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Triantafyllias K, Thiele LE, Cavagna L, Baraliakos X, Bertsias G, Schwarting A. Arterial Stiffness as a Surrogate Marker of Cardiovascular Disease and Atherosclerosis in Patients with Arthritides and Connective Tissue Diseases: A Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13111870. [PMID: 37296720 DOI: 10.3390/diagnostics13111870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The increased cardiovascular (CV) risk among patients with autoimmune rheumatic diseases, such as arthritides and connective tissue diseases, has been extensively documented. From a pathophysiological standpoint, systemic inflammation in the context of the disease can lead to endothelial dysfunction, accelerated atherosclerosis, and structural changes in vessel walls, which, in turn, are associated with exaggerated CV morbidity and mortality. In addition to these abnormalities, the increased prevalence of traditional CV risk factors, such as obesity, dyslipidemia, arterial hypertension, and impaired glucose metabolism, can further worsen the status of and overall prognosis for CV in rheumatic patients. However, data on appropriate CV screening methods for patients with systemic autoimmune diseases are scarce, and traditional algorithms may lead to an underestimation of the true CV risk. The reason for this is that these calculations were developed for the general population and thus do not take into account the effect of the inflammatory burden, as well as other chronic-disease-associated CV risk factors. In recent years, different research groups, including ours, have examined the value of different CV surrogate markers, including carotid sonography, carotid-femoral pulse wave velocity, and flow-mediated arterial dilation, in the assessment of CV risk in healthy and rheumatic populations. In particular, arterial stiffness has been thoroughly examined in a number of studies, showing high diagnostic and predictive value for the occurrence of CV events. To this end, the present narrative review showcases a series of studies examining aortic and peripheral arterial stiffness as surrogates of all-cause CV disease and atherosclerosis in patients with rheumatoid and psoriatic arthritis, as well as in systemic lupus erythematosus and systemic sclerosis. Moreover, we discuss the associations of arterial stiffness with clinical, laboratory, and disease-specific parameters.
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Affiliation(s)
- Konstantinos Triantafyllias
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Leif-Erik Thiele
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
| | - Lorenzo Cavagna
- Department of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation Pavia, 27100 Pavia, Italy
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, 44649 Herne, Germany
| | - George Bertsias
- Department of Internal Medicine and Rheumatology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Andreas Schwarting
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
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Waddell HMM, Moore MK, Herbert-Olsen MA, Stiles MK, Tse RD, Coffey S, Lamberts RR, Aitken-Buck HM. Identifying sex differences in predictors of epicardial fat cell morphology. Adipocyte 2022; 11:325-334. [PMID: 35531882 PMCID: PMC9122305 DOI: 10.1080/21623945.2022.2073854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 11/12/2022] Open
Abstract
Predictors of overall epicardial adipose tissue deposition have been found to vary between males and females. Whether similar sex differences exist in epicardial fat cell morphology is currently unknown. This study aimed to determine whether epicardial fat cell size is associated with different clinical measurements in males and females. Fat cell sizes were measured from epicardial, paracardial, and appendix adipose tissues of post-mortem cases (N= 118 total, 37 females). Epicardial, extra-pericardial, and visceral fat volumes were measured by computed tomography from a subset of cases (N= 70, 22 females). Correlation analyses and stepwise linear regression were performed to identify predictors of fat cell size in males and females. Median fat cell sizes in all depots did not differ between males and females. Body mass index (BMI) and age were independently predictive of epicardial, paracardial, and appendix fat cell sizes in males, but not in females. Epicardial and appendix fat cell sizes were associated with epicardial and visceral fat volumes, respectively, in males only. In females, paracardial fat cell size was associated with extra-pericardial fat volume, while appendix fat cell size was associated with BMI only. No predictors were associated with epicardial fat cell size in females at the univariable or multivariable levels. To conclude, no clinical measurements were useful surrogates of epicardial fat cell size in females, while BMI, age, and epicardial fat volume were independent, albeit weak, predictors in males only.
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Affiliation(s)
- Helen M. M. Waddell
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Matthew K. Moore
- Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Morgan A. Herbert-Olsen
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Martin K. Stiles
- Department of Cardiology, Waikato District Health Board, Hamilton, New Zealand
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand
| | - Rexson D. Tse
- Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Sean Coffey
- Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Cardiology, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand
| | - Regis R. Lamberts
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Hamish M. Aitken-Buck
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
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Yuvaraj J, Isa M, Che ZC, Lim E, Nerlekar N, Nicholls SJ, Seneviratne S, Lin A, Dey D, Wong DTL. Atherogenic index of plasma is associated with epicardial adipose tissue volume assessed on coronary computed tomography angiography. Sci Rep 2022; 12:9626. [PMID: 35688850 PMCID: PMC9187675 DOI: 10.1038/s41598-022-13479-5] [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: 11/09/2021] [Accepted: 05/25/2022] [Indexed: 11/09/2022] Open
Abstract
The atherogenic index of plasma (AIP) is a novel biomarker of atherogenic dyslipidaemia (AD), but its relationship with cardiac adipose tissue depots is unknown. We aimed to assess the association of AD with cardiac adipose tissue parameters on coronary computed tomography angiography (CCTA). We studied 161 patients who underwent CCTA between 2008 and 2011 (age 59.0 ± 14.0 years). AD was defined as triglyceride (TG) > 1.7 mmol/L and HDL < 1.0 mmol/L (n = 34). AIP was defined as the base 10 logarithmic ratio of TG to HDL. Plaque burden was assessed using the CT-Leaman score (CT-LeSc). We studied volume and attenuation of epicardial adipose tissue (EAT-v and EAT-a) and pericoronary adipose tissue (PCAT-v and PCAT-a) on CCTA using semi-automated software. Patients with AD had higher PCAT-v (p = 0.042) and EAT-v (p = 0.041). AIP was associated with EAT-v (p = 0.006), type II diabetes (p = 0.009) and male sex (p < 0.001) and correlated with CT-LeSc (p = 0.040). On multivariable analysis, AIP was associated with EAT-v ≥ 52.3 cm3, age, male sex and type II diabetes when corrected for traditional risk factors and plaque burden. AIP is associated with increased EAT volume, but not PCAT-a, after multivariable adjustment. These findings indicate AIP is associated with adverse adipose tissue changes which may increase coronary risk.
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Affiliation(s)
- Jeremy Yuvaraj
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.,School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Mourushi Isa
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Zhu Chung Che
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Egynne Lim
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.,School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Sujith Seneviratne
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.,School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew Lin
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.,School of Clinical Sciences, Monash University, Clayton, VIC, Australia.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Victorian Heart Institute, MonashHeart and Monash University, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia. .,School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
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Podzolkov VI, Bragina AE, Osadchiy KK, Rodionova YN, Jafarova ZB, Lobanova MV, Larionova YS. Relationship between the volume of perivascular adipose tissue and the vascular wall lesion. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the relationship between the volume of perivascular adipose tissue (PVAT) and the vascular wall lesion.Material and methods. The study included 318 patients without cardiovascular disease (mean age, 63,5±13,7 years). Hypertension was detected in 268 (84,3%) patients. All patients underwent assessment of anthropometric characteristics, lipid profile, arterial wall stiffness with the estimation of cardio-ankle vascular index, intima-media thickness, brachial artery endothelial vasomotor function. Chest computed tomography was performed with the estimation of the volumes of PVAT and pericardial adipose tissue (PAT).Results. The volume of PVAT, on average, was 0,3 [0,2; 0,4] cm3 . The VAT volume was significantly higher in obese individuals when compared with patients with normal body weight: 0,4 [0,3; 0,5] vs 0,25 [0,2; 0,4] cm3 (p=0,0007). The VAT volume was higher in individuals with an increased CAVI level when compared with patients with normal CAVI values: 0,4 [0,3; 0,5] vs 0,3 [0,25; 0,3] (p=0,02). A significant correlation was found between the VAT volume and body mass index (r=0,27, p<0,005), waist circumference (r=0,41, p<0,005), CAVI (r=0,49, p<0,05), impaired endothelium-dependent brachial artery vasodilation (r=0,38, p<0,05). When performing multiple linear regression, a significant relationship of CAVI was found with age (β±SE, 0,51±0,15; p=0,002) and volume of PVAT (β±SE, 0,41±0,13; p=0,005).Conclusion. The results indicate the relationship of PVAT with visceral obesity and vascular wall stiffness parameters.
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Ballenger BK, Hunter GR, Fisher G. Vascular hemodynamics and blood pressure differences between young and older women. Clin Hypertens 2021; 27:25. [PMID: 34776005 PMCID: PMC8591875 DOI: 10.1186/s40885-021-00181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cardiovascular disease is one of the main causes of death in the United States, and hypertension is a primary risk factor. Therefore, the primary causes of hypertension need to be identified so they may be addressed for treatment. The purpose of this study was to compare blood pressure with hemodynamic values and identify factors that may explain blood pressure differences between a cohort of healthy normotensive younger and older women. Methods Participants were 49 young (age: 33.8 ± 5.9) and 103 old (age: 65.8 ± 4) who were non-hypertensive, had no previous history of heart disease or type 2 diabetes, body mass index less than 30 kg/m2, normal electrocardiography response at rest and during exercise, nonsmokers, and no use of medications known to affect cardiovascular or metabolic function. Body composition measured by dual-energy X-ray absorptiometry. Hemodynamic values measured by non-invasive pulse wave velocity through radial artery tonometry. Markers of inflammation measured through blood sample analysis. Results Significant differences exist between young and old groups in %fat (P < 0.001), systolic blood pressure (SBP) (P = 0.001), large artery elasticity (P = 0.005), small artery elasticity (P < 0.001), systemic vascular resistance (P = 0.004), total vascular impedance (P < 0.001), estimated cardiac output (P < 0.001), and tumor necrosis factor-⍺ (TNF-⍺) (P < 0.001). Using ANCOVA the difference in SBP between age groups was no longer significant after adjusting for small artery elasticity (P < 0.001) and TNF-⍺ (P = 0.041). Conclusions These data demonstrate that blood pressure and vascular hemodynamic measures differ significantly between young and old women independent of body composition. Furthermore, these differences may be explained by the inflammation marker TNF-⍺ and/or small artery elasticity.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, 39762, USA.
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Gordon Fisher
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.,Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
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Excess epicardial fat volume in women is a novel risk marker for microvascular dysfunction, which may be a contributing factor in the atypical chest pain syndrome. Egypt Heart J 2021; 73:37. [PMID: 33847857 PMCID: PMC8044276 DOI: 10.1186/s43044-021-00159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background Excess epicardial fat volume (EFV) has been recently implicated in cardiovascular structural and functional abnormalities. It has been associated with abnormal microvascular stiffness (as reflected by radial artery waveform; C2), which may result in microvascular dysfunction and contribute to the atypical chest pain syndrome without obstructive coronary artery disease (CAD). Women have been statistically shown to present with atypical chest pain more often than men and specifically without obstructive CAD. The aim of this study is to assess whether excess EFV in female subjects is associated with significant microvascular dysfunction (i.e., C2), in subjects without obstructive CAD. Results We screened 596 asymptomatic subjects, ages 20–79, using the Early Cardiovascular Health Risk Scoring System (ECVHRS), which has been reported. Out of the 596 total subjects, 230 subjects had a CACS. Out of these 230 subjects, 77 subjects (45 females; 32 males) had a 0 CACS. The 45 females from this cohort were the subjects of this study, and they were further categorized into 3 groups: group 1 (normal EFV, non-obese female subjects; n=16), females with ECVHRS < 3 and ACC/AHA risk score < 5%; group 2 (n = 9), females with elevated EFV and no abdominal visceral obesity; and group 3 (n=20), females with elevated EFV and abdominal visceral obesity. The average EFV was determined to be 72±20 cm3 among group 1, which indicates the values for normal EFV. The results in group 2 indicate that excess EFV is contributing to the development of microvascular dysfunction, resulting in abnormal micro-arterial (C2) elasticity (p< 0.00001), increase in resting blood pressure (p =0.0001), an abnormal rise in blood pressure (BP) at rest and post-mild protocol exercise (PME) (p = < 0.00001), and abnormal increase in carotid intima-media thickness (CIMT) (p = 0.000164). Conclusion Excess EFV appears to be not only a novel cardiovascular risk marker, but also the culprit for other cardiovascular risk markers. Based on these findings, elevated EFV may contribute to the development of the atypical chest pain syndrome in females without obstructive CAD. Additionally, EFV is emerging as a potential clinically relevant significant cardiovascular risk biomarker and may become a target to reduce cardiovascular morbidity and mortality.
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Emlek N, Yilmaz AS, Özer S, Gündoğdu H, Durakoğlugil ME, Çetin M. Increased Epicardial Adipose Tissue is Associated with the Extent of Aortic Dissection. J Saudi Heart Assoc 2020; 32:415-420. [PMID: 33299785 PMCID: PMC7721452 DOI: 10.37616/2212-5043.1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/07/2020] [Accepted: 06/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection. Methods We retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of the dissection flap at sagittal images. Results We included 78 patients with the mean age of 63.9 ± 11.7 and 57 (73.5%) patients were male. Dissection length was correlated positively with EAT (r = 0.409, p < 0.001), body mass index (r = 0.408, p = 0.018), and admission systolic blood pressure (r = 0.830, p = 0.026) whereas an inverse correlation existed between age and dissection length (r = −0.318, p = 0.005). Multivariate analysis identified age and EAT as independent predictors of dissection length. Conclusion Increased EAT was independently associated with the extent of aortic dissection. We think that either paracrine and endocrine functions of EAT might have contributed to the extent of aortic dissection.
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Affiliation(s)
- Nadir Emlek
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Cardiology, Rize, Turkey
| | - Ahmet Seyda Yilmaz
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Cardiology, Rize, Turkey
| | - Savaş Özer
- Recep Tayyip Erdoğan Üniversitesi Training and Research Hospital, Department of Cardiology, Rize, Turkey
| | - Hasan Gündoğdu
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Radiology, Rize, Turkey
| | | | - Mustafa Çetin
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Cardiology, Rize, Turkey
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Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2020; 19:53-60. [PMID: 32802014 PMCID: PMC7422287 DOI: 10.5114/pm.2020.97835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022]
Abstract
Introduction Cardiovascular disease is more frequent in postmenopausal women. Atherosclerosis is associated with inflammation and the neutrophil/lymphocyte ratio (NLR) is a marker of inflammation whose behavior in postmenopause is unknown. Aim of the study To know the relationship of the NLR with cardiovascular risk markers in premenopausal and postmenopausal women. Material and methods Premenopausal and postmenopausal women were studied, in all of them a complete hemogram and the NLR, platelet/lymphocyte ratio (PLR) were calculated, also glucose and lipids levels were measured. In all of them subcutaneous and visceral fat, carotid intima-media thickness (IMT), epicardial fat were measured by ultrasound Also baseline and and after flow-mediated stimulus the arterial diameter, the pulsatility index and the resistive index of the brachial artery were measured by ultrasound. The results are reported with medians and intervals, Mann-Whitney U and Spearman correlation analysis were performed. Results Eighty two patients were recruited, 41 premenopausal and 41 postmenopausal. When comparing both groups there was no difference in glucose, lipids, NLR, PLR, carotid IMT, epicardial fat, subcutaneous fat, visceral fat or Doppler parameters of the brachial artery. Conclusion NLR was not different between premenopausal and postmenopausal women but abnormal PLR was greater in those postmenopausal with vasomotor symptoms.
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Tóth Š, Olexa P, Hertelyová Z, Štefanič P, Kopolovets I, Berek P, Filip V, Chakravarty R, Široká M, Pella D. PCSK9 concentrations in different stages of subclinical atherosclerosis and their relationship with inflammation. OPEN CHEM 2020. [DOI: 10.1515/chem-2020-0147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AbstractThe aim of this study was to detect the concentrations of PCSK9 in various subclinical stages of atherosclerosis and to highlight its relationship with inflammation. One hundred and fifty-nine healthy patients were divided into three groups, based on the extent of atherosclerotic changes in the carotid artery: a group without identifiable atherosclerosis, cIMT>75‰ and an asymptomatic plaque group. The PCSK9 was measured by ELISA and hsCRP by the immunoturbidimetric method. Vascular changes were identified by a carotid ultrasound. PCSK9 was elevated, when comparing the healthy group with the cIMT>75‰ group; however, no significant increase was detected between cIMT>75‰ and the asymptomatic plaque group. A positive linear correlation of the PCSK9 concentration and atherosclerotic changes was found; however, after the re-analysis in each group, this correlation persisted only in the group with still normal values. Additionally, a significant linear correlation was found between the PCSK9 concentrations and lipid parameters. However, no significant association was found with hsCRP. PCSK9 was found to be elevated only in cIMT>75‰, but not in the later plaque stage. A linear correlation of PCSK9 values was detected only in the group with still reference values. Based on this fact, we assumed the direct linear role of PCSK9 in initiating atherosclerosis; however, in the later phases, the relationship, which highlights other risk factors such as inflammation, is not linear.
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Affiliation(s)
- Štefan Tóth
- Department of Gerontology and Geriatrics, Air Force Military Hospital, Faculty of Medicine, Pavol Jozef Safarik University, Murgašova 1, 040 86 Košice, Slovakia
| | - Peter Olexa
- Department of Gerontology and Geriatrics, Air Force Military Hospital, Faculty of Medicine, Pavol Jozef Safarik University, Murgašova 1, 040 86 Košice, Slovakia
| | - Zdenka Hertelyová
- Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Trieda SNP 1, 041 90 Košice, Slovakia
| | - Peter Štefanič
- Department of Vascular Surgery, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11, Košice, Slovakia
| | - Ivan Kopolovets
- Department of Vascular Surgery, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11, Košice, Slovakia
| | - Peter Berek
- Department of Vascular Surgery, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11, Košice, Slovakia
| | - Vladimir Filip
- Department of Orthopaedics and Traumatology of Locomotory Apparatus, Louis Pasteur University Hospital, Pavol Jozef Safarik University, Trieda SNP 1, 041 90 Košice, Slovakia
| | - Ryan Chakravarty
- Department of Gerontology and Geriatrics, Air Force Military Hospital, Faculty of Medicine, Pavol Jozef Safarik University, Murgašova 1, 040 86 Košice, Slovakia
| | - Monika Široká
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Safarik University, Trieda SNP 1, 041 90 Košice, Slovakia
| | - Daniel Pella
- 2nd Department of Cardiology, Faculty of Medicine, Pavol Jozef Safarik University and East Slovak Institute of Cardiovascular Diseases, Ondavská 8, 040 11 Košice, Slovakia
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Association of rs699947 (-2578 C/A) and rs2010963 (-634 G/C) Single Nucleotide Polymorphisms of the VEGF Gene, VEGF-A and Leptin Serum Level, and Cardiovascular Risk in Patients with Excess Body Mass: A Case-Control Study. J Clin Med 2020; 9:jcm9020469. [PMID: 32046348 PMCID: PMC7073834 DOI: 10.3390/jcm9020469] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Two single nucleotide polymorphisms (SNPs) of the VEGF gene, rs699947 and rs2010963, are responsible for differentiated gene expression. A mutual dependence between VEGF and leptin serum level has been observed. This study investigated the associations between the rs699947 and rs2010963 SNPs of VEGF gene, VEGF-A, and leptin serum concentrations, and cardiometabolic risk of body mass excess. Methods: In this case–control study, 212 subjects with excess body mass and 145 normal-weight controls gave blood samples and underwent anthropometric and pulse wave analysis. Genotyping of VEGF gene was carried out to analyze the rs699947 (−2578 C/A) and rs2010963 (−634 G/C) SNPs. (ClinicalTrials.gov ID: NCT04077554). Results: This study showed a significant positive correlation between serum levels of VEGF-A and leptin in individuals with excess body mass possessing the CC genotype of the rs699947 variant of the VEGF gene. It has been registered that an increase in VEGF-A serum level correlates with an increase in arterial stiffness in excess body mass patients harboring AA genotype of the rs699947 (−2578 C/A) variant of the VEGF gene. No differences in VEGF-A and leptin serum concentrations were noted between particular genotypes. Conclusions: The CC genotype of the rs699947 variant of the VEGF gene promotes a positive interdependency between leptin and VEGF-A serum levels in subjects with excess body mass.
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Akcay M, Coksevim M, Ulubaşoğlu H, Gedikli O, Yılmaz O. Evaluation of Left Atrial Electromechanical Delay and Left Atrial Phasic Functions in Surgical Early Menopause Patients. J Cardiovasc Imaging 2019; 27:137-146. [PMID: 30993949 PMCID: PMC6470075 DOI: 10.4250/jcvi.2019.27.e22] [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: 10/24/2018] [Revised: 02/02/2019] [Accepted: 02/26/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This study evaluated the atrial electromechanical delay (AEMD) and the left atrial (LA) mechanical functions in patients with surgical early menopause. METHODS A total of 62 patients were included in the study: 33 patients with surgical early menopause and 29 age- and sex-matched healthy controls. The duration distance from the start of the P wave to the beginning of the A wave for the lateral mitral annulus, septal mitral annulus, and lateral tricuspid annulus was assessed by tissue Doppler echocardiography. The differences in these durations were used to calculate the inter- and intra-atrial mechanical delays. LA volumes were evaluated using the biplane area-length technique, and LA mechanical function values were measured. RESULTS The baseline laboratory and clinical characteristics were similar between the two groups. Surgical early menopause patients displayed increased static atrial electromechanical connection (PA′) times for the septal mitral annulus and lateral tricuspid annulus compared to the controls. However, the lateral mitral annulus, the inter-atrial, the intra-LA, and the right atrial EMD PA′ times were not significantly altered in surgical early menopause patients compared to controls. Importantly, the LA volume index (28.1 ± 8.17 vs. 24.89 ± 7.96 mL/m2, p = 0.019), the maximal LA volume (49.6 ± 14.1 vs. 42.9 ± 16.1 mL, p = 0.004), the minimal LA volume (18.4 ± 7.0 vs. 15.2 ± 9.0 mL, p = 0.022), and the atrial precontraction LA volume (31.0 ± 10.9 vs. 24.9 ± 10.1 mL, p = 0.006) were higher in the patients with surgical early menopause compared to the controls. The LA reservoir, conduit and pumping functions and the total, passive, and active emptying volumes were all comparable between the two groups (p = 0.09; 0.06; 0.68; 0.06; 0.48; 0.07, respectively). CONCLUSIONS Patients with surgical early menopause demonstrated impaired atrial electrical delay and electromechanical functions.
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Affiliation(s)
- Murat Akcay
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
| | - Metin Coksevim
- Clinic of Cardiology, Giresun Bulancak State Hospital, Giresun, Turkey
| | - Hasan Ulubaşoğlu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Omer Gedikli
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ozcan Yılmaz
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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