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Martins NS, Barreto J, Kimura-Medorima ST, Vitte SH, Quinaglia T, Assato B, Coelho-Filho OR, Matos-Souza JR, Nadruz W, Sposito AC. Carotid intima layer thickness but not intima-media thickness is related to coronary artery calcification in type 2 diabetes individuals: Results from the Brazilian diabetes study. Nutr Metab Cardiovasc Dis 2023; 33:2384-2388. [PMID: 37798228 DOI: 10.1016/j.numecd.2023.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/06/2023] [Accepted: 07/20/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIMS Carotid intima-media thickness (cIMT) is inconsistent in predicting cardiovascular risk. This may stem from the variability of the media thickness (cM) outweighing the intimal thickness (cIT) as the sign of atherosclerosis. Thus, we evaluated in type 2 diabetes (T2D) individuals, the association between carotid measures and coronary artery calcification (CAC). METHODS AND RESULTS Association between the presence of CAC and cIT, cM, and cIMT were examined on 224 individuals. Logistic binary regression was used to assess CAC predictors. The Akaike information criterion (AIC) and log-likelihood test (LLT) were used to assess differences among univariate models. The cIT (0.335 mm vs 0.363 mm; p = 0.001) and cIMT (0.715 vs 0.730; p = 0.019), but not cM (0.386 mm vs 0,393 mm; p = 0.089) were higher among individuals with CAC. In unadjusted analysis, cIT (273;-134; p = 0.001) showed greater relationship with CAC, when compared to cIMT (279;-137; p = 0.022) and cM (281;-139; p = 0.112) based on the AIC and LLT, respectively. In multivariate logistic regression, CAC was related to carotid plaque (OR): 1.91, 95% confidence interval (CI):1.08, 3.38; p = 0.027), and high-cIT (OR: 2.70, 95%CI:1.51, 4.84; p = 0.001), but not to high-cIMT (OR:1.70, 95%CI:0.96, 3.00; p = 0.067) nor high-cM (OR:1.33, 95%CI:0.76, 2.34; p = 0.322). CONCLUSION In T2D individuals, cIT is a better predictor of CAC than cIMT; cM is not associated with CAC.
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Affiliation(s)
- Nestor S Martins
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Joaquim Barreto
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil; Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Sheila Tatsumi Kimura-Medorima
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil; Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Sofia Helena Vitte
- Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Thiago Quinaglia
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil; Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Barbara Assato
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil; Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Otavio Rizzi Coelho-Filho
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Jose Roberto Matos-Souza
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Wilson Nadruz
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Andrei C Sposito
- Cardiology Division, Department of Internal Medicine, State University of Campinas (Unicamp), Sao Paulo, Brazil; Atherosclerosis and Vascular Biology Laboratory (Aterolab), Cardiology Division, State University of Campinas (Unicamp), Sao Paulo, Brazil.
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Lind L. A comparison of intima media thickness in the common carotid artery, the bulb and plaque area as predictions of incident atherosclerotic events. PLoS One 2023; 18:e0294722. [PMID: 37983212 PMCID: PMC10659152 DOI: 10.1371/journal.pone.0294722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND AND AIMS There is a debate on how to evaluate carotid artery intima-media thickness (IMT). We here compared IMT of the common carotid artery (CCA) and bulb with plaque area regarding incident atherosclerotic disease. METHODS In the PIVUS study (age 70 at baseline, 53% women, n = 856), IMT-CCA, IMT-bulb and plaque area were measured at ages 70, 75 and 80 years and these three measurements were used in updated Cox proportional hazard analysis. RESULTS Over 15 years follow-up, 135 individuals experienced a first-time atherosclerotic disease (myocardial infarction or ischemic stroke). IMT-CCA was not significantly related to this composite endpoint (p = 0.10). IMT-bulb was significantly related to the endpoint (p = 0.003), but this relationship was attenuated following adjustment for CVD risk factors (p = 0.02). On the contrary, plaque area was consistently related to incident atherosclerotic disease also following adjustment for CVD risk factors (p<0.001). When added on top of traditional risk factors, both IMT-bulb and plaque area, but not IMT-CCA, improved the discrimination compared to the traditional risk factors (+5.2%, p = 0.0026 for IMT-bulb, +3.8%, p = 0.013 for plaque area and 0.0% for IMT-CCA). CONCLUSION In elderly subjects, both IMT-bulb and plaque area improved the discrimination regarding incident atherosclerotic disease when added to traditional risk factors. This was not seen for IMT-CCA. IMT-CCA was therefore inferior compared to the other two carotid artery ultrasonographic measurements in this sample of elderly subjects.
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Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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3
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Bažadona D, Matovinović M, Krbot Skorić M, Grbavac H, Belančić A, Malojčić B. The Interconnection between Carotid Intima-Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1512. [PMID: 37763631 PMCID: PMC10534814 DOI: 10.3390/medicina59091512] [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: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Carotid intima-media thickness (CIMT) and obesity are considered independent determinants of cardio- and cerebrovascular events. The aim of our study was to investigate the effect of obesity on CIMT and to define which traditional cardiovascular risk factors correlate the most with CIMT values in patients with obesity. Materials and Methods: Anthropometric measurements were collected for the whole study group, as well as body composition and blood pressure data, and biochemical blood analyses were also performed. Results: Although our study group was significantly older according to vascular compared with chronological age, the mean CIMT values were lower when compared with the reference values. We found a statistically significant correlation of CIMT with chronological and vascular age, systolic blood pressure, fasting glucose, total cholesterol and triglyceride levels, waist-to-hip ratio, waist circumference, body muscle mass and skeletal muscle mass index. Atherosclerotic Cardiovascular Disease (ASCVD) risk assessment and SCORE (Systematic COronary Risk Evaluation) showed significant positive correlations, but there was only a weak correlation of ASCVD with CIMT. Conclusions: To deduce, since no diagnostic tool currently includes body weight as an individual risk factor, further trials are highly needed to determine if SCORE, SCORE2, ASCVD risk assessment or CIMT would be the most accurate and relevant diagnostic tool for prediction of risk for future CV events in patients with obesity.
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Affiliation(s)
- Danira Bažadona
- Department of Neurology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (D.B.); (M.K.S.)
| | - Martina Matovinović
- Croatian Referral Center for Obesity Treatment, Department of Endocrinology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Magdalena Krbot Skorić
- Department of Neurology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (D.B.); (M.K.S.)
| | - Hrvoje Grbavac
- University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia;
| | - Andrej Belančić
- Department of Clinical Pharmacology, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia;
- Department of Basic and Clinical Pharmacology with Toxicology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Branko Malojčić
- Department of Neurology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (D.B.); (M.K.S.)
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4
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Tschiderer L, Seekircher L, Izzo R, Mancusi C, Manzi MV, Baldassarre D, Amato M, Tremoli E, Veglia F, Tuomainen TP, Kauhanen J, Voutilainen A, Iglseder B, Lind L, Rundek T, Desvarieux M, Kato A, de Groot E, Aşçi G, Ok E, Agewall S, Beulens JWJ, Byrne CD, Calder PC, Gerstein HC, Gresele P, Klingenschmid G, Nagai M, Olsen MH, Parraga G, Safarova MS, Sattar N, Skilton M, Stehouwer CDA, Uthoff H, van Agtmael MA, van der Heijden AA, Zozulińska-Ziółkiewicz DA, Park HW, Lee MS, Bae JH, Beloqui O, Landecho MF, Plichart M, Ducimetiere P, Empana JP, Bokemark L, Bergström G, Schmidt C, Castelnuovo S, Calabresi L, Norata GD, Grigore L, Catapano A, Zhao D, Wang M, Liu J, Ikram MA, Kavousi M, Bots ML, Sweeting MJ, Lorenz MW, Willeit P. Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies. J Am Heart Assoc 2023:e027657. [PMID: 37301757 DOI: 10.1161/jaha.122.027657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/12/2023] [Indexed: 06/12/2023]
Abstract
Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I2=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I2=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I2=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.
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Affiliation(s)
- Lena Tschiderer
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Lisa Seekircher
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Maria V Manzi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine University of Milan Milan Italy
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | - Mauro Amato
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | | | | | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Bernhard Iglseder
- Department of Geriatric Medicine Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik Salzburg Austria
- Department of Geriatric Medicine Paracelsus Medical University Salzburg Austria
| | - Lars Lind
- Department of Medicine Uppsala University Uppsala Sweden
| | - Tatjana Rundek
- Department of Neurology University of Miami Miller School of Medicine Miami FL
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health Columbia University New York NY
- METHODS Core, Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1153 Paris France
| | - Akihiko Kato
- Blood Purification Unit Hamamatsu University Hospital Hamamatsu Japan
| | - Eric de Groot
- Imagelabonline and Cardiovascular Erichem the Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center-Academic Medical Centre Amsterdam the Netherlands
| | - Gülay Aşçi
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Ercan Ok
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Stefan Agewall
- Department of Clinical Sciences, Danderyd Hospital Division of Cardiology Karolinska Institutet Stockholm Sweden
- Institute of Clinical Sciences University of Oslo Oslo Norway
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | - Christopher D Byrne
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Hertzel C Gerstein
- Department of Medicine and Population Health Research Institute McMaster University Hamilton Ontario Canada
- Hamilton General Hospital Hamilton Ontario Canada
| | - Paolo Gresele
- Division of Internal and Cardiovascular Medicine, Department of Medicine and Surgery University of Perugia Perugia Italy
| | | | - Michiaki Nagai
- Department of Internal Medicine General Medicine and Cardiology, Hiroshima City Asa Hospital Hiroshima Japan
| | - Michael H Olsen
- Department of Internal Medicine, Holbaek Hospital University of Southern Denmark Odense Denmark
| | - Grace Parraga
- Department of Medical Biophysics, Robarts Research Institute Western University London ON Canada
| | - Maya S Safarova
- Department of Cardiovascular Medicine University of Kansas Medical Center Kansas City KS
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Michael Skilton
- Charles Perkins Centre, Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht Maastricht University Medical Centre Maastricht the Netherlands
| | - Heiko Uthoff
- Department of Angiology University Hospital Basel Basel Switzerland
| | - Michiel A van Agtmael
- Department of Internal Medicine Amsterdam University Medical Center, Vrije Universiteit Amsterdam the Netherlands
| | - Amber A van der Heijden
- Department of General Practice, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | | | - Hyun-Woong Park
- Division of Cardiology, Department of Internal Medicine Chungnam National University Sejong Hospital Sejong-si South Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, College of Medicine Konyang University Daejeon South Korea
- Department of Occupational and Environmental Medicine Konyang University Hospital Daejeon South Korea
| | - Jang-Ho Bae
- Heart Center, Konyang University Hospital Daejeon South Korea
- Department of Cardiology Konyang University College of Medicine Daejeon South Korea
| | - Oscar Beloqui
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Manuel F Landecho
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Matthieu Plichart
- Paris Cardiovascular Research Centre University Paris Descartes Paris France
- Fondation Santé Service, Hospital at Home Levallois-Perret France
| | | | | | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Clinical Physiology Sahlgrenska University Hospital, Region Västragötaland Gothenburg Sweden
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Samuela Castelnuovo
- Centro Dislipidemie, Aziende Socio Sanitarie Territoriali Grande Ospedale Metropolitano Niguarda Milan Italy
| | - Laura Calabresi
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
| | - Giuseppe D Norata
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Società Italiana per lo Studio dell'Aterosclerosi Center for the Study of Atherosclerosis, Bassini Hospital Cinisello Balsamo Italy
| | - Liliana Grigore
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Miao Wang
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - M Arfan Ikram
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands
| | - Michael J Sweeting
- Department of Health Sciences University of Leicester Leicester UK
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Matthias W Lorenz
- Klinik für Neurologie Krankenhaus Nordwest Frankfurt am Main Germany
- Department of Neurology Goethe University Frankfurt am Main Germany
| | - Peter Willeit
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
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Naessen T, Einarsson G, Henrohn D, Wikström G. Peripheral Vascular Ageing in Pulmonary Arterial Hypertension as Assessed by Common Carotid Artery Intima Thickness and Intima/Media Thickness Ratio: An Investigation Using Non-Invasive High-Resolution Ultrasound. Heart Lung Circ 2023; 32:338-347. [PMID: 36550005 DOI: 10.1016/j.hlc.2022.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH; World Heath Organization [WHO] Group 1) is associated with increased pulmonary arterial pressure and resistance, with pulmonary vascular remodelling. The vascular anatomy of the systemic arteries has been less well studied. METHOD Nineteen (19) patients with PAH, confirmed by right heart catheterisation (RHC), 14 patients with left ventricular heart failure with reduced ejection fraction (LVrEF), and 30 healthy subjects were enrolled. Common carotid artery (CCA) intima thickness, intima/media (I/M) thickness ratio, and intima-media thickness (IMT) were assessed using non-invasive ultrasound (22 MHz centre frequency). RESULTS The CCA intima thickness was correlated with several RHC variables (all p<0.05). The intima was 56% thicker (+0.05 mm; 95% CI 0.03, 0.06; p<0.0001) and the I/M thickness ratio was 128% greater (+0.21; 95% CI 0.13, 0.28; p<0.0001) in patients with PAH than healthy subjects. These values were also significantly higher than in patients with LVrEF. In ROC curve analysis, the c-values for CCA intima thickness (0.92) and I/M ratio (0.87), but not for IMT, correctly indicated which individuals belonged to the PAH or healthy control groups. The CCA IMT showed no corresponding significant group differences or associations and was of no use according to receiver operating curve analysis. CONCLUSIONS Patients with PAH displayed signs of peripheral vascular remodelling, challenging the common opinion that vascular changes in PAH are restricted to the lung vasculature. Correlations with cardiopulmonary variables from RHC support peripheral vascular coupling and the association with vascular ageing. Results from this pilot study warrant further confirmation.
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Affiliation(s)
- Tord Naessen
- Department of Women's and Children's Health/Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
| | - Gunnar Einarsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dan Henrohn
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gerhard Wikström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Velásquez IM, Malarstig A, Baldassarre D, Borne Y, de Faire U, Engström G, Eriksson P, Giral P, Humphries SE, Kurl S, Leander K, Lind L, Lindén A, Orsini N, Pirro M, Silveira A, Smit AJ, Tremoli E, Veglia F, Strawbridge RJ, Gigante B. Causal analysis of plasma IL-8 on carotid intima media thickness, a measure of subclinical atherosclerosis. Curr Res Transl Med 2023; 71:103374. [PMID: 36493747 DOI: 10.1016/j.retram.2022.103374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND We investigated the causality of IL-8 on carotid intima-media thickness (c-IMT), a measure of sub-clinical atherosclerosis. METHODS The IMPROVE is a multicenter European study (n = 3,711). The association of plasma IL-8 with c-IMT (mm) was estimated by quantile regression. Genotyping was performed using the Illumina CardioMetabo and Immuno chips. Replication was attempted in three independent studies and a meta-analysis was performed using a random model. RESULTS In IMPROVE, each unit increase in plasma IL-8 was associated with an increase in median c-IMT measures (all p<0·03) in multivariable analyses. Linear regression identified rs117518778 and rs8057084 as associated with IL-8 levels and with measures of c-IMT. The two SNPs were combined in an IL-8-increasing genetic risk that showed causality of IL-8 on c-IMT in IMPROVE and in the UK Biobank (n = 22,179). The effect of IL-8 on c-IMT measures was confirmed in PIVUS (n = 1,016) and MDCCC (n = 6,103). The association of rs8057084 with c-IMT was confirmed in PIVUS and UK Biobank with a pooled estimate effect (β) of -0·006 with 95%CI (-0·008- -0·003). CONCLUSION Our results indicate that genetic variants associated with plasma IL-8 also associate with c-IMT. However, we cannot infer causality of this association, as these variants lie outside of the IL8 locus.
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Affiliation(s)
- Ilais Moreno Velásquez
- Gorgas Memorial Institute for Health Studies, Panama City, Panama; Max Delbrück Center for Molecular Medicine in the Helmholtz-Association, Molecular Epidemiology Research Group, Berlin, Germany
| | - Anders Malarstig
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Emerging Science and Innovation, Pfizer Worldwide Research, Development and Medical, Stockholm, Sweden
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Yan Borne
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Ulf de Faire
- Cardiovascular and Nutritional Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Per Eriksson
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital Solna, Stockholm, Sweden
| | - Philippe Giral
- Sorbonne Université, INSERM UMR1166, Cardiovascular prevention unit, AP-HP, Groupe Hôpitalier Pitié-Salpetriere, Paris, France
| | - Steve E Humphries
- Cardiovascular Genetics, Institute Cardiovascular Science, University College London, United Kingdom
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Finland
| | - Karin Leander
- Cardiovascular and Nutritional Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars Lind
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Anders Lindén
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Stockholm, Sweden; Karolinska Severe COPD Center, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Matteo Pirro
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Angela Silveira
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital Solna, Stockholm, Sweden
| | - Andries J Smit
- Department of Medicine, University Medical Center Groningen, Groningen & Isala Clinics Zwolle, Department of Medicine, the Netherlands
| | | | - Fabrizio Veglia
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Maria Cecilia Hospital, Cotignola, RA, Italy
| | - Rona J Strawbridge
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Health Data Research, United Kingdom
| | - Bruna Gigante
- Division of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.
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7
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Ljunggren M, Naessén T, Theorell‐Haglöw J, Franklin KA, Lindberg E. Rapid eye movement sleep apnea and carotid intima thickness in men and women: a SHE-MUSTACHE cohort study. J Sleep Res 2022; 31:e13599. [PMID: 35415915 PMCID: PMC9786679 DOI: 10.1111/jsr.13599] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/23/2022] [Accepted: 03/20/2022] [Indexed: 12/30/2022]
Abstract
Rapid eye movement (REM) obstructive sleep apnea might be particularly harmful to the cardiovascular system. We aimed to investigate the association between sleep apnea during REM sleep and signs of atherosclerotic disease in the form of carotid intima thickness in a community-based sample of men and women and possible sex differences in this association. The association between sleep apnea during REM sleep and intima thickness was analysed cross-sectionally in women from the community-based "Sleep and Health in Women" (SHE) study (n = 253) and age- and body mass index (BMI)-matched men from the "Men in Uppsala; a Study of sleep, Apnea and Cardiometabolic Health" (MUSTACHE) study (n = 338). Confounders adjusted for were age, BMI, gender, alcohol, and smoking. All participants underwent a full-night polysomnography, high-resolution ultrasonography of the common carotid artery, anthropometric measurements, blood pressure measurements, and answered questionnaires. There was an association between sleep apnea during REM sleep and thicker carotid intima that remained after adjustment for confounding (adjusted β = 0.008, p = 0.032). The intima was increased by 9.9% in the group with severe sleep apnea during REM sleep, and this association between severe sleep apnea during REM sleep and increased intima thickness remained after adjustment for confounders (adjusted β = 0.043, p = 0.021). More women than men had severe sleep apnea during REM sleep; moreover, in sex-stratified analyses, the association between sleep apnea during REM sleep and intima thickness was found in women but not in men. We conclude that severe REM sleep apnea is independently associated with signs of atherosclerosis. When stratified by sex, the association is seen in women but not in men.
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Affiliation(s)
- Mirjam Ljunggren
- Department of Medical Sciences, Respiratory, Allergy and Sleep ResearchUppsala UniversityUppsalaSweden
| | - Tord Naessén
- Department of Women's and Children's Health, Obstetrics and GynaecologyUppsala UniversityUppsalaSweden
| | - Jenny Theorell‐Haglöw
- Department of Medical Sciences, Respiratory, Allergy and Sleep ResearchUppsala UniversityUppsalaSweden
| | - Karl A. Franklin
- Department of Surgical and Perioperative Sciences, SurgeryUmeå UniversityUppsalaSweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep ResearchUppsala UniversityUppsalaSweden
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8
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Association of carotid wall layers with atherosclerotic plaques and cardiac hypertrophy in hypertensive subjects. J Hum Hypertens 2022; 36:732-737. [PMID: 34131263 DOI: 10.1038/s41371-021-00565-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/08/2021] [Indexed: 01/20/2023]
Abstract
Carotid intima-media thickness (cIMT) is considered a marker of subclinical atherosclerosis and is related to target-organ damage in hypertensive patients. However, increased cIMT may be due to increases in the thickness of intima (cIT) and media (cMT) layers. This study evaluated whether cIMT layers (cIT and cMT) had a greater association with carotid atherosclerotic plaques and left ventricular hypertrophy (LVH) than cIMT in hypertensive subjects. We cross-sectionally evaluated clinical, carotid, and echocardiography characteristics of 186 hypertensive patients followed at an outpatient clinic. High-resolution images of common carotid arteries were obtained by ultrasonography equipped with 10-MHz transducers, and cIT, cMT, and cIMT were manually measured using an image-processing software. Among all participants (n = 186; age = 60.8 ± 10.9 years, 43% males), there were 58% with carotid plaques and 58% with LVH. Mean cIT, cMT, and cIMT values were 0.267 ± 0.060, 0.475 ± 0.107, and 0.742 ± 0.142 mm, respectively. In logistic regression analysis adjusted for relevant covariates, carotid plaques showed stronger association with cIT than with cMT and cIMT. Furthermore, cIT showed greater area under the ROC curve (0.92; 95% CI 0.87-0.96) than cIMT (0.79; 95% CI 0.72-0.85) and cMT (0.64; 95% CI 0.56-0.72) to identify plaques. Conversely, cIT, cMT, and cIMT had modest association and accuracy to identify LVH (area under the ROC curve = 0.61, 0.57, and 0.60, respectively). In conclusion, cIT is a more accurate marker of atherosclerosis than cMT or cIMT, while cIT and cMT provide no incremental value in identifying LVH when compared with cIMT among hypertensive subjects.
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9
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Radial artery lumen diameter and intima thickness in patients with abdominal aortic aneurysm. JVS Vasc Sci 2022; 3:274-284. [PMID: 36052216 PMCID: PMC9424594 DOI: 10.1016/j.jvssci.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
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10
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Naessen T, Bergsten P, Lundmark T, Forslund A. Obesity in adolescents associated with vascular aging - a study using ultra-high-resolution ultrasound. Ups J Med Sci 2022; 127:8676. [PMID: 35846851 PMCID: PMC9254329 DOI: 10.48101/ujms.v127.8676] [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: 03/31/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Obesity in adolescents is increasing worldwide and associated with an elevated cardiovascular risk later in life. In a group-comparative study, we investigated the association between adiposity in adolescents and signs of vascular aging and inflammation. METHODS Thirty-nine adolescents (10-18 years old), 19 with obesity and 20 with normal weight, were enrolled. The intima thickness and intima/media thickness ratio (I/M) were assessed using high-resolution ultrasound in the common carotid artery (center frequency 22 MHz) and the distal radial artery (RA; 50 MHz). Increased intima and high I/M are signs of vascular aging. Body characteristics, high-sensitivity C-reactive protein (hs-CRP), plasma lipids, and glycemic parameters were measured. RESULTS Adolescents with obesity, compared to normal-weight peers, had elevated plasma lipid, insulin c-peptide, and hs-CRP levels, the latter increasing exponentially with increasing adiposity. Obese adolescents had a thicker RA intima layer [0.005 mm; 95% confidence intervals (0.000, 0.009); P = 0.043] and a higher RA I/M [0.10; (0.040, 0.147); P < 0.0007]. Group differences for the RA I/M remained significant after adjustment for age, sex, fasting plasma insulin, and body mass index, both separately and together (P = 0.032). The RA I/M was correlated with hs-CRP, and both were correlated with the analyzed cardiovascular risk factors. Receiver operating curve c-values for RA I/M (0.86) and hs-CRP (0.90) strongly indicated correct placement in the obese or non-obese group. CONCLUSIONS Adolescents with obesity had significantly more extensive vascular aging in the muscular RA, than normal-weight peers. The findings support an inflammatory link between obesity and vascular aging in adolescents.
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Affiliation(s)
- Tord Naessen
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Tobias Lundmark
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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11
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Li H, Xu X, Luo B, Zhang Y. The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors-A "SPIDER" Promoting Atherosclerosis. Front Cardiovasc Med 2021; 8:706490. [PMID: 34447790 PMCID: PMC8382941 DOI: 10.3389/fcvm.2021.706490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Insufficient recommendations do not support the clinical use of carotid ultrasonography for further risk stratification in moderate-to-high risk patients with cardiovascular disease (CVD). A literature review was performed to assess six aspects of the research progress and limitations of carotid ultrasonography and carotid atherosclerosis-related risk factors: (1) structures of the carotid intima and media; (2) plaques; (3) inflammation; (4) dynamics of carotid blood flow; (5) early detection and intervention; and (6) risk factors for CVD. Although carotid intima-media thickness and carotid plaques are well-acknowledged independent predictors of CVD risk, normative and cut-off values are difficult to define due to the heterogeneous measurements reported in previous studies. Plaque properties, including location, number, density, and size, become more important risk predictors for cardiovascular disease, but a better approach for clinical use needs to be further established. Three-dimensional ultrasound and contrast-enhanced ultrasound are promising for promoting risk stratification with more details on plaque morphology. Moreover, inflammatory diseases and biomarkers should be evaluated for a full assessment of the inflammatory burden for atherosclerosis. Carotid flow velocity is not only an indicator for stenosis but also a potential risk predictor. Carotid atherosclerosis should be detected and treated early, and additional clinical trials are needed to determine the efficacy of these measures in reducing CVD risk. Cardiovascular risk factors tend to affect carotid plaques, and early treat-to-target therapy might yield clinical benefits. Based on the aforementioned six aspects, we consider that these six important factors act like a “SPIDER” spinning the web of atherosclerosis; a timely comprehensive assessment and intervention may halt the progression to CVD. Carotid ultrasound results should be combined with other atherosclerotic factors, and a comprehensive risk assessment may help to guide cardiovascular prevention decisions.
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Affiliation(s)
- Hongwei Li
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Xiaolin Xu
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
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12
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Akhter T, Wikström G, Larsson M, Bondesson U, Hedeland M, Naessen T. Dimethylarginines correlate to common carotid artery wall layer dimensions and cardiovascular risk factors in pregnant women with/without preeclampsia: A group comparative study. Eur J Obstet Gynecol Reprod Biol 2021; 258:288-293. [PMID: 33498001 DOI: 10.1016/j.ejogrb.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Asymmetric- and symmetric dimethylarginines (ADMA, SDMA) are elevated in cardiovascular disease (CVD). Preeclampsia is a pregnancy-specific syndrome and is an independent risk factor for subsequent CVD. Aims were to investigate whether ADMA, SDMA levels and l-arginine/ADMA and l-arginine/SDMA ratios during pregnancy and their changes from pregnancy to postpartum are associated to arterial wall layer dimensions and cardiovascular risk factors in women with and without preeclampsia. STUDY DESIGN Dimethylarginines were analyzed by LC-MS, and the common-carotid-artery (CCA) intima and media thicknesses were estimated using 22-MHz non-invasive ultrasonography in women with preeclampsia (cases = 48) and normal pregnancies (controls = 58) in similar gestational age, with reassessment one-year postpartum. A thick intima, thin media and high intima/media ratio (I/M) indicates a less healthy arterial wall. RESULTS The median age of cases and controls was 30 years. During pregnancy, women with preeclampsia had higher plasma ADMA, SDMA and lower l-arginine/ADMA and l-arginine/SDMA (all p < 0.01) than women with normal pregnancies. Further, ADMA, SDMA, l-arginine/ADMA and l-arginine/SDMA correlated to intima thickness (rs = 0.33/0.33/-0.33/-0.35 and p < 0.01), I/M (rs = 0.26/0.28/-0.22/-0.26 and p < 0.05) and mean arterial pressure (MAP) (rs = 0.43/0.42/-0.39/-0.40 and p < 0.0001). Changes in ADMA, SDMA and l-arginine/SDMA from pregnancy to postpartum correlated to changes in intima thickness (rs = 0.22/0.32/-0.21 and p < 0.05/<0.01/<0.05), I/M (rs = 0.22/0.31/0.08 and p < 0.05/<0.01/=0.43) and MAP (rs = 0.31/0.53/-0.25 and p < 0.01/<0.001/<0.05). No correlations were found for conventional CCA intima-media-thickness. CONCLUSIONS Dimethylarginines were associated to signs of adverse effects on arterial wall layer dimensions and cardiovascular risk factors in women with and without preeclampsia, during pregnancy and to their changes from pregnancy up to one-year postpartum.
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Affiliation(s)
- Tansim Akhter
- Department of Women's and Children's Health, Obstetrics and Gynecology, Sweden.
| | | | - Marita Larsson
- Department of Women's and Children's Health, Obstetrics and Gynecology, Sweden
| | - Ulf Bondesson
- National Veterinary Institute (SVA), Department of Chemistry, Environment and Feed Hygiene, Sweden; Department of Medical Chemistry, Analytical Pharmaceutical Chemistry, Uppsala University, Sweden
| | - Mikael Hedeland
- National Veterinary Institute (SVA), Department of Chemistry, Environment and Feed Hygiene, Sweden; Department of Medical Chemistry, Analytical Pharmaceutical Chemistry, Uppsala University, Sweden
| | - Tord Naessen
- Department of Women's and Children's Health, Obstetrics and Gynecology, Sweden
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13
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Association of left ventricular strain and E/e’ ratio with carotid wall layers. Atherosclerosis 2020; 310:109-110. [DOI: 10.1016/j.atherosclerosis.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/21/2020] [Indexed: 11/21/2022]
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14
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Kirollos S, Skilton M, Patel S, Arnott C. A Systematic Review of Vascular Structure and Function in Pre-eclampsia: Non-invasive Assessment and Mechanistic Links. Front Cardiovasc Med 2019. [PMID: 31803759 DOI: 10.3389/fcvm.2019.00166, 10.3389/fmed.2019.00166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Hypertensive disorders of pregnancy, such as pre-eclampsia, are known to be independently associated with the development of premature cardiovascular disease (CVD) in women. In pre-eclampsia, the placenta secretes excess anti-angiogenic factors into the maternal circulation, leading to widespread endothelial damage, and inflammation. This endothelial damage is evidenced to persist beyond the acute illness. However, whether it is permanent and responsible for the elevated rates of premature CVD seen in this at-risk group remains unclear. A systematic review of the available literature with respect to vascular structure and function prior to, during and after a pregnancy complicated by pre-eclampsia was performed. Studies non-invasively assessing vascular structure using carotid intima-media thickness (CIMT), retinal microvasculature caliber, CT coronary angiogram, or coronary calcium scores were included. Vascular function was assessed using brachial flow-mediated dilation (FMD), pulse wave analysis (PWA), and peripheral arterial tonometry (PAT). In total 59 articles were included (13 CIMT, 5 CTCA/Ca score, five retinal microvasculature, 27 FMD, 7 PAT, and 14 PWV/PWA), consisting of prospective and retrospective cohort, and case-control studies. Change in vascular structure was evidenced with significant increases in CIMT by 73-180 μm greater than that of non-affected women. This is tempered by other studies reporting resolution of structural changes postpartum, highlighting the need for further research. Accelerated coronary calcification and plaque deposition was identified, with greater rates of increased calcium scores and subclinical coronary artery disease shown by CTCA in women with a history of pre-eclampsia at 30 years postpartum. Impaired endothelial function was consistently reported prior to, during and immediately after pregnancy as evidenced by differences in FMD of 1.7-12.2% less than non-affected women, an increase in PWV by 13.2-26%, and reduced retinal microvascular caliber and arterial elasticity indices. The evidence was less conclusive for the persistence of long-term endothelial dysfunction. Understanding the underlying mechanistic links between pre-eclampsia and CVD is a key step to identifying targeted therapies aimed at "repairing the endothelium" and attenuating risk. This review has highlighted the need for a greater understanding of vascular structure and function following pre-eclampsia through high quality studies with large sample sizes, particularly in the longer postpartum period when clinical CVD disease starts to manifest.
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Affiliation(s)
- Shady Kirollos
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Michael Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health University of Sydney, Sydney, NSW, Australia
| | - Sanjay Patel
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Department of Coronary Diseases, The Heart Research Institute, Sydney, NSW, Australia
| | - Clare Arnott
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Department of Coronary Diseases, The Heart Research Institute, Sydney, NSW, Australia.,Department of Cardiology, The George Institute for Global Health, Sydney, NSW, Australia
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15
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Kirollos S, Skilton M, Patel S, Arnott C. A Systematic Review of Vascular Structure and Function in Pre-eclampsia: Non-invasive Assessment and Mechanistic Links. Front Cardiovasc Med 2019; 6:166. [PMID: 31803759 PMCID: PMC6873347 DOI: 10.3389/fcvm.2019.00166] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022] Open
Abstract
Hypertensive disorders of pregnancy, such as pre-eclampsia, are known to be independently associated with the development of premature cardiovascular disease (CVD) in women. In pre-eclampsia, the placenta secretes excess anti-angiogenic factors into the maternal circulation, leading to widespread endothelial damage, and inflammation. This endothelial damage is evidenced to persist beyond the acute illness. However, whether it is permanent and responsible for the elevated rates of premature CVD seen in this at-risk group remains unclear. A systematic review of the available literature with respect to vascular structure and function prior to, during and after a pregnancy complicated by pre-eclampsia was performed. Studies non-invasively assessing vascular structure using carotid intima-media thickness (CIMT), retinal microvasculature caliber, CT coronary angiogram, or coronary calcium scores were included. Vascular function was assessed using brachial flow-mediated dilation (FMD), pulse wave analysis (PWA), and peripheral arterial tonometry (PAT). In total 59 articles were included (13 CIMT, 5 CTCA/Ca score, five retinal microvasculature, 27 FMD, 7 PAT, and 14 PWV/PWA), consisting of prospective and retrospective cohort, and case-control studies. Change in vascular structure was evidenced with significant increases in CIMT by 73–180 μm greater than that of non-affected women. This is tempered by other studies reporting resolution of structural changes postpartum, highlighting the need for further research. Accelerated coronary calcification and plaque deposition was identified, with greater rates of increased calcium scores and subclinical coronary artery disease shown by CTCA in women with a history of pre-eclampsia at 30 years postpartum. Impaired endothelial function was consistently reported prior to, during and immediately after pregnancy as evidenced by differences in FMD of 1.7–12.2% less than non-affected women, an increase in PWV by 13.2–26%, and reduced retinal microvascular caliber and arterial elasticity indices. The evidence was less conclusive for the persistence of long-term endothelial dysfunction. Understanding the underlying mechanistic links between pre-eclampsia and CVD is a key step to identifying targeted therapies aimed at “repairing the endothelium” and attenuating risk. This review has highlighted the need for a greater understanding of vascular structure and function following pre-eclampsia through high quality studies with large sample sizes, particularly in the longer postpartum period when clinical CVD disease starts to manifest.
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Affiliation(s)
- Shady Kirollos
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Michael Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health University of Sydney, Sydney, NSW, Australia
| | - Sanjay Patel
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Department of Coronary Diseases, The Heart Research Institute, Sydney, NSW, Australia
| | - Clare Arnott
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Department of Coronary Diseases, The Heart Research Institute, Sydney, NSW, Australia.,Department of Cardiology, The George Institute for Global Health, Sydney, NSW, Australia
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16
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Arnold M, Linden A, Clarke R, Guo Y, Du H, Bian Z, Wan E, Yang M, Wang L, Chen Y, Chen J, Long H, Gu Q, Collins R, Li L, Chen Z, Parish S. Carotid Intima-Media Thickness but Not Carotid Artery Plaque in Healthy Individuals Is Linked to Lean Body Mass. J Am Heart Assoc 2019; 8:e011919. [PMID: 31364443 PMCID: PMC6761650 DOI: 10.1161/jaha.118.011919] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/11/2019] [Indexed: 01/08/2023]
Abstract
Background Lean body mass has been identified as a key determinant of left ventricular mass and wall thickness. However, the importance of lean body mass or other body-size measures as normative determinants of carotid intima-media thickness (cIMT), a widely used early indicator of atherosclerosis, has not been well established. Methods and Results Carotid artery ultrasound measurements of cIMT and carotid artery plaque burden (derived from plaque number and maximum size) and measurements of body size, including height, body mass index, weight, body fat proportion, and lean body mass ([1-body fat proportion]×weight), were recorded in 25 020 participants from 10 regions of China. Analyses were restricted to a healthy younger subset (n=6617) defined as never or long-term ex-regular smokers aged <60 years (mean age, 50) without previous ischemic heart disease, stroke, diabetes mellitus, or hypertension and with plasma non-high-density lipoprotein cholesterol <4 mmol/L. Among these 6617 participants, 86% were women (because most men smoked) and 9% had carotid artery plaque. In both women and men separately, lean body mass was strongly positively associated with cIMT, but was not associated with plaque burden: overall, each 10 kg higher lean body mass was associated with a 0.03 (95% CI, 0.03-0.04) mm higher cIMT (P=5×10-33). Fat mass, height, and other body-size measures were more weakly associated with cIMT. Conclusions The strong association of lean body mass with cIMT, but not with plaque burden, in healthy adults suggests a normative relationship rather than reflecting atherosclerotic pathology. Common mechanisms may underlie the associations of lean body mass with cIMT and with nonatherosclerotic vascular traits.
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Affiliation(s)
- Matthew Arnold
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Andrew Linden
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
- MRC Population Health Research UnitUniversity of OxfordOxfordUnited Kingdom
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Eric Wan
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Meng Yang
- Division of Ultrasound DiagnosisPeking Union Medical College HospitalBeijingChina
| | - Liang Wang
- Division of Ultrasound DiagnosisPeking Union Medical College HospitalBeijingChina
| | - Yuexin Chen
- Centre of Vascular SurgeryPeking Union Medical College HospitalBeijingChina
| | | | - Huajun Long
- NCDs Prevention and Control DepartmentLiuyang CDCLiuyangChina
| | | | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Liming Li
- Chinese Academy of Medical SciencesBeijingChina
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Sarah Parish
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
- MRC Population Health Research UnitUniversity of OxfordOxfordUnited Kingdom
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17
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Sub-clinical atherosclerosis in the common carotid artery in women with/without previous pre-eclampsia: A seven-year follow-up. Atherosclerosis 2019; 290:206-213. [PMID: 31200939 DOI: 10.1016/j.atherosclerosis.2019.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/04/2019] [Accepted: 05/24/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Pre-eclampsia is associated with increased risk of cardiovascular disease and premature death. However, conventional common carotid artery intima-media thickness (CCA-IMT) measurement does not reflect this. In contrast, measurement of the individual CCA intima and media thicknesses clearly indicates increased vascular risk both at diagnosis and about one year after pre-eclampsia. This study examined whether individual CCA wall layers, risk factors for cardiovascular disease, and markers of endothelial dysfunction had normalized or remained unfavorable seven years after pre-eclampsia. METHODS The individual CCA intima and media thicknesses were measured using 22 MHz ultrasound. Conventional cardiovascular risk factors were recorded. A thick intima, thin media and high intima/media thickness ratio (I/M) are signs of sub-clinical atherosclerosis. RESULTS The median age of women with previous pre-eclampsia (cases = 23) or normal pregnancies (controls = 35) was 39/37 years. At follow-up (median about seven years), the intima remained thicker and the I/M was higher in cases than in controls [all p < 0.0001; p < 0.001 after adjustment for time to follow-up, body mass index (BMI), and mean arterial pressure (MAP)], whereas the CCA-IMT was illogically thinner. Further, BMI, MAP, hip circumference, abdominal height, serum endostatin and apolipoprotein B levels were higher in cases (all p < 0.05). Intima and I/M measurements were correlated with age, MAP, endostatin and apolipoprotein B, whereas no logical correlations were found for CCA-IMT. CONCLUSIONS The arteries in cases but not controls were still adversely affected after seven years. Measuring intima thickness and I/M appears preferable to measuring CCA-IMT for demonstrating vascular risk after pre-eclampsia.
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18
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Johnsson IW, Naessén T, Ahlsson F, Gustafsson J. High birth weight was associated with increased radial artery intima thickness but not with other investigated cardiovascular risk factors in adulthood. Acta Paediatr 2018; 107:2152-2157. [PMID: 29791055 DOI: 10.1111/apa.14414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 04/20/2018] [Accepted: 05/18/2018] [Indexed: 11/29/2022]
Abstract
AIM This study investigated whether a high birth weight was associated with increased risk factors for cardiovascular disease when Swedish adults reached 34-40. METHODS We studied 27 subjects born at Uppsala University Hospital in 1975-1979, weighing at least 4500 g, and compared them with 27 controls selected by the Swedish National Board of Welfare with birth weights within ±1 standard deviations scores and similar ages and gender. The study included body mass index (BMI), blood pressure, lipid profile, haemoglobin A1c (HbA1c), C-reactive protein (CRP) and high-frequency ultrasound measurements of intima-media thickness, intima thickness (IT) and intima:media ratio of the carotid and radial arteries. RESULTS Subjects with a high birth weight did not differ from controls with regard to BMI, blood pressure, lipid profile, high-sensitivity CRP, HbA1c or carotid artery wall dimensions. However, their radial artery intima thickness was 37% greater than the control group and their intima:media ratio was 44% higher. CONCLUSION Our findings indicate that a high birth weight was associated with increased radial artery intima thickness, but not with other investigated cardiovascular risk factors, at 34-40 years of age. The clinical implications of these findings should be investigated further, especially in subjects born with a very high birth weight.
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Affiliation(s)
- I W Johnsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - T Naessén
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - F Ahlsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - J Gustafsson
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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Ljunggren M, Lindberg E, Franklin KA, Öhagen P, Larsson M, Theorell-Haglöw J, Naessén T. Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women. Sleep 2018; 41:4995715. [DOI: 10.1093/sleep/zsy099] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Indexed: 01/01/2023] Open
Affiliation(s)
- Mirjam Ljunggren
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Patrik Öhagen
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Marita Larsson
- Department of Women’s and Children’s Health, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Jenny Theorell-Haglöw
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Tord Naessén
- Department of Women’s and Children’s Health, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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20
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Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0191172. [PMID: 29649236 PMCID: PMC5896895 DOI: 10.1371/journal.pone.0191172] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/29/2017] [Indexed: 12/28/2022] Open
Abstract
AIMS Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
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Affiliation(s)
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Cambridge, United Kingdom
| | | | - Giuseppe Danilo Norata
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, UMR, Paris, France
| | - Irene Schmidtmann
- Institut fuer Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitaetsmedizin Mainz, Mainz, Germany
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Sathanur R. Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Coen D. A. Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joseph F. Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Moise Desvarieux
- Department of Epidemiology,Mailman School of Public Health,Columbia University, New York, United States of America
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Daniel Staub
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Cesare R. Sirtori
- Center of Dyslipidemias, Niguarda Ca’ Granda Hospital, Milano, Italy
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Oscar Beloqui
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Alfonso Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Liliana Grigore
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Stefan Blankenberg
- 2nd Department of Medicine, Johannes Gutenberg-Universität, Mainz, Germany
- Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | | | - Henry Völzke
- German Center for Cardiovascular Research (DZHK),partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Raffaele Izzo
- School of Medicine, Federico II University, Naples, Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Thapat Wannarong
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | | | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health,National Taiwan University, Taipei, Taiwan
| | - Jackie F. Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, Gothenburg University, Götheborg, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Elena Tremoli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
| | | | - Manuel F. Landecho
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Maria Rosvall
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Rafael Gabriel
- Escuela National de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Nicola de Luca
- School of Medicine, Federico II University, Naples, Italy
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eric de Groot
- Imagelabonline & Cardiovascular, Eindhoven and Lunteren, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - David N. Yanez
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Simon G. Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Hu X, Zhang Y, Cai G, Zhang K, Deng L, Gao L, Han S, Chen J. A dynamic ultrasound simulation of a pulsating three-layered CCA for validation of two-dimensional wall motion and blood velocity estimation algorithms. Med Phys 2017; 45:131-143. [PMID: 29148586 DOI: 10.1002/mp.12678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/13/2017] [Accepted: 10/23/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE A dynamic ultrasound simulation model for the common carotid artery (CCA) with three arterial layers for validation of two-dimensional wall motion and blood velocity estimation algorithms is proposed in the present study. This model describes layers with not only characteristics of echo distributions conforming to clinical ones but also varying thicknesses, axial, and radial displacements with pulsatile blood pressure during a cardiac cycle. METHODS The modeling process is as follows: first, a geometrical model according with the clinical structure size of a CCA is built based on the preset layer thicknesses and the diameter of lumen. Second, a three-dimensional scatterer model is constructed by a mapping with a Hilbert space-filling curve from the one-dimensional scatterer distribution with the position and amplitude following Gamma and Gaussian distributions, respectively. The characteristics of three layers and blood are depicted by smoothly adjusting the scatterer density, the scale, and shape parameters of the Gamma distribution as well as the mean and standard deviation of the Gaussian distribution. To obtain the values of parameters of scatterer distributions, including the shape parameter, density, and intensity, for arterial layers and blood, the envelope signals simulated from different configurations of scatterer distribution are compared with those from different kinds of tissue of CCAs in vivo through a statistic analysis. Finally, the dynamic scatterer model is realized based on the blood pressure, elasticity modulus of intima-media (IM) and adventitia, varying IM thickness, axial displacement of IM as well as blood flow velocity at central axis during a cardiac cycle. Then, the corresponding radiofrequency (RF) signals, envelope signals, and B-mode images of the pulsatile CCA are generated in a dynamic scanning mode using Field II platform. RESULTS The three arterial layers, blood, and surrounding tissue in simulated B-mode ultrasound images are clearly legible. The results based on a statistical analysis for the envelope signals from 30 simulations indicate that the echo characteristics of blood, intima, media, and adventitia are in accordant with clinical ones. The maximum relative errors between the preset geometrical sizes and the measured ones from the simulated images for the diameter of the lumen and the thicknesses of the intima, media, and adventitia are 0.13%, 3.89%, 1.35%, and 0.06%, respectively. For the dynamic parameters, the variation in IM thickness, the radial displacements of lumen and adventitia as well as the axial displacement of IM and blood flow velocity are measured with the mean relative errors of 68.03%, 9.27%, 2.10%, 4.93%, and 17.34%, respectively. CONCLUSION The simulated results present static sizes and dynamical variations according with preset values; echo distributions conforming to clinical versions. Therefore, the presented simulation model could be useful as a data source to evaluate the performance of studies on measurements of ultrasound-based tissue structures and dynamic parameters for the CCA layers.
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Affiliation(s)
- Xiao Hu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Guanghui Cai
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Kexin Zhang
- Department of Cardiovascular, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650031, China
| | - Li Deng
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Lian Gao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Suya Han
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Jianhua Chen
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
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22
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The influence of prenatal exercise and pre-eclampsia on maternal vascular function. Clin Sci (Lond) 2017; 131:2223-2240. [PMID: 28798074 DOI: 10.1042/cs20171036] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/03/2017] [Accepted: 07/06/2017] [Indexed: 01/10/2023]
Abstract
During healthy pregnancy, the cardiovascular system undergoes diverse adaptations to support adequate transfer of oxygen and nutrients from mother to fetus. In order to accommodate the large expansion of blood volume and associated cardiac output, the structure, mechanics, and function of the arteries are altered. Specifically, in healthy pregnancy there is a remodeling of arteries (increased angiogenesis and vasodilation), a generalized reduction in arterial stiffness (increased compliance), and an enhanced endothelial function. The development of pregnancy complications, specifically pre-eclampsia, is associated with poor placentation (decreased angiogenesis), increased arterial stiffness, and vascular dysfunction (reduced endothelial function). Many of the positive adaptations that occur in healthy pregnancy are enhanced in response to chronic exercise. Specifically, placental angiogenesis and endothelial function have been shown to improve to a greater extent in women who are active during their pregnancy compared with those who are not. Prenatal exercise may be important in helping to reduce the risk of vascular dysfunction in pregnancy. However, our knowledge of the vascular adaptations resulting from maternal exercise is limited. This review highlights maternal vascular adaptations occurring during healthy pregnancy, and contrasts the vascular maladaptation associated with pre-eclampsia. Finally, we discuss the role of prenatal exercise on vascular function in the potential prevention of vascular complications associated with pre-eclampsia.
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Akhter T, Wikström AK, Larsson M, Larsson A, Wikström G, Naessen T. Serum Pentraxin 3 is associated with signs of arterial alteration in women with preeclampsia. Int J Cardiol 2017; 241:417-422. [DOI: 10.1016/j.ijcard.2017.03.076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
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Akhter T, Wikström A, Larsson M, Larsson A, Wikström G, Naessen T. Association between angiogenic factors and signs of arterial aging in women with pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:93-99. [PMID: 27256927 PMCID: PMC5516159 DOI: 10.1002/uog.15981] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/07/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Pre-eclampsia (PE) is associated with an increased risk of cardiovascular disease later in life. In cases with PE there is a substantial increase in levels of the antiangiogenic factor soluble fms-like tyrosine kinase-1 (sFlt-1) and decreased levels of the proangiogenic factor placental growth factor (PlGF). Elevated levels of sFlt-1 are also found in individuals with cardiovascular disease. The aims of this study were to assess levels of sFlt-1, PlGF and the sFlt-1/PlGF ratio and their correlation with signs of arterial aging by measuring the common carotid artery (CCA) intima and media thicknesses and their ratio (I/M ratio) in women with and without PE. METHODS Serum sFlt-1 and PlGF levels were measured using commercially available enzyme-linked immunosorbent assay kits, and CCA intima and media thicknesses were estimated using high-frequency (22-MHz) ultrasonography in 55 women at PE diagnosis and in 64 women with normal pregnancy at a similar gestational age, with reassessment at 1 year postpartum. RESULTS During pregnancy, higher levels of sFlt-1, lower levels of PlGF, a thicker intima, a thinner media and a higher I/M ratio of the CCA were found in women with PE vs controls (all P < 0.0001). Further, sFlt-1 and the sFlt-1/PlGF ratio were positively correlated with intima thickness and I/M ratio (all P < 0.0001). At 1 year postpartum, levels of sFlt-1 and the sFlt-1/PlGF ratio had decreased in both groups; however, their levels in the PE group were still higher than in the controls (P = 0.001 and < 0.0001, respectively). Levels of sFlt-1 and the sFlt-1/PlGF ratio remained positively correlated with intima thickness and I/M ratio at 1 year postpartum. CONCLUSIONS Higher sFlt-1 levels and sFlt-1/PlGF ratio in women with PE were positively associated with signs of arterial aging during pregnancy. At 1 year postpartum, sFlt-1 levels and the sFlt-1/PlGF ratio were still higher in the PE group and were associated with the degree of arterial aging. © 2016 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- T. Akhter
- Department of Women's and Children's Health, Section of Obstetrics and GynaecologyUppsala UniversityUppsalaSweden
| | - A.‐K. Wikström
- Department of Women's and Children's Health, Section of Obstetrics and GynaecologyUppsala UniversityUppsalaSweden
| | - M. Larsson
- Department of Women's and Children's Health, Section of Obstetrics and GynaecologyUppsala UniversityUppsalaSweden
| | - A. Larsson
- Clinical Chemistry, Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - G. Wikström
- Cardiology, Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - T. Naessen
- Department of Women's and Children's Health, Section of Obstetrics and GynaecologyUppsala UniversityUppsalaSweden
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Kim JH, Youn HJ, Kim GH, Moon KW, Yoo KD, Kim CM. The Clinical Significance of Separate Measurements of Carotid Arterial Wall to Assess the Risk Factor for Atherosclerosis. J Cardiovasc Ultrasound 2016; 24:48-54. [PMID: 27081444 PMCID: PMC4828414 DOI: 10.4250/jcu.2016.24.1.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 11/25/2015] [Accepted: 02/01/2016] [Indexed: 11/22/2022] Open
Abstract
Background Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. Methods Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). Results In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. Conclusion We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
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Affiliation(s)
- Ji-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gee-Hee Kim
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Keon-Woong Moon
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Chul-Min Kim
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
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Akhter T, Larsson M, Wikström AK, Naessen T. Thicknesses of individual layers of artery wall indicate increased cardiovascular risk in severe pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 43:675-680. [PMID: 24375803 DOI: 10.1002/uog.13289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 12/05/2013] [Accepted: 12/11/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess whether thicknesses of the intima and media in the common carotid artery (CCA) and the intima/media ratio (I/M) indicate an increased cardiovascular risk in non-pregnant women with a history of previous severe pre-eclampsia. METHODS Thicknesses of the CCA intima and media layers were measured using non-invasive high-frequency (22 MHz) ultrasound in 42 women with a history of severe pre-eclampsia and 44 women with previous normal pregnancy. RESULTS Women with a history of severe pre-eclampsia had a thicker CCA intima and a higher I/M than had women with previous normal pregnancy, also after adjustment for mean arterial pressure, body mass index and CCA intima-media thickness (IMT) (all P < 0.0001). CCA-IMT did not differ significantly between groups. In receiver-operating characteristics curve analysis, intima thickness and I/M clearly discriminated between women with and those without previous pre-eclampsia (area under the receiver-operating characteristics curve (AUC), 0.98 and 0.93), whereas CCA-IMT did not (AUC, 0.52). CONCLUSIONS CCA individual intima and media thicknesses as well as I/M, but not CCA-IMT, reflect the known increased long-term cardiovascular risk of pre-eclampsia. Estimation of individual CCA layers using high-frequency ultrasound appears preferable to measuring CCA-IMT for investigating arterial effects and the increased cardiovascular risk in women with a history of severe pre-eclampsia.
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Affiliation(s)
- T Akhter
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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Akhter T, Wikström AK, Larsson M, Naessen T. Individual common carotid artery wall layer dimensions, but not carotid intima-media thickness, indicate increased cardiovascular risk in women with preeclampsia: an investigation using noninvasive high-frequency ultrasound. Circ Cardiovasc Imaging 2013; 6:762-8. [PMID: 23811751 DOI: 10.1161/circimaging.113.000295] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Preeclampsia (PE) is associated with increased risk of cardiovascular disease later in life. Ultrasound assessment of the common carotid artery intima-media thickness (IMT) during or after PE has not indicated any increased cardiovascular risk. METHODS AND RESULTS We used high-frequency ultrasound (22 MHz) to estimate the individual common carotid artery IMTs in 55 women at PE diagnosis and in 64 women with normal pregnancies at a similar stage. All were re-examined about 1 year postpartum. A thick intima, thin media, and high intima/media (I/M) ratio are signs of a less healthy artery wall. PE was associated with a significantly thicker mean common carotid artery intima, thinner media, and higher I/M ratio than in normal pregnancy (mean I/M difference, 0.21; 95% confidence interval, 0.17-0.25; P<0.0001). After adjustment for first trimester body mass index and mean arterial pressure, differences in intima thickness and I/M remained significant. About 1 year postpartum, these values had improved in both groups, but group differences remained significant (all adjusted P<0.0001). There were no significant differences in IMT between groups. In receiver-operating characteristic curve analysis, intima thickness and I/M were strongly predictive of prevalent PE (area under the curve, ≈0.95), whereas IMT was not (area under the curve, 0.49). CONCLUSIONS The arteries of women with PE were negatively affected during pregnancy and 1 year postpartum compared with women with normal pregnancies, indicating increased cardiovascular risk. Estimation of intima thickness and I/M ratio seem preferable to estimation of common carotid artery IMT in imaging cardiovascular risk in PE. Results from this pilot study warrant further confirmation.
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Affiliation(s)
- Tansim Akhter
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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de la Cuesta F, Zubiri I, Maroto AS, Posada M, Padial LR, Vivanco F, Alvarez-Llamas G, Barderas MG. Deregulation of smooth muscle cell cytoskeleton within the human atherosclerotic coronary media layer. J Proteomics 2013; 82:155-65. [PMID: 23429260 DOI: 10.1016/j.jprot.2013.01.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/16/2013] [Accepted: 01/24/2013] [Indexed: 11/16/2022]
Abstract
UNLABELLED Fatal events derived from coronary atherosclerosis are the major cause of mortality in the developed countries. Proteomic analysis of the atherosclerotic coronary artery has been mainly carried out with whole tissue extracts, making it difficult to distinguish the alterations present in every region of the plaque. For this reason, we have recently described proteins altered in the human coronary intima layer as a consequence of the atherosclerotic disease. In order to complement this work, we aimed here to analyze proteomic alterations occurring within the human coronary media layer. Media layers from human atherosclerotic and preatherosclerotic coronary arteries were isolated by laser microdissection and compared by means of two-dimensional differential in-gel electrophoresis (2D-DIGE). Twelve proteins were found altered, 5 of which were cytoskeleton proteins decreased in the atherosclerotic coronary media. Among these, 4 proteins (filamin A, gelsolin, vinculin and vimentin) were further analyzed by immunohistochemistry and its alteration validated. Such cytoskeleton deregulation evidence, at the molecular level, explains how medial vascular smooth muscle cells (VSMCs) switch from a contractile to a synthetic phenotype. Moreover, an oxidative stress response within the media, leaded by superoxide dismutase 3 and glycolysis activation, may have been triggered by atherosclerosis development. BIOLOGICAL SIGNIFICANCE Although atherosclerosis is mainly a disease of the intima layer, the media plays an important role in the initiation of the pathology, as a source of vascular smooth muscle cells (VSMCs), which migrate into the intima and may additionally be affected by intima layer degeneration through pathogenesis. In fact, intimal thickening has been related to a mechanical compression of the media layer, resulting on a significant thinning of the latter in the atherosclerotic carotid and coronary arteries, which may provoke alterations at a molecular level. Here we provide the first differential proteomic analysis of atherosclerotic coronary media layer, reporting important alterations of this sub-proteome with pathogenesis. It is important to remark a cytoskeleton deregulation observed at the molecular level within VSMCs, which may be explained by a contractile to synthetic phenotype switch. Moreover, atherosclerosis seems to trigger an oxidative stress response within the coronary media layer.
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Affiliation(s)
- Fernando de la Cuesta
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, SESCAM, Toledo, Spain
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Akhter T, Larsson A, Larsson M, Wikström AK, Naessen T. Artery wall layer dimensions during normal pregnancy: a longitudinal study using noninvasive high-frequency ultrasound. Am J Physiol Heart Circ Physiol 2012; 304:H229-34. [PMID: 23125216 DOI: 10.1152/ajpheart.00670.2012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The vascular effects of normal pregnancy were investigated by estimating the intima and media thicknesses of the common carotid artery separately using 22-MHz ultrasound (Collagenoson, Meudt, Germany) in 57 healthy women with normal pregnancies and pregnancy outcomes, in all three trimesters and at 1 yr postpartum. A thick intima, thin media, and high intima-to-media (I/M) ratio are signs of a less healthy artery wall. Mean artery wall layer dimensions remained fairly constant during pregnancy, but the intima thickness and I/M thickness ratio appeared to improve (decrease) postpartum (P < 0.001 for both). The cardiovascular risk parameters of age, body mass index, and blood pressure in the first trimester were associated with higher I/M ratios, especially in the second trimester, whereas higher serum estradiol levels were significantly associated with a lower I/M ratio. Changes from the first to second trimesters in I/M ratio, taking into account differential changes in intima and media thickness, were significantly (P < 0.05-0.001) associated with all risk parameters tested except age, which was associated with increased intima thickness (P = 0.02). Associations with third trimester values and changes from first to third trimesters were similar but less apparent. Thus, fairly constant mean artery wall layer dimensions during pregnancy appeared to improve postpartum. However, higher age, body mass index, or blood pressure and lower serum estradiol levels in the first trimester appeared to negatively affect the artery wall, strongly suggesting that pregnancy has negative vascular effects in some women. A less likely explanation involves possible adaptation to physiological changes during and after pregnancy.
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Affiliation(s)
- Tansim Akhter
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
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Lorenz MW, Polak JF, Kavousi M, Mathiesen EB, Völzke H, Tuomainen TP, Sander D, Plichart M, Catapano AL, Robertson CM, Kiechl S, Rundek T, Desvarieux M, Lind L, Schmid C, DasMahapatra P, Gao L, Ziegelbauer K, Bots ML, Thompson SG. Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet 2012; 379:2053-62. [PMID: 22541275 PMCID: PMC3918517 DOI: 10.1016/s0140-6736(12)60441-3] [Citation(s) in RCA: 428] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) is related to the risk of cardiovascular events in the general population. An association between changes in cIMT and cardiovascular risk is frequently assumed but has rarely been reported. Our aim was to test this association. METHODS We identified general population studies that assessed cIMT at least twice and followed up participants for myocardial infarction, stroke, or death. The study teams collaborated in an individual participant data meta-analysis. Excluding individuals with previous myocardial infarction or stroke, we assessed the association between cIMT progression and the risk of cardiovascular events (myocardial infarction, stroke, vascular death, or a combination of these) for each study with Cox regression. The log hazard ratios (HRs) per SD difference were pooled by random effects meta-analysis. FINDINGS Of 21 eligible studies, 16 with 36,984 participants were included. During a mean follow-up of 7·0 years, 1519 myocardial infarctions, 1339 strokes, and 2028 combined endpoints (myocardial infarction, stroke, vascular death) occurred. Yearly cIMT progression was derived from two ultrasound visits 2-7 years (median 4 years) apart. For mean common carotid artery intima-media thickness progression, the overall HR of the combined endpoint was 0·97 (95% CI 0·94-1·00) when adjusted for age, sex, and mean common carotid artery intima-media thickness, and 0·98 (0·95-1·01) when also adjusted for vascular risk factors. Although we detected no associations with cIMT progression in sensitivity analyses, the mean cIMT of the two ultrasound scans was positively and robustly associated with cardiovascular risk (HR for the combined endpoint 1·16, 95% CI 1·10-1·22, adjusted for age, sex, mean common carotid artery intima-media thickness progression, and vascular risk factors). In three studies including 3439 participants who had four ultrasound scans, cIMT progression did not correlate between occassions (reproducibility correlations between r=-0·06 and r=-0·02). INTERPRETATION The association between cIMT progression assessed from two ultrasound scans and cardiovascular risk in the general population remains unproven. No conclusion can be derived for the use of cIMT progression as a surrogate in clinical trials. FUNDING Deutsche Forschungsgemeinschaft.
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Affiliation(s)
- Matthias W Lorenz
- Department of Neurology, University Hospital, J W Goethe-University, Frankfurt am Main, Germany.
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Frisk P, Arvidson J, Larsson M, Naessén T. Risk factors for cardiovascular disease are increased in young adults treated with stem cell transplantation during childhood. Pediatr Transplant 2012; 16:385-91. [PMID: 22471896 DOI: 10.1111/j.1399-3046.2012.01693.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We measured risk factors for CVD in 18 patients at a median of 18.2 yr after SCT and in sex and age-matched controls. Three patients (17%), but none of the controls, met the criteria for the MetS (p = 0.25). In the patients, we found higher levels of triglycerides (0.94 vs. 0.62 mm, p = 0.019), total cholesterol (5.1 vs. 4.0 mm, p = 0.017), LDL (3.4 vs. 2.6 mm, p = 0.019), apolipoprotein B (1.04 vs. 0.74 g/L, p = 0.004), apolipoprotein B/A1 ratio (0.7 vs. 0.5, p = 0.026), and lower levels of adiponectin (4.9 vs. 7.5 mg/L, p = 0.008) than in the controls. The patients had a lower GHmax (9 vs. 20.7 mU/L, p = 0.002). GHmax was significantly correlated inversely with triglycerides (r = -0.64, p = 0.008), total cholesterol (r = -0.61, p = 0.011), apolipoprotein B (r = -0.60, p = 0.014), and apolipoprotein B/A1 ratio (r = -0.66, p = 0.005). We recorded a significantly thicker carotid intima layer among the patients than among matched controls (0.15 vs. 0.13 mm, p = 0.034). The level of adiponectin correlated inversely with carotid intima thickness (r = -0.55, p = 0.023). After SCT in childhood, long-term survivors may be at risk of developing premature CVD.
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Affiliation(s)
- Per Frisk
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Tran LTT, Park HJ, Kim HD. Is the carotid intima-media thickness really a good surrogate marker of atherosclerosis? J Atheroscler Thromb 2012; 19:680-90. [PMID: 22653163 DOI: 10.5551/jat.11767] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Intima-media thickness (IMT) is considered a surrogate measurement of atherosclerosis but this is still under debate. METHODS To evaluate the relationship between carotid IMT and atherosclerosis, postmortem specimens of the distal segments of the left common carotid artery (CCA) from 133 Korean men aged from 20 to 78 years were used for histopathology and computer-assisted morphometry. Blood lipids and atherosclerosis-associated collagen and elastin were quantitatively analyzed. RESULTS Correlation coefficients of IMT were smaller than those of intima thickness but IMT was well associated with age (r= 0.55, p <0.00001), atherosclerosis score (or grade, AS, r= 0.73, p < 0.00001), plaque area (PA, r= 0.72, p <0.00001), total cholesterol (TC, r= 0.69, p <0.00001), low-density lipoprotein cholesterol (LDL-c, r= 0.72, p <0.00001) and triglyceride (TG, r= 0.38, p < 0.001). Coronary artery stenosis (CAS) and coronary calcification were also well associated with age (p <0.00001), IMT (p <0.005) and PA (p <0.00001). When IMT was thicker than 1 mm, the possibility of carotid atherosclerosis accompanied with CAS and coronary calcification, TC, LDL-c and TG was much higher (CAS with coronary calcification,p <0.005; TC, p <0.00001; LDL-c, p < 0.00005; TG, p <0.00001). Collagen tended to increase while elastin tended to decrease as AS increased (p <0.005); collagen increased and elastin decreased (p <0.00001) when comparing plaque to the plaque-free area in the same segment. CONCLUSION These results support that the carotid IMT in association with TC, LDL-c and TG can be used as a good surrogate marker of atherosclerosis and predictor of coronary heart disease. Plaque formation may influence significant quantitative changes in collagen and elastin.
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Affiliation(s)
- Loan Thi Thanh Tran
- Department of Anatomy Cardiovascular Research Unit, Sungkyunkwan University, School of Medicine, South Korea
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Lau KH, Fung YK, Cheung YT, Tsang WK, Ying M. Repeatability and reproducibility of ultrasonographic measurement of carotid intima thickness. JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:79-84. [PMID: 22105470 DOI: 10.1002/jcu.20906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 10/11/2011] [Indexed: 05/31/2023]
Abstract
PURPOSE To evaluate the repeatability and reproducibility of intima thickness (IT) measurements at different sites along the common carotid artery and compare with intima-media thickness (IMT) measurements. METHODS Ultrasound examinations of common carotid artery were performed in 30 healthy subjects and 20 patients with diabetes mellitus. Carotid IT and IMT were measured at 10 mm, 13 mm, and 16 mm upstream from the carotid bulb. Each subject was scanned by three operators to evaluate inter-operator reproducibility. Each operator scanned the subjects twice to evaluate intra-operator repeatability. Inter-equipment reproducibility of the measurements was evaluated. RESULTS The inter-operator reproducibility for measuring carotid IT at the three sites was 81.5%, 81.9% and 69.1%, respectively, slightly lower than carotid IMT measurement (89.7%, 86.5%, 75.2%, respectively). The intra-operator repeatability for carotid IT measurement at the three sites ranged 76.9-89.5%, 67.4-90.3%, and 55.2-70.5%, respectively, and was lower than for IMT measurement (86.5-96.9%, 87.6-95.7%, 79.9-86.5%, respectively). The inter-equipment reproducibility of IMT (75.7-86.6%) was slightly better than for IT measurement (71.4-75.9%). CONCLUSIONS Ultrasonographic measurement of carotid IT is repeatable and reproducible, although not as good as IMT. Measurements preformed 10 mm to 13 mm upstream from the carotid bulb yield more repeatable and reproducible results.
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Affiliation(s)
- Kar-Ho Lau
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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Deng HB, Jiang CQ, Tomlinson B, Liu B, Lin JM, Wong KS, Cheung BMY, Lam TH, Thomas GN. A polymorphism in transforming growth factor-β1 is associated with carotid plaques and increased carotid intima-media thickness in older Chinese men: the Guangzhou Biobank Cohort Study-Cardiovascular Disease Subcohort. Atherosclerosis 2010; 214:391-6. [PMID: 21167485 DOI: 10.1016/j.atherosclerosis.2010.11.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 11/15/2010] [Accepted: 11/15/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Polymorphisms of the transforming growth factor-β1 (TGFB1) gene have not been associated with asymptomatic atherosclerosis previously. We investigated the relationship between a single nucleotide polymorphism (SNP) rs4803455 in TGFB1 and atherosclerosis identified by the presence of carotid plaque and increased intima-media thickness (IMT) in an older Chinese population. METHODS 1996 subjects (992 (49.7%) men aged 50-85 years) from the Guangzhou Biobank Cohort Study-Cardiovascular Subcohort (GBCS-CVD) were genotyped. Carotid plaque and IMT were assessed by B-mode ultrasonography. RESULTS In male subjects, the C allele of TGFB1 rs4803455 was significantly associated with prevalence of carotid plaque (adjusted OR: 2.49, 95% CI: 1.16-5.36, P = 0.03). The C allele was related to increased number of common carotid artery (CCA) plaques (P=0.03) and larger carotid plaque area (P = 0.02) in men. The homozygous carriers of allele C in male subjects also had a higher risk of having carotid IMT ≥ 1 mm (adjusted OR: 1.75, 95% CI: 1.05-2.93, P = 0.03). These associations were independent of age, smoking, physical activity, body mass index, blood pressure, lipid profile, fasting glucose and high sensitivity C-reactive protein. CONCLUSION This is the first study to show that the C allele in TGFB1 was associated with increased risk of atherosclerosis in older Chinese men. Further investigations on the linkage between the TGFB1 gene and progression of atherosclerosis in asymptomatic populations are warranted.
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Affiliation(s)
- Han-Bing Deng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
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Saba L, Sanfilippo R, Montisci R, Mallarini G. Associations between carotid artery wall thickness and cardiovascular risk factors using multidetector CT. AJNR Am J Neuroradiol 2010; 31:1758-63. [PMID: 20634310 DOI: 10.3174/ajnr.a2197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE It has been demonstrated that the increase in CAWT is associated with an increased risk of stroke and its severity. The aim of this study was to determine whether CAWT evaluated by MDCTA is associated with the following cardiovascular risk factors: hypertension, diabetes mellitus, dyslipidemia, and smoking. MATERIALS AND METHODS This was a retrospective study. One hundred sixty-eight patients (120 men; mean age, 68.96 years ± 11.2 years SD) were analyzed by using a multidetector row CT scanner. In each patient, CAWT was measured by using an internal digital caliper. Continuous data were described as the mean value ± SD and were compared by using the Student t test. We performed simple logistic regressions to evaluate the association between CAWT and the following: hypertension, diabetes mellitus, dyslipidemia, and smoking. A P value < .05 indicated statistical significance. RESULTS The distal common CAWT varied from 0.5 to 1.5 mm. We observed that hypertension and diabetes mellitus were associated with increased (>1 mm) CAWT (P = .0041 and P = .0172, respectively). There was no significant association between increased CAWT and dyslipidemia or smoking. CONCLUSIONS In our selected group, the results of this work show that an increased CAWT is associated with the cardiovascular risk determinants hypertension and diabetes. Further studies are necessary to evaluate whether it is possible to apply our observations to the general population.
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Affiliation(s)
- L Saba
- Departments of Radiology, Azienda Ospedaliero Universitaria, di Cagliari-Polo di Monserrato s.s. 554, Monserrato, Cagliari, Italy.
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Naessen T, Sjogren U, Bergquist J, Larsson M, Lind L, Kushnir MM. Endogenous steroids measured by high-specificity liquid chromatography-tandem mass spectrometry and prevalent cardiovascular disease in 70-year-old men and women. J Clin Endocrinol Metab 2010; 95:1889-97. [PMID: 20164295 DOI: 10.1210/jc.2009-1722] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT There is a need for increased knowledge about endogenous sex hormone levels and clinical outcomes of risk/benefit. Immunoassays have poor specificity to reliably measure low steroid concentrations in elderly. OBJECTIVE The objective of the study was to evaluate plasma steroid concentrations with regard to prevalent cardiovascular disease (CVD) in elderly, using mass spectrometry. SETTING The study was conducted at a university hospital research unit. DESIGN AND METHODS Plasma samples were analyzed from 202 70-yr-olds as part of a large population-based study, Prospective Investigation of the Vasculature in Uppsala Seniors. Twenty-eight of these had prevalent CVD. Eleven steroids were quantified, using liquid chromatography-tandem mass spectrometry. Women with current/previous menopausal hormone therapy (n = 35) were excluded. RESULTS Men without prevalent CVD had higher plasma 17beta-estradiol (E2), compared with women. Men with prevalent CVD, compared with those without, had lower 17-hydroxypregnenolone (17OHPregn), 17-hydroxyprogesterone, and higher estrone/androstenedione and E2/testosterone (T) (aromatase activity). Women with prevalent CVD had lower pregnenolone, 17OHPregn, and dehydroepiandrosterone (DHEA) but higher DHEA/17OHPregn, androstenedione/DHEA, E2/T, E2/estrone, and E2/SHBG. The aromatase index, E2/T, was higher for prevalent CVD in both sexes. Adjustment for statin use, smoking, and body mass index yielded additional significant differences in men, whereas some were lost in women. Logistic regression indicated strong associations between prevalent CVD and low 17OHPregn, adjusted odds ratio of 0.18, 95% confidence interval (0.06-0.61); P = 0.006, in women and low 17-hydroxyprogesterone, 0.45 (0.25-0.80); P = 0.007 in men, most likely caused by increased throughput (consumption) toward estrogen synthesis. CONCLUSIONS Prevalent CVD was associated with indications of lower androgen precursors, increased aromatase activity, and higher estrogen levels in both sexes. Results might represent an endogenous response to a condition of developing atherosclerosis, rather than a causative relationship. Furthermore studies are needed.
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Affiliation(s)
- Tord Naessen
- Department of Women's and Children's Health, Section for Obstetrics and Gynecology, University Hospital, Uppsala SE-751 85, Sweden.
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Myredal A, Gan LM, Osika W, Friberg P, Johansson M. Increased intima thickness of the radial artery in individuals with prehypertension and hypertension. Atherosclerosis 2010; 209:147-51. [DOI: 10.1016/j.atherosclerosis.2009.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 08/24/2009] [Accepted: 09/08/2009] [Indexed: 10/20/2022]
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Adam SK, Das S, Jaarin K. A detailed microscopic study of the changes in the aorta of experimental model of postmenopausal rats fed with repeatedly heated palm oil. Int J Exp Pathol 2009; 90:321-7. [PMID: 19563614 DOI: 10.1111/j.1365-2613.2009.00658.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hypercholesterolaemia, increase in lipid peroxidation and hyperhomocysteinaemia may contribute to the pathogenesis of atherosclerosis. This study was performed to examine the effects of repeatedly heated palm oil mixed with 2% cholesterol diet on atherosclerosis in oestrogen-deficient postmenopausal rats. Ovariectomy causes disruption of tunica intima layer of the rat aorta simulating a postmenopausal condition in females. Twenty-four ovariectomized female Sprague-Dawley rats were divided into four groups. The control group received 2% cholesterol diet without palm oil. A diet with 2% cholesterol content fortified with fresh, once-heated and five-times-heated palm oil was given to the other treatment groups. The rats were sacrificed at the end of 4 months of study and the aortic arch tissue was processed for histomorphometry and electron microscopy. On observation, there was disruption of the intimal layer of the ovariectomized rat aorta. There was no obvious ultrastructural change in the aorta of the rats fed with fresh palm oil. The ultrastructural changes were minimal with once-heated palm oil, in which there was a focal disruption of the endothelial layer. The focal disruption was more pronounced with five-times-heated palm oil. The results of this study show that the ingestion of fresh palm oil may have a protective effect on the aorta but such a protective action may be lost when the palm oil is repeatedly heated. The study may be clinically important for all postmenopausal women who are susceptible to atherosclerosis.
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Affiliation(s)
- Siti Khadijah Adam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Choi YS, Youn HJ, Youn JS, Park CS, Oh YS, Chung WS. Measurement of the intimal thickness of the carotid artery: comparison between 40 MHz ultrasound and histology in rats. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:962-966. [PMID: 19285785 DOI: 10.1016/j.ultrasmedbio.2008.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 11/19/2008] [Accepted: 12/03/2008] [Indexed: 05/27/2023]
Abstract
Common carotid artery intimal thickness (IT) has been shown to be as useful as a measurement of the whole layer of intima-media thickness (IMT) for evaluating the early phase of atherosclerosis. The aim of this study was to elucidate the relationship between high echogenic intimal thickening (HEIT), which was measured using a 40 MHz ultrasound biomicroscope (UBM), and the histologically determined IT in rat carotid arteries. HEIT was estimated in 10 Wistar-Kyoto rats (group I), 15 spontaneous hypertensive rats (SHR) fed a standard diet (group II) and 10 SHR fed a high-fat diet (group III). IT and IMT measurements were determined in Masson trichrome-stained tissues and were compared with the HEIT and IMT evaluated using the UBM. In group I, the HEIT and the IT were 33 +/- 4 microm and 12 +/- 1 mirom, respectively. In group II, the HEIT and the IT were 68 +/- 8 microm and 16 +/- 2 microm, respectively. In group III, the HEIT and the IT were 65 +/- 26 microm and 33 +/- 14 microm, respectively. In SHR, the HEIT and the mean IMT measured with echography were significantly correlated with the IT and the IMT that were determined by histologic measurement (r = 0.60, p = 0.003 and r = 0.53, p = 0.01, respectively). Moreover, HEIT may be associated with the intimal pathology and atherosclerotic burden. The HEIT measurement is a noninvasive method that may be used to assess atherosclerosis in humans.
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Affiliation(s)
- Yun-Seok Choi
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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41
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Cardiovascular reactivity to psychological stress and carotid intima-media thickness in children. Psychophysiology 2009; 46:293-9. [DOI: 10.1111/j.1469-8986.2008.00776.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Adam SK, Das S, Othman F, Jaarin K. Fresh soy oil protects against vascular changes in an estrogen-deficient rat model: an electron microscopy study. Clinics (Sao Paulo) 2009; 64:1113-9. [PMID: 19936186 PMCID: PMC2780529 DOI: 10.1590/s1807-59322009001100012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 08/24/2009] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To observe the effects of consuming repeatedly heated soy oil on the aortic tissues of estrogen-deficient rats. METHODS Thirty female Sprague Dawley rats (200-250 g) were divided equally into five groups. One group served as the normal control (NC) group. The four treated groups were ovariectomized and were fed as follows: 2% cholesterol diet (OVXC); 2% cholesterol diet + fresh soy oil (FSO); 2% cholesterol diet + once-heated soy oil (1HSO); and 2% cholesterol diet + five-times-heated soy oil (5HSO). After four months, the rats were sacrificed, and the aortic tissues were obtained for histological studies. RESULTS After four months of feeding, the NC, FSO and 1HSO groups had a lower body weight gain compared to the OVXC and 5HSO groups. The tunica intima/media ratio in the 5HSO group was significantly thicker (p < 0.05) compared to the NC, OVXC and FSO groups. Electron microscopy showed that endothelial cells were normally shaped in the FSO and NC groups but irregular in the 1HSO and 5HSO groups. A greater number of collagen fibers and vacuoles were observed in the 5HSO group compared to the other treatment groups. CONCLUSIONS Fresh soy oil offered protection in the estrogen-deficient state, as these rats had similar features to those of the NC group. The damage to the tunica intima and the increase in the ratio of tunica intima/media thickness showed the deleterious effect of consuming repeatedly heated soy oil in castrated female rats.
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Affiliation(s)
- Siti Khadijah Adam
- Universiti Kebangsaan Malaysia, Department of Pharmacology, Faculty of Medicine - Kuala Lumpur, Malaysia
| | - Srijit Das
- Universiti Kebangsaan Malaysia, Department of Anatomy, Faculty of Medicine - Kuala Lumpur, Malaysia.
| | - Faizah Othman
- Universiti Kebangsaan Malaysia, Department of Anatomy, Faculty of Medicine - Kuala Lumpur, Malaysia.
| | - Kamsiah Jaarin
- Universiti Kebangsaan Malaysia, Department of Pharmacology, Faculty of Medicine - Kuala Lumpur, Malaysia
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43
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Hansen T, Ahlström H, Johansson L. Whole-body screening of atherosclerosis with magnetic resonance angiography. Top Magn Reson Imaging 2007; 18:329-337. [PMID: 18025987 DOI: 10.1097/rmr.0b013e318159aaa2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
With whole-body magnetic resonance angiography (WBMRA), it is possible to examine the whole arterial tree except intracranial and coronary vessels in a single examination without the risks involved in ionizing radiation or arterial cannulation. Whole-body magnetic resonance angiography is well suited for repeated clinical examinations in patients with systemic diseases such as vasculitis or atherosclerosis and can also be used for scientific purposes. On the basis of the WBMRA overview, a possible further development of the WBMRA concept can be to perform further acquisitions at sites with atherosclerotic plaques with higher-resolution scans to determine the degree of stenosis more accurately or to achieve plaque characterization. A total validation of WBMRA compared with digital subtraction angiography (DSA) is not possible owing to the hazards of ionizing radiation. Studies have shown a high sensitivity and specificity for the pelvic and lower limb arteries in comparison with DSA. No systematic validation against DSA has been performed for the renal, aortic, and carotid arteries. Various methods have been used, however, for confirmation of vascular abnormalities found on WBMRA such as ultrasonography, dedicated MRA, or DSA, with reasonably high agreement. The WBMRA method has not been studied with regard to prediction of future cardiovascular (CV) events, as have intima media thickness, coronary artery calcium scoring, and the ankle-brachial index. The full usefulness of WBMRA in an epidemiological setting and as a complementary screening tool for assessing CV risk still needs to be validated against future CV events.
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Affiliation(s)
- Tomas Hansen
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
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44
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Osika W, Dangardt F, Grönros J, Lundstam U, Myredal A, Johansson M, Volkmann R, Gustavsson T, Gan LM, Friberg P. Increasing Peripheral Artery Intima Thickness From Childhood to Seniority. Arterioscler Thromb Vasc Biol 2007; 27:671-6. [PMID: 17194890 DOI: 10.1161/01.atv.0000256468.95403.6f] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Using new, very high-resolution ultrasound biomicroscopy, we examined the thickness of artificial layers of silicone and intima thickness (IT) of radial and anterior tibial arteries in healthy subjects and in patients with vascular disease.
Methods and Results—
Silicone layers of varying thicknesses and mesenteric artery specimens obtained from 18 patients undergoing colectomy were measured by both ultrasound biomicroscopy (55 MHz) and morphometry. There was high correlation (
r
>0.9;
P
<0.0001) between IT and intima area versus ultrasound biomicroscopy. In 90 healthy subjects (aged between 10 and 90 years), radial and anterior tibial arterial IT and intima-media thickness were measured, as was carotid intima-media thickness in 56 of these subjects. Age was strongly related with both media thickness and IT of both peripheral arteries. Correlations were found between carotid intima-media thickness and both radial and anterior tibial IT/intima-media thickness (
r
=0.44 to 0.53;
P
<0.0001). The IT-to-lumen diameter ratio increased with age and was larger at all ages in the anterior tibial artery (0.067±0.034) versus the radial artery (0.036±0.012;
P
<0.0001). A thicker radial intimal layer was found in patients with peripheral artery disease.
Conclusion—
This study is the first to our knowledge in humans to show the feasibility of measuring IT of the radial and anterior tibial arteries using very high-resolution ultrasound. IT progresses with age, and the IT-to-lumen diameter ratio is largest in the arteries of the foot. Assessment of IT by ultrasound biomicroscopy may aid in detecting early peripheral vascular abnormalities.
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Affiliation(s)
- Walter Osika
- Department of Clinical Physiology, Sahlgrenska University Hospital/Sahlgrenska, SE-413 45 Göteborg, Sweden.
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