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Belcaro G, Cornelli U, Cox D, Dugall M, Cesarone MR, Ledda A, Scipione V, Scipione C, Feragalli B, Cotellese R. Intestinal fat absorption shifting by polyglucosamine biopolymer: control of lipids and reduction of progression of early subclinical atherosclerosis. Minerva Gastroenterol (Torino) 2024; 70:22-28. [PMID: 37943250 DOI: 10.23736/s2724-5985.23.03539-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Atherosclerosis progression is possible in subjects with limited alteration of body weight, lipid profile, and oxidative stress. The ultrasound carotid thickness (IMT) and arterial wall modification (granulation and bubbles) are evident signs of the disease. Intestinal fats absorption shifting (IFAS) is expected to prevent or reduce the arterial damage. The aim of the registry was to evaluate the effects of a mild diet in association with lifestyle modifications (standard management [SM]) and SM+ a polyglucosamine biopolymer (BP) shifting the intestinal absorption of dietary fats. METHODS The present is a two-year registry comparing two groups of otherwise healthy subjects, respectively 150 (SM) and 144 (SM+BP). BP was administered at the dosage of 3g/day. IMT and relative arterial damages were measured together with lipid profile, oxidative stress, anthropometric and vital measures. RESULTS The two groups at the baseline were comparable for all variables: 8 cases of drop out were found limited to SM. Compliance with BP was optimal (>97%) and no side effect were observed. IMT showed a significant decrease in thickness (P<0.05) using BP+SM, while increased in SM group. Intimal granulations and lipid wall bubbles were also significantly decreased with BP in comparison to SM only (P<0.05). BMI significantly decreased with BP (P<0.05) as well as BW, fat mass, lipid profile and oxidative stress in comparison to SM only. A positive variation in blood pressure and heart rate (P<0.05) was also observed. CONCLUSIONS BP allows IFAS to improve early subclinical arterial lesions that tend to progress to plaques and clinical events. The long-term and safe treatment of BP is effective on IMT, lipids, BW, and early lesions of the arterial wall structure in subjects with subclinical conditions. BP also reduces oxidative stress which contributes to lipid oxidation and deposition into the arterial wall layer in areas of high dynamic stress (arterial bifurcations).
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Affiliation(s)
- Gianni Belcaro
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy -
| | | | - David Cox
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
| | - Mark Dugall
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
| | - Maria R Cesarone
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
| | - Andrea Ledda
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
| | - Valeria Scipione
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
| | - Claudia Scipione
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Italy
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2
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Rehberger Likozar A, Ugovšek S, Šebeštjen M. Effects of proprotein convertase subtilisin-kexin type 9 inhibitors on inflammatory and hemostatic parameters in post myocardial infarction patients. Eur J Pharmacol 2024; 963:176232. [PMID: 38070635 DOI: 10.1016/j.ejphar.2023.176232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024]
Abstract
Despite progress in treatment, elevated levels of low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a) (Lp(a)), represent a significant part of the residual risk. Both are associated with inflammation and the coagulation fibrinolytic system. The purpose of our research was to evaluate the effect of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) on lipid parameters and indicators of inflammation, coagulation and fibrinolysis. We included 100 post myocardial infarction (MI) patients with insufficiently controlled LDL-C values despite the maximum dose of statin, and highly elevated Lp(a). Patients received alirocumab or evolocumab (150 mg sc or 140 mg sc every two weeks, respectively), or placebo for 6 months. In patients receiving PCSK9i, a significant decrease in total cholesterol (TC), LDL-C, triglycerides (TG) and Lp(a), and an increase in high density lipoprotein cholesterol (p < 0.001 for all) was found. Before treatment, the concentrations of TC, LDL-C and TG correlated with the concentrations of thrombin activatable fibrinolysis inhibitor (r = 0.41, p < 0.001; r = 0.353, p < 0.001; r = 0.311, p = 0.003, respectively), and plasminogen activator inhibitor-1 (r = 0.302, p = 0.007; r = 0.218, p = 0.049; r = 0.278; p = 0.013, respectively). The concentrations of TC and LDL-C correlated with overall fibrinolytic potential (r = -0.220, p = 0.034; r = -0.207, p = 0.047, respectively). The concentration of TG was related to the concentration of interleukin 6 (r = 0.290, p = 0.004) and interleukin 8 (r = 0.332, p = 0.001). No correlations between Lp(a) and inflammatory or hemostatic variables were found. No associations were found after treatment. Our results show that inflammatory cytokines and fibrinolytic parameters are related to LDL-C and not Lp(a) in post-MI patients before and with neither of them following PCSK9i treatment. The trial registration number: NCT04613167, Date of registration: November 3, 2020.
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Affiliation(s)
- Andreja Rehberger Likozar
- Department of Vascular Diseases, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Sabina Ugovšek
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Cardiology, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia
| | - Miran Šebeštjen
- Department of Vascular Diseases, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Cardiology, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia.
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3
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Labib HA, Ali RM, Tharwat AI. Can statins reduce mortality in critically ill COVID-19 patients? A retrospective cohort study. EGYPTIAN JOURNAL OF ANAESTHESIA 2023. [DOI: 10.1080/11101849.2023.2173205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Heba A. Labib
- Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rania M. Ali
- Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman I. Tharwat
- Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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4
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Li A, Yan J, Zhao Y, Yu Z, Tian S, Khan AH, Zhu Y, Wu A, Zhang C, Tian XL. Vascular Aging: Assessment and Intervention. Clin Interv Aging 2023; 18:1373-1395. [PMID: 37609042 PMCID: PMC10441648 DOI: 10.2147/cia.s423373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023] Open
Abstract
Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.
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Affiliation(s)
- Ao Li
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330031, People’s Republic of China
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Jinhua Yan
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ya Zhao
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Zhenping Yu
- Institute of Translational Medicine, School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Shane Tian
- Department of Biochemistry/Chemistry, Ohio State University, Columbus, OH, USA
| | - Abdul Haseeb Khan
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Yuanzheng Zhu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Andong Wu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Cuntai Zhang
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiao-Li Tian
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
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5
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Belcaro G, Cornelli U, Hosoi M, Cox D, Dugall M, Cesarone MR, Ledda A, Scipione V, Scipione C, Feragalli B, Cotellese R. Intestinal fat absorption shifting: polyglucosamine biopolymer controls lipids and weight and reduces the progression of subclinical atherosclerosis. Minerva Gastroenterol (Torino) 2023; 69:114-122. [PMID: 36856275 DOI: 10.23736/s2724-5985.22.03280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Intestinal fat absorption shifting (IFAS) can be obtained in hyperlipidemic subjects with polyglucosamine biopolymer (BP) able to segregate most metabolic fats in the gut, making them unavailable for intestinal interaction (shift). The aim of this study was to evaluate the effects of a SM (standard management) for hyperlipidemia in asymptomatic subjects for primary cardiovascular prevention focusing on arterial wall morphology (IMT thickness) in comparison to SM associated to the administration of the BP. METHODS Two groups of comparable subjects (SM and SM+oral BP, 3 g/day) were considered; subjects were managed - in a supplement, pilot registry - for a year. Weight, fat mass, lipid profile, oxidative stress, IMT (carotids), the presence of granulations at the internal arterial layers and "near wall low density 'bubbles' were observed and compared at 1 year of management. A non-parallel, comparable group of subjects (102) using a statin for the same conditions was used as a reference population. RESULTS Two hundred eighty-four subjects completed one year (140 in the SM group and 144 in the SM+BP group). Compliance was optimal with (96.3% of the table correctly used) with no side effects. BMI, fat mass and oxidative stress decreased more in the SM+BP group (P<0.05). Cholesterol and triglycerides levels were significantly improved with BP (P<0.05). IMT measurements were significantly decreased (P<0.05) in the SM+BP group (as for the intimal granulation/bubbles) with minimal variations in the comparative SM group. In the statin group, the lipid profile was modified (P<0.05) but not the IMT and the rate of drop outs was higher (15.7%); these patients stopped the management; in 23% of these subjects muscular pain not seen with BP, was observed. CONCLUSIONS These results indicate positive effects of IFAS due to BP on IMT and arterial wall morphology and weight after 12 months. Fat shifting at intestinal level and the reduction of oxidative stress limit lipid oxidation/deposition into the arterial wall.
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Affiliation(s)
- Gianni Belcaro
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy -
| | | | - Morio Hosoi
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - David Cox
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Mark Dugall
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Maria R Cesarone
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Andrea Ledda
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Valeria Scipione
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Claudia Scipione
- Irvine3 Institute and International Agency for Pharma-Standard Supplements, Pescara, Chieti-Pescara, Italy
| | - Beatrice Feragalli
- SMOBiotec Department, D'Annunzio University, Chieti, Chieti-Pescara, Italy
| | - Roberto Cotellese
- SMOBiotec Department, D'Annunzio University, Chieti, Chieti-Pescara, Italy
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6
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Akashi N, Umemoto T, Yamada H, Fujiwara T, Yamamoto K, Taniguchi Y, Sakakura K, Wada H, Momomura SI, Fujita H. Teneligliptin, a DPP-4 Inhibitor, Improves Vascular Endothelial Function via Divergent Actions Including Changes in Circulating Endothelial Progenitor Cells. Diabetes Metab Syndr Obes 2023; 16:1043-1054. [PMID: 37077576 PMCID: PMC10108873 DOI: 10.2147/dmso.s403125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/03/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Dipeptidyl peptidase-4 (DPP-4) inhibitors increase endothelial progenitor cells (EPCs) in peripheral blood circulation. However, the underlying mechanisms and effects on vascular endothelial function remain unclear. We evaluated whether the DPP-4 inhibitor teneligliptin increases circulating EPCs by inhibiting stromal-derived factor-1α (SDF-1α) and improves flow-mediated vascular dilatation (FMD) in type 2 diabetes mellitus patients with acute coronary syndrome (ACS) or its risk factors. PATIENTS AND METHODS This single-center, open-label, prospective, randomized controlled trial evaluated 17 patients (hemoglobin A1c ≤7.5% and peak creatinine phosphokinase <2000 IU/mL) with ACS or a history of ACS or multiple cardiovascular risk factors. Metabolic variables of glucose and lipids, circulating EPCs, plasma DPP-4 activity, and SDF-1α levels, and FMD were evaluated at baseline and 28 ± 4 weeks after enrollment. Patients were randomly assigned to either the teneligliptin (n = 8) or control (n = 9) groups. RESULTS The DPP-4 activity (∆-509.5 ± 105.7 vs ∆32.8 ± 53.4 μU/mL) and SDF-1α levels (∆-695.6 ± 443.2 vs ∆11.1 ± 193.7 pg/mL) were significantly decreased after 28 weeks in the teneligliptin group than those in the control group. The number of EPCs showed an increasing trend in the teneligliptin treated group; albeit this did not reach statistical significance. Glucose and lipid levels were not significantly different between the groups before and after 28 weeks. However, FMD was significantly improved in the teneligliptin group when compared to the control group (∆3.8% ± 2.1% vs ∆-0.3% ± 2.9%, P=0.006). CONCLUSION Teneligliptin improved FMD through a mechanism other than increasing the number of circulating EPCs.
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Affiliation(s)
- Naoyuki Akashi
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tomio Umemoto
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Correspondence: Tomio Umemoto, Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan, Tel +81-48-647-2111, Fax +81-48-648-5188, Email
| | - Hodaka Yamada
- Division of Endocrinology and Metabolism, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Takayuki Fujiwara
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kei Yamamoto
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yousuke Taniguchi
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroshi Wada
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Shin-ichi Momomura
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
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7
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Bassareo PP, O’Brien ST, Dunne E, Duignan S, Martino E, Martino F, Mcmahon CJ. Should We Be Screening for Ischaemic Heart Disease Earlier in Childhood? CHILDREN 2022; 9:children9070982. [PMID: 35883966 PMCID: PMC9320497 DOI: 10.3390/children9070982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/18/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
Ischaemic heart disease is the most common cause of death in males and the second in the female gender. Yet we often only focus on identification and treatment of this foremost cause of death in adulthood. The review asks the question what form of coronary disease do we encounter in childhood, what predisposing factors give rise to atherosclerosis and what strategies in childhood could we employ to detect and reduce atherosclerosis development in later life.
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Affiliation(s)
- Pier Paolo Bassareo
- Mater Misercordiae Hospital, Mater, D07 R2WY Dublin, Ireland
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
- School of Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- Correspondence:
| | - Stephen T. O’Brien
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Esme Dunne
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Sophie Duignan
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Eliana Martino
- Department of Paediatrics, La Sapienza University, 00185 Roma, Italy; (E.M.); (F.M.)
| | - Francesco Martino
- Department of Paediatrics, La Sapienza University, 00185 Roma, Italy; (E.M.); (F.M.)
| | - Colin J. Mcmahon
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
- School of Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
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8
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Belcaro G, Cornelli U, Hosoi M, Cesarone MR, Scipione V, Scipione C, Dugall M, Feragalli B, Pellegrini L, Cotellese R. Intestinal fat absorption shifting (IFAS) with a chitosan biopolymer slows down the progression of subclinical atherosclerosis. A pilot study. Minerva Gastroenterol (Torino) 2022; 68:223-230. [PMID: 35179340 DOI: 10.23736/s2724-5985.22.03141-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Intestinal fat absorption shifting (IFAS) can be achieved with a chitosan biopolymer (BP) able to retain most fats in the gut so that they are available to the intestinal microbiota (shift). The aim of this study was to evaluate the effects of the standard management (SM) of asymptomatic cardiovascular disease prevention on intima-media thickness (IMT) in comparison with SM combined with BP. METHODS Two groups (SM and SM+3 g BP/day) were compared. They consisted of 86 and 81 subjects respectively treated for 6 months. Anthropometric variables, vital signs, fat mass, lipid profile, oxidative stress, carotid IMT, granulations at the IM layer and near-wall low density bubbles were measured. RESULTS Seventy-eight cases in the SM group and 81 in the SM+BP group completed the management period. Compliance was optimal (>97%) with no side effects. The anthropometric variables, vital signs, fat mass and oxidative stress were significantly lower only in the SM+BP group (P<0.05). Cholesterol and triglyceride levels improved with BP use (P<0.05). The changes in IMT were reduced significantly (P<0.05) in the SM+BP group only. The same was true for intimal granulation/bubbles. CONCLUSIONS The preliminary results suggest that the IFAS caused by BP has a positive effect on IMT and arterial wall structure (thickness and low-density bubbles) even during a short period of management. The intestinal fat shifting and reduction in oxidative stress seem to limit lipid oxidation and deposition on the arterial wall.
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Affiliation(s)
- Gianni Belcaro
- Irvine 3 Institute, San Valentino, Pescara, Italy - .,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy -
| | | | - Morio Hosoi
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
| | - Maria R Cesarone
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
| | - Valeria Scipione
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
| | - Claudia Scipione
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
| | - Mark Dugall
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
| | | | - Luciano Pellegrini
- Irvine 3 Institute, San Valentino, Pescara, Italy.,International Agency for Pharma-Standard Supplements - IAPSS, Pescara, Italy
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9
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van Bergen en Henegouwen K, Hutten BA, Luirink IK, Wiegman A, de Groot E, Kusters DM. Intima-media Thickness in treated and untreated patients with and without Familial Hypercholesterolemia: a Systematic Review and Meta-analysis. J Clin Lipidol 2022; 16:128-142. [DOI: 10.1016/j.jacl.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 12/14/2022]
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10
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Bjelakovic B, Stefanutti C, Reiner Ž, Watts GF, Moriarty P, Marais D, Widhalm K, Cohen H, Harada-Shiba M, Banach M. Risk Assessment and Clinical Management of Children and Adolescents with Heterozygous Familial Hypercholesterolaemia. A Position Paper of the Associations of Preventive Pediatrics of Serbia, Mighty Medic and International Lipid Expert Panel. J Clin Med 2021; 10:4930. [PMID: 34768450 PMCID: PMC8585021 DOI: 10.3390/jcm10214930] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipid lowering therapy irrespective of the presence of CV risk factors, family history and/or LDL-C levels Those children with FH and cIMT ≥0.4 mm should be carefully monitored to initiate lipid lowering management in the most suitable time. Likewise, all genetically confirmed children with FH and LDL-C levels ≥4.1 mmol/L (160 mg/dL), should be treated with lifestyle changes and LLT irrespective of the cIMT, presence of additional RF or family history of CHD.
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Affiliation(s)
- Bojko Bjelakovic
- Clinic of Pediatrics, Clinical Center, Medical Faculty, University of Nis, 18000 Nis, Serbia
| | - Claudia Stefanutti
- Extracorporeal Therapeutic Techniques Unit, Lipid Clinic and Atherosclerosis Prevention Centre, Immunohematology and Transfusion Medicine, Department of Molecular Medicine, “Umberto I” Hospital, “Sapienza” University of Rome, I-00161 Rome, Italy
| | - Željko Reiner
- Department of Internal Diseases, University Hospital Center Zagreb, 10000 Zagreb, Croatia;
- School of Medicine, Zagreb University, 10000 Zagreb, Croatia
| | - Gerald F. Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine, University of Western Australia, Crawley 6009, Australia;
| | - Patrick Moriarty
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO 66104, USA;
| | - David Marais
- Division of Chemical Pathology, Department of Pathology, University of Cape Town Health Sciences, 6.33 Falmouth Building, Anzio Rd, Observatory, Cape Town 7925, South Africa;
| | - Kurt Widhalm
- Academic Institute for Clinical Nutrition, Alserstraße 14/4, 3100 Vienna, Austria;
- Department of Gastroenterology and Hepatology, Austria Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Hofit Cohen
- The Bert W. Strassburger Lipid Center, The Chaim Sheba Medical Center, Tel-Hashomer Israel, Sackler Faculty of Medicine, Tel Aviv University Israel, Tel Aviv 39040, Israel;
| | - Mariko Harada-Shiba
- Mariko Harada-Shiba Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shinmachi, Suita 564-8565, Japan;
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 93-338 Lodz, Poland
- Department of Cardiology and Congenital Diseases in Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, 65-038 Zielona Gora, Poland
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11
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Francesca S, Rattazzi M, Faggin E, Palatini P, Puato M. Carotid elasticity is impaired in stage 1 hypertensive patients with well-controlled blood pressure levels. J Hum Hypertens 2021; 36:898-903. [PMID: 34354251 DOI: 10.1038/s41371-021-00584-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/09/2022]
Abstract
Whether impaired arterial elasticity in stage 1 hypertension can be brought back to normal by antihypertensive treatment is unknown. Aim of this study was to evaluate the impact of long-term well-controlled blood pressure (BP) on carotid artery elasticity and endothelial function in stage 1 hypertensive patients. We studied 40 middle-age hypertensives (mean age 49.7 years) whose BP had been kept at target by pharmacological treatment and/or lifestyle modifications for a mean of 7.5 years. Carotid compliance coefficient (CC) and distensibility coefficient (DC) were measured by B-mode ultrasound system. Measurement of carotid intima-media thickness (IMT) was performed in each carotid artery segment, bilaterally. Endothelial function was evaluated by post-occlusion flow mediated dilation (FMD). Forty normotensive subjects matched for age and sex served as controls. In the hypertensive subjects, BP levels were well controlled throughout the study period (mean office BP 133.7 ± 9.0/81.27 ± 7.0 mmHg). However, compared to controls, significantly higher office BP levels and waist circumference were present. Compared to normotensives, carotid elasticity (DC 24.5 ± 9.0 vs 37.0 ± 8.5 10-3/kPa, and CC 0.92 ± 0.34 vs 1.28 ± 0.36 mm2/kPa, p < 0.0005 for both) as well as endothelial function (FMD 5.7 ± 2.4% vs 9.2 ± 2.9%, p < 0.0005) were significantly impaired in hypertensives. In a logistic regression, hypertensive patients had increased risk of impaired carotid vascular stiffness (odds ratio, 95% CI: 13.04 (2.27-74.96), p = 0.004). Despite the "pseudo-normalization" of BP levels, hypertensive patients with long-term well-controlled BP according to current standards exhibited increased local arterial stiffness and endothelial dysfunction suggesting that lower BP targets should be sought.
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Affiliation(s)
- Saladini Francesca
- Cardiology Unit, Cittadella Town Hospital, Cittadella, Padova, Italy. .,Department of Medicine, DIMED, University of Padova, Padova, Italy.
| | - Marcello Rattazzi
- Department of Medicine, DIMED, University of Padova, Padova, Italy.,Medicina Interna I^, Ca' Foncello Hospital, Treviso, Italy
| | | | - Paolo Palatini
- Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Massimo Puato
- Medicine Unit, Mirano Town Hospital, Mirano, Venezia, Italy
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12
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Assessment of microvascular function and pharmacological regulation in genetically confirmed familial hypercholesterolemia. Microvasc Res 2021; 138:104216. [PMID: 34182004 DOI: 10.1016/j.mvr.2021.104216] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is a genetic lipid disorder leading to accelerated atherosclerosis, premature cardiovascular disease and death. Microvascular endothelial dysfunction is one of the earliest vascular pathology manifestations and may precede symptomatic atherosclerosis. METHODS In this paper, microvascular endothelial function was assessed in FH patients and healthy controls using flow mediated skin fluorescence (FMSF), based on measurements of nicotinamide adenine dinucleotide fluorescence intensity during brachial artery occlusion (ischemic response, IR) and immediately after occlusion (hyperemic response, HR). Low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were used to assess its relation with microvascular parameters evaluated in vivo. RESULTS LDL-C levels were significantly correlated to both HRmax (r = -0.548, p = 0.001) and HRindex (r = -0.514, p = 0.003). Similarly, there was a significant inverse correlation of TC levels and both HRmax (r = -0.538, p = 0.002) and HRindex (r = -0.512, p = 0.003). All FMSF parameters were found lower in FH patients compared to age- and sex-matched healthy controls. Hyperemic response (HRmax) was significantly higher in FH patients examined on statins compared to those without any lipid-lowering treatment (19.9 ± 3.1 vs. 16.4 ± 4.2 respectively, p = 0.022). CONCLUSIONS This study shows that, in patients with FH, microvascular endothelial-dependent hyperemic response is impaired and inversely correlated to plasma cholesterol levels. Microvascular function was found better in FH patients receiving statins.
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13
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Komatsu T, Ayaori M, Uto-Kondo H, Hayashi K, Tamura K, Sato H, Sasaki M, Nishida T, Takiguchi S, Yakushiji E, Nakaya K, Ikewaki K. Atorvastatin Reduces Circulating S100A12 Levels in Patients with Carotid Atherosclerotic Plaques - A Link with Plaque Inflammation. J Atheroscler Thromb 2021; 29:775-784. [PMID: 33952812 PMCID: PMC9135643 DOI: 10.5551/jat.61630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims: Inflammation is involved in various processes of atherosclerosis development. Serum C-reactive protein (CRP) levels, a predictor for cardiovascular risk, are reportedly reduced by statins. However, several studies have demonstrated that CRP is a bystander during atherogenesis. While S100A12 has been focused on as an inflammatory molecule, it remains unclear whether statins affect circulating S100A12 levels. Here, we investigated whether atorvastatin treatment affected S100A12 and which biomarkers were correlated with changes in arterial inflammation.
Methods: We performed a prospective, randomized open-labeled trial on whether atorvastatin affected arterial (carotid and thoracic aorta) inflammation using18fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and inflammatory markers. Thirty-one statin-naïve patients with carotid atherosclerotic plaques were randomized to either a group receiving dietary management (n=15) or one receiving atorvastatin (10mg/day,n=16) for 12weeks.18F-FDG-PET/CT and flow-mediated vasodilation (FMD) were performed, the latter to evaluate endothelial function.
Results: Atorvastatin, but not the diet-only treatment, significantly reduced LDL-cholesterol (LDL-C, -43%), serum CRP (-37%) and S100A12 levels (-28%) and improved FMD (+38%).18F-FDG-PET/CT demonstrated that atorvastatin, but not the diet-only treatment, significantly reduced accumulation of18F-FDG in the carotid artery and thoracic aorta. A multivariate analysis revealed that reduction in CRP, S100A12, LDL-C, oxidized-LDL, and increase in FMD were significantly associated with reduced arterial inflammation in the thoracic aorta, but not in the carotid artery.
Conclusions: Atorvastatin treatment reduced S100A12/CRP levels, and the changes in these circulating markers mirrored the improvement in arterial inflammation. Our observations suggest that S100A12 may be an emerging therapeutic target for atherosclerosis.
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Affiliation(s)
- Tomohiro Komatsu
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Makoto Ayaori
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College.,Tokorozawa Heart Center
| | - Harumi Uto-Kondo
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | | | | | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Makoto Sasaki
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Takafumi Nishida
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Shunichi Takiguchi
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Emi Yakushiji
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Kazuhiro Nakaya
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
| | - Katsunori Ikewaki
- Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College
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14
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Pederiva C, Capra ME, Viggiano C, Rovelli V, Banderali G, Biasucci G. Early Prevention of Atherosclerosis: Detection and Management of Hypercholesterolaemia in Children and Adolescents. Life (Basel) 2021; 11:life11040345. [PMID: 33919973 PMCID: PMC8070896 DOI: 10.3390/life11040345] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022] Open
Abstract
Coronary heart disease (CHD) is the main cause of death and morbidity in the world. There is a strong evidence that the atherosclerotic process begins in childhood and that hypercholesterolaemia is a CHD major risk factor. Hypercholesterolaemia is a modifiable CHD risk factor and there is a tracking of hypercholesterolaemia from birth to adulthood. Familial hypercholesterolaemia (FH) is the most common primitive cause of hypercholesterolaemia, affecting 1:200–250 individuals. Early detection and treatment of hypercholesterolaemia in childhood can literally “save decades of life”, as stated in the European Atherosclerosis Society Consensus. Multiple screening strategies have been proposed. In 2008, the American Academy of Pediatrics published the criteria for targeted screening, while some expert panels recommend universal screening particularly in the young, although cost effectiveness has not been fully analysed. Blood lipid profile evaluation [total cholesterol, Low-Density Lipoprotein Cholesterol (LDL-C), High-Density Lipoprotein Cholesterol (HDL-C) and triglycerides] is the first step. It has to be ideally performed between two and ten years of age. Hypercholesterolaemia has to be confirmed with a second sample and followed by the detection of family history for premature (before 55 years in men and 60 years in women) or subsequent cardio-vascular events and/or hypercholesterolaemia in 1st and 2nd degree relatives. The management of hypercholesterolaemia in childhood primarily involves healthy lifestyle and a prudent low-fat diet, emphasising the benefits of the Mediterranean diet. Statins are the cornerstone of the drug therapy approved in USA and in Europe for use in children. Ezetimibe or bile acid sequestrants may be required to attain LDL-C goal in some patients. Early identification of children with severe hypercholesterolaemia or with FH is important to prevent atherosclerosis at the earliest stage of development, when maximum benefit can still be obtained via lifestyle adaptations and therapy. The purpose of our review is to highlight the importance of prevention and treatment of hypercholesterolaemia starting from the earliest stages of life.
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Affiliation(s)
- Cristina Pederiva
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Maria Elena Capra
- Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
- Correspondence:
| | - Claudia Viggiano
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Valentina Rovelli
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Giuseppe Banderali
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Giacomo Biasucci
- Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
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15
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Vuorio A, Kovanen PT. Statins as Adjuvant Therapy for COVID-19 to Calm the Stormy Immunothrombosis and Beyond. Front Pharmacol 2021; 11:579548. [PMID: 33542685 PMCID: PMC7851087 DOI: 10.3389/fphar.2020.579548] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Alpo Vuorio
- Mehiläinen Airport Health Centre, Vantaa, Finland.,Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
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16
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Vlad CE, Foia L, Florea L, Costache II, Covic A, Popescu R, Reurean-Pintilei D, Covic A. Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania. Lipids Health Dis 2021; 20:4. [PMID: 33430859 PMCID: PMC7798287 DOI: 10.1186/s12944-020-01428-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/22/2020] [Indexed: 01/20/2023] Open
Abstract
Background Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and non-traditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were: (a) to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b) to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents. Methods This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH(SM score) were included. Results Nine hundred-eighty patients were examined and 61 (6.2%) were received the clinical diagnosis of FH. The mean age was 48.5±12.5 years, with more female patients than male patients (63.9% versus 36%). Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. The effective lipid-lowering drugs used were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new cardiovascular events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them. Conclusions In patients with suspected FH, the lipid-lowering agents during the follow-up period delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.
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Affiliation(s)
- Cristiana-Elena Vlad
- Department of Nephrology-Internal Medicine, "Dr. C. I. Parhon" Clinical Hospital, Iasi, Romania.,Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Liliana Foia
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania.
| | - Laura Florea
- Department of Nephrology-Internal Medicine, "Dr. C. I. Parhon" Clinical Hospital, Iasi, Romania.,Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Irina-Iuliana Costache
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Andreea Covic
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Roxana Popescu
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Delia Reurean-Pintilei
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania
| | - Adrian Covic
- Department of Nephrology-Internal Medicine, "Dr. C. I. Parhon" Clinical Hospital, Iasi, Romania.,Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania; Universitatii street, 700115, Iasi, Romania.,The Academy of Romanian Scientists, Bucharest, Romania
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17
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Cholesterol and Inflammation in Atherosclerosis: An Immune-Metabolic Hypothesis. Nutrients 2020; 12:nu12082444. [PMID: 32823869 PMCID: PMC7468975 DOI: 10.3390/nu12082444] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality worldwide [...].
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18
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Caimmi C, De Marchi S, Bosello SL, Giuggioli D, Caramaschi P, Di Giorgio A, Spinella A, Astorino G, Canestrari G, Cocchiara E, Gremese E, Viapiana O, Rossini M. Ultrasonography involvement of carotid, upper and lower limb arteries in a large cohort of systemic sclerosis patients. Int J Rheum Dis 2020; 23:681-692. [DOI: 10.1111/1756-185x.13824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/26/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Sergio De Marchi
- Angiology Unit Department of Medicine University of Verona Verona Italy
| | - Silvia Laura Bosello
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Dilia Giuggioli
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | | | - Angela Di Giorgio
- UOS di Angiologia Columbus Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Amelia Spinella
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | | | - Giovanni Canestrari
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Emanuele Cocchiara
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | - Elisa Gremese
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
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19
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Reiner Ž, Simental-Mendía LE, Ruscica M, Katsiki N, Banach M, Al Rasadi K, Jamialahmadi T, Sahebkar A. Pulse wave velocity as a measure of arterial stiffness in patients with familial hypercholesterolemia: a systematic review and meta-analysis. Arch Med Sci 2019; 15:1365-1374. [PMID: 31749863 PMCID: PMC6855171 DOI: 10.5114/aoms.2019.89450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 06/22/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The aim of this meta-analysis was to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is changed in patients with familial hypercholesterolemia (FH). MATERIAL AND METHODS Studies comparing PWV between patients with FH and controls were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (up to November 26, 2017). A meta-analysis was conducted using Comprehensive Meta-Analysis V2 software. A random-effects model (using the DerSimonian-Laird method) and the generic inverse variance method were used to compensate for the heterogeneity of studies concerning demographic characteristics and differences in the studies' design. RESULTS This meta-analysis of 8 studies involving 317 patients with FH and 244 non-FH individuals did not suggest a significantly altered PWV in FH patients versus controls (weighted mean difference (WMD): 0.17 m/s, 95% confidence interval (CI): -0.31, 0.65, p = 0.489; I 2 = 80.15%). The result was robust in the sensitivity analysis and its significance was not influenced after omitting each of the included studies from the meta-analysis. Subanalysis of 6 of these studies which had data on intima-media thickness (IMT) indicated an increased IMT in FH patients when compared with controls (WMD = 0.03 mm, 95% CI: 0.003, 0.06, p = 0.034; I 2 = 48.95%). However, the effect size was sensitive to some of the included studies. CONCLUSIONS This meta-analysis suggests that FH patients do not have significantly altered PWV when compared with normocholesterolemic individuals. However, a subanalysis of studies in which IMT was measured indicated that IMT is increased in FH patients compared with controls.
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Affiliation(s)
- Željko Reiner
- University Hospital Center Zagreb, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Khalid Al Rasadi
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Tannaz Jamialahmadi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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20
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Greaney JL, Stanhewicz AE, Kenney WL. Chronic statin therapy is associated with enhanced cutaneous vascular responsiveness to sympathetic outflow during passive heat stress. J Physiol 2019; 597:4743-4755. [PMID: 31397898 DOI: 10.1113/jp278237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/08/2019] [Indexed: 12/20/2022] Open
Abstract
KEY POINTS Impairments in both central sympathetic and peripheral microvascular function contribute to blunted reflex cutaneous vasodilatation during heat stress in healthy older adults. Hypercholesterolaemia is associated with decrements in neurovascular function; however, little is known about the impact of hypercholesterolaemia on the integrated responses to heat stress. Further, whether chronic statin therapy alters skin sympathetic outflow or its relation to cutaneous vascular conductance during heat stress is unknown. We demonstrate that reflex cutaneous vasodilatation is impaired in older hypercholesterolaemic adults but not in formerly hypercholesterolaemic adults currently treated with a statin compared to age-matched controls. Additionally, chronic statin treatment-induced improvements in reflex vasodilatation are mediated, in part, by increases in end-organ responsiveness to efferent sympathetic outflow during whole-body heating. These data add to the growing body of literature substantiating the beneficial pleiotropic neurovascular effects of chronic statin treatment and provide further support for the use of statins to confer additional cardioprotective benefits in older adults. ABSTRACT Attenuated reflex cutaneous vasodilatation in healthy human ageing is mediated by alterations in both central (sympathetic outflow) and peripheral (microvascular endothelial) function. Hypercholesterolaemia is associated with further impairments in neurovascular function. HMG-CoA reductase inhibitors (statins) improve cutaneous endothelium-dependent dilatation; however, whether statin therapy alters skin sympathetic nervous system activity (SSNA) or its relation to cutaneous vascular conductance (CVC) during passive heat stress is unknown. We hypothesized that (1) hypercholesterolaemic older adults would demonstrate blunted increases in both SSNA and CVC during passive heating and (2) chronic statin treatment would improve the response range and sensitivity of the SSNA:CVC relation. Reflex vasodilatation in response to a 1.0°C rise in oral temperature (Tor ; water perfused suit) was induced in 13 healthy normocholesterolaemic adults (62 ± 2 years; LDL = 113 ± 7 mg/dl), 10 hypercholesterolaemic adults (60 ± 1 years; LDL = 183 ± 2 mg/dl), and 10 previously hypercholesterolaemic adults (64 ± 1 years; LDL = 102 ± 2 mg/dl) treated with lipophilic statin (10-40 mg daily). SSNA (peroneal microneurography) and red cell flux (laser-Doppler flowmetry) in the innervated dermatome (dorsum of foot) were continuously measured. Reflex vasodilatation was blunted in hypercholesterolaemic adults, but not in statin-treated adults, compared to normocholesterolaemic adults (at ∆Tor = 1.0°C: normal = 36 ± 1%CVCmax , high = 32 ± 1%CVCmax , statin = 38 ± 1%CVCmax ; P < 0.01). ∆SSNA was not different (at ∆Tor = 1.0°C: normal: ∆ = 393 ± 96%, high: ∆ = 311 ± 120%, statin: ∆ = 256 ± 90%; P = 0.11). The slope of the SSNA:CVC relation was blunted in hypercholesterolaemic adults (0.02 ± 0.03%CVCmax /%baseline ) compared to both normocholesterolaemic (0.09 ± 0.02%CVCmax /%baseline ; P = 0.024) and statin-treated (0.12 ± 0.05%CVCmax /%baseline ; P = 0.03) adults. Chronic statin treatment improves reflex cutaneous vasodilatation in formerly hypercholesterolaemic older adults by increasing end-organ responsiveness to sympathetic outflow during passive heat stress.
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Affiliation(s)
- Jody L Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA.,Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Anna E Stanhewicz
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - W Larry Kenney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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21
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Zhang Y, Zhang H, Li P. Cardiovascular risk factors in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2019; 32:699-705. [PMID: 31199772 DOI: 10.1515/jpem-2018-0382] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/25/2019] [Indexed: 01/08/2023]
Abstract
Objective Cardiovascular disease is a major complication among children with type 1 diabetes mellitus (T1DM). This prospective study aimed at examining the presence of cardiovascular risk factors in children with T1DM. Methods We evaluated several cardiovascular risk factors, including atherosclerosis, artery intima-media thickness (IMT) and metabolic responses, in 175 children with T1DM, with 150 non-diabetic children as normal controls. Results The diabetic children had significantly higher carotid IMT (cIMT) and aortic IMT (aIMT), higher values for diastolic wall stress (DWS), incremental elastic modulus (IEM), and flow-mediated dilatation (FMD) than the controls. The levels of tumor necrosis factor-α (TNF-α), interleukin-4 (IL4), high-sensitivity C-reactive protein (hs-CRP) and leptin were significantly higher in T1DM patients. In T1DM children, the cIMT and aIMT were correlated with several risk factors, including age, weight, body mass index (BMI), duration of diabetes, waist/hip ratio, as well as levels of total cholesterol, triglycerides and apolipoprotein B (apoB). In addition to common risk factors, cIMT was also associated with systolic blood pressure (BP). Other risk factors, such as height, diastolic BP, low-density lipoprotein (LDL)/high-density lipoprotein (HDL)-cholesterol ratio, apolipoprotein A1 (apoA1) and S-creatinine levels, were not all independent risk factors of cardiovascular disease in T1DM children. Conclusions T1DM is associated with early impairment of the common carotid and aortic artery structure and function, and the diabetic state may be the main risk factor for arterial wall stiffening and thickening.
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Affiliation(s)
- Ying Zhang
- Department of Endocrinology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Han Zhang
- Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Pin Li
- Department of Endocrinology, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai 200062, China, Phone/Fax: +86-021-62474880
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22
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Ceska R, Latkovskis G, Ezhov MV, Freiberger T, Lalic K, Mitchenko O, Paragh G, Petrulioniene Z, Pojskic B, Raslova K, Shek AB, Vohnout B, Altschmiedova T, Todorovova V. The Impact of the International Cooperation On Familial Hypercholesterolemia Screening and Treatment: Results from the ScreenPro FH Project. Curr Atheroscler Rep 2019; 21:36. [PMID: 31230174 PMCID: PMC6589142 DOI: 10.1007/s11883-019-0797-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose of Review Familial hypercholesterolemia (FH) is often perceived and described as underdiagnosed and undertreated, though effective treatment of FH is available. Owing to the mentioned facts, it is ever more imperative to screen and treat FH patients. Subsequent to the identification of patients, the project focuses on the improvement of their prognoses. The ScreenPro FH project was established as a functional international network for the diagnosis, screening, and treatment of FH. Individual countries were assigned goals, e.g., to define the actual situation and available treatment. With “central support,” more centers and countries participated in the project. Subsequently, individual countries reported the results at the beginning and end of the project. Collected data were statistically evaluated. Recent Findings The increasing number of patients in databases, from 7500 in 2014 to 25,347 in 2018, demonstrates the improvement in overall effectiveness, as well as an increase in the number of centers from 70 to 252. Before all, LDL-C decreased by 41.5% and total cholesterol by 32.3%. As data from all countries and patients were not available at the time of the analysis, only those results from 10 countries and 5585 patients at the beginning of the project and at the time of writing are included. Summary Our data are quite positive. However, our results have only limited validity. Our patients are far from the target levels of LDL-C. The situation can be improved with the introduction of new therapy, PCSK9-i, evolocumab, and alirocumab. International cooperation improved the screening of FH and finally led to an improvement in cardiovascular risk.
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Affiliation(s)
- Richard Ceska
- Third Department of Medicine - Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
| | - Gustavs Latkovskis
- Latvian Research Institute of Cardiology, Faculty of Medicine, University of Latvia, Riga, Latvia.,Paul Stradins Clinical University Hospital, Riga, Latvia
| | | | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic.,Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Katarina Lalic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zaneta Petrulioniene
- Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Belma Pojskic
- Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
| | - Katarina Raslova
- Coordination Center for Familial Hyperlipidemias, Slovak Medical University, Bratislava, Slovakia
| | - Aleksandr B Shek
- Head of Department of Ischemic Heart Disease and Atherosclerosis, Republican Specialised Center of Cardiology, Tashkent, Uzbekistan
| | - Branislav Vohnout
- Institute of Nutrition, Faculty of Nursing and Health Professional Studies and Coordination Centre for Familial Hyperlipoproteinemias, Slovak Medical University in Bratislava, Bratislava, Slovakia.,Institute of Epidemiology, School of Medicine, Comenius University, Bratislava, Slovakia
| | - Tereza Altschmiedova
- Third Department of Medicine - Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Veronika Todorovova
- Third Department of Medicine - Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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23
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Relationship of PCSK9 levels with indices of vascular function and subclinical atherosclerosis in patients with familial dyslipidemias. Hellenic J Cardiol 2019; 60:124-128. [DOI: 10.1016/j.hjc.2018.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/14/2018] [Accepted: 05/18/2018] [Indexed: 11/18/2022] Open
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24
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Brunt VE, Howard MJ, Francisco MA, Ely BR, Minson CT. Reply from Vienna E. Brunt, Matthew J. Howard, Michael A. Francisco, Brett R. Ely and Christopher T. Minson. J Physiol 2018; 595:3669-3670. [PMID: 28568770 DOI: 10.1113/jp274129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Matthew J Howard
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Michael A Francisco
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
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25
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Jeangeorges A, Rubio A. Évaluation des connaissances et pratiques sur le dépistage de l’hypercholestérolémie familiale hétérozygote chez l’enfant. Arch Pediatr 2018; 25:107-111. [DOI: 10.1016/j.arcped.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 09/12/2017] [Accepted: 11/05/2017] [Indexed: 12/01/2022]
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26
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Cicero AFG, Pirro M, Watts GF, Mikhailidis DP, Banach M, Sahebkar A. Effects of Allopurinol on Endothelial Function: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs 2017; 78:99-109. [DOI: 10.1007/s40265-017-0839-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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27
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Serum lipid profile, sleep-disordered breathing and blood pressure in the elderly: a 10-year follow-up of the PROOF-SYNAPSE cohort. Sleep Med 2017; 39:14-22. [PMID: 29157582 DOI: 10.1016/j.sleep.2017.07.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/08/2017] [Accepted: 07/12/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Dyslipidemia, sleep-disordered breathing (SDB) and hypertension are comorbid factors evidenced in adults, but poorly studied in old people. This study aimed to examine the long-term evolution of the serum lipid profile, and its relationships with SDB and blood pressure (BP) in the elderly. METHODS A ten-year follow-up of the prospective Prognostic Indicator of Cardiovascular and Cerebrovascular Events (PROOF) and the Autonomic Nervous System Activity, Aging and Sleep Apnea/Hypopnea (SYNAPSE) cohort, which initially included 1011 elderly subjects from the general population, and who were untreated by continuous positive airway pressure (CPAP). Serum lipid profile, respiratory polygraphy for SDB and ambulatory blood pressure monitoring were performed. RESULTS A total of 266 subjects (male/female 150/116; age 66.2 ± 0.8 years) were reassessed after 9.6 ± 0.7 years (age 75.8 ± 1.2 years). The prevalence of high-risk dyslipidemia decreased from 61.3 to 44.4%, and hypertension from 57.9 to 27.4%. The nocturnal oxygen desaturation index increased (mean + 2.3 ± 6.7 events/hour; p < 0.001), while the mean SaO2 and minimal SaO2 decreased. These variations (Δ) of oxygen desaturation worsened whether or not elderly subjects took anti-hypertensive and lipid-lowering treatments, and were not associated with serum lipid variations. The decrease in diurnal diastolic BP was independently associated with aging, and with the lowering of the waist/hip ratio (ΔW/H) and low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, while the decrease in diurnal systolic BP only depended on aging and ΔW/H. CONCLUSIONS The results suggested that the observed worsening of nocturnal oxygen desaturation after 10 years in the elderly was independent of the change in circulating lipids, and not influenced by lipid-lowering treatments. However, the variation in blood pressure remained associated with aging, waist/hip and LDL-C/HDL-C ratios. TRIAL REGISTRY NCT00759304 and NCT00766584 at clinicaltrials.gov.
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28
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Skoumas I, Ioakeimidis N, Vlachopoulos C, Chrysohoou C, Michalakeas C, Georgakopoulos C, Katsi V, Panagiotakos D, Tousoulis D. Statin Therapy and Risk of Diabetes Mellitus in Aging Patients With Heterozygous Familial Hypercholesterolemia or Familial Combined Hyperlipidemia: A 10-Year Follow-Up. Angiology 2017; 69:242-248. [DOI: 10.1177/0003319717718331] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ioannis Skoumas
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Nikolaos Ioakeimidis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christina Chrysohoou
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christos Michalakeas
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christos Georgakopoulos
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Vicky Katsi
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Syndrome Unit, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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29
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Chiesa ST, Bhowruth DJ, Trangmar SJ. Short-term heat therapy: sufficient stimulus for structural vascular adaptations? J Physiol 2017; 595:3667-3668. [PMID: 28568771 DOI: 10.1113/jp274047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Scott T Chiesa
- National Centre for Cardiovascular Preventions and Outcomes (NCCPO), Institute of Cardiovascular Science, University College London, London, UK
| | - Devina J Bhowruth
- National Centre for Cardiovascular Preventions and Outcomes (NCCPO), Institute of Cardiovascular Science, University College London, London, UK
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30
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Sharifi M, Higginson E, Bos S, Gallivan A, Harvey D, Li KW, Abeysekera A, Haddon A, Ashby H, Shipman KE, Cooper JA, Futema M, Roeters van Lennep JE, Sijbrands EJG, Labib M, Nair D, Humphries SE. Greater preclinical atherosclerosis in treated monogenic familial hypercholesterolemia vs. polygenic hypercholesterolemia. Atherosclerosis 2017; 263:405-411. [PMID: 28549500 PMCID: PMC5567405 DOI: 10.1016/j.atherosclerosis.2017.05.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/27/2017] [Accepted: 05/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is a common inherited disorder of low density lipoprotein-cholesterol (LDL-C) metabolism. It is associated with higher risk of premature coronary heart disease. Around 60% of patients with a clinical diagnosis of FH do not have a detectable mutation in the genes causing FH and are most likely to have a polygenic cause for their raised LDL-C. We assessed the degree of preclinical atherosclerosis in treated patients with monogenic FH versus polygenic hypercholesterolemia. METHODS FH mutation testing and genotypes of six LDL-C-associated single nucleotide polymorphisms (SNPs) were determined using routine methods. Those with a detected mutation (monogenic) and mutation-negative patients with LDL-C SNP score in the top two quartiles (polygenic) were recruited. Carotid intima media thickness (IMT) was measured by B-mode ultrasound and the coronary artery calcium (CAC) score was performed in three lipid clinics in the UK and the Netherlands. RESULTS 86 patients (56 monogenic FH, 30 polygenic) with carotid IMT measurement, and 166 patients (124 monogenic, 42 polygenic) with CAC score measurement were examined. After adjustment for age and gender, the mean of all the carotid IMT measurements and CAC scores were significantly greater in the monogenic than the polygenic patients [carotid IMT mean (95% CI): 0.74 mm (0.7-0.79) vs. 0.66 mm (0.61-0.72), p = 0.038 and CAC score mean (95%): 24.5 (14.4-41.8) vs. 2.65 (0.94-7.44), p = 0.0004]. CONCLUSIONS In patients with a diagnosis of FH, those with a monogenic cause have a higher severity of carotid and coronary preclinical atherosclerosis than those with a polygenic aetiology.
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Affiliation(s)
- Mahtab Sharifi
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK; Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Elizabeth Higginson
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Sven Bos
- Department of Internal Medicine, Rotterdam, The Netherlands
| | - Angela Gallivan
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Darren Harvey
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Ka Wah Li
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK
| | - Amali Abeysekera
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Angela Haddon
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Helen Ashby
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Kate E Shipman
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Jackie A Cooper
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK
| | - Marta Futema
- Inherited Cardiovascular Diseases, Institute for Cardiovascular Science, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | | | | | - Mourad Labib
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Devaki Nair
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK.
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31
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De Lorenzo A, Moreira AS, Muccillo FB, Assad M, Tibirica EV. Microvascular Function and Endothelial Progenitor Cells in Patients with Severe Hypercholesterolemia and the Familial Hypercholesterolemia Phenotype. Cardiology 2017; 137:231-236. [DOI: 10.1159/000470829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/28/2017] [Indexed: 01/05/2023]
Abstract
Objective: To evaluate endothelial progenitor cells (EPCs) and systemic microvascular function in patients with severe hypercholesterolemia, comparing patients with the definite familial hypercholesterolemia (FH) phenotype (DFH) or probable/possible FH phenotype (PFH). There is a large spectrum of atherosclerotic disease between these two clinical phenotypes of FH, and to acquire further knowledge of the pathophysiology of vascular disease in both is desirable. Methods: Subjects with severe hypercholesterolemia, defined as low-density lipoprotein cholesterol (LDL-C) >190 mg/dL, were classified as DFH or PFH and underwent measurement of the number of EPCs by flow cytometry and evaluation of cutaneous microvascular reactivity using a laser speckle contrast-imaging system with iontophoresis of acethylcholine (ACh) or sodium nitroprusside. EPCs were defined as CD45- or CD45low, CD34+CD133+CD309+ cells. Categorical variables were compared using Fisher test and continuous variables with Student t test or Mann-Whitney test, and a value of p < 0.05 was considered statistically significant. Results: Patients with DFH had higher LDL-C than those with PFH. There was no difference in the median number of EPCs between patients with DFH or PFH, but there was a significant reduction of endothelial-dependent, ACh-induced vasodilatation in the former. Conclusion: Patients with DFH have impaired microvascular endothelial-dependent vasodilatation compared to those with PFH, indicating more severe vascular disease in the former.
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32
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Yaguchi T, Cong Y, Shimo K, Kurokawa T, Sugita S, Nagayama K, Masuda H, Matsumoto T. A Novel Apparatus for the Multifaceted Evaluation of Arterial Function Through Transmural Pressure Manipulation. Ann Biomed Eng 2017; 45:1487-1495. [PMID: 28194660 DOI: 10.1007/s10439-017-1810-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 02/04/2017] [Indexed: 11/28/2022]
Abstract
A novel apparatus for the multifaceted evaluation of artery function was developed. It measures endothelial and smooth muscle functions and the pressure-strain elastic modulus (E p). A rigid airtight chamber with an ultrasound probe was attached to the upper arm to manipulate the transmural pressure of the brachial artery. Endothelial function was measured via a standard flow-mediated dilation (FMD) protocol. Smooth muscle function was evaluated via a myogenic contraction of the artery following the application of negative pressure to the chamber and was named pressure-mediated contraction (PMC). E p was obtained by measuring the instantaneous increase in the artery diameter following the negative pressure application. The PMC and FMD values had a significant negative correlation with age, indicating that the age-related decrease in FMD is caused by the decay of endothelial and smooth muscle function. A consideration of PMC may help improve the accuracy of artery function measurement. E p in subjects aged >40 years was found to be significantly higher in the supra-physiological pressure range than in the physiological one (p = 0.02); this did not occur in younger subjects. Artery stiffening may begin in the supra-physiological range, and this stiffness may also be used for the diagnosis of atherosclerosis.
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Affiliation(s)
- Toshiyuki Yaguchi
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan. .,Division of Electronic and Mechanical Engineering, Department of Science and Engineering, School of Science and Engineering, Tokyo Denki University, Hikigun, 350-0394, Japan.
| | - Yalin Cong
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan
| | - Kenji Shimo
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan
| | - Takahiro Kurokawa
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan
| | - Shukei Sugita
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan
| | - Kazuaki Nagayama
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan.,Department of Intelligent Systems Engineering, College of Engineering, Ibaraki University, Hitachi, 316-8511, Japan
| | | | - Takeo Matsumoto
- Biomechanics Laboratory, Department of Mechanical Engineering, Nagoya Institute of Technology, Nagoya, 466-8555, Japan. .,Biomechanics Laboratory, Department of Mechanical Science and Engineering, Graduate School of Engineering, Nagoya University, Nagoya, 464-8603, Japan.
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Asahina M, Matsumoto H, Yasuhara Y, Suzuki N, Takami R, Takeyama M, Tozawa R. Osborne-Mendel rats simultaneously develop cardiac and renal dysfunction, left atrial thrombosis, peripheral artery occlusion, and ascending aortic dissection. Biochem Biophys Res Commun 2017; 485:550-555. [PMID: 28088517 DOI: 10.1016/j.bbrc.2017.01.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/11/2017] [Indexed: 11/19/2022]
Abstract
Although chronic kidney disease (CKD) is strongly associated with onsets of cardiovascular disease (CVD), the pathogenic mechanism between these diseases has not been fully understood. To develop and validate new therapeutic strategies for this complication, appropriate experimental models that reflect the complexity of the underlying pathophysiology are needed. The Osborne-Mendel (OM) rat was identified as an atherosclerosis-prone and a premature-death rat strain among 16 inbred rat strains when fed high-cholesterol containing diet. When fed high-cholesterol diet, OM rats showed simultaneous occurrence of aortic aneurysm, aortic dissection, peripheral artery occlusion, and left atrial thrombosis. OM rats had significantly lower max dP/dt and higher min dP/dt than F344 rats did, indicating impaired left ventricle contractility and relaxation. OM rats developed renal dysfunction, showing increased urinary albumin excretion. OM rats also showed mild hypertension, decreased endothelial function, and enhanced coagulation and platelet aggregation, compared with F344 rats. We now report that OM rat would be a novel spontaneous animal model which simultaneously demonstrates cardiac and renal dysfunction, and CVD events. This model could be a useful model for the pre-clinical testing of pharmacological therapies and could provide new insight into potential targets and pathways for the treatment of CKD and CVD.
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Affiliation(s)
- Makoto Asahina
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan.
| | - Hideki Matsumoto
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
| | - Yoshitaka Yasuhara
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
| | - Noriko Suzuki
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
| | - Ritsuko Takami
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
| | - Michiyasu Takeyama
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
| | - Ryuichi Tozawa
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., 26-1, Muraoka-Higashi 2chome, Fujisawa, Kanagawa, 251-8555, Japan
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34
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Xin W, Mi S, Lin Z. Allopurinol therapy improves vascular endothelial function in subjects at risk for cardiovascular diseases: a meta-analysis of randomized controlled trials. Cardiovasc Ther 2016; 34:441-449. [PMID: 27542348 DOI: 10.1111/1755-5922.12215] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Wei Xin
- Department of Cardiology; Beijing Anzhen Hospital; Capital Medical University; Beijing China
| | - Shuhua Mi
- Department of Cardiology; Beijing Anzhen Hospital; Capital Medical University; Beijing China
| | - Zhiqin Lin
- Department of Cardiovascular Medicine; Affiliated Hospital of Guiyang Medical College; Guizhou China
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35
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Walsh MT, Hussain MM. Targeting microsomal triglyceride transfer protein and lipoprotein assembly to treat homozygous familial hypercholesterolemia. Crit Rev Clin Lab Sci 2016; 54:26-48. [PMID: 27690713 DOI: 10.1080/10408363.2016.1221883] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Homozygous familial hypercholesterolemia (HoFH) is a polygenic disease arising from defects in the clearance of plasma low-density lipoprotein (LDL), which results in extremely elevated plasma LDL cholesterol (LDL-C) and increased risk of atherosclerosis, coronary heart disease, and premature death. Conventional lipid-lowering therapies, such as statins and ezetimibe, are ineffective at lowering plasma cholesterol to safe levels in these patients. Other therapeutic options, such as LDL apheresis and liver transplantation, are inconvenient, costly, and not readily available. Recently, lomitapide was approved by the Federal Drug Administration as an adjunct therapy for the treatment of HoFH. Lomitapide inhibits microsomal triglyceride transfer protein (MTP), reduces lipoprotein assembly and secretion, and lowers plasma cholesterol levels by over 50%. Here, we explain the steps involved in lipoprotein assembly, summarize the role of MTP in lipoprotein assembly, explore the clinical and molecular basis of HoFH, and review pre-clinical studies and clinical trials with lomitapide and other MTP inhibitors for the treatment of HoFH. In addition, ongoing research and new approaches underway for better treatment modalities are discussed.
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Affiliation(s)
- Meghan T Walsh
- a School of Graduate Studies, Molecular and Cell Biology Program, State University of New York Downstate Medical Center , Brooklyn , NY , USA.,b Department of Cell Biology , State University of New York Downstate Medical Center , Brooklyn , NY , USA
| | - M Mahmood Hussain
- b Department of Cell Biology , State University of New York Downstate Medical Center , Brooklyn , NY , USA.,c Department of Pediatrics , SUNY Downstate Medical Center , Brooklyn , NY , USA.,d VA New York Harbor Healthcare System , Brooklyn , NY , USA , and.,e Winthrop University Hospital , Mineola , NY , USA
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Vlachopoulos C, Terentes-Printzios D, Georgiopoulos G, Skoumas I, Koutagiar I, Ioakeimidis N, Stefanadis C, Tousoulis D. Prediction of cardiovascular events with levels of proprotein convertase subtilisin/kexin type 9: A systematic review and meta-analysis. Atherosclerosis 2016; 252:50-60. [PMID: 27501130 DOI: 10.1016/j.atherosclerosis.2016.07.922] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/11/2016] [Accepted: 07/27/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces atherogenic lipoproteins and could lead to reduction of cardiovascular (CV) events. However, it is unclear whether blood PCSK9 levels predict future CV events. We performed a meta-analysis of all longitudinal studies to determine the ability of PCSK9 levels to predict risk of future CV events. METHODS A comprehensive search of electronic databases was conducted up to February 2016. Longitudinal studies that reported events or relative risk (RR) estimates with 95% confidence intervals (CI) were included. RESULTS All 9 studies included (12,081 participants, mean follow-up 6.62 years) reported results on total CV events. The pooled RR of total CV events for an increase in baseline PCSK9 by 1 standard deviation (SD) was 1.098 (95% CI, 1.02-1.18), corresponding to a risk increase of 10% (Z = 2.43, p = 0.015). The pooled RR of total CV events for subjects categorized in the highest tertile of baseline PCSK9 was 1.228 (95% CI, 1.035-1.457), corresponding to a risk increase of 23% (Z = 2.35, p = 0.019). When pooled estimates were derived independently for low- and high-CV risk populations, baseline PCSK9 levels predicted total CV events only in apparently healthy subjects (RR = 1.13, 95% CI: 1.050-1.222, Z = 3.21, p = 0.001) and not in populations with established CV or renal disease (RR = 1.09, 95% CI: 0.961-1.23, Z = 1.33, p = 0.182). CONCLUSIONS PCSK9 levels are modestly but significantly associated with increased risk of total CV events. These results suggest a predictive role of PCSK9 levels on CV health and support the possible clinical role of PCSK9 inhibitors.
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Affiliation(s)
- Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
| | - Dimitrios Terentes-Printzios
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Georgios Georgiopoulos
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Ioannis Skoumas
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Iosif Koutagiar
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Nikolaos Ioakeimidis
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Christodoulos Stefanadis
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Unit, (1st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
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Doutrelon C, Skopinski S, Boulon C, Constans J. Atteinte macrovasculaire de la sclérodermie systémique : étude descriptive prospective de 20 patients en échodoppler. ACTA ACUST UNITED AC 2016; 41:253-9. [DOI: 10.1016/j.jmv.2016.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 04/02/2016] [Indexed: 11/16/2022]
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Puato M, Boschetti G, Rattazzi M, Zanon M, Pesavento R, Faggin E, Fania C, Benetti E, Palatini P, Pauletto P. Intima-media thickness remodelling in hypertensive subjects with long-term well-controlled blood pressure levels. Blood Press 2016; 26:48-53. [PMID: 27216375 DOI: 10.1080/08037051.2016.1184964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aim of this study was to evaluate in a long follow-up the carotid artery remodelling in a cohort of young hypertensive subjects having good blood pressure (BP) control. We studied 20 grade I hypertensives (HT) by assessing the B-mode ultrasound of mean carotid intima-media thickness (mean-IMT) and maximum IMT (M-MAX) in each carotid artery segment (common, bulb, internal), bilaterally. We compared their ultrasound measurements with those recorded 5 and 10 years earlier. While the first 5-year follow-up was observational, in the second 5-year follow-up, lifestyle modifications and/or pharmacological therapy were started to obtain well-controlled BP levels. Office BP was measured at the time of the ultrasound studies and every 6 months during the follow-up. BP levels were: 10 years 144/91 mmHg, 5 years 143/90 mmHg and 129 ± 79 mmHg at the time of the study. In the first 5-year observational follow-up, both mean-IMT and M-MAX increased (Δ 0.116 and Δ 0.165 mm, respectively, p < 0.0005). In the 5-year intervention follow-up, characterized by well-controlled BP, mean-IMT slightly but significantly increased (Δ 0.084 mm, p = 0.004), whereas M-MAX remained stable (Δ 0.026 mm). In our HT, well-controlled BP levels were able to prevent pro-atherogenic remodelling (expressed by M-MAX). Conversely, good BP control slightly decreased but did not stop the progression in mean-IMT, which is likely to reflect some hypertrophy of the arterial media layer.
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Affiliation(s)
- Massimo Puato
- a Department of Medicine , University of Padova , Padova , Italy
| | | | - Marcello Rattazzi
- a Department of Medicine , University of Padova , Padova , Italy.,b Medicina I, Ospedale Ca' Foncello , Treviso , Italy
| | - Marta Zanon
- a Department of Medicine , University of Padova , Padova , Italy
| | | | | | - Claudio Fania
- a Department of Medicine , University of Padova , Padova , Italy
| | | | - Paolo Palatini
- a Department of Medicine , University of Padova , Padova , Italy
| | - Paolo Pauletto
- a Department of Medicine , University of Padova , Padova , Italy.,b Medicina I, Ospedale Ca' Foncello , Treviso , Italy
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Cansu GB, Yılmaz N, Özdem S, Balcı MK, Süleymanlar G, Arıcı C, Boz A, Sarı R, Altunbaş HA. Parathyroidectomy in asymptomatic primary hyperparathyroidism reduces carotid intima-media thickness and arterial stiffness. Clin Endocrinol (Oxf) 2016; 84:39-47. [PMID: 26399562 DOI: 10.1111/cen.12952] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/11/2015] [Accepted: 09/03/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Although an International Workshop has suggested that cardiovascular assessment in asymptomatic primary hyperparathyroidism (PHPT) patients is not necessary, improvements in risk factors of subclinical atherosclerosis have been shown following parathyroidectomy. The objectives of this study were to determine whether parathyroidectomy in asymptomatic PHPT patients causes any change in carotid intima-media thickness (CIMT), arterial stiffness [pulse wave velocity (PWV)] and soluble CD40 ligand (sCD40L) levels. DESIGN Prospective study evaluating female patients diagnosed with asymptomatic PHPT in a single centre over a 6-month period. PATIENTS A total of 48 subjects were included: 17 hypercalcaemic (HC, mean age: 51 ± 8 years, Ca: 2·73 ± 0·17 mmol/l) and 16 normocalcaemic (NC, mean age: 58 ± 7 years, Ca: 2·30 ± 0·10 mmol/l) PHPT patients, and 15 healthy controls (mean age: 52 ± 4 years, Ca: 2·27 ± 0·07 mmol/l). MEASUREMENTS Biochemical tests, CIMT, PWV and sCD40L levels were compared at baseline and 6 months after parathyroidectomy (PTx). RESULTS At baseline, CIMT and PWV values in the HC and NC patients were higher than in the control group. While there was a significant reduction in CIMT (601 ± 91 μm vs 541 ± 65 μm, P = 0·006) and PWV (9·6 ± 1·8 vs 8·4 ± 1·5 m/s, P = 0·000) in the hypercalcaemic group at the end of the 6th month after PTx, no change was observed in normocalcaemic group (P = 0·686 and P = 0·196 respectively). No differences were observed in sCD40L levels between patient and control groups or between baseline and 6 months in patients undergoing parathyroidectomy. CONCLUSION Parathyroidectomy leads to an improvement in the structural and functional impairment associated with atherosclerosis in the vascular wall in asymptomatic hypercalcaemic PHPT patients.
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Affiliation(s)
- Güven Barış Cansu
- Division of Endocrinology and Metabolism, Yunusemre State Hospital, Eskişehir, Turkey
| | - Nusret Yılmaz
- Division of Endocrinology and Metabolism, Şırnak State Hospital, Şırnak, Turkey
| | - Sebahat Özdem
- Department of Biochemistry, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Mustafa Kemal Balcı
- Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey
| | | | - Cumhur Arıcı
- Department of General Surgery, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Adil Boz
- Department of Nuclear Medicine, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Ramazan Sarı
- Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Hasan Ali Altunbaş
- Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey
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Rathod KS, Velmurugan S, Ahluwalia A. A 'green' diet-based approach to cardiovascular health? Is inorganic nitrate the answer? Mol Nutr Food Res 2015; 60:185-202. [PMID: 26256112 DOI: 10.1002/mnfr.201500313] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/16/2015] [Accepted: 07/10/2015] [Indexed: 12/22/2022]
Abstract
Ingestion of fruit and vegetables rich in inorganic nitrate (NO(3)(-)) has emerged as an effective method for acutely elevating vascular nitric oxide (NO) levels through formation of an NO(2)(-) intermediate. As such a number of beneficial effects of NO(3)(-) and NO(2)(-) ingestion have been demonstrated including reductions in blood pressure, measures of arterial stiffness and platelet activity. The pathway for NO generation from such dietary interventions involves the activity of facultative oral microflora that facilitate the reduction of inorganic NO(3)(-), ingested in the diet, to inorganic NO(2)(-). This NO(2)(-) then eventually enters the circulation where, through the activity of one or more of a range of distinct NO(2)(-) reductases, it is chemically reduced to NO. This pathway provides an alternative route for in vivo NO generation that could be utilized for therapeutic benefit in those cardiovascular disease states where reduced bioavailable NO is thought to contribute to pathogenesis. Indeed, the cardiovascular benefits of NO(2)(-) and NO(3)(-) are now starting to be translated in patients in several clinical trials. In this review, we discuss recent evidence supporting the potential utility of delivery of NO(3)(-) or NO(2)(-) for the treatment of cardiovascular diseases.
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Affiliation(s)
- Krishnaraj Sinhji Rathod
- William Harvey Research Institute, Barts NIHR Cardiovascular Biomedical Research Unit, Barts & The London Medical School, Queen Mary University of London, Charterhouse Square, London, UK
| | - Shanti Velmurugan
- William Harvey Research Institute, Barts NIHR Cardiovascular Biomedical Research Unit, Barts & The London Medical School, Queen Mary University of London, Charterhouse Square, London, UK
| | - Amrita Ahluwalia
- William Harvey Research Institute, Barts NIHR Cardiovascular Biomedical Research Unit, Barts & The London Medical School, Queen Mary University of London, Charterhouse Square, London, UK
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Barkas F, Elisaf M, Milionis H. Statins decrease the risk of stroke in individuals with heterozygous familial hypercholesterolemia: A systematic review and meta-analysis. Atherosclerosis 2015; 243:60-4. [PMID: 26350916 DOI: 10.1016/j.atherosclerosis.2015.08.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/27/2015] [Accepted: 08/28/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is undoubtedly associated with premature coronary heart disease, but it is debatable whether FH increases the risk for stroke. OBJECTIVE To meta-analyze available evidence regarding the incidence of stroke in individuals with heterozygous (He) FH. METHODS We conducted a systematic review and a meta-analysis of epidemiological studies, including English-language publications until June 2015; four observational studies, with 3374 participants with HeFH, were included in the analysis. Cerebrovascular disease comprised of ischemic stroke or transient ischemic attack. Since studies did not include any control subjects, the corresponding general population of the same reference area and period of time for each HeFH study served as control group. Analyses were performed according to the period of time during which the studies were conducted: prestatin and statin era (before and after 1987 when lovastatin was launched). RESULTS In the prestatin era, individuals with HeFH exhibited a higher risk for stroke compared with the general population [odds ratio (OR) = 7.658, 95% confidence interval (CI): 6.059-9.678, p < 0.01]. In contrast, FH subjects had a lower odds for stroke following the generalization of statin therapy (OR = 0.251, 95% CI: 0.176-0.358, p < 0.01). CONCLUSIONS Taking into account the small number of studies and methodological issues, HeFH was associated with a higher risk of cerebrovascular disease compared with the general population in the prestatin era, which was significantly reduced after the introduction of statin therapy.
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Affiliation(s)
- Fotios Barkas
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
| | - Moses Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Haralampos Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
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Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cífková R, Cosentino F, De Carlo M, Gallino A, Landmesser U, Laurent S, Lekakis J, Mikhailidis DP, Naka KK, Protogerou AD, Rizzoni D, Schmidt-Trucksäss A, Van Bortel L, Weber T, Yamashina A, Zimlichman R, Boutouyrie P, Cockcroft J, O'Rourke M, Park JB, Schillaci G, Sillesen H, Townsend RR. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis 2015; 241:507-32. [DOI: 10.1016/j.atherosclerosis.2015.05.007] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/29/2015] [Accepted: 05/14/2015] [Indexed: 02/07/2023]
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Maharaj S, Chang S, Nayak SB. Familial hypercholesterolemia presenting with multiple nodules of the hands and elbow. Clin Case Rep 2015; 3:411-4. [PMID: 26185639 PMCID: PMC4498853 DOI: 10.1002/ccr3.249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 12/19/2014] [Accepted: 02/20/2015] [Indexed: 11/11/2022] Open
Abstract
Familial hypercholesterolemia (FH) is a common but commonly missed diagnosis. Tendon xanthomas are a physical sign strongly suggestive of FH. Physicians must identify tendon xanthomas, apply validated clinical scoring such as the Dutch Lipid Clinic Network criteria and offer cascade screening. This approach will increase recognition of FH.
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Affiliation(s)
- Satish Maharaj
- Department of Medicine, Eric Williams Medical Sciences Complex, The University of the West Indies Champs Fleurs, Trinidad and Tobago
| | - Simone Chang
- Department of Medicine, Eric Williams Medical Sciences Complex, The University of the West Indies Champs Fleurs, Trinidad and Tobago
| | - Shivananda B Nayak
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies Champs Fleurs, Trinidad and Tobago
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Wiegman A, Gidding SS, Watts GF, Chapman MJ, Ginsberg HN, Cuchel M, Ose L, Averna M, Boileau C, Borén J, Bruckert E, Catapano AL, Defesche JC, Descamps OS, Hegele RA, Hovingh GK, Humphries SE, Kovanen PT, Kuivenhoven JA, Masana L, Nordestgaard BG, Pajukanta P, Parhofer KG, Raal FJ, Ray KK, Santos RD, Stalenhoef AFH, Steinhagen-Thiessen E, Stroes ES, Taskinen MR, Tybjærg-Hansen A, Wiklund O. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment. Eur Heart J 2015; 36:2425-37. [PMID: 26009596 PMCID: PMC4576143 DOI: 10.1093/eurheartj/ehv157] [Citation(s) in RCA: 546] [Impact Index Per Article: 60.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/19/2015] [Indexed: 12/27/2022] Open
Abstract
Familial hypercholesterolaemia (FH) is a common genetic cause of premature coronary heart disease (CHD). Globally, one baby is born with FH every minute. If diagnosed and treated early in childhood, individuals with FH can have normal life expectancy. This consensus paper aims to improve awareness of the need for early detection and management of FH children. Familial hypercholesterolaemia is diagnosed either on phenotypic criteria, i.e. an elevated low-density lipoprotein cholesterol (LDL-C) level plus a family history of elevated LDL-C, premature coronary artery disease and/or genetic diagnosis, or positive genetic testing. Childhood is the optimal period for discrimination between FH and non-FH using LDL-C screening. An LDL-C ≥5 mmol/L (190 mg/dL), or an LDL-C ≥4 mmol/L (160 mg/dL) with family history of premature CHD and/or high baseline cholesterol in one parent, make the phenotypic diagnosis. If a parent has a genetic defect, the LDL-C cut-off for the child is ≥3.5 mmol/L (130 mg/dL). We recommend cascade screening of families using a combined phenotypic and genotypic strategy. In children, testing is recommended from age 5 years, or earlier if homozygous FH is suspected. A healthy lifestyle and statin treatment (from age 8 to 10 years) are the cornerstones of management of heterozygous FH. Target LDL-C is <3.5 mmol/L (130 mg/dL) if >10 years, or ideally 50% reduction from baseline if 8–10 years, especially with very high LDL-C, elevated lipoprotein(a), a family history of premature CHD or other cardiovascular risk factors, balanced against the long-term risk of treatment side effects. Identifying FH early and optimally lowering LDL-C over the lifespan reduces cumulative LDL-C burden and offers health and socioeconomic benefits. To drive policy change for timely detection and management, we call for further studies in the young. Increased awareness, early identification, and optimal treatment from childhood are critical to adding decades of healthy life for children and adolescents with FH.
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Affiliation(s)
- Albert Wiegman
- Department of Paediatrics, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Samuel S Gidding
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Gerald F Watts
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Western Australia, Australia
| | - M John Chapman
- Pierre and Marie Curie University, Paris, France National Institute for Health and Medical Research (INSERM), Pitié-Salpêtrière University Hospital, Paris, France
| | - Henry N Ginsberg
- Columbia University College of Physicians and Surgeons, New York, NY, USA Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, USA
| | - Marina Cuchel
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Leiv Ose
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Lipid Clinic, Oslo University Hospital, Oslo, Norway
| | - Maurizio Averna
- Department of Internal Medicine, University of Palermo, Italy
| | - Catherine Boileau
- Diderot Medical School, University Paris 7, Paris, France Genetics Department, Bichat University Hospital, Paris, France INSERM U698, Paris, France
| | - Jan Borén
- Department of Medicine, Sahlgrenska Academy, Göteborg University, Gothenburg, Sweden Wallenberg Laboratory for Cardiovascular Research, Gothenburg, Sweden
| | - Eric Bruckert
- Department of Endocrinology and Prevention of Cardiovascular Disease, University Hospital Pitié-Salpêtrière, Paris, France
| | - Alberico L Catapano
- Department of Pharmacology, Faculty of Pharmacy, University of Milano, Milan, Italy Multimedica IRCSS, Milan, Italy
| | - Joep C Defesche
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | | | - Robert A Hegele
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - G Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, Institute of Cardiovascular Sciences, London, UK
| | | | - Jan Albert Kuivenhoven
- Department of Pediatrics, Section Molecular Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Luis Masana
- Vascular Medicine and Metabolic Unit, Department of Medicine and Surgery, University Rovira and Virgili, Reus-Tarragona, Spain
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Päivi Pajukanta
- Department of Human Genetics, Center for Metabolic Disease Prevention, University of California, Los Angeles, USA
| | - Klaus G Parhofer
- Department of Endocrinology and Metabolism, University of Munich, Munich, Germany
| | - Frederick J Raal
- Carbohydrate & Lipid Metabolism Research Unit; and Division of Endocrinology & Metabolism, University of the Witwatersrand, Johannesburg, South Africa
| | - Kausik K Ray
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
| | - Raul D Santos
- Lipid Clinic of the Heart Institute (InCor), University of São Paulo, São Paulo, Brazil Department of Cardiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Anton F H Stalenhoef
- Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erik S Stroes
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Marja-Riitta Taskinen
- Research Programs Unit, Diabetes & Obesity, University of Helsinki and Heart & Lung Centre, Helsinki University Hospital, Helsinki, Finland
| | - Anne Tybjærg-Hansen
- Department of Clinical Biochemistry, Section for Molecular Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Olov Wiklund
- Department of Experimental and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Puato M, Rattazzi M, Zanon M, Benetti E, Faggin E, Palatini P, Pauletto P. Predictors of vascular remodelling in hypertensive subjects with well-controlled blood pressure levels. J Hum Hypertens 2014; 29:561-5. [DOI: 10.1038/jhh.2014.121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/12/2014] [Accepted: 11/17/2014] [Indexed: 11/09/2022]
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Rahmani-Cherati T, Mokhtari-Dizaji M, Vajhi A, Rostami A. Evaluation of statin therapy on endothelial function in hypercholesterolemic rabbits by automatic measurement of arterial wall movement using ultrasound images. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:2415-2424. [PMID: 25018028 DOI: 10.1016/j.ultrasmedbio.2014.03.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 01/13/2014] [Accepted: 03/31/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to evaluate arterial endothelial function, assessed as acetylcholine-mediated dilation (AMD), in a hypercholesterolemic atherosclerotic rabbit model to investigate the effects of atorvastatin in the atherosclerotic process, using a new computerized analysis model and ultrasound images. Twenty-seven rabbits were fed a high-cholesterol (2%) diet for 6 wk and then divided into three groups for an additional 9 wk: Group A received regular chow food, group B received a 2% cholesterol-rich diet plus atorvastatin drug, and group C received regular chow food plus atorvastatin. Ultrasound examinations of endothelial function of the rabbit abdominal aorta artery were performed immediately after the 6 weeks (0 wk) and then 3, 6 and 9 wk after that. For off-line analysis, a computerized analysis method for evaluating instantaneous changes in the wall of the rabbit abdominal aorta was used. As parameters of improvement resulting from treatment, endothelium-dependent acetylcholine-induced dilation and endothelium-independent nitroglycerin-induced dilation were evaluated in treated rabbits. Differences among groups were tested using analysis of variance. On histopathology, intima-media thickness decreased after treatment in all groups. There were no significant differences in arterial diameter and blood velocity changes among treated rabbits at 0, 3, 6 and 9 wk of treatment in all groups, except in end-diastolic velocity, radial strain percentage, pulse index and resistance index in group C. In group A, AMD did not significantly improve after 3, 6 and 9 wk, as compared with 0 wk. Atorvastatin treatment significantly increased AMD (18%) at 3 wk in group B, compared with week 0. AMD significantly increased after 3 (26%), 6 (124%) and 9 (182%) wk in group C, compared with 0 wk. It is concluded that the new automatic method enables accurate and repeated evaluation of endothelial function during the progression and regression of atherosclerosis. Also, the results obtained in this study indicate that short-term administration of atorvastatin can improve endothelial function in cholesterol-fed rabbits.
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Affiliation(s)
- Tavoos Rahmani-Cherati
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Manijhe Mokhtari-Dizaji
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Alireza Vajhi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Abdorrazzagh Rostami
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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Wang DG, Tang XW, Fan Y, Leng RX, Ni J, Deng SM, Wang C, Cen H, Pan HF, Ye DQ. Decreased Flow-Mediated Dilatation in Patients with Systemic Lupus Erythematosus: a Meta-analysis. Inflammation 2014; 37:2067-75. [DOI: 10.1007/s10753-014-9940-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Belcaro G, Cornelli U, Finco A. The Carotid intima-media thickness modification following atorvastatin is bound to the modification of the oxidative balance. J Cardiovasc Pharmacol Ther 2014; 19:446-50. [PMID: 24742765 DOI: 10.1177/1074248414528574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the reduction in cholesterol (CH) levels, the modification of carotid intima-media thickness (CIMT) is not evident in all the patients treated with statins. Activities other than CH reduction may determine the improvement in CIMT. METHODS Twenty-two patients with hypercholesterolemia (aged 45-60; males) with CIMT increase started the treatment with atorvastatin. The CIMT (via echography), CH level, and the oxidative balance (OB) were measured at baseline and after 4 weeks. The OB consisted of the determination of the plasmatic hydroperoxides (reactive oxygen metabolites [d-ROMs] test) and the antioxidant reserve (plasma antioxidants test [PAT]). The d-ROMs/CH and PAT/CH ratios allowed to measure, respectively, the oxidative index (OI) and the protective index (PI). The OI/PI ratio represented the OB Risk Index (OBRI) to be compared with the CIMT modifications. RESULTS An average reduction of 22% in CH was achieved in the group of patients together with an increase in both OI and PI (16% and 39% respectively) with a significant improvement in OBRI from 2.6 to 1.7 (analysis of variance P < .01). A reduction of >20% in CIMT was obtained in 10 patients whereas in the 12 patients no modification of CIMT was detected, despite the same CH reduction (-55 ± 24.8 and -66 ± 27.1 mg/dL respectively; P > .05). Only those patients with a decrease in OBRI ≥0.8 showed a reduction in CIMT >20%. CONCLUSIONS In this preliminary study, a significant modification in CIMT was obtained with atorvastatin treatment only in those patients showing an improvement in the OB (OBRI > 0.8).
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Affiliation(s)
- Gianni Belcaro
- Cardiovascular Research- Arca delle Professioni, University of Chieti-Chieti-Italy, Chieti, Italy
| | - Umberto Cornelli
- Pharmacology & Experimental Therapeutics Department, Loyola University School of Medicine, Chicago, IL, USA
| | - Annarosa Finco
- Oxidation Research Department, Cor Con International Srl, Parma, Italy
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Vlahos AP, Naka KK, Bechlioulis A, Theoharis P, Vakalis K, Moutzouri E, Miltiadous G, Michalis LK, Siamopoulou-Mavridou A, Elisaf M, Milionis HJ. Endothelial dysfunction, but not structural atherosclerosis, is evident early in children with heterozygous familial hypercholesterolemia. Pediatr Cardiol 2014; 35:63-70. [PMID: 23821294 DOI: 10.1007/s00246-013-0742-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 06/18/2013] [Indexed: 11/29/2022]
Abstract
Children with heterozygous familial hypercholesterolemia (heFH) are prone to premature atherosclerosis. Vascular endothelial dysfunction may predict increased cardiovascular risk in children with heFH. The aim of this study was to assess for early functional and structural vascular changes in children with heFH. This cross-sectional study included 30 children with heFH (mean age 12 years) and 30 age- and sex-matched controls. Brachial artery flow-mediated dilation (FMD), carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity, and large- and small vessel compliance were measured noninvasively. HeFH children exhibited significantly greater total and LDL cholesterol, apolipoprotein B, and lipoprotein (a) levels (p < 0.05 for all) and lower FMD (6.23 ± 3.88 vs. 9.46 ± 4.54 %, p < 0.004) compared with controls. When children were divided in age subgroups, FMD was found to be significantly decreased in heFH compared with control subjects only in ages >10 years (p < 0.05). However, FMD was found to be similarly impaired in heFH children in all age subgroups (two-way analysis of variance, p = 0.39). No differences in other vascular function indices were found. In heFH patients, but not in controls, FMD was inversely correlated with cIMT (r = -0.378, p = 0.036). In conclusion, endothelial dysfunction occurs early in heFH children indicating an increased risk for premature cardiovascular disease and reflecting probably the need for early initiation of anticholesterolemic treatment. Decreased FMD is detected before structural atherosclerotic changes occur.
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Affiliation(s)
- Antonios P Vlahos
- Department of Pediatrics, Medical School, University of Ioannina, Ioannina, Greece,
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Pirro M, Vaudo G, Lupattelli G, Pasqualini L, Mannarino MR, Schillaci G, Alaeddin A, Paciullo F, Fallarino F, Bagaglia F, Mannarino E. On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: Impact on carotid intima-media thickness. Life Sci 2013; 93:338-43. [DOI: 10.1016/j.lfs.2013.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 06/24/2013] [Accepted: 07/06/2013] [Indexed: 12/17/2022]
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