive evidence regarding fluid overload as a mediator between these circulatory systems is lacking. Further research is needed to investigate this relationship.
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Affiliation(s)
- Seoyon Koh
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seung-Jung Kim
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Shina Lee
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
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Celant M, Toro EF, Bertaglia G, Cozzio S, Caleffi V, Valiani A, Blanco PJ, Müller LO. Modeling essential hypertension with a closed-loop mathematical model for the entire human circulation. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3748. [PMID: 37408358 DOI: 10.1002/cnm.3748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 07/07/2023]
Abstract
Arterial hypertension, defined as an increase in systemic arterial pressure, is a major risk factor for the development of diseases affecting the cardiovascular system. Every year, 9.4 million deaths worldwide are caused by complications arising from hypertension. Despite well-established approaches to diagnosis and treatment, fewer than half of all hypertensive patients have adequately controlled blood pressure. In this scenario, computational models of hypertension can be a practical approach for better quantifying the role played by different components of the cardiovascular system in the determination of this condition. In the present work we adopt a global closed-loop multi-scale mathematical model for the entire human circulation to reproduce a hypertensive scenario. In particular, we modify the model to reproduce alterations in the cardiovascular system that are cause and/or consequence of the hypertensive state. The adaptation does not only affect large systemic arteries and the heart but also the microcirculation, the pulmonary circulation and the venous system. Model outputs for the hypertensive scenario are validated through assessment of computational results against current knowledge on the impact of hypertension on the cardiovascular system.
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Affiliation(s)
- Morena Celant
- Department of Mathematics, University of Trento, Trento, Italy
| | - Eleuterio F Toro
- Laboratory of Applied Mathematics, DICAM, University of Trento, Trento, Italy
| | - Giulia Bertaglia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Susanna Cozzio
- U.O. di Medicina Interna, Ospedale di Rovereto, Azienda Sanitaria per i Servizi Provinciali di Trento, Trento, Italy
| | - Valerio Caleffi
- Department of Engineering, University of Ferrara, Ferrara, Italy
| | | | - Pablo J Blanco
- National Laboratory for Scientific Computing, Petròpolis, Brazil
| | - Lucas O Müller
- Department of Mathematics, University of Trento, Trento, Italy
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Bernhardt A, Krause A, Reichardt C, Steffen H, Isermann B, Völker U, Hammer E, Geffers R, Philipsen L, Dhjamandi K, Ahmad S, Brandt S, Lindquist JA, Mertens PR. Excessive sodium chloride ingestion promotes inflammation and kidney fibrosis in aging mice. Am J Physiol Cell Physiol 2023; 325:C456-C470. [PMID: 37399499 DOI: 10.1152/ajpcell.00230.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
In aging kidneys, a decline of function resulting from extracellular matrix (ECM) deposition and organ fibrosis is regarded as "physiological." Whether a direct link between high salt intake and fibrosis in aging kidney exists autonomously from arterial hypertension is unclear. This study explores kidney intrinsic changes (inflammation, ECM derangement) induced by a high-salt diet (HSD) in a murine model lacking arterial hypertension. The contribution of cold shock Y-box binding protein (YB-1) as a key orchestrator of organ fibrosis to the observed differences is determined by comparison with a knockout strain (Ybx1ΔRosaERT+TX). Comparisons of tissue from mice fed with normal-salt diet (NSD, standard chow) or high-salt diet (HSD, 4% NaCl in chow; 1% NaCl in water) for up to 16 mo revealed that with HSD tubular cell numbers decrease and tubulointerstitial scarring [periodic acid-Schiff (PAS), Masson's trichrome, Sirius red staining] prevails. In Ybx1ΔRosaERT+TX animals tubular cell damage, a loss of cell contacts with profound tubulointerstitial alterations, and tubular cell senescence was seen. A distinct tubulointerstitial distribution of fibrinogen, collagen type VI, and tenascin-C was detected under HSD, transcriptome analyses determined patterns of matrisome regulation. Temporal increase of immune cell infiltration was seen under HSD of wild type, but not Ybx1ΔRosaERT+TX animals. In vitro Ybx1ΔRosaERT+TX bone marrow-derived macrophages exhibited a defect in polarization (IL-4/IL-13) and abrogated response to sodium chloride. Taken together, HSD promotes progressive kidney fibrosis with premature cell aging, ECM deposition, and immune cell recruitment that is exacerbated in Ybx1ΔRosaERT+TX animals.NEW & NOTEWORTHY Short-term experimental studies link excessive sodium ingestion with extracellular matrix accumulation and inflammatory cell recruitment, yet long-term data are scarce. Our findings with a high-salt diet over 16 mo in aging mice pinpoints to a decisive tipping point after 12 mo with tubular stress response, skewed matrisome transcriptome, and immune cell infiltration. Cell senescence was aggravated in knockout animals for cold shock Y-box binding protein (YB-1), suggesting a novel protective protein function.
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Affiliation(s)
- Anja Bernhardt
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Anna Krause
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Charlotte Reichardt
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Hannes Steffen
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig University, Leipzig, Germany
| | - Uwe Völker
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Elke Hammer
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Robert Geffers
- Genome Analytics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Lars Philipsen
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke University, Magdeburg, Germany
| | - Kristin Dhjamandi
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Sohail Ahmad
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Sabine Brandt
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Jonathan A Lindquist
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
| | - Peter R Mertens
- Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany
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Dixon AJ, Osei-Owusu P. Elastin haploinsufficiency accelerates age-related structural and functional changes in the renal microvasculature and impairment of renal hemodynamics in female mice. Front Physiol 2023; 14:1141094. [PMID: 37179824 PMCID: PMC10167050 DOI: 10.3389/fphys.2023.1141094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/11/2023] [Indexed: 05/15/2023] Open
Abstract
Age-related decline in functional elastin is associated with increased arterial stiffness, a known risk factor for developing cardiovascular disease. While the contribution of elastin insufficiency to the stiffening of conduit arteries is well described, little is known about the impact on the structure and function of the resistance vasculature, which contributes to total peripheral resistance and the regulation of organ perfusion. In this study, we determined how elastin insufficiency impinges on age-related changes in the structure and biomechanical properties of the renal microvasculature, altering renal hemodynamics and the response of the renal vascular bed to changes in renal perfusion pressure (RPP) in female mice. Using Doppler ultrasonography, we found that resistive index and pulsatility index were elevated in young Eln +/- and aged mice. Histological examination showed thinner internal and external elastic laminae, accompanied by increased elastin fragmentation in the medial layer without any calcium deposits in the small intrarenal arteries of kidneys from young Eln +/- and aged mice. Pressure myography of interlobar arteries showed that vessels from young Eln +/- and aged mice had a slight decrease in distensibility during pressure loading but a substantial decline in vascular recoil efficiency upon pressure unloading. To examine whether structural changes in the renal microvasculature influenced renal hemodynamics, we clamped neurohumoral input and increased renal perfusion pressure by simultaneously occluding the superior mesenteric and celiac arteries. Increased renal perfusion pressure caused robust changes in blood pressure in all groups; however, changes in renal vascular resistance and renal blood flow (RBF) were blunted in young Eln +/- and aged mice, accompanied by decreased autoregulatory index, indicating greater impairment of renal autoregulation. Finally, increased pulse pressure in aged Eln +/- mice positively correlated with high renal blood flow. Together, our data show that the loss of elastin negatively affects the structural and functional integrity of the renal microvasculature, ultimately worsening age-related decline in kidney function.
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Affiliation(s)
- Alethia J Dixon
- Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Patrick Osei-Owusu
- Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Liang C, Gu C, Wang N. Retinal Vascular Caliber in Coronary Heart Disease and Its Risk Factors. Ophthalmic Res 2022; 66:151-163. [PMID: 36044871 DOI: 10.1159/000526753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many clinical and experimental articles have suggested that the retinal vascular diameter can be used as a predictor of coronary heart disease (CHD). However, the results and reliability of the prediction are still controversial. OBJECTIVE A meta-analysis of observational study was conducted to clarify the relationships of retinal vessel caliber with CHD and CHD risk factors. METHOD PubMed and Embase were searched for all observational studies on the relationship of retinal vessel caliber with CHD and CHD risk factors from 2001 to 2021. The meta-analysis has been registered in PROSPERO (registration number is CRD42021267154). RESULT A total of 14 articles were selected for the inclusion in this meta-analysis. In the primary outcome, smaller retinal arteriolar caliber was related to CHD, and the results achieved statistical significance (MD: -5.55, 95% CI: -8.07 to -3.02, p < 0.0001), while there was no significant difference in vein caliber between CHD and healthy people (MD: 1.10, 95% CI: -3.55 to 5.76, p = 0.64 > 0.05). Smaller retinal arteriolar caliber was related to increasing age, male sex, bigger BMI, and hypertension. Bigger retinal arteriolar caliber was related to current smoking. Smaller retinal venule caliber was related to increasing age and hypertension. Bigger retinal venule caliber was related to current smoking, bigger BMI, and diabetes. CONCLUSION Smaller retinal arteriolar caliber was related to CHD, while there was no significant difference in venule caliber between CHD and healthy people. Retinal vascular caliber also independently related to CHD risk factors (e.g., age, gender, smoke, BMI, hypertension, and diabetes).
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Affiliation(s)
| | - Chen Gu
- Jining Puming Eye Hospital, Jining, China
| | - Ning Wang
- Jinan Seventh People's Hospital, Jinan, China
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Qingfeng Z, Yi W, Wenhua L, Hongmei Z, Geqi D, Xuebing L, Chunmei L, Yan D, Lixue Y. Evaluation of left ventricular function by treadmill exercise stress echocardiography combined with layer‐specific strain technique in essential hypertension patients. J Clin Hypertens (Greenwich) 2022; 24:312-319. [PMID: 35188326 PMCID: PMC8924995 DOI: 10.1111/jch.14407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to evaluate the diagnostic utility of treadmill exercise stress echocardiography (TESE) combined with left ventricular (LV) layer‐specific strain (LSS) in subclinical myocardial and reserve function of hypertensive patients. A total of 55 hypertensive patients and 51 controls were evaluated during rest and exercise. Two‐dimensional speckle tracking (2DST) and LSS technique was used to measure longitudinal and circumferential strains at rest and peak exercise, strain difference characteristics were then evaluated. Compared to the control subjects, both longitudinal and circumferential LSS showed different degrees of reduction in hypertensive group, which was more pronounced at peak exercise. The global longitudinal endocardium strain (GLSendo) at rest was 24.4% ± 1.5% in the control group versus 20.4% ± 2.3% in the hypertensive group, while the difference was more obvious at peak state (control vs. hypertensive group, 30.8% ± 2.8% and 22.8% ± 2.9%, respectively). In particular, endocardial strain under exercise can be used as a sensitive indicator where the LV contractile reserve (CR) function of the three layers are all impaired. TESE combined with LSS might increase diagnostic accuracy of myocardial performance in hypertension patients.
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Affiliation(s)
- Zhang Qingfeng
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Wang Yi
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Li Wenhua
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Zhang Hongmei
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Ding Geqi
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Liu Xuebing
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Li Chunmei
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Deng Yan
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
| | - Yin Lixue
- Key laboratory of ultrasound in cardiac electrophysiology and biomechanics The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China Chengdu China
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Lee WH, Lee M, Lim H, Kim M, Ryu CK, Han Y, Kim J. Retinal nerve fibre layer/ganglion cell-inner plexiform layer thickness ratio in patients with systemic hypertension. Acta Ophthalmol 2022; 100:e150-e156. [PMID: 33884766 DOI: 10.1111/aos.14884] [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: 07/30/2020] [Revised: 01/05/2021] [Accepted: 04/04/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Acute and chronic hypertension may have different pathophysiological mechanisms in the retina. Here, we compared the retinal nerve fibre layer (RNFL)/ganglion cell-inner plexiform layer (GC-IPL) thickness ratios of patients with 'relieved' severe hypertensive retinopathy (relieved HTNR) and chronic hypertension without retinopathy (chronic HTN) to those of normal controls. METHODS We performed cross-sectional study. The eyes were divided into the following groups: normal controls (Group A, age ≥50 years; Group D, age <50 years); chronic HTN (Group B, <10 years of HTN; TNHT; Group C, ≥10 years of HTN); and relieved HTNR (previously diagnosed with grade IV HTNR and relieved retinopathy for >1 year; Group E), and the RNFL/GC-IPL thickness ratio was compared among Groups A-C and between Groups D and E. RESULTS A total of 379 eyes were included in this study. Groups A-E consisted of 145, 59, 63, 60 and 52 eyes, respectively. The RNFL/GC-IPL thickness ratios were 1.161 ± 0.093, 1.158 ± 0.082 and 1.162 ± 0.089 in groups A-C, respectively, and did not showed a statistically difference (p = 0.966). The RNFL/GC-IPL thickness ratio of groups D and E were 1.169 ± 0.080 and 1.221 ± 0.080, respectively, and showed a statistically difference (p = 0.001). CONCLUSIONS The RNFL/GC-IPL thickness ratios of the chronic HTN group did not show a difference compared with the normal controls. However, relieved HTNR patients showed a higher ratio than the normal controls. Physicians should be aware that acute hypertensive injury could affect the RNFL/GC-IPL thickness ratio.
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Affiliation(s)
- Woo Hyuk Lee
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
- Department of Ophthalmology Gyeongsang University College of Medicine Changwon Hospital Changwon Korea
| | - Min‐Woo Lee
- Department of Ophthalmology Konyang University College of Medicine Daejeon Korea
| | - Hyung‐Bin Lim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Min‐Su Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Cheon Kuk Ryu
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Yong‐Seop Han
- Department of Ophthalmology Gyeongsang National University College of Medicine Jinju Korea
| | - Jung‐Yeul Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
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11
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István L, Czakó C, Benyó F, Élő Á, Mihály Z, Sótonyi P, Varga A, Nagy ZZ, Kovács I. The effect of systemic factors on retinal blood flow in patients with carotid stenosis: an optical coherence tomography angiography study. GeroScience 2022; 44:389-401. [PMID: 34837589 PMCID: PMC8810958 DOI: 10.1007/s11357-021-00492-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/16/2021] [Indexed: 12/17/2022] Open
Abstract
Carotid artery stenosis (CAS) is among the leading causes of mortality and permanent disabilities in the Western world. CAS is a consequence of systemic atherosclerotic disease affecting the majority of the aging population. Optical coherence tomography angiography (OCTA) is a novel imaging technique for visualizing retinal blood flow. It is a noninvasive, fast method for qualitative and quantitative assessment of the microcirculation. Cerebral and retinal circulation share similar anatomy, physiology, and embryology; thus, retinal microvasculature provides a unique opportunity to study the pathogenesis of cerebral small vessel disease in vivo. In this study, we aimed to analyze the effect of systemic risk factors on retinal blood flow in the eyes of patients with significant carotid artery stenosis using OCT angiography. A total of 112 eyes of 56 patients with significant carotid stenosis were included in the study. We found that several systemic factors, such as decreased estimated glomerular filtration rate (eGFR), hypertension, and carotid occlusion have a significant negative effect on retinal blood flow, while statin use and carotid surgery substantially improve ocular microcirculation. Neither diabetes, clopidogrel or acetylsalicylic acid use, BMI, serum lipid level, nor thrombocyte count showed a significant effect on ocular blood flow. Our results demonstrate that a systematic connection does exist between certain systemic risk factors and retinal blood flow in this patient population. OCTA could help in the assessment of cerebral circulation of patients with CAS due to its ability to detect subtle changes in retinal microcirculation that is considered to represent changes in intracranial blood flow.
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Affiliation(s)
- Lilla István
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary
| | - Cecilia Czakó
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary
| | - Fruzsina Benyó
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary
| | - Ágnes Élő
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary
| | - Zsuzsa Mihály
- Department of Vascular & Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Péter Sótonyi
- Department of Vascular & Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Andrea Varga
- Department of Vascular & Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary
| | - Illés Kovács
- Department of Ophthalmology, Semmelweis University, 39 Mária Street, 1085, Budapest, Hungary.
- Department of Ophthalmology, Weill Cornell Medical College, New York, USA.
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.
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12
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Ma L, He W, Li X, Liu X, Cao H, Guo L, Xiao X, Xu Y, Wu Y. Decreased CSF Dynamics in Treatment-Naive Patients with Essential Hypertension: A Study with Phase-Contrast Cine MR Imaging. AJNR Am J Neuroradiol 2021; 42:2146-2151. [PMID: 34620585 DOI: 10.3174/ajnr.a7284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Arterial sclerosis resulting from hypertension slows CSF transportation in the perivascular spaces, showing the intrinsic relationship between the CSF and the blood vasculature. However, the exact effect of hypertension on human CSF flow dynamics remains unclear. The present study aimed to evaluate CSF flow dynamics in treatment-naive patients with essential hypertension using phase-contrast cine MR imaging. MATERIALS AND METHODS The study included 60 never-treated patients with essential hypertension and 60 subjects without symptomatic atherosclerosis. CSF flow parameters, such as forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, average flow, and net flow volume, were measured with phase-contrast cine MR imaging. Differences between the 2 groups were assessed to determine the independent determinants of these CSF flow parameters. RESULTS Forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, and average flow in the patients with hypertension significantly decreased (all, P < .05). Increasing systolic blood pressure was significantly associated with lower forward flow volume (β = -0.44 mL/mL/mm Hg; 95% CI, -0.83 to -0.06 mL/mL/mm Hg), forward peak velocity (β = -0.50 cm/s/mm Hg; 95% CI, -0.88 to -0.12 cm/s/mm Hg), reverse flow volume (β = -0.61 mL/mL/mm Hg; 95% CI, -0.97 to -0.26 mL/mL/mm Hg), reverse peak velocity (β = -0.55 cm/s/mm Hg; 95% CI, -0.91-0.18 cm/s/mm Hg), and average flow (β = -0.50 mL/min/mm Hg; 95% CI, -0.93 to -0.08 mL/min/mm Hg). CONCLUSIONS The CSF flow dynamics in patients with hypertension are decreased, and increasing systolic blood pressure is strongly associated with lower CSF flow dynamics.
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Affiliation(s)
- L Ma
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - W He
- Department of Radiology (W.H.), Guangdong 999 Brain Hospital, Guangzhou, China
| | - X Li
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Liu
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - H Cao
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - L Guo
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Xiao
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y Xu
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Y Wu
- From the Department of Medical Imaging (L.M., X. Li, X. Liu, H.C., L.G., X.X., Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, China
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13
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Bayés-Genís A, Díez J. Transition to heart failure in hypertension: going to the heart of the matter. Eur Heart J 2021; 43:3332-3334. [PMID: 34516629 DOI: 10.1093/eurheartj/ehab651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Antoni Bayés-Genís
- Heart Institute, Hospital Universitari German Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain.,CIBERCV, Instituto de Salud, Carlos III, Madrid, Spain
| | - Javier Díez
- CIBERCV, Instituto de Salud, Carlos III, Madrid, Spain.,Departments of Nephrology and Cardiology, University of Navarra Clinic, Pamplona, Spain.,Program of Cardiovascular Diseases, Center of Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
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14
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Lichtenecker DCK, Argeri R, Castro CHDM, Dias-da-Silva MR, Gomes GN. Cross-sex testosterone therapy modifies the renal morphology and function in female rats and might underlie increased systolic pressure. Clin Exp Pharmacol Physiol 2021; 48:978-986. [PMID: 33711175 DOI: 10.1111/1440-1681.13495] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/05/2020] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Testosterone esters are hormones commonly used for affirming gender identity in transmen. The present study evaluates the effect of testosterone on renal morphology and function in an animal model submitted to cross-sex hormone therapy used for transmen. Two-month-old Wistar rats were divided into three groups: male control (MC), female control (FC), and female on testosterone therapy (FTT). The FTT group received testosterone cypionate (3.0 mg/kg, i.m.), and the MC and MF groups received vehicle oil every 10 days for 4 months. Renal function and indirect systolic blood pressure (SBP) measurements were evaluated at 6 months of age. Plasma and urine concentrations of urea, creatinine, sodium, potassium, osmolality, and glomerular filtration rate (GFR) were measured. The kidneys were weighed, paraffin-embedded, and histological sections were prepared to evaluate the glomerular area. We verified that the FTT group, in comparison to FC, had increased kidney weight [MC, 3.2 ± 0.05; FC, 1.8 ± 0.04; FTT, 2.2 ± 0.06; g], decreased urine osmolarity [MC, 486.9 ± 18.3; FC, 1012.0 ± 5.4; FTT, 768.2 ± 40.3 mOsm/L/g kw], reduced GFR [MC, 0.77 ± 0.04; FC, 0.78 ± 0.02; FTT, 0.67 ± 0.03; mL/min/g kw], larger glomerular area [MC, 9334 ± 120.8; FC, 7884 ± 112.8; FTT, 9078 ± 133.4 µm2 ], and higher SBP [MC, 126 ± 3.4; FC, 119 ± 1.0; FTT, 131 ± 1.4; mmHg]. Sodium excretion was higher in FC and FTT in comparison to MC [MC, 0.34 ± 0.05; FC, 0.56 ± 0.06; FTT, 0.54 ± 0.04; mEq/24 h/g kw]. Cross-sex hormone therapy with testosterone in female rats induces renal morphofunctional changes and may underlie increased systolic pressure, suggesting an adaptation similar to what is observed in transmen on long-term testosterone therapy.
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Affiliation(s)
- Débora Conte Kimura Lichtenecker
- Laboratory of Renal Physiology, Department of Physiology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Rogerio Argeri
- Laboratory of Renal Physiology, Department of Physiology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Charlles Heldan de Moura Castro
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Magnus Regios Dias-da-Silva
- Laboratory of Molecular and Translational Endocrinology, Endocrinology Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Guiomar Nascimento Gomes
- Laboratory of Renal Physiology, Department of Physiology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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15
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Wang-Evers M, Casper MJ, Glahn J, Luo T, Doyle AE, Karasik D, Kim AC, Phothong W, Nathan NR, Heesakker T, Kositratna G, Manstein D. Assessing the impact of aging and blood pressure on dermal microvasculature by reactive hyperemia optical coherence tomography angiography. Sci Rep 2021; 11:13411. [PMID: 34183707 PMCID: PMC8238964 DOI: 10.1038/s41598-021-92712-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/14/2021] [Indexed: 12/12/2022] Open
Abstract
Visualization and quantification of the skin microvasculature are important for studying the health of the human microcirculation. We correlated structural and pathophysiological changes of the dermal capillary-level microvasculature with age and blood pressure by using the reactive hyperemia optical coherence tomography angiography (RH-OCT-A) technique and evaluated both conventional OCT-A and the RH-OCT-A method as non-invasive imaging alternatives to histopathology. This observational pilot study acquired OCT-A and RH-OCT-A images of the dermal microvasculature of 13 young and 12 old healthy Caucasian female subjects. Two skin biopsies were collected per subject for histological analysis. The dermal microvasculature in OCT-A, RH-OCT-A, and histological images were automatically quantified and significant indications of vessel rarefaction in both old subjects and subjects with high blood pressure were observed by RH-OCT-A and histopathology. We showed that an increase in dermal microvasculature perfusion in response to reactive hyperemia was significantly lower in high blood pressure subjects compared to normal blood pressure subjects (117% vs. 229%). These results demonstrate that RH-OCT-A imaging holds functional information of the microvasculature with respect to physiological factors such as age and blood pressure that may help to monitor early disease progression and assess overall vascular health. Additionally, our results suggest that RH-OCT-A images may serve as a non-invasive alternative to histopathology for vascular analysis.
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Affiliation(s)
- Michael Wang-Evers
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Malte J Casper
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Joshua Glahn
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Yale School of Medicine, New Haven, CT, USA
| | - Tuanlian Luo
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Abigail E Doyle
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Karasik
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anne C Kim
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Weeranut Phothong
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Siriraj Hospital, Mahidol University, BKK, Thailand
| | - Neera R Nathan
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tammy Heesakker
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Garuna Kositratna
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dieter Manstein
- Cutaneous Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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16
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Fukutsu K, Saito M, Noda K, Murata M, Kase S, Shiba R, Isogai N, Asano Y, Hanawa N, Dohke M, Kase M, Ishida S. A Deep Learning Architecture for Vascular Area Measurement in Fundus Images. OPHTHALMOLOGY SCIENCE 2021; 1:100004. [PMID: 36246007 PMCID: PMC9560649 DOI: 10.1016/j.xops.2021.100004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/06/2021] [Accepted: 02/16/2021] [Indexed: 12/27/2022]
Abstract
Purpose To develop a novel evaluation system for retinal vessel alterations caused by hypertension using a deep learning algorithm. Design Retrospective study. Participants Fundus photographs (n = 10 571) of health-check participants (n = 5598). Methods The participants were analyzed using a fully automatic architecture assisted by a deep learning system, and the total area of retinal arterioles and venules was assessed separately. The retinal vessels were extracted automatically from each photograph and categorized as arterioles or venules. Subsequently, the total arteriolar area (AA) and total venular area (VA) were measured. The correlations among AA, VA, age, systolic blood pressure (SBP), and diastolic blood pressure were analyzed. Six ophthalmologists manually evaluated the arteriovenous ratio (AVR) in fundus images (n = 102), and the correlation between the SBP and AVR was evaluated manually. Main Outcome Measures Total arteriolar area and VA. Results The deep learning algorithm demonstrated favorable properties of vessel segmentation and arteriovenous classification, comparable with pre-existing techniques. Using the algorithm, a significant positive correlation was found between AA and VA. Both AA and VA demonstrated negative correlations with age and blood pressure. Furthermore, the SBP showed a higher negative correlation with AA measured by the algorithm than with AVR. Conclusions The current data demonstrated that the retinal vascular area measured with the deep learning system could be a novel index of hypertension-related vascular changes.
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Affiliation(s)
- Kanae Fukutsu
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michiyuki Saito
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kousuke Noda
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Ocular Circulation and Metabolism, Hokkaido University, Sapporo, Japan
- Correspondence: Kousuke Noda, MD, PhD, Department of Ophthalmology, Hokkaido University Graduate School of Medicine, N-15, W-7, Kita-ku, Sapporo 060-8638, Japan.
| | - Miyuki Murata
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Ocular Circulation and Metabolism, Hokkaido University, Sapporo, Japan
| | - Satoru Kase
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | | | | | | | | | - Manabu Kase
- Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Susumu Ishida
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Ocular Circulation and Metabolism, Hokkaido University, Sapporo, Japan
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17
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Ameer OZ, Salman IM, Alwadi AY, Ouban A, Abu-Owaimer FM, AlSharari SD, Bukhari IA. Regional functional and structural abnormalities within the aorta as a potential driver of vascular disease in metabolic syndrome. Exp Physiol 2021; 106:771-788. [PMID: 33450088 DOI: 10.1113/ep089213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
NEW FINDINGS What is the central question of this study? Is aortic dysfunction, a significant contributor to cardiovascular disease in metabolic syndrome, expressed uniformly across both the thoracic and abdominal aorta? What is the main finding and its importance? Our study shows that, in the setting of metabolic syndrome, functional and structural deficits in the aorta are differentially expressed along its length, with the abdominal portion displaying more extensive vascular abnormalities. It is, therefore, likely that early interventional strategies targeting the abdominal aorta might alleviate cardiovascular pathologies driven by the metabolic syndrome. ABSTRACT The extent of vascular dysfunction associated with metabolic syndrome might vary along the length of the aorta. In this study, we investigated regional functional and structural changes in the thoracic and abdominal aorta of a rat model of metabolic syndrome, namely, high-fat diet (HFD) streptozotocin-induced diabetes mellitus (HFD-D). Four-week-old male Wistar albino rats were fed with either HFD or control diet (CD) for 10 weeks. At week 6, 40 mg/kg streptozotocin and its vehicle were injected i.p. into HFD and CD groups, respectively. At the end of the feeding period, rats were euthanised and aortic segments collected for assessment of vascular functional responses and histomorphometry. Tail-cuff systolic blood pressures (154 ± 6 vs. 110 ± 4 mmHg) and areas under the curve for oral glucose and i.p. insulin tolerance tests were greater in HFD-D versus CD rats. Abdominal aortic vasoconstriction in response to noradrenaline and KCl was greater in HFD-D compared with CD rats. Thoracic vasoconstrictor responses to noradrenaline, but not KCl, were greater in the HFD-D group. Abdominal, but not thoracic, endothelium-dependent vasorelaxation in response to acetylcholine was blunted in HFD-D relative to CD rats; however, nitric oxide-dependent vasorelaxation in HFD-D rats was impaired in both thoracic and abdominal segments. The abdominal aorta of HFD-D rats showed deranged interlamellar spacing and increased lipid plaque deposition. In conclusion, vascular dysfunction in metabolic syndrome is expressed differentially along the length of the aorta, with the abdominal aorta exhibiting increased susceptibility to vasoconstrictors and greater deficits in endothelium-dependent relaxation. These vascular functional abnormalities could potentially underlie the development of hypertensive cardiovascular disease associated with the metabolic syndrome.
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Affiliation(s)
- Omar Z Ameer
- College of Pharmacy, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Ibrahim M Salman
- College of Pharmacy, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Aiman Y Alwadi
- College of Pharmacy, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Abderrahman Ouban
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Shakir D AlSharari
- College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ishfaq A Bukhari
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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18
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Chow RS. Terms, Definitions, Nomenclature, and Routes of Fluid Administration. Front Vet Sci 2021; 7:591218. [PMID: 33521077 PMCID: PMC7844884 DOI: 10.3389/fvets.2020.591218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Fluid therapy is administered to veterinary patients in order to improve hemodynamics, replace deficits, and maintain hydration. The gradual expansion of medical knowledge and research in this field has led to a proliferation of terms related to fluid products, fluid delivery and body fluid distribution. Consistency in the use of terminology enables precise and effective communication in clinical and research settings. This article provides an alphabetical glossary of important terms and common definitions in the human and veterinary literature. It also summarizes the common routes of fluid administration in small and large animal species.
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Affiliation(s)
- Rosalind S Chow
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MI, United States
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19
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Balaban Kocas B, Cetinkal G, Ser OS, Kilci H, Keskin K, Ozcan SN, Verdi Y, Zeren MI, Kilickesmez K. The relation between left ventricular global longitudinal strain and troponin levels in patients hospitalized with COVID-19 pneumonia. Int J Cardiovasc Imaging 2020; 37:125-133. [PMID: 33206248 PMCID: PMC7673246 DOI: 10.1007/s10554-020-02102-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/08/2020] [Indexed: 12/17/2022]
Abstract
Left ventricular global longitudinal strain (LVGLS) from two-dimensional speckle-tracking echocardiography (2D-STE) provides a more accurate estimation of subclinical myocardial dysfunction. In patients with COVID-19, elevated high sensitive troponin (hs-TnI) levels are frequent independent from the underlying cardiovascular disease. However, the relationship between high troponin levels and LVGLS in such patients remains unknown. We aimed to investigate the relation between troponin levels and LVGLS values in patients with COVID-19. A total of thirty-eight patients diagnosed with COVID-19 pneumonia who underwent echocardiography examination within the first week of hospital admission were enrolled in our study. Patients were divided into two groups according to their hs-TnI levels. Conventional left venticular (LV) function parameters, including ejection fraction, LV diastolic and systolic volumes were obtained and LVGLS was determined using 2D-STE. Frequency of hypertension, diabetes mellitus and current smoking were similar among groups. Compared with the patients in the negative troponin group, those in the positive troponin group were more likely to have a higher age; higher levels of D-dimer, C-reactive protein and ferritin; higher need for high-flow oxygen, invasive mechanical ventilation therapy or both; and a higher number of intensive care unit admissions. There was no statistically significant difference in LVGLS and ejection fraction values between the two groups.(− 18.5 ± 2.9, − 19.8 ± 2.8, p = 0.19; 55.2 ± 9.9, 59.5 ± 5.9, p = 0.11 respectively). Despite troponin increase is highly related to in-hospital adverse events; no relevance was found between troponin increase and LVGLS values of COVID-19 patients.
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Affiliation(s)
- Betul Balaban Kocas
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey.
| | - Gokhan Cetinkal
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey
| | - Ozgur Selim Ser
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey
| | - Hakan Kilci
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey
| | - Kudret Keskin
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey
| | - Safiye Nur Ozcan
- Department of Infectious Disease and Microbiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey
| | - Yildiz Verdi
- Department of Infectious Disease and Microbiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey
| | - Mustafa Ismet Zeren
- Department of Infectious Disease and Microbiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey
| | - Kadriye Kilickesmez
- Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Mecidiyekoy, 34360, Istanbul, Turkey
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20
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Meade RD, Akerman AP, Notley SR, McGinn R, Poirier P, Gosselin P, Kenny GP. Physiological factors characterizing heat-vulnerable older adults: A narrative review. ENVIRONMENT INTERNATIONAL 2020; 144:105909. [PMID: 32919284 DOI: 10.1016/j.envint.2020.105909] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/24/2020] [Accepted: 06/17/2020] [Indexed: 05/26/2023]
Abstract
More frequent and intense periods of extreme heat (heatwaves) represent the most direct challenge to human health posed by climate change. Older adults are particularly vulnerable, especially those with common age-associated chronic health conditions (e.g., cardiovascular disease, hypertension, obesity, type 2 diabetes, chronic kidney disease). In parallel, the global population is aging and age-associated disease rates are on the rise. Impairments in the physiological responses tasked with maintaining homeostasis during heat exposure have long been thought to contribute to increased risk of health disorders in older adults during heatwaves. As such, a comprehensive overview of the provisional links between age-related physiological dysfunction and elevated risk of heat-related injury in older adults would be of great value to healthcare officials and policy makers concerned with protecting heat-vulnerable sectors of the population from the adverse health impacts of heatwaves. In this narrative review, we therefore summarize our current understanding of the physiological mechanisms by which aging impairs the regulation of body temperature, hemodynamic stability and hydration status. We then examine how these impairments may contribute to acute pathophysiological events common during heatwaves (e.g., heatstroke, major adverse cardiovascular events, acute kidney injury) and discuss how age-associated chronic health conditions may exacerbate those impairments. Finally, we briefly consider the importance of physiological research in the development of climate-health programs aimed at protecting heat-vulnerable individuals.
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Affiliation(s)
- Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ryan McGinn
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Pierre Gosselin
- Institut National de Santé Publique du Québec and Université Laval, Québec, Québec, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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21
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Tikhonova IV, Grinevich AA, Guseva IE, Tankanag AV. Effect of orthostasis on the regulation of skin blood flow in upper and lower extremities in human. Microcirculation 2020; 28:e12655. [PMID: 32860464 DOI: 10.1111/micc.12655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/08/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The research is aimed to investigate interactions between cardiovascular signals and to assess contributions of central and local mechanisms to skin blood flow regulation in upper and lower extremities at rest and under orthostasis. METHODS Heart rate variability, respiration, forearm, and foot skin blood flow were assessed at rest and during postural test in 25 healthy volunteers. Spectral analysis was performed. Phase synchronization degree of analyzed signals was determined by group phase wavelet coherence function. RESULTS Skin blood flow was lower on foot at rest and during postural test than on forearm. High-frequency component of heart rate variability was higher at ~0.3 Hz during postural test versus rest. Blood flow oscillation amplitudes on the foot were lower in frequency range including respiratory interval at rest than on forearm. Postural exposure increased amplitude of foot blood flow oscillations in respiratory interval and decreased amplitudes in cardiac interval versus rest. Orthostasis increased group wavelet phase coherence between foot blood flow and heart rate variability or respiration, as well as between forearm and foot blood flow at 0.3 Hz corresponding to respiration. CONCLUSIONS The contribution of central mechanisms associated with respiration to blood flow regulation increased in lower extremities during orthostasis.
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Affiliation(s)
- Irina V Tikhonova
- Institute of Cell Biophysics of Russian Academy of Sciences, Pushchino, Russia
| | - Andrey A Grinevich
- Institute of Cell Biophysics of Russian Academy of Sciences, Pushchino, Russia
| | - Irina E Guseva
- Hospital of Pushchino Scientific Centre of Russian Academy of Sciences, Pushchino, Russia
| | - Arina V Tankanag
- Institute of Cell Biophysics of Russian Academy of Sciences, Pushchino, Russia
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22
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Retinal microvascular metrics in untreated essential hypertensives using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2020; 259:395-403. [PMID: 32613576 DOI: 10.1007/s00417-020-04714-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/10/2020] [Accepted: 04/21/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To quantify early changes of macular microvascular density, complexity, and peripapillary vessel caliber in hypertension using optical coherence tomography angiography (OCTA). METHODS Hypertension (137 eyes) and healthy eyes (79 eyes) as control were involved in this prospective observational study. Indices of the microcirculation included vessel density (VD), skeleton density (SD), vessel diameter index (VDI), fractal dimension (FD) and foveal avascular zone (FAZ) of superficial retinal layer (SRL) and deep retinal layer (DRL), and peripapillary vessel calibers. The correlation of these indices with mean arterial pressure (MAP) and ocular perfusion pressure (OPP) was analyzed. RESULTS Mean VD of DRL, SD of SRL and DRL, and FD of SRL and DRL were significantly reduced in the macula of hypertensive eyes (all P < 0.01). Meanwhile, hypertensive eyes had margin results of narrower peripapillary arteriolar caliber (P = 0.04). No significant finding was demonstrated on VD of SRL, VDI and FAZ of SRL and DRL, peripapillary total vascular caliber, and peripapillary venal caliber (all P > 0.05). SD and VD of the DRL correlated negatively with MAP (both R = - 0.152, P = 0.03). CONCLUSION OCTA algorithms may provide an additional inexpensive tool to aid in the preclinical assessment of hypertensive subject.
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23
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Zhang Y, Lacolley P, Protogerou AD, Safar ME. Arterial Stiffness in Hypertension and Function of Large Arteries. Am J Hypertens 2020; 33:291-296. [PMID: 32060496 DOI: 10.1093/ajh/hpz193] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/28/2019] [Accepted: 02/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Arterial stiffness-typically assessed from non-invasive measurement of pulse wave velocity along a straight portion of the vascular tree between the right common carotid and femoral arteries-is a reliable predictor of cardiovascular risk in patients with essential hypertension. METHODS We reviewed how carotid-femoral pulse wave velocity increases with age and is significantly higher in hypertension (than in age- and gender-matched individuals without hypertension), particularly when hypertension is associated with diabetes mellitus. RESULTS From the elastic aorta to the muscular peripheral arteries of young healthy individuals, there is a gradual but significant increase in stiffness, with a specific gradient. This moderates the transmission of pulsatile pressure towards the periphery, thus protecting the microcirculatory network. The heterogeneity of stiffness between the elastic and muscular arteries causes the gradient to disappear or be inversed with aging, particularly in long-standing hypertension. CONCLUSIONS In hypertension therefore, pulsatile pressure transmission to the microcirculation is augmented, increasing the potential risk of damage to the brain, the heart, and the kidney. Furthermore, elevated pulse pressure exacerbates end-stage renal disease, particularly in older hypertensive individuals. With increasing age, the elastin content of vessel walls declines throughout the arterial network, and arterial stiffening increases further due to the presence of rigid wall material such as collagen, but also fibronectin, proteoglycans, and vascular calcification. Certain genes, mainly related to angiotensin and/or aldosterone, affect this aging process and contribute to the extent of arterial stiffness, which can independently affect both forward and reflected pressure waves.
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Affiliation(s)
- Yi Zhang
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | | | - Athanase D Protogerou
- Cardiovascular Prevention and Research Unit, Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michel E Safar
- Diagnosis and Therapeutics Department, Hôtel-Dieu Hospital, Paris, France
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24
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Dai G, He W, Xu L, Pazo EE, Lin T, Liu S, Zhang C. Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population. PLoS One 2020; 15:e0230111. [PMID: 32134976 PMCID: PMC7058325 DOI: 10.1371/journal.pone.0230111] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/23/2020] [Indexed: 11/18/2022] Open
Abstract
Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with fundus photographs. This study aimed to use deep learning technique that can detect subclinical features appearing below the threshold of a human observer to explore the effect of hypertension on morphological features of retinal microvasculature. We collected 2012 retinal photographs which included 1007 from patients with a diagnosis of hypertension and 1005 from normotensive control. By method of vessel segmentation, we removed interference information other than retinal vasculature and contained only morphological information about blood vessels. Using these segmented images, we trained a small convolutional neural networks (CNN) classification model and used a deep learning technique called Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heat maps for the class “hypertension”. Our model achieved an accuracy of 60.94%, a specificity of 51.54%, a precision of 59.27%, and a recall of 70.48%. The AUC was 0.6506. In the heat maps for the class “hypertension”, red patchy areas were mainly distributed on or around arterial/venous bifurcations. This indicated that the model has identified these regions as being the most important for predicting hypertension. Our study suggested that the effect of hypertension on retinal microvascular morphology mainly occurred at branching of vessels. The change of the branching pattern of retinal vessels was probably the most significant in response to elevated blood pressure.
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Affiliation(s)
- Guangzheng Dai
- The Second Clinical College, Dalian Medical University, Dalian, Liaoning, China
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
| | - Wei He
- The Second Clinical College, Dalian Medical University, Dalian, Liaoning, China
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
- Clinical College, He University, Shenyang, Liaoning, China
- * E-mail:
| | - Ling Xu
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
- Clinical College, He University, Shenyang, Liaoning, China
| | - Eric E. Pazo
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
- Clinical College, He University, Shenyang, Liaoning, China
| | - Tiezhu Lin
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
- Clinical College, He University, Shenyang, Liaoning, China
| | - Shasha Liu
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
| | - Chenguang Zhang
- The Second Clinical College, Dalian Medical University, Dalian, Liaoning, China
- Clinical Research Center, He Eye Specialists Hospitals, Shenyang, Liaoning, China
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25
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Maderuelo-Fernandez JA, Garcia-Garcia A, Chamoso P, Recio-Rodríguez JI, Rodríguez-González S, Patino-Alonso MC, Rodriguez-Sanchez E, Corchado-Rodríguez JM, Gómez-Marcos MA, Garcia-Ortiz L. Automatic image analyser to assess retinal vessel calibre (ALTAIR). A new tool to evaluate the thickness, area and length of the vessels of the retina. Int J Med Inform 2020; 136:104090. [PMID: 32045743 DOI: 10.1016/j.ijmedinf.2020.104090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/12/2020] [Accepted: 01/27/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES The examination of the fundus allows to evaluate retinal the microcirculation in vivo. We assess the reliability and validity of ALTAIR software, and to evaluate its clinical relevance by the association of thickness, area and length of the retinal vessels with other measures of vascular structure and function, target organ damage and cardiovascular risk. METHODS Cross-sectional study involving a total of 250 subjects aged 62 ± 9 years, 51 % males. In a random subsample of 60 subjects (118 retinographies), we estimated the intraobserver, interobserver and interdevice intraclass correlation coefficients (ICC) of the measurements of retinal vascular thickness, area and length in 3 concentric circles. Concurrent validity was assessed with all 250 subjects (495 retinographies), analysing the relationship to age, blood pressure, target organ damage, vascular structure and function, and cardiovascular risk. RESULTS Of the sample, 69 % were diagnosed with hypertension and 17 % with diabetes. Intraobserver ICC ranged from 0.640 for venous length to 0.906 for arterial area. Interobserver ICC ranged from 0.809 for arterial length to 0.916 for venous area, and interdevice ICC for arteriovenous ratio (AVR) was 0.887, thickness of arteries 0.590 and vein thickness 0.677. We found a moderate correlation between retinal vascular parameters and vascular structure and function, and target organ damage. In multiple linear regression analysis, the association with blood pressure, albumin/creatinine ratio, carotid intima-media thickness and cardiovascular risk is maintained. CONCLUSION The ALTAIR tool has been useful for analysing the thickness, area and length of retinal vessels, with adequate reliability and a concomitant association of retinal vessel measurements with other cardiovascular parameters and cardiovascular risk. Therefore, in addition to thickness, the area and length of retinal vessels could also play a role in the prediction of cardiovascular risk.
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Affiliation(s)
- Jose A Maderuelo-Fernandez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain.
| | - Angel Garcia-Garcia
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain.
| | - Pablo Chamoso
- BISITE Research Group, Computers and Automation Department, University of Salamanca (USAL), Salamanca Institute for Biomedical Research (IBSAL), Salamanca, Spain.
| | - Jose I Recio-Rodríguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Nurse and Physiotherapy, University of Salamanca (USAL), Salamanca, Spain.
| | - Sara Rodríguez-González
- BISITE Research Group, Computers and Automation Department, University of Salamanca (USAL), Salamanca Institute for Biomedical Research (IBSAL), Salamanca, Spain.
| | - Maria C Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Statistics, University of Salamanca (USAL), Salamanca, Spain.
| | - Emiliano Rodriguez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Medicine, University of Salamanca (USAL), Salamanca, Spain.
| | - Juan M Corchado-Rodríguez
- BISITE Research Group, Computers and Automation Department, University of Salamanca (USAL), Salamanca Institute for Biomedical Research (IBSAL), Salamanca, Spain.
| | - Manuel A Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Medicine, University of Salamanca (USAL), Salamanca, Spain.
| | - Luis Garcia-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit of Salamanca (APISAL). Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Biomedical and Diagnostic Sciences, University of Salamanca (USAL), Salamanca, Spain.
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26
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Colli LG, Belardin LB, Echem C, Akamine EH, Antoniassi MP, Andretta RR, Mathias LS, Rodrigues SFDP, Bertolla RP, de Carvalho MHC. Systemic arterial hypertension leads to decreased semen quality and alterations in the testicular microcirculation in rats. Sci Rep 2019; 9:11047. [PMID: 31363128 PMCID: PMC6667492 DOI: 10.1038/s41598-019-47157-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/19/2019] [Indexed: 11/09/2022] Open
Abstract
Arterial hypertension is a cardiovascular disease that leads to important systemic alterations and drastically impairs normal organ function over time. Hypertension affects around 700 million men of reproductive age and hypertensive men present increased risk for reproductive disorders, such as erectile dysfunction. However, the link between arterial hypertension and male reproductive disorders is associative at best. Moreover, many studies have reported associations between decreased male fertility and/or semen quality and alterations to general male health. In this study we aim to investigate the effect of systemic high blood pressure in sperm quality, sperm functional characteristics and testicular physiology in a rat model. Hypertensive rats presented altered testicular morphology – mainly vascular alterations and impaired testicular vasomotion. Hypertensive rats also presented decrease in sperm concentration, DNA integrity and increased percentages of sperm with dysfunctional mitochondria, intracellular superoxide anion activity and abnormal morphology. This study provides mechanistic insights by which arterial hypertension affects the testes, evidencing the testes as another target organ for hypertension as well as its impact on sperm quality.
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Affiliation(s)
- Lucas Giglio Colli
- Department of Pharmacology, Division of Vascular Biology, Hypertension Section, Instituto de Ciências Biomédicas, Universidade de São Paulo -ICB/USP, São Paulo, SP, Brazil.
| | - Larissa Berloffa Belardin
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Cinthya Echem
- Department of Pharmacology, Division of Vascular Biology, Hypertension Section, Instituto de Ciências Biomédicas, Universidade de São Paulo -ICB/USP, São Paulo, SP, Brazil
| | - Eliana Hiromi Akamine
- Department of Pharmacology, Division of Vascular Biology, Hypertension Section, Instituto de Ciências Biomédicas, Universidade de São Paulo -ICB/USP, São Paulo, SP, Brazil
| | - Mariana Pereira Antoniassi
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Rhayza Roberta Andretta
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Lucas Solla Mathias
- Department of Internal Medicine, Botucatu Medical University, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Stephen Fernandes de Paula Rodrigues
- Department of Pharmacology, Division of Vascular Biology, Hypertension Section, Instituto de Ciências Biomédicas, Universidade de São Paulo -ICB/USP, São Paulo, SP, Brazil
| | - Ricardo Pimenta Bertolla
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
| | - Maria Helena Catelli de Carvalho
- Department of Pharmacology, Division of Vascular Biology, Hypertension Section, Instituto de Ciências Biomédicas, Universidade de São Paulo -ICB/USP, São Paulo, SP, Brazil.
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27
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Duanmu Z, Chen W, Gao H, Yang X, Luo X, Hill NA. A One-Dimensional Hemodynamic Model of the Coronary Arterial Tree. Front Physiol 2019; 10:853. [PMID: 31338038 PMCID: PMC6629789 DOI: 10.3389/fphys.2019.00853] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/20/2019] [Indexed: 01/28/2023] Open
Abstract
One-dimensional (1D) hemodynamic models of arteries have increasingly been applied to coronary circulation. In this study, we have adopted flow and pressure profiles in Olufsen's 1D structured tree as coronary boundary conditions, with terminals coupled to the dynamic pressure feedback resulting from the intra-myocardial stress because of ventricular contraction. We model a trifurcation structure of the example coronary tree as two adjacent bifurcations. The estimated results of blood pressure and flow rate from our simulation agree well with the clinical measurements and published data. Furthermore, the 1D model enables us to use wave intensity analysis to simulate blood flow in the developed coronary model. Six characteristic waves are observed in both left and right coronary flows, though the waves' magnitudes differ from each other. We study the effects of arterial wall stiffness on coronary blood flow in the left circumflex artery (LCX). Different diseased cases indicate that distinct pathological reactions of the cardiovascular system can be better distinguished through Wave Intensity analysis, which shows agreement with clinical observations. Finally, the feedback pressure in terminal vessels and measurement deviation are also investigated by changing parameters in the LCX. We find that larger feedback pressure increases the backward wave and decreases the forward one. Although simplified, this 1D model provides new insight into coronary hemodynamics in healthy and diseased conditions. We believe that this approach offers reference resources for studies on coronary circulation disease diagnosis, treatment and simulation.
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Affiliation(s)
- Zheng Duanmu
- Key Laboratory of the Ministry of Education for Optoelectronic Measurement Technology and Instrument, Beijing Information Science and Technology University, Beijing, China
| | - Weiwei Chen
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Guangxi, China
| | - Hao Gao
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Xilan Yang
- Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyu Luo
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Nicholas A Hill
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
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28
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Sulistyowati E, Jan RL, Liou SF, Chen YF, Wu BN, Hsu JH, Yeh JL. Vasculoprotective effects of Centella asiatica, Justicia gendarussa and Imperata cylindrica decoction via the NOXs-ROS-NF-κB pathway in spontaneously hypertensive rats. J Tradit Complement Med 2019; 10:378-388. [PMID: 32695655 PMCID: PMC7365787 DOI: 10.1016/j.jtcme.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/06/2019] [Accepted: 06/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background and aim Centella asiatica, Justicia gendarussa and Imperata cylindrica decoction (CJID) is efficacious for hypertension. NADPH (nicotinamide adenine dinucleotide phosphate) oxidase (NOX)-induced reactive oxygen species (ROS) generation modulates nuclear factor kappa B (NF-κB) activation and thus mediates hypertension-induced vascular remodeling. This research aims to investigate the anti-remodeling effect of CJID through the mechanism of NOXs-ROS-NF-κB pathway in spontaneously hypertensive rats (SHRs). Experimental procedure CJID was orally administered once a day for five weeks in SHRs and normotensive-WKY (Wistar Kyoto) rats. All rats were sacrificed at the end of study and different assays were performed to determine whether CJID ameliorates vascular remodeling in SHRs, such as histological examination; lactate dehydrogenase (LDH), nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) assays; superoxide and hydrogen peroxide (H2O2) generation assays, immunohistochemistry and immunofluorescence assays. . Changes in levels of inducible nitric oxide synthase (iNOS), NF-κB-p65, NF-κB inhibitor alpha/IκBα (inhibitory kappa B- alpha), phosphorylation of IκBα (p-IκBα) and NOX1, NOX2, NOX4 in the thoracic aorta were determined. Results Vascular remodeling indicators, media thickness, collagen and elastic accumulation in the thoracic aorta, of SHRs-treated CJID were attenuated. Redox homeostasis, aortic superoxide and hydrogen peroxide generation were decreased in SHRs-treated group. Aortic iNOS, p-IκBα, NF-κB-p65 and NOX1, NOX2, NOX4 expressions were suppressed. Conclusions CJI treatment diminishes oxidative stress response in the thoracic aorta of SHRs via regulation of NOXs-ROS-NF-κB signaling pathway. These findings indicate that CJI possess protective effect against hypertension-induced vascular remodeling in SHRs.
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Affiliation(s)
- Erna Sulistyowati
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Medicine, University of Islam Malang, Malang city, East Java, Indonesia
| | - Ren-Long Jan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.,Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shu-Fen Liou
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Ying-Fu Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Sin-Lau Christian Hospital, Tainan, Taiwan
| | - Bin-Nan Wu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jong-Hau Hsu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jwu-Lai Yeh
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan
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29
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Hadjadj L, Pál É, Monori-Kiss A, Sziva RE, Korsós-Novák Á, Mária Horváth E, Benkő R, Magyar A, Magyar P, Benyó Z, Nádasy GL, Várbíró S. Vitamin D deficiency and androgen excess result eutrophic remodeling and reduced myogenic adaptation in small cerebral arterioles in female rats. Gynecol Endocrinol 2019; 35:529-534. [PMID: 30623742 DOI: 10.1080/09513590.2018.1554037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Vitamin D (vitD) insufficiency affects 1 billion people worldwide. Androgen excess (AE) occurs in 8% of fertile females. There are few data about the combined effect of vitD deficiency and AE on the early biomechanical changes of cerebral arterioles in fertile-aged female. Forty-six adolescent female Wistar rats (21-28 day-old, weighing 90-110 g) were grouped randomly in four groups: vitD supplemented groups with and without transdermal testosterone (T) treatment, as well as vitD deficient groups also with and without transdermal T (n = 11 or 12, in all cases). After 8 weeks of treatment, anterior cerebral arterioles (in vivo diameter of 90-130 µm) were obtained and cylindrical segments were examined by pressure arteriography. Myogenic tone, tangential stress and incremental elastic moduli were computed and statistically analyzed. Elastic density was studied on resorcin-fuchsin-stained histological section. VitD deficiency with T treatment resulted in significantly lower inner radii and higher wall thickness values with reduced tangential stress and increased elastic fiber density. VitD deficiency reduced myogenic tone at higher intraluminar pressures (>110 mmHg). Our conclusion is that plasma vitD level is an important factor in the control of myogenic tone in cerebral resistance arteries. AE and vitD deficiency acting parallel induce remodeling of their wall.
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Affiliation(s)
- Leila Hadjadj
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Éva Pál
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Anna Monori-Kiss
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Réka Eszter Sziva
- b 2nd Department of Obstetrics and Gynecology, Faculty of Medicine , Semmelweis University , Budapest , Hungary
| | - Ágnes Korsós-Novák
- c Department of Pathology , Jász-Nagykun-Szolnok Megyei Hetényi Géza Regional Hospital , Szolnok , Hungary
| | - Eszter Mária Horváth
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Rita Benkő
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Attila Magyar
- e Department of Anatomy, Histology and Embryology , Semmelweis University , Faculty of Medicine , Budapest , Hungary
| | - Péter Magyar
- f Department of Radiology , Semmelweis University , Faculty of Medicine , Budapest , Hungary
| | - Zoltán Benyó
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - György L Nádasy
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Szabolcs Várbíró
- b 2nd Department of Obstetrics and Gynecology, Faculty of Medicine , Semmelweis University , Budapest , Hungary
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30
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Lu J, Xu F, Zhang J. Inhibition of angiotensin II-induced cerebrovascular smooth muscle cell proliferation by LRRC8A downregulation through suppressing PI3K/AKT activation. Hum Cell 2019; 32:316-325. [PMID: 31127489 DOI: 10.1007/s13577-019-00260-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022]
Abstract
Cerebrovascular smooth muscle cell proliferation is the major contributor to cerebrovascular remodeling and stroke. Chloride channels have been suggested to play an important role in the regulation of smooth muscle cell proliferation. This study aims to investigate the effect of leucine-rich repeat-containing 8A (LRRC8A), an essential component of volume-sensitive chloride channels, on cerebrovascular smooth muscle cell proliferation. The data showed that LRRC8A expression was increased in mouse brain artery during angiotensin II (AngII)-induced cerebrovascular remodeling. Similarly, AngII also increased the expression of LRRC8A in human brain vascular smooth muscle cells (HBVSMCs). Knockdown of LRRC8A by siRNA significantly inhibited AngII-induced the proliferation, migration, and invasion in HBVSMCs. The inhibition of HBVSMCs proliferation by LRRC8A downregulation appeared to be involved in suppression of cell-cycle transition. AngII-induced the decrease in p21 and p27 expression and the increase in CDK4 and cyclin D1 expression were attenuated by LRRC8A downregulation. Moreover, inhibition of LRRC8A suppressed AngII-induced PI3K/AKT activation and reactive oxygen species generation, but had no effect on JNK, ERK, and p38 phosphorylation. In addition, activation of PI3K/AKT-signaling pathways with specific agonists significantly abolished the effect of LRRC8A deficiency on HBVSMC proliferation. This present study demonstrates that knockdown of LRRC8A ameliorates AngII-induced cerebrovascular smooth muscle cell proliferation via inhibiting PI3K/AKT pathway, suggesting that LRRC8A may be a novel molecular target in the treatment of vascular remodeling and stroke.
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Affiliation(s)
- Jingjing Lu
- Department of Neurology, People's Hospital of Zhengzhou University, No. 7 Wai-5 Road, Zhengzhou, 450052, Henan, China
| | - Feng Xu
- Department of Urology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Jiewen Zhang
- Department of Neurology, People's Hospital of Zhengzhou University, No. 7 Wai-5 Road, Zhengzhou, 450052, Henan, China.
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31
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González A, Ravassa S, López B, Moreno MU, Beaumont J, San José G, Querejeta R, Bayés-Genís A, Díez J. Myocardial Remodeling in Hypertension. Hypertension 2019; 72:549-558. [PMID: 30354762 DOI: 10.1161/hypertensionaha.118.11125] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Arantxa González
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Susana Ravassa
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Begoña López
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - María U Moreno
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Javier Beaumont
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Gorka San José
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Ramón Querejeta
- Division of Cardiology, Donostia University Hospital, University of the Basque Country, San Sebastián, Spain (R.Q.)
| | - Antoni Bayés-Genís
- CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.).,Heart Failure Unit and Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain (A.B.-G.).,Department of Medicine, Universitat Autònoma de Barcelona, Spain (A.B.-G.)
| | - Javier Díez
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.).,Department of Cardiology and Cardiac Surgery (J.D.).,Department of Nephrology (J.D.), University of Navarra Clinic, University of Navarra, Pamplona, Spain
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32
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Lim HB, Lee MW, Park JH, Kim K, Jo YJ, Kim JY. Changes in Ganglion Cell-Inner Plexiform Layer Thickness and Retinal Microvasculature in Hypertension: An Optical Coherence Tomography Angiography Study. Am J Ophthalmol 2019; 199:167-176. [PMID: 30502337 DOI: 10.1016/j.ajo.2018.11.016] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE To investigate retinal blood flow in patients with hypertension using optical coherence tomography angiography (OCTA) and the relationship between blood flow metrics and ganglion cell-inner plexiform layer (GC-IPL) thickness. DESIGN Retrospective, cross-sectional study. METHODS A total of 201 eyes from 117 healthy subjects and 84 hypertensive patients without any ocular abnormalities were included. Hypertensive patients were divided into the 2 groups according to disease periods (<5 years: Hypertension Group 1; ≥5 years: Hypertension Group 2). Macular 3 × 3-mm angiography was acquired using the Zeiss Cirrus 5000 OCT instrument. Vessel density (VD), perfusion density (PD), and foveal avascular zone metrics of the superficial capillary plexus were automatically calculated, and the thicknesses of the central fovea, GC-IPL, and peripapillary retinal nerve fiber layer (RNFL) were measured. All measurements were compared among the 3 groups, and retinal blood flow metrics were correlated with the thickness of each retinal layer. Logistic regression analyses were performed to determine the factors associated with prolonged hypertension. RESULTS The average GC-IPL (P < .001) and peripapillary RNFL (P = .048) thicknesses in Hypertension Group 2 were significantly thinner compared to the control group. The 3 mm total area of the VD and PD was also decreased compared to the control group and Hypertension Group 1 (all P < .05), and was significantly correlated with the GC-IPL (VD: r = 0.450, P = .001; PD: r = 0.467, P < .001) and peripapillary RNFL (VD: r = 0.314, P = .027; PD: r = 0.328, P = .023) thicknesses in Hypertension Group 2. Using multivariate logistic analyses, only the average GC-IPL thickness was a significant factor for prolonged hypertension (odds ratio = 0.911, P = .002). CONCLUSIONS In patients with hypertension lasting more than 5 years, inner retinal layer thinning, particularly GC-IPL thinning, was observed, which was significantly correlated with a decrease in retinal blood flow. Therefore, physicians should consider the effects of hypertension on the GC-IPL.
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Affiliation(s)
- Hyung Bin Lim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, South Korea
| | - Min Woo Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Jae Hyeong Park
- Division of Cardiology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Kyeungmin Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Young Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Jung Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, South Korea.
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33
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Swart R, Schutte AE, van Rooyen JM, Smith W, Mels CMC. The Association of Measures of the Micro- and Macro-Vasculature with Selenium and GPx Activity in a Young Bi-Ethnic Population: The African-PREDICT Study. J Am Coll Nutr 2019; 38:614-622. [PMID: 30822227 DOI: 10.1080/07315724.2019.1570479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Rijané Swart
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Aletta E. Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
- Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Johannes M. van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
- Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
- Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Catharina M. C. Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
- Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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34
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de Jager SCA, Hoefer IE. Beyond the matrix: MMP2 as critical regulator of inflammation-mediated vascular dysfunction. Cardiovasc Res 2019; 113:1705-1707. [PMID: 29040383 DOI: 10.1093/cvr/cvx202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Saskia C A de Jager
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Imo E Hoefer
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, G03.550, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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35
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Zafeiridis A, Triantafyllou A, Papadopoulos S, Koletsos N, Touplikioti P, Zafeiridis AS, Gkaliagkousi E, Dipla K, Douma S. Dietary nitrate improves muscle microvascular reactivity and lowers blood pressure at rest and during isometric exercise in untreated hypertensives. Microcirculation 2019; 26:e12525. [DOI: 10.1111/micc.12525] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Andreas Zafeiridis
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Areti Triantafyllou
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Stavros Papadopoulos
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Nikolaos Koletsos
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Alexandros S. Zafeiridis
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Eugenia Gkaliagkousi
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Stella Douma
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
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36
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Dong H, Ming S, Fang J, Li Y, Liu L. Icariin ameliorates angiotensin II-induced cerebrovascular remodeling by inhibiting Nox2-containing NADPH oxidase activation. Hum Cell 2018; 32:22-30. [PMID: 30386989 DOI: 10.1007/s13577-018-0220-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 10/03/2018] [Indexed: 12/31/2022]
Abstract
Cerebrovascular smooth muscle cells (SMCs) hyperplasia is an important contributor to cerebrovascular remodeling during hypertension. The aim of present study was to investigate the effects of Icariin on cerebrovascular SMCs proliferation and remodeling and the underlying mechanisms. The results revealed that Icariin administration attenuated the enhanced basilar artery constriction in angiotensin II (AngII)-induced hypertension rat model, as well as the inhibition of basilar artery diameter reduction in response to AngII and phenylephrine. In addition, histological analyses showed that Icariin also significantly ameliorated basilar artery remodeling in AngII hypertensive rats. In human brain vascular SMCs (HBVSMCs), AngII-induced cell proliferation, migration and invasion were markedly inhibited by Icariin treatment. Moreover, Icariin treatment largely limited AngII-induced the increase of reactive oxygen species (ROS) production in HBVSMCs, which was closely associated with cell proliferation. Analysis of the mechanisms showed that Icariin decreased ROS production via inhibiting NADPH oxidase activity but not mitochondria-derived ROS production. Further, Icariin promoted Nox2 degradation and consequently reduced its protein expression. In conclusion, these findings demonstrate that Icariin attenuates cerebrovascular SMCs hyperplasia and subsequent remodeling through inhibiting Nox2-containing NADPH oxidase activation, suggesting Icariin may be a potential therapeutic agent to prevent the onset and progression of stroke.
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MESH Headings
- Angiotensin II/adverse effects
- Animals
- Basilar Artery/pathology
- Brain/blood supply
- Cell Movement/drug effects
- Cell Proliferation/drug effects
- Cells, Cultured
- Disease Models, Animal
- Drugs, Chinese Herbal
- Flavonoids/pharmacology
- Flavonoids/therapeutic use
- Humans
- Hyperplasia
- Hypertension/chemically induced
- Hypertension/pathology
- Hypertension/physiopathology
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- NADPH Oxidase 2/antagonists & inhibitors
- NADPH Oxidase 2/metabolism
- NADPH Oxidases/antagonists & inhibitors
- NADPH Oxidases/metabolism
- Phytotherapy
- Rats, Sprague-Dawley
- Reactive Oxygen Species/metabolism
- Stroke/etiology
- Stroke/prevention & control
- Vascular Remodeling/drug effects
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Affiliation(s)
- Huanhuan Dong
- Department of Encephalopathy, Hubei Provincial Traditional Chinese Medicine Hospital, Wuhan, People's Republic of China
- Department of Encephalopathy, Hubei Institute of Traditional Chinese Medicine, Wuhan, People's Republic of China
| | - Shuping Ming
- Department of Encephalopathy, Hubei Provincial Traditional Chinese Medicine Hospital, Wuhan, People's Republic of China
- Department of Encephalopathy, Hubei Institute of Traditional Chinese Medicine, Wuhan, People's Republic of China
| | - Jie Fang
- Department of Encephalopathy, Hubei Provincial Traditional Chinese Medicine Hospital, Wuhan, People's Republic of China
- Department of Encephalopathy, Hubei Institute of Traditional Chinese Medicine, Wuhan, People's Republic of China
| | - Yun Li
- Department of Encephalopathy, Hubei Provincial Traditional Chinese Medicine Hospital, Wuhan, People's Republic of China
- Department of Encephalopathy, The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, No. 4 Huayuan Hill, Wuchang District, Wuhan, 430061, Hubei, People's Republic of China
| | - Ling Liu
- Department of Encephalopathy, Hubei Provincial Traditional Chinese Medicine Hospital, Wuhan, People's Republic of China.
- Department of Encephalopathy, The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, No. 4 Huayuan Hill, Wuchang District, Wuhan, 430061, Hubei, People's Republic of China.
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37
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Capoulade R, Clavel MA, Le Ven F, Dahou A, Thébault C, Tastet L, Shen M, Arsenault M, Bédard É, Beaudoin J, O'Connor K, Bernier M, Dumesnil JG, Pibarot P. Impact of left ventricular remodelling patterns on outcomes in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 2018; 18:1378-1387. [PMID: 28064154 DOI: 10.1093/ehjci/jew288] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/04/2016] [Indexed: 11/12/2022] Open
Abstract
Aims The objective of this study was to examine the association between the different patterns of left ventricular (LV) remodelling/hypertrophy on all-cause and cardiovascular mortality in patients with aortic stenosis (AS). Methods and results In total, 747 consecutive patients (69 ± 14 years, 57% men) with AS and preserved LV ejection fraction were included in this study. According to LV mass index and relative wall thickness, patients were classified into four LV patterns: normal, concentric remodelling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). One hundred and sixteen patients (15%) had normal pattern, 66 (9%) had EH, 169 (23%) had CR, and 396 (53%) had CH. During a median follow-up of 6.4 years, 339 patients died (242 from cardiovascular causes). CH was associated with higher risk of all-cause mortality compared with the three other LV patterns (all P < 0.05). After multivariable adjustment, CH remained associated with higher risk of mortality (HR = 1.27, 95% CI 1.01-1.61, P = 0.046). There was a significant interaction (P < 0.05) between sex and CH with regards to the impact on mortality: CH was associated with worse outcome in women (P = 0.0001) but not in men (P = 0.22). In multivariable analysis, CH remained associated with higher risk of worse outcome in women (HR = 1.56, 95% CI 1.08-2.24, P = 0.018). Conclusions This study shows that CH was independently associated with increased risk of mortality in AS patients with preserved ejection fraction. This association was observed in women but not in men. The pattern of LV remodelling/hypertrophy should be integrated in the risk stratification process in patients with AS.
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Affiliation(s)
- Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Florent Le Ven
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Abdellaziz Dahou
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Christophe Thébault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Kim O'Connor
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
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Lee SR, Kim KH, You HS, Fu J, Hsieh TCM, Bhargava V, Raj Rajasekaran M. Characterization of age-related penile microvascular hemodynamic impairment using laser speckle contrast imaging: possible role of increased fibrogenesis. Physiol Rep 2018; 5:5/21/e13481. [PMID: 29122956 PMCID: PMC5688777 DOI: 10.14814/phy2.13481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/17/2017] [Indexed: 02/07/2023] Open
Abstract
Current technology for penile hemodynamic evaluations in small animals is invasive and has limitations. We evaluated a novel laser speckle contrast imaging (LSCI) technique to determine age‐related changes in penile microvascular perfusion (PMP) and tested the role of cavernosal muscle (CC) fibrosis mediated by Wnt‐TGF β1 signaling pathways in a mouse model. Ten young (2–3 months) and old (24–28 months) wild‐type C57BL6 male mice were subjected to PMP measured using a LSCI system. Penile blood flow (PBF, peak systolic velocity, PSV) was also measured using a color Doppler ultrasound for comparison. Measurements were made before and after injection of vasoactive drugs: prostaglandin E1 (PGE1) and acetylcholine (ACh). CC was processed for immunohistochemical studies for markers of endothelium and fibrosis. Protein levels were quantified by Western blot.PMP and PBF increased significantly from baseline after injection of vasoactive drugs. Peak PMP after PGE1 and ACh was higher in young mice (225.0 ± 12.0 and 211.3 ± 12.1 AU) compared to old (155.9 ± 7.1 and 162.6 ± 5.1 AU, respectively). PSV after PGE1 was higher in young than old mice (112.7 ± 8.5 vs. 78.2 ± 4.6 mm/sec). PSV after ACh was also higher in young (112.7 ± 5.6 mm/sec) than older mice (69.2 ± 7.1 mm/sec). PMP positively correlated with PSV (r = 0.867, P = 0.001). Immunostaining and Western blot showed increased protein expression of all fibrosis markers with aging. LSCI is a viable technique for evaluating penile hemodynamics. Increased cavernosal fibrosis may cause impaired penile hemodynamics and increased incidence of erectile dysfunction in older men.
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Affiliation(s)
- Seung-Ryeol Lee
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ki-Ho Kim
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Ho-Song You
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, Chonnam National University Hospital, Gwangju, Korea
| | - Johnny Fu
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - Tung-Chin Mike Hsieh
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - Valmik Bhargava
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - M Raj Rajasekaran
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
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Weech M, Altowaijri H, Mayneris-Perxachs J, Vafeiadou K, Madden J, Todd S, Jackson KG, Lovegrove JA, Yaqoob P. Replacement of dietary saturated fat with unsaturated fats increases numbers of circulating endothelial progenitor cells and decreases numbers of microparticles: findings from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study. Am J Clin Nutr 2018; 107:876-882. [PMID: 29741564 DOI: 10.1093/ajcn/nqy018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/18/2018] [Indexed: 01/07/2023] Open
Abstract
Background Endothelial progenitor cells (EPCs) and microparticles are emerging as novel markers of cardiovascular disease (CVD) risk, which could potentially be modified by dietary fat. We have previously shown that replacing dietary saturated fatty acids (SFAs) with monounsaturated or n-6 (ω-6) polyunsaturated fatty acids (MUFAs or PUFAs, respectively) improved lipid biomarkers, blood pressure, and markers of endothelial activation, but their effects on circulating EPCs and microparticles are unclear. Objective The Dietary Intervention and VAScular function (DIVAS) Study investigated the replacement of 9.5-9.6% of total energy (%TE) contributed by SFAs with MUFAs or n-6 PUFAs for 16 wk on EPC and microparticle numbers in United Kingdom adults with moderate CVD risk. Design In this randomized, controlled, single-blind, parallel-group dietary intervention, men and women aged 21-60 y (n = 190) with moderate CVD risk (≥50% above the population mean) consumed 1 of three 16-wk isoenergetic diets. Target compositions for total fat, SFAs, MUFAs, and n-6 PUFAs (%TE) were as follows: SFA-rich diet (36:17:11:4; n = 64), MUFA-rich diet (36:9:19:4; n = 62), and n-6 PUFA-rich diet (36:9:13:10; n = 66). Circulating EPC, endothelial microparticle (EMP), and platelet microparticle (PMP) numbers were analyzed by flow cytometry. Dietary intake, vascular function, and other cardiometabolic risk factors were determined at baseline. Results Relative to the SFA-rich diet, MUFA- and n-6 PUFA-rich diets decreased EMP (-47.3%, -44.9%) respectively and PMP (-36.8%, -39.1%) numbers (overall diet effects, P < 0.01). The MUFA-rich diet increased EPC numbers (+28.4%; P = 0.023). Additional analyses that used stepwise regression models identified the augmentation index (measuring arterial stiffness determined by pulse-wave analysis) as an independent predictor of baseline EPC and microparticle numbers. Conclusions Replacement of 9.5-9.6%TE dietary SFAs with MUFAs increased EPC numbers, and replacement with either MUFAs or n-6 PUFAs decreased microparticle numbers, suggesting beneficial effects on endothelial repair and maintenance. Further studies are warranted to determine the mechanisms underlying the favorable effects on EPC and microparticle numbers after SFA replacement. This trial was registered at www.clinicaltrials.gov as NCT01478958.
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Affiliation(s)
- Michelle Weech
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Hana Altowaijri
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Jordi Mayneris-Perxachs
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Katerina Vafeiadou
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Jacqueline Madden
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Susan Todd
- Department of Mathematics and Statistics, University of Reading, Whiteknights, Reading, United Kingdom
| | - Kim G Jackson
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Parveen Yaqoob
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
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Cheng L, Barlis P, Gibson J, Colville D, Hutchinson A, Gleeson G, Lamoureux E, VanGaal W, Savige J. Microvascular retinopathy and angiographically-demonstrated coronary artery disease: A cross-sectional, observational study. PLoS One 2018; 13:e0192350. [PMID: 29738542 PMCID: PMC5940193 DOI: 10.1371/journal.pone.0192350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/22/2018] [Indexed: 11/24/2022] Open
Abstract
Epidemiological studies suggest retinal microvascular abnormalities predict cardiac events. This study examined microvascular features associated with coronary artery abnormalities. This was a single-centre, cross-sectional, observational study of 144 consecutive subjects undergoing coronary angiography for clinical indications. Their angiograms were deidentified and graded for disease (Leaman score, LAD stenosis ≥ 70%, number of vessels stenosed ≥ 70%), and Thrombolysis in Myocardial Infarction (TIMI) blush score. Subjects also underwent retinal photography (KOWA non-mydriatic camera, Japan), and their deidentified retinal images were graded for hypertensive microvascular retinopathy (Wong and Mitchell classification), vessel calibre using a computer-assisted method (IVAN, U Wisconsin), and diabetic retinopathy (modified Airlie House scheme) independently by a trained grader and an ophthalmologist. Retinal abnormalities were compared between subjects with high and low angiography scores using one way ANOVA, Chi squared and logistic regression analysis (StataCorp, Texas). Subjects had a mean age of 61 years (range 32–88), and included 101 males (70%). Seventeen (12%) had Leaman scores > 10.5, 46 (32%) had LAD stenosis, 13 (9%) had ≥ 3 arteries stenosed, and 20 (14%) had TIMI blush scores < 1. Twenty-six subjects (18%) had a retinal hemorrhage, and 115 (74%) a mild or moderate hypertensive retinopathy. Fifty-five (38%) had diabetes, and 24 (17%) a background (n = 20) or proliferative (n = 4) diabetic retinopathy. A retinal hemorrhage (p = 0.046), moderate microvascular retinopathy (p = 0.08) and proliferative diabetic retinopathy (p = 0.04) were all associated with a higher Leaman score. Venular calibre was increased with triple vessel disease (205.7 ± 21.6 μm, and 193.7 ± 22.3 μm in normals, p = 0.03). Diabetic retinopathy correlated with an increased TIMI blush score (p = 0.01). Retinal microvascular imaging warrants further evaluation in identifying the presence, extent and nature of coronary artery disease.
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Affiliation(s)
- Lisa Cheng
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
| | - Peter Barlis
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
| | - Joel Gibson
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
| | - Deb Colville
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
| | - Anastasia Hutchinson
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
| | - Geoff Gleeson
- Department of Cardiology, Northern Health, Melbourne, Australia
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore
| | - William VanGaal
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
- Department of Cardiology, Northern Health, Melbourne, Australia
| | - Judy Savige
- The University of Melbourne, Department of Medicine, Northern Health, Melbourne, Australia
- The University of Melbourne Department of Medicine, Melbourne Health, Melbourne, Australia
- * E-mail:
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Lukaszewicz KM, Durand MJ, Priestley JRC, Schmidt JR, Allen LA, Geurts AM, Lombard JH. Evaluation of Vascular Control Mechanisms Utilizing Video Microscopy of Isolated Resistance Arteries of Rats. J Vis Exp 2017. [PMID: 29286398 DOI: 10.3791/56133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This protocol describes the use of in vitro television microscopy to evaluate vascular function in isolated cerebral resistance arteries (and other vessels), and describes techniques for evaluating tissue perfusion using Laser Doppler Flowmetry (LDF) and microvessel density utilizing fluorescently labeled Griffonia simplicifolia (GS1) lectin. Current methods for studying isolated resistance arteries at transmural pressures encountered in vivo and in the absence of parenchymal cell influences provide a critical link between in vivo studies and information gained from molecular reductionist approaches that provide limited insight into integrative responses at the whole animal level. LDF and techniques to selectively identify arterioles and capillaries with fluorescently-labeled GS1 lectin provide practical solutions to enable investigators to extend the knowledge gained from studies of isolated resistance arteries. This paper describes the application of these techniques to gain fundamental knowledge of vascular physiology and pathology in the rat as a general experimental model, and in a variety of specialized genetically engineered "designer" rat strains that can provide important insight into the influence of specific genes on important vascular phenotypes. Utilizing these valuable experimental approaches in rat strains developed by selective breeding strategies and new technologies for producing gene knockout models in the rat, will expand the rigor of scientific premises developed in knockout mouse models and extend that knowledge to a more relevant animal model, with a well understood physiological background and suitability for physiological studies because of its larger size.
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Affiliation(s)
| | | | | | - James R Schmidt
- Graduate Programs of Nurse Anesthesia, Texas Wesleyan University
| | | | - Aron M Geurts
- Department of Physiology, Medical College of Wisconsin
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Pierelli G, Stanzione R, Forte M, Migliarino S, Perelli M, Volpe M, Rubattu S. Uncoupling Protein 2: A Key Player and a Potential Therapeutic Target in Vascular Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:7348372. [PMID: 29163755 PMCID: PMC5661070 DOI: 10.1155/2017/7348372] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/19/2017] [Accepted: 09/10/2017] [Indexed: 12/17/2022]
Abstract
Uncoupling protein 2 (UCP2) is an inner mitochondrial membrane protein that belongs to the uncoupling protein family and plays an important role in lowering mitochondrial membrane potential and dissipating metabolic energy with prevention of oxidative stress accumulation. In the present article, we will review the evidence that UCP2, as a consequence of its roles within the mitochondria, represents a critical player in the predisposition to vascular disease development in both animal models and in humans, particularly in relation to obesity, diabetes, and hypertension. The deletion of the UCP2 gene contributes to atherosclerosis lesion development in the knockout mice, also showing significantly shorter lifespan. The UCP2 gene downregulation is a key determinant of higher predisposition to renal and cerebrovascular damage in an animal model of spontaneous hypertension and stroke. In contrast, UCP2 overexpression improves both hyperglycemia- and high-salt diet-induced endothelial dysfunction and ameliorates hypertensive target organ damage in SHRSP. Moreover, drugs (fenofibrate and sitagliptin) and several vegetable compounds (extracts from Brassicaceae, berberine, curcumin, and capsaicin) are able to induce UCP2 expression level and to exert beneficial effects on the occurrence of vascular damage. As a consequence, UCP2 becomes an interesting therapeutic target for the treatment of common human vascular diseases.
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Affiliation(s)
- Giorgia Pierelli
- Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy
| | | | | | - Serena Migliarino
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Marika Perelli
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Massimo Volpe
- IRCCS Neuromed, Pozzilli, Isernia, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Speranza Rubattu
- IRCCS Neuromed, Pozzilli, Isernia, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Tadic M, Cuspidi C, Vukomanovic V, Ilic S, Obert P, Kocijancic V, Celic V. Layer-specific deformation of the left ventricle in uncomplicated patients with type 2 diabetes and arterial hypertension. Arch Cardiovasc Dis 2017; 111:17-24. [PMID: 28927959 DOI: 10.1016/j.acvd.2017.01.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 12/14/2016] [Accepted: 01/25/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Detailed analysis of layer-specific mechanical changes in patients with type 2 diabetes mellitus (DM) might improve insight into left ventricular (LV) remodelling and diabetic cardiomyopathy. AIM We sought to investigate layer-specific LV deformation in patients with DM, with and without hypertension. METHODS This cross-sectional study included 146 subjects (44 controls; 48 patients with DM; 54 patients with DM and hypertension) who underwent complete examination by two-dimensional echocardiography (2DE), including multilayer strain analysis. RESULTS 2DE LV longitudinal and circumferential strains deteriorated progressively and significantly from controls, through patients with DM, to patients with DM and hypertension. 2DE radial strain was lower in patients with DM and hypertension than in controls. 2DE longitudinal and circumferential mid-myocardial and epicardial layer strains decreased progressively from controls to patients with DM and hypertension, whereas endocardial layer strain was lower in patients with DM and patients with DM and hypertension than in controls. Variables of DM control (fasting glucose and glycated haemoglobin) were associated with 2DE LV longitudinal and circumferential layer-specific strains, independent of age, body mass index, blood pressure, LV diastolic function and hypertrophy in patients with DM. CONCLUSION DM and hypertension significantly affect LV deformation assessed by 2DE traditional strain and 2DE multilayer strain. Hypertension showed an additional negative effect on LV deformation in patients with DM. Fasting glucose and glycated haemoglobin were associated with LV mechanics evaluated by comprehensive 2DE strain analysis, independent of LV structure and diastolic function.
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Affiliation(s)
- Marijana Tadic
- Department of Cardiology, University Hospital "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Cesare Cuspidi
- Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy
| | - Vladan Vukomanovic
- Department of Cardiology, University Hospital "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia
| | - Sanja Ilic
- Department of Endocrinology, University Hospital "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia
| | - Philippe Obert
- LAPEC EA4278, School of Exercise Science, Avignon University, Avignon, France
| | - Vesna Kocijancic
- Department of Cardiology, University Hospital "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia
| | - Vera Celic
- Department of Cardiology, University Hospital "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Csiszar A, Tarantini S, Fülöp GA, Kiss T, Valcarcel-Ares MN, Galvan V, Ungvari Z, Yabluchanskiy A. Hypertension impairs neurovascular coupling and promotes microvascular injury: role in exacerbation of Alzheimer's disease. GeroScience 2017; 39:359-372. [PMID: 28853030 PMCID: PMC5636770 DOI: 10.1007/s11357-017-9991-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022] Open
Abstract
Hypertension in the elderly substantially increases both the risk of vascular cognitive impairment (VCI) and Alzheimer's disease (AD); however, the underlying mechanisms are not completely understood. This review discusses the effects of hypertension on structural and functional integrity of cerebral microcirculation, including hypertension-induced alterations in neurovascular coupling responses, cellular and molecular mechanisms involved in microvascular damage (capillary rarefaction, blood-brain barrier disruption), and the genesis of cerebral microhemorrhages and their potential role in exacerbation of cognitive decline associated with AD. Understanding and targeting the hypertension-induced cerebromicrovascular alterations that are involved in the onset and progression of AD and contribute to cognitive impairment are expected to have a major role in preserving brain health in high-risk older individuals.
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Affiliation(s)
- Anna Csiszar
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stefano Tarantini
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Gábor A Fülöp
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Division of Clinical Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamas Kiss
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - M Noa Valcarcel-Ares
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Veronica Galvan
- Department of Cellular and Integrative Physiology, Barshop Institute for Longevity and Aging Studies University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Zoltan Ungvari
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Andriy Yabluchanskiy
- Reynolds Oklahoma Center on Aging, Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Translational Geroscience Laboratory, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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The role of laser Doppler flowmetry tests, serum angiopoietin-2, asymmetric and symmetric dimethylarginine to predict outcome in chronic kidney disease. J Hypertens 2017; 35:1109-1118. [DOI: 10.1097/hjh.0000000000001256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Govoni V, Sanders TAB, Reidlinger DP, Darzi J, Berry SEE, Goff LM, Seed PT, Chowienczyk PJ, Hall WL. Compliance with dietary guidelines affects capillary recruitment in healthy middle-aged men and women. Eur J Nutr 2017; 56:1037-1044. [PMID: 26746219 PMCID: PMC5346414 DOI: 10.1007/s00394-015-1151-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/23/2015] [Indexed: 10/27/2022]
Abstract
PURPOSE Healthy microcirculation is important to maintain the health of tissues and organs, most notably the heart, kidney and retina. Single components of the diet such as salt, lipids and polyphenols may influence microcirculation, but the effects of dietary patterns that are consistent with current dietary guidelines are uncertain. It was hypothesized that compliance to UK dietary guidelines would have a favourable effect on skin capillary density/recruitment compared with a traditional British diet (control diet). METHODS A 12-week randomized controlled trial in men and women aged 40-70 years was used to test whether skin microcirculation, measured by skin video-capillaroscopy on the dorsum of the finger, influenced functional capillary density (number of capillaries perfused under basal conditions), structural capillary density (number of anatomical capillaries perfused during finger cuff inflation) and capillary recruitment (percentage difference between structural and functional capillary density). RESULTS Microvascular measures were available for 137 subjects out of the 165 participants randomized to treatment. There was evidence of compliance to the dietary intervention, and participants randomized to follow dietary guidelines showed significant falls in resting supine systolic, diastolic and mean arterial pressure of 3.5, 2.6 and 2.9 mmHg compared to the control diet. There was no evidence of differences in capillary density, but capillary recruitment was 3.5 % (95 % CI 0.2, 6.9) greater (P = 0.04) on dietary guidelines compared with control. CONCLUSIONS Adherence to dietary guidelines may help maintain a healthy microcirculation in middle-aged men and women. This study is registered at www.isrctn.com as ISRCTN92382106.
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Affiliation(s)
- Virginia Govoni
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Thomas A B Sanders
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Dianne P Reidlinger
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Julia Darzi
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Sarah E E Berry
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Louise M Goff
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - Paul T Seed
- Women's Health Division, King's College London, St Thomas' Hospital, London, UK
| | - Philip J Chowienczyk
- British Heart Foundation Centre, School of Medicine, King's College London, St Thomas' Hospital, London, UK
| | - Wendy L Hall
- Diabetes and Nutritional Sciences Division, Faculty of Life Sciences and Medicine, King's College London, 4.108 Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK.
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Burkhardt D, Bartosova M, Schaefer B, Grabe N, Lahrmann B, Nasser H, Freise C, Schneider A, Lingnau A, Degenhardt P, Ranchin B, Sallay P, Cerkauskiene R, Malina M, Ariceta G, Schmitt CP, Querfeld U. Reduced Microvascular Density in Omental Biopsies of Children with Chronic Kidney Disease. PLoS One 2016; 11:e0166050. [PMID: 27846250 PMCID: PMC5113061 DOI: 10.1371/journal.pone.0166050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/21/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Endothelial dysfunction is an early manifestation of cardiovascular disease (CVD) and consistently observed in patients with chronic kidney disease (CKD). We hypothesized that CKD is associated with systemic damage to the microcirculation, preceding macrovascular pathology. To assess the degree of "uremic microangiopathy", we have measured microvascular density in biopsies of the omentum of children with CKD. PATIENTS AND METHODS Omental tissue was collected from 32 healthy children (0-18 years) undergoing elective abdominal surgery and from 23 age-matched cases with stage 5 CKD at the time of catheter insertion for initiation of peritoneal dialysis. Biopsies were analyzed by independent observers using either a manual or an automated imaging system for the assessment of microvascular density. Quantitative immunohistochemistry was performed for markers of autophagy and apoptosis, and for the abundance of the angiogenesis-regulating proteins VEGF-A, VEGF-R2, Angpt1 and Angpt2. RESULTS Microvascular density was significantly reduced in uremic children compared to healthy controls, both by manual imaging with a digital microscope (median surface area 0.61% vs. 0.95%, p<0.0021 and by automated quantification (total microvascular surface area 0.89% vs. 1.17% p = 0.01). Density measured by manual imaging was significantly associated with age, height, weight and body surface area in CKD patients and healthy controls. In multivariate analysis, age and serum creatinine level were the only independent, significant predictors of microvascular density (r2 = 0.73). There was no immunohistochemical evidence for apoptosis or autophagy. Quantitative staining showed similar expression levels of the angiogenesis regulators VEGF-A, VEGF-receptor 2 and Angpt1 (p = 0.11), but Angpt2 was significantly lower in CKD children (p = 0.01). CONCLUSIONS Microvascular density is profoundly reduced in omental biopsies of children with stage 5 CKD and associated with diminished Angpt2 signaling. Microvascular rarefaction could be an early systemic manifestation of CKD-induced cardiovascular disease.
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Affiliation(s)
- Dorothea Burkhardt
- Department of Pediatric Nephrology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Bartosova
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Betti Schaefer
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Niels Grabe
- Bioquant, Hamamatsu Tissue Imaging and Analysis (TIGA) Center, University of Heidelberg, Heidelberg, Germany
| | - Bernd Lahrmann
- Bioquant, Hamamatsu Tissue Imaging and Analysis (TIGA) Center, University of Heidelberg, Heidelberg, Germany
| | - Hamoud Nasser
- Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Freise
- Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Axel Schneider
- Department of Pediatric Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Lingnau
- Department of Pediatric Urology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Petra Degenhardt
- Department of Pediatric Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Pediatric Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Bruno Ranchin
- Hospices Civils de Lyon, Service de Nephrologie Pediatrique and Epicime-Centre d’Investigation Clinique 1407, Hopital Femme Mere Enfant, Lyon, France
| | - Peter Sallay
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Rimante Cerkauskiene
- Coordinating Centre for Children’s Rare Diseases, Children´s Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | - Michal Malina
- Department of Pediatrics, Second Faculty of Medicine, Charles University-Prague, Prague 5, Czech Republic
| | - Gema Ariceta
- Servicio de Nefrología Pediátrica, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Claus Peter Schmitt
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Uwe Querfeld
- Department of Pediatric Nephrology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Center for Cardiovascular Research, Charité Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
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Gupta A, Bhatnagar S. Vasoregression: A Shared Vascular Pathology Underlying Macrovascular And Microvascular Pathologies? OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2016; 19:733-53. [PMID: 26669709 DOI: 10.1089/omi.2015.0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vasoregression is a common phenomenon underlying physiological vessel development as well as pathological microvascular diseases leading to peripheral neuropathy, nephropathy, and vascular oculopathies. In this review, we describe the hallmarks and pathways of vasoregression. We argue here that there is a parallel between characteristic features of vasoregression in the ocular microvessels and atherosclerosis in the larger vessels. Shared molecular pathways and molecular effectors in the two conditions are outlined, thus highlighting the possible systemic causes of local vascular diseases. Our review gives us a system-wide insight into factors leading to multiple synchronous vascular diseases. Because shared molecular pathways might usefully address the diagnostic and therapeutic needs of multiple common complex diseases, the literature analysis presented here is of broad interest to readership in integrative biology, rational drug development and systems medicine.
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Affiliation(s)
- Akanksha Gupta
- 1 Computational and Structural Biology Laboratory, Division of Biotechnology, Netaji Subhas Institute of Technology , Dwarka, New Delhi, India .,2 Department of Biotechnology, IMS Engineering College , Ghaziabad, India
| | - Sonika Bhatnagar
- 1 Computational and Structural Biology Laboratory, Division of Biotechnology, Netaji Subhas Institute of Technology , Dwarka, New Delhi, India
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Abstract
Hypertension is associated with alterations in the vascular structure, which in turn enhance the risk of cardiovascular events. Notably, anti-hypertensive treatment may prevent or regress the changes of arterial wall structures. Lercanidipine is a third-generation CCB with peculiar pharmaceutical properties. Enalapril is an effective drug acting on the renin-angiotensin-aldosterone axis. This commentary discusses the vascular effects of the lercanidipine/enalapril combination, and comments on their potential clinical relevance.
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Affiliation(s)
- Gianfranco Parati
- a Department of Medicine and Surgery, University of Milan-Bicocca , Milan , Italy
- b Department of Cardiovascular Neural and Metabolic Sciences, S.Luca Hospital, IRCCS Istituto Auxologico Italiano , Milan , Italy
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50
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Hillard JG, Gast TJ, Chui TY, Sapir D, Burns SA. Retinal Arterioles in Hypo-, Normo-, and Hypertensive Subjects Measured Using Adaptive Optics. Transl Vis Sci Technol 2016; 5:16. [PMID: 27617182 PMCID: PMC5015982 DOI: 10.1167/tvst.5.4.16] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/07/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Small artery and arteriolar walls thicken due to elevated blood pressure. Vascular wall thickness show a correlation with hypertensive subject history and risk for stroke and cardiovascular events. METHODS The inner and outer diameter of retinal arterioles from less than 10 to over 150 μm were measured using a multiply scattered light adaptive optics scanning laser ophthalmoscope (AOSLO). These measurements were made on three populations, one with habitual blood pressures less than 100/70 mm Hg, one with normal blood pressures without medication, and one with managed essential hypertension. RESULTS The wall to lumen ratio was largest for the smallest arterioles for all three populations. Data from the hypotensive group had a linear relationship between outer and inner diameters (r2 = 0.99) suggesting a similar wall structure in individuals prior to elevated blood pressures. Hypertensive subjects fell below the 95% confidence limits for the hypotensive relationship and had larger wall to lumen ratios and the normotensive group results fell between the other two groups. CONCLUSION High-resolution retinal imaging of subjects with essential hypertension showed a significant decrease in vessel inner diameter for a given outer diameter, and increases in wall to lumen ratio and wall cross-sectional areas over the entire range of vessel diameters and suggests that correcting for vessel size may improve the ability to identify significant vascular changes. TRANSLATIONAL RELEVANCE High-resolution imaging allows precise measurement of vasculature and by comparing results across risk populations may allow improved identification of individuals undergoing hypertensive arterial wall remodeling.
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Affiliation(s)
| | | | | | - Dan Sapir
- Indiana University Bloomington, IN, USA
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