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Hajdusianek W, Żórawik A, Macek P, Poręba M, Poręba R, Gać P. Stiffness and Elasticity of Aorta Assessed Using Computed Tomography Angiography as a Marker of Cardiovascular Health-A Cross-Sectional Study. J Clin Med 2024; 13:384. [PMID: 38256515 PMCID: PMC10816888 DOI: 10.3390/jcm13020384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/21/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Cardiovascular (CV) health can be measured using the American Health Association's Life's Simple 7 scale (ALS7). Aortic stiffness (AoS) and elasticity (AoE) can be assessed using various methods, e.g., computed tomography (CT). To measure AoE, we use aortic strain and distensibility (AoD). The aim of this study was to examine the relationship between ALS7, AoS, and AoE. The study group (SG) was composed of 96 patients (mean age 70.41 ± 8.32 years) with a BMI of 25.58 ± 3.12 kg/m2; 28.1% were smokers, 54.2% had hypertension, 11.4% had diabetes, and 67.7% had hypercholesterolemia. The SG was further divided into three subgroups (optimal (ALS7-H), intermediate (ALS7-I), and inadequate (ALS7-L)) based on the ALS7. The AoS and AoE were assessed in each of them. We found that the ALS7-I and ALS7-H had significantly lower AoS values compared to the ALS7-L (AoS: 3.50 ± 0.53 and 4.10 ± 0.70 vs. 4.57 ± 1.03, respectively). The opposite relationship was observed for AoE measured with AoD in the ALS7-H vs. ALS7-L (AoD: 0.23 ± 0.14 vs. 0.11 ± 0.09 cm2/dyn). AoS correlated (r = 0.61) with systolic blood pressure (BP). In our regression model, higher scores on the ALS7 in BP, smoking, and BMI were independent protective factors against greater AoS. Higher ALS7 scores in BP, smoking, BMI, and physical activity were protective factors against lesser aortic strain. Higher scores in ALS7 for BP and smoking were protective factors against lesser AoD. We conclude that better cardiovascular health expressed via higher scores obtained on the ALS7 is associated with lower AoS and higher AoE on CT.
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Affiliation(s)
- Wojciech Hajdusianek
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368 Wroclaw, Poland
| | - Aleksandra Żórawik
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368 Wroclaw, Poland
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Małgorzata Poręba
- Department of Paralympic Sports, Wroclaw University of Health and Sport Sciences, Witelona 25a, 51-617 Wroclaw, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Paweł Gać
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368 Wroclaw, Poland
- Centre of Diagnostic Imaging, 4th Military Hospital, Weigla 5, 50-981 Wroclaw, Poland
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Jonsson A, Holmer J, Kullman L, Eriksdotter M, Ahlqvist J, Levring Jäghagen E, Buhlin K. Calcified carotid artery atheromas in individuals with cognitive dysfunction. Acta Odontol Scand 2022; 81:325-331. [PMID: 36538364 DOI: 10.1080/00016357.2022.2152863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this case-control study was to investigate whether cognitively impaired individuals have a higher burden of calcified carotid artery atheroma (CCAA) than controls without cognitive impairment. MATERIAL AND METHODS The study included 154 cases with Alzheimer's disease (n = 52), mild cognitive impairment (n = 51), or subjective cognitive decline (n = 51) diagnosed at a university memory clinic. Seventy-six cognitively healthy controls were sampled through the Swedish population register. All participants underwent clinical oral and panoramic radiographic examinations. Two oral and maxillofacial radiologists performed blinded analyses of the panoramic radiographs for signs of CCAA, which was registered as absent or present and, if present, unilateral or bilateral. Consensus assessment was used for all statistical analyses. RESULTS CCAA was common (40%) in this middle-aged and older Swedish population. We found no differences in the prevalence of CCAA between cases and controls (40% vs. 42%). CONCLUSION Cognitively impaired patients do not have a higher burden of CCAA than matched controls without cognitive impairment.
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Affiliation(s)
- Anton Jonsson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Department of Periodontology, Public Dental Service at Eastmaninstitutet, Stockholm County Council, Stockholm, Sweden
| | - Jacob Holmer
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Leif Kullman
- Division of Oral and Maxillofacial Radiology, Department of Dental Medicine Karolinska Institutet, Huddinge, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Jan Ahlqvist
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Eva Levring Jäghagen
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Huo R, Liu Y, Xu H, Li J, Xin R, Xing Z, Deng S, Wang T, Yuan H, Zhao X. Associations between carotid atherosclerotic plaque characteristics determined by magnetic resonance imaging and improvement of cognition in patients undergoing carotid endarterectomy. Quant Imaging Med Surg 2022; 12:2891-2903. [PMID: 35502372 PMCID: PMC9014142 DOI: 10.21037/qims-21-981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/05/2022] [Indexed: 08/29/2023]
Abstract
BACKGROUND To determine the predictive value of carotid plaque characteristics for the improvement of cognition in patients with moderate-to-severe carotid stenosis after carotid endarterectomy (CEA), using vessel wall magnetic resonance imaging (MRI). METHODS This was a prospective cohort study. Patients with unilateral, moderate-to-severe carotid stenosis referred to the Peking University Third Hospital for CEA were prospectively recruited and underwent carotid vessel wall MRI within 1 week before CEA. We performed Montreal Cognitive Assessment (MoCA) within 1 week before and 3-4 days after CEA. The morphological and compositional characteristics of carotid plaques on MRI were evaluated. Improvement of cognition was defined as >10% increase of the total MoCA score after CEA compared with baseline. Carotid plaque characteristics were compared between patients with and without cognitive improvement. RESULTS In total, 105 patients (91 males; mean age, 65.5±8.4 years) were included. The volume {48.0 [interquartile range (IQR), 21.0 to 91.6] vs. 16.3 (IQR, 8.1 to 53.1) mm3; P=0.005} and cumulative slice [4.0 (IQR, 3.0 to 7.0) vs. 3.0 (IQR, 2.0 to 5.0); P=0.019] of carotid calcification, and maximum percentage of calcification area [13.1% (IQR, 6.0% to 19.8%) vs. 6.2% (IQR, 3.7% to 10.8%); P=0.004] were significantly smaller in participants with cognitive improvement compared to those without. Univariate logistic regression analysis showed that volume [odds ratio (OR) =0.994; 95% confidence interval (CI): 0.989 to 1.000; P=0.043] and cumulative slice (OR =0.823; 95% CI: 0.698 to 0.970; P=0.020) of carotid calcification, and maximum percentage of calcification area (OR =0.949; 95% CI: 0.909 to 0.991; P=0.018) were significantly correlated with cognitive improvement. After adjusting for confounding factors, these associations remained statistically or marginally significant (volume: OR =0.994; 95% CI: 0.988 to 1.000; P=0.057; maximum percentage of calcification area: OR =0.937; 95% CI: 0.890 to 0.987; P=0.014; and cumulative slice: OR =0.791; 95% CI: 0.646 to 0.967; P=0.022). No significant associations were found between other plaque characteristics and cognitive improvement (all P>0.05). CONCLUSIONS More than half of the participants with unilateral, moderate-to-severe carotid atherosclerotic stenosis had cognitive improvement. The size of calcification might be an effective indicator of cognitive improvement after CEA.
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Affiliation(s)
- Ran Huo
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Ying Liu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Huimin Xu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Jin Li
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ruijing Xin
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhangli Xing
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shasha Deng
- School of Medical Imaging, Changsha Medical University, Changsha, China
| | - Tao Wang
- Department of Neurosurgery, Peking University Third Hospital, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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Vitamin K2 Holds Promise for Alzheimer's Prevention and Treatment. Nutrients 2021; 13:nu13072206. [PMID: 34199021 PMCID: PMC8308377 DOI: 10.3390/nu13072206] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
Recent studies have highlighted the importance of vitamin K2 (VK2) in human health. However, there have been no clinical studies investigating the role of VK2 in the prevention or treatment of Alzheimer's disease (AD), a debilitating disease for which currently there is no cure. In reviewing basic science research and clinical studies that have connected VK2 to factors involved in AD pathogenesis, we have found a growing body of evidence demonstrating that VK2 has the potential to slow the progression of AD and contribute to its prevention. In our review, we consider the antiapoptotic and antioxidant effects of VK2 and its impact on neuroinflammation, mitochondrial dysfunction, cognition, cardiovascular health, and comorbidities in AD. We also examine the link between dysbiosis and VK2 in the context of the microbiome's role in AD pathogenesis. Our review is the first to consider the physiological roles of VK2 in the context of AD, and, given the recent shift in AD research toward nonpharmacological interventions, our findings emphasize the timeliness and need for clinical studies involving VK2.
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Wang Y, Li C, Ding M, Lin L, Li P, Wang Y, Dong Q, Yang Y, Cui M. Carotid Atherosclerotic Calcification Characteristics Relate to Post-stroke Cognitive Impairment. Front Aging Neurosci 2021; 13:682908. [PMID: 34113247 PMCID: PMC8185032 DOI: 10.3389/fnagi.2021.682908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Together with cerebral small vessel disease (CSVD), large vessel atherosclerosis is considered to be an equally important risk factor in the progression of vascular cognitive impairment. This article aims to investigate whether carotid atherosclerotic calcification is associated with the increased risk of post-stroke cognitive impairment (PSCI). Methods: A total of 128 patients (mean age: 62.1 ± 12.2 years, 37 women) suffering from ischemic stroke underwent brain/neck computer tomography angiography examination. The presence and characteristic of carotid calcification (size, number and location) were analyzed on computer tomography angiography. White matter hyperintensity (WMH) was assessed using Fazekas scales. PSCI was diagnosed based on a battery of neuropsychological assessments implemented 6−12 months after stroke. Results: Among 128 patients, 26 developed post-stroke dementia and 96 had carotid calcification. Logistic regression found carotid calcification (odds ratio [OR] = 7.15, 95% confidence interval [CI]: 1.07–47.69) and carotid artery stenosis (OR = 6.42, 95% CI: 1.03–40.15) both significantly increased the risk for post-stroke dementia. Moreover, multiple, thick/mixed, and surface calcifications exhibited an increasing trend in PSCI (Ptrend = 0.004, 0.016, 0.045, respectively). The prediction model for post-stroke dementia including carotid calcification (area under curve = 0.67), WMH (area under curve = 0.67) and other covariates yielded an area under curve (AUC) of 0.90 (95% CI: 0.82–0.99). Conclusion: Our findings demonstrated that the quantity and location of carotid calcifications were independent indicators for PSCI. The significant role of large vessel atherosclerosis in PSCI should be concerned in future study.
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Affiliation(s)
- Yingzhe Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chanchan Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Mengyuan Ding
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Luyi Lin
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Peixi Li
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yizhe Wang
- Department of Medicine, Nanchang University, Nanchang, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yanmei Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,The State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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Intracranial artery calcifications: Risk factors and association with cardiovascular disease and cognitive function. J Neuroradiol 2020; 49:281-287. [DOI: 10.1016/j.neurad.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/27/2020] [Accepted: 08/13/2020] [Indexed: 11/21/2022]
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Gallo G, Bianchi F, Cotugno M, Volpe M, Rubattu S. Natriuretic Peptides, Cognitive Impairment and Dementia: An Intriguing Pathogenic Link with Implications in Hypertension. J Clin Med 2020; 9:jcm9072265. [PMID: 32708758 PMCID: PMC7408839 DOI: 10.3390/jcm9072265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/30/2020] [Accepted: 07/15/2020] [Indexed: 12/11/2022] Open
Abstract
The natriuretic peptides (NPs) belong to a family of cardiac hormones that exert relevant protective functions within the cardiovascular system. An increase of both brain and atrial natriuretic peptide levels, particularly of the amino-terminal peptides (NT-proBNP and NT-proANP), represents a marker of cardiovascular damage. A link between increased NP levels and cognitive decline and dementia has been reported in several human studies performed both in general populations and in cohorts of patients affected by cardiovascular diseases (CVDs). In particular, it was reported that the elevation of NP levels in dementia can be both dependent and independent from CVD risk factors. In the first case, it may be expected that, by counteracting early on the cardiovascular risk factor load and the pathological processes leading to increased aminoterminal natriuretic peptide (NT-proNP) level, the risk of dementia could be significantly reduced. In case of a link independent from CVD risk factors, an increased NP level should be considered as a direct marker of neuronal damage. In the context of hypertension, elevated NT-proBNP and mid-regional (MR)-proANP levels behave as markers of brain microcirculatory damage and dysfunction. The available evidence suggests that they could help in identifying those subjects who would benefit most from a timely antihypertensive therapy.
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Affiliation(s)
- Giovanna Gallo
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy; (G.G.); (M.V.)
| | - Franca Bianchi
- IRCCS Neuromed, 86077 Pozzilli (Isernia), Italy; (F.B.); (M.C.)
| | - Maria Cotugno
- IRCCS Neuromed, 86077 Pozzilli (Isernia), Italy; (F.B.); (M.C.)
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy; (G.G.); (M.V.)
- IRCCS Neuromed, 86077 Pozzilli (Isernia), Italy; (F.B.); (M.C.)
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy; (G.G.); (M.V.)
- IRCCS Neuromed, 86077 Pozzilli (Isernia), Italy; (F.B.); (M.C.)
- Correspondence:
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