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Sun WT, Du JY, Wang J, Wang YL, Dong ED. Potential preservative mechanisms of cardiac rehabilitation pathways on endothelial function in coronary heart disease. SCIENCE CHINA. LIFE SCIENCES 2024:10.1007/s11427-024-2656-6. [PMID: 39395086 DOI: 10.1007/s11427-024-2656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/17/2024] [Indexed: 10/14/2024]
Abstract
Cardiac rehabilitation, a comprehensive exercise-based lifestyle and medical management, is effective in decreasing morbidity and improving life quality in patients with coronary heart disease. Endothelial function, an irreplaceable indicator in coronary heart disease progression, is measured by various methods in traditional cardiac rehabilitation pathways, including medicinal treatment, aerobic training, and smoking cessation. Nevertheless, studies on the effect of some emerging cardiac rehabilitation programs on endothelial function are limited. This article briefly reviewed the endothelium-beneficial effects of different cardiac rehabilitation pathways, including exercise training, lifestyle modification and psychological intervention in patients with coronary heart disease, and related experimental models, and summarized both uncovered and potential cellular and molecular mechanisms of the beneficial roles of various cardiac rehabilitation pathways on endothelial function. In exercise training and some lifestyle interventions, the enhanced bioavailability of nitric oxide, increased circulating endothelial progenitor cells (EPCs), and decreased oxidative stress are major contributors to preventing endothelial dysfunction in coronary heart disease. Moreover, the preservation of endothelial-dependent hyperpolarizing factors and inflammatory suppression play roles. On the one hand, to develop more endothelium-protective rehabilitation methods in coronary heart disease, adequately designed and sized randomized multicenter clinical trials should be advanced using standardized cardiac rehabilitation programs and existing assessment methods. On the other hand, additional studies using suitable experimental models are warranted to elucidate the relationship between some new interventions and endothelial protection in both macro- and microvasculature.
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Affiliation(s)
- Wen-Tao Sun
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, China.
| | - Jian-Yong Du
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, China
| | - Jia Wang
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, China
| | - Yi-Long Wang
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, China
| | - Er-Dan Dong
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, 266071, China.
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, 100191, China.
- The Institute of Cardiovascular Sciences, Peking University, Beijing, 100191, China.
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, 100191, China.
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Bauwelinck M, De Boever P, Dons E, Standaert A, Ambros A, Laeremans M, Avila-Palencia I, Carrasco-Turigas G, Wegener S, Anaya E, Orjuela JP, de Nazelle A, Nieuwenhuijsen MJ, Panis LI, Dadvand P. Greenspace exposure and the retinal microvasculature in healthy adults across three European cities. Health Place 2024; 89:103342. [PMID: 39236517 DOI: 10.1016/j.healthplace.2024.103342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Emerging evidence points to the beneficial role of greenspace exposure in promoting cardiovascular health. Most studies have evaluated such associations with conventional cardiovascular endpoints such as mortality, morbidity, or macrovascular markers. In comparison, the microvasculature, a crucial compartment of the vascular system where early subclinical signs of cardiovascular problems appear, has not been studied in association with greenspace exposure. The current study assessed the association between surrounding greenness and microvascular status, as assessed by retinal vessel diameters. METHODS This study included a sample of healthy adults (n = 114 and 18-65 years old) residing in three European cities [Antwerp (Belgium), Barcelona (Spain), and London (UK)]. The exposures to greenspace at the home and work/school locations were characterized as average surrounding greenness [normalized difference vegetation index (NDVI)] within buffers of 100 m, 300 m, and 500 m. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated from fundus pictures taken at three different time points. We developed linear mixed-effect models to estimate the association of greenspace exposure with indicators of retinal microvasculature, adjusted for relevant individual and area-level covariates. RESULTS We observed the most robust associations with CRVE. Higher levels of greenspace at work/school were associated with smaller retinal venules [(seasonal NDVI) 300m: 3.85, 95%CI -6.67,-1.03; 500m: 5.11, 95%CI -8.04, -2.18]. Findings for surrounding greenness and CRAE were not conclusive. CONCLUSION Our study suggests an association of greenspace exposure with better microvascular status, specifically for retinal venules. Future research is needed to confirm our findings across different contextual settings.
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Affiliation(s)
- Mariska Bauwelinck
- Brussels Institute for Social and Population Studies (BRISPO), Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick De Boever
- Hasselt University, Centre for Environmental Sciences, Diepenbeek, Belgium; Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium; Antwerp University Hospital (UZA), 2650, Edegem, Belgium.
| | - Evi Dons
- Hasselt University, Centre for Environmental Sciences, Diepenbeek, Belgium; Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium
| | - Arnout Standaert
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium
| | - Albert Ambros
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Michelle Laeremans
- Hasselt University, Centre for Environmental Sciences, Diepenbeek, Belgium; Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium
| | - Ione Avila-Palencia
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Glòria Carrasco-Turigas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Wegener
- University of Natural Resources and Life Sciences Vienna, Institute for Transport Studies, Vienna, Austria
| | - Esther Anaya
- Centre for Environmental Policy (CEP), Imperial College, London, United Kingdom
| | - Juan Pablo Orjuela
- Centre for Environmental Policy (CEP), Imperial College, London, United Kingdom; Transport Studies Unit, School of Geography and the Environment, University of Oxford, Oxford, United Kingdom
| | - Audrey de Nazelle
- Centre for Environmental Policy (CEP), Imperial College, London, United Kingdom
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Luc Int Panis
- Hasselt University, Centre for Environmental Sciences, Diepenbeek, Belgium; Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Saloň A, De Boever P, Goswami N. Microvascular Changes during Viral Infections: A Systematic Review of Studies Using Retinal Vessel Diameter Assessments. Biomedicines 2024; 12:1488. [PMID: 39062061 PMCID: PMC11274461 DOI: 10.3390/biomedicines12071488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/18/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Viral infection frequently affects the cardiovascular system, and vascular disturbances in patients can lead to health complications. One essential component of the cardiovascular system that is vulnerable to the inflammatory effects of viral infections is the microcirculatory system. As a suitable and practical non-invasive method to assess the structure and function of the retinal microcirculation, a proxy for the microcirculatory system, retinal fundus imaging can be used. We examined the impact of viral infections on retinal vessel diameters and performed a systematic analysis of the literature. Our search was carried out on PubMed using predefined search queries. After a methodological filtering process, we were able to reduce the corpus of 363 publications to 16 studies that met the search parameters. We used a narrative review style to summarise the observations. Six studies covered COVID-19, seven described HIV, and three were included in the subgroup called others, covering viruses, such as Dengue Fever and Crimean-Congo Haemorrhagic Fever. Analysis of the literature showed that viral infections are associated with alterations in the retinal vessels' vasoactivity. COVID-19 and other infections cause inflammation-associated the vasodilatation of microvasculature as a short-term effect of the infection. Long COVID-19 as well as HIV are the cause of chronic inflammation impacting microvascular morphology via retinal vessel diameter narrowing. The review emphasises the importance of the understudied area of viral infections' effects on retinal microcirculation. Continuous research in this area is needed to further verify retinal fundus imaging as an innovative tool for the optimal diagnosis of microvascular changes. As changes in the microvasculature precede changes in bigger arteries, the early detection of microvascular changes can go a long way in reducing the morbidity and mortality associated with cardiovascular diseases.
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Affiliation(s)
- Adam Saloň
- Division of Physiology & Pathophysiology, Otto Loewi Research Centre for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, 8010 Graz, Austria
- Vascular Biology Center, Augusta University, Augusta, GA 30912, USA
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, 2624 Lillehammer, Norway
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, 3500 Hasselt, Belgium;
- Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Nandu Goswami
- Division of Physiology & Pathophysiology, Otto Loewi Research Centre for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, 8010 Graz, Austria
- Center for Space and Aviation Health, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
- Integrative Health Department, Alma Mater Europaea, 2000 Maribor, Slovenia
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Saloň A, Çiftci GM, Zubac D, Šimunič B, Pišot R, Narici M, Fredriksen PM, Nkeh-Chungag BN, Sourij H, Šerý O, Schmid-Zalaudek K, Steuber B, De Boever P, Goswami N. Retinal venular vessel diameters are smaller during ten days of bed rest. Sci Rep 2023; 13:19258. [PMID: 37935771 PMCID: PMC10630473 DOI: 10.1038/s41598-023-46177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/28/2023] [Indexed: 11/09/2023] Open
Abstract
Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spaceflight. This study investigates changes in retinal microcirculation during a ten-day bed rest protocol. Ten healthy young males (22.9 ± 4.7 years; body mass index: 23.6 ± 2.5 kg·m-2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a significant decrease in retinal venular diameter was observed, indicated by a significantly lower central retinal vein equivalent (from 226.1 µm, CI 8.90, to 211.4 µm, CI 8.28, p = .026), while no significant changes in central retinal artery equivalent were noted. Prolonged bed rest confinement resulted in a significant (up to 6.5%) reduction in retinal venular diameter. These findings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and reflect overall (cardio)-vascular deconditioning.
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Affiliation(s)
- Adam Saloň
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Göktuğ Mert Çiftci
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - Damir Zubac
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department 1 of Internal Medicine, Centre for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Marco Narici
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Per Morten Fredriksen
- Faculty of Applied Ecology, Agricultural Sciences and Biotechnology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, 5117, South Africa
| | - Harald Sourij
- Internal Medicine, Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
| | - Omar Šerý
- Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Karin Schmid-Zalaudek
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Bianca Steuber
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Nandu Goswami
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria.
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria.
- Integrative Health, Alma Mater Europaea Maribor, Maribor, Slovenia.
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
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Dinevski D, Lučovnik M, Žebeljan I, Guzelj D, Dinevski IV, Salon A, De Boever P, Goswami N. Analysis of Retinal Blood Vessel Diameters in Pregnant Women Practicing Yoga: A Feasibility Study. Healthcare (Basel) 2022; 10:1356. [PMID: 35885883 PMCID: PMC9318989 DOI: 10.3390/healthcare10071356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 12/04/2022] Open
Abstract
Studies have shown that practicing yoga during pregnancy beneficially affects maternal and neonatal outcomes. The objective of this study was to determine the effect of prenatal yoga on the microvascular circulatory system via non-invasive measurements of retinal blood vessels. We included 29 women who practiced prenatal yoga in the study. There were no statistically significant differences in arteriolar and venular diameters pre- vs. post-90 min yoga practice (150.5 ± 11.4 μm pre- vs. 151.2 ± 10.2 μm post-yoga; p = 0.53 for arteriolar and 221.8 ± 16.1 μm pre- vs. 223.2 ± 15.7 μm post-yoga; p = 0.51 for venular diameters). The current study demonstrated the feasibility of the setup. More extensive studies are needed to determine the potential microvascular effects of practicing yoga throughout pregnancy.
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Affiliation(s)
- Dejan Dinevski
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia;
| | - Miha Lučovnik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia;
| | | | - Domen Guzelj
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia;
| | | | - Adam Salon
- Physiology Division, Medical University of Graz, 8036 Graz, Austria; (A.S.); (N.G.)
| | - Patrick De Boever
- Department of Biology, University of Antwerp, 2020 Antwerpen, Belgium;
- Centre for Environmental Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Nandu Goswami
- Physiology Division, Medical University of Graz, 8036 Graz, Austria; (A.S.); (N.G.)
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Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis. J Clin Med 2021; 10:jcm10194427. [PMID: 34640445 PMCID: PMC8509415 DOI: 10.3390/jcm10194427] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022] Open
Abstract
Autoimmune rheumatic diseases (AIRDs) with unknown etiology are increasing in incidence and prevalence. Up to 5% of the population is affected. AIRDs include rheumatoid arthritis, system lupus erythematosus, systemic sclerosis, and Sjögren's syndrome. In patients with autoimmune diseases, the immune system attacks structures of its own body, leading to widespread tissue and organ damage, which, in turn, is associated with increased morbidity and mortality. One third of the mortality associated with autoimmune diseases is due to cardiovascular diseases. Atherosclerosis is considered the main underlying cause of cardiovascular diseases. Currently, because of finding macrophages and lymphocytes at the atheroma, atherosclerosis is considered a chronic immune-inflammatory disease. In active inflammation, the liberation of inflammatory mediators such as tumor necrotic factor alpha (TNFa), interleukine-6 (IL-6), IL-1 and other factors like T and B cells, play a major role in the atheroma formation. In addition, antioxidized, low-density lipoprotein (LDL) antibodies, antinuclear antibodies (ANA), and rheumatoid factor (RF) are higher in the atherosclerotic patients. Traditional risk factors like gender, age, hypercholesterolemia, smoking, diabetes mellitus, and hypertension, however, do not alone explain the risk of atherosclerosis present in autoimmune diseases. This review examines the role of chronic inflammation in the etiology-and progression-of atherosclerosis in autoimmune rheumatic diseases. In addition, discussed here in detail are the possible effects of autoimmune rheumatic diseases that can affect vascular function. We present here the current findings from studies that assessed vascular function changes using state-of-the-art techniques and innovative endothelial function biomarkers.
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Vaes AW, Spruit MA, Goswami N, Theunis J, Franssen FME, De Boever P. Analysis of retinal blood vessel diameters in patients with COPD undergoing a pulmonary rehabilitation program. Microvasc Res 2021; 139:104238. [PMID: 34492257 DOI: 10.1016/j.mvr.2021.104238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/05/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Regular exercise positively affects cardiovascular physiology, translating into the adequate capacity of microvascular blood vessels to dilate in response to acute bouts of exercise. However, this remains unstudied in patients with chronic obstructive pulmonary disease (COPD), who often suffer from cardiovascular comorbidity. Therefore, we studied acute changes in retinal blood vessel diameters in response to high-intensity exercise in patients with COPD. The effect of an exercise-based 8-week pulmonary rehabilitation (PR) program was evaluated. We consider changes in these retinal metrics as an indicator of microvascular reactivity. METHODS Demographics and clinical characteristics of 41 patients were collected at the start and end of the PR program. Patients performed a high-intensity exercise test on a cycle ergometer at the start and end of the PR program, during which we collected retinal images. Fundus images were taken immediately before and 0, 5, 10, 15, and 30 min after the ergometer test. Widths of retinal blood vessels, represented as Central Retinal Arteriolar and Venular Equivalents (CRAE and CRVE), were calculated. RESULTS Thirty patients with COPD completed the study protocol (57% males; mean age: 64 ± 7 years; mean FEV1: 45 ± 17%pred). We did not observe a change in retinal vessel widths following the ergometer test at the start of the PR program. This null result remained at the end of the 8-week PR program. Our observations did not alter when considering responders and non-responders to PR. CONCLUSION Retinal blood vessel diameters of patients with COPD did not change following an exercise test on an ergometer. The exercise-based PR program of eight weeks did not counteract the blunted retinal microvascular response.
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Affiliation(s)
- Anouk W Vaes
- Department of Research and Development, Ciro, Horn, the Netherlands.
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Nandu Goswami
- Division of Physiology, Medical University of Graz, Graz, Austria
| | - Jan Theunis
- Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Frits M E Franssen
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Patrick De Boever
- Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium; Department of Biology, University of Antwerp, Wilrijk, Belgium; Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
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Goswami N, Fredriksen PM, Lundin KEA, Agu C, Elias SO, Motaung KS, Brix B, Cvirn G, Sourij H, Stelzl E, Kessler HH, Saloň A, Nkeh-Chungag B. COVID-19 and its effects on endothelium in HIV-positive patients in sub-Saharan Africa: Cardiometabolic risk, thrombosis and vascular function (ENDOCOVID STUDY). BMC Infect Dis 2021; 21:719. [PMID: 34332551 PMCID: PMC8325201 DOI: 10.1186/s12879-021-06426-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/10/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND COVID-19 has affected almost every country in the world, especially in terms of health system capacity and economic burden. People from sub-Saharan Africa (SSA) often face interaction between human immunodeficiency virus (HIV) infection and non-communicable diseases such as cardiovascular disease. Role of HIV infection and anti-retroviral treatment (ART) in altered cardiovascular risk is questionable and there is still need to further carry out research in this field. However, thus far it is unclear, what impact the COVID-19 co-infection in people living with HIV (PLHIV), with or without therapy will have. The ENDOCOVID project aims to investigate whether and how HIV-infection in COVID-19 patients modulates the time course of the disease, alters cardiovascular risk, and changes vascular endothelial function and coagulation parameters/ thrombosis risk. METHODS A total of 1026 patients will be included into this study. Cardiovascular research PLHIV with (n = 114 in each of the three recruiting centers) - or without - ART (n = 114 in each of the three recruiting centers) with COVID-19 and HIV-negative with COVID-19 (n = 114 in each of the three recruiting centers) will be carried out via clinical and biochemical measurements for cardiovascular risk factors and biomarkers of cardiovascular disease (CVD). Vascular and endothelial function will be measured by brachial artery flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) assessments, and retinal blood vessel analyses, along with vascular endothelial biomarkers and cogualation markers. The correlation between HIV-infection in COVID-19 PLHIV with or without ART and its role in enhancement of cardiovascular risk and endothelial dysfunction will be assessed at admission, weekly, at discharge and, 4 weeks post-discharge (if possible). IMPACT OF PROJECT The ENDOCOVID project aims to evaluate in the long-term the cardiovascular risk and vascular endothelial function in PLHIV thus revealing an important transitional cardiovascular phenotype in COVID-19. The study was registered under clinicaltrials.gov (NCT04709302).
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Affiliation(s)
- Nandu Goswami
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria.
- Divison of Health Sciences, Alma Mater Europea Maribor, Maribor, Slovenia.
- Department of Biological & Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University (WSU), Mthatha, South Africa.
| | - Per Morten Fredriksen
- School of Health Sciences, Kristiania University College, Prinsensgate 7-9, 0152, Oslo, Norway
| | - Knut E A Lundin
- KG Jebsen Coeliac Disease Research Centre, University of Oslo and Oslo University Hospital- Rikshospitalet, 0372, Oslo, Norway
| | - Chidozie Agu
- Management Sciences for Health, Global Fund RSSH Project, Abuja, Nigeria
| | - Simiat Olanike Elias
- Department of Physiology, Faculty of Basic Medical Sciences, University College of Medicine, Lagos, Nigeria
| | - Keolebogile Shirley Motaung
- Department of Technology Transfer & Innovation, Durban University of Technology, Tromso Annex, Steve Biko Campus, Durban, 4000, South Africa
| | - Bianca Brix
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria
| | - Gerhard Cvirn
- Physiological Chemistry Section, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Harald Sourij
- Clinical Division for Endocrinology and Diabetology, Medical University Graz, Graz, Austria
| | - Evelyn Stelzl
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Harald H Kessler
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Adam Saloň
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria
| | - Benedicta Nkeh-Chungag
- Department of Biological & Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University (WSU), Mthatha, South Africa
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Nkeh-Chungag BN, Engwa GA, Businge C, Mdondolo M, Pajaro Medina M, Goswami N. Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES). BMC Cardiovasc Disord 2021; 21:322. [PMID: 34193034 PMCID: PMC8247111 DOI: 10.1186/s12872-021-02130-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/21/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The risk of cardiovascular diseases (CVDs) is becoming more prevalent in pregnant women though not much data is available for pregnant women with human immunodeficiency virus (HIV). Foetoplacental vascular endothelial dysfunction is thought to be at the origin of chronic diseases such as diabetes and obesity later on in life. Because HIV and anti-retroviral treatment (ARTs) are associated with endothelial dysfunction, children exposed in utero to these conditions may be at greater risk of developing CVDs. Despite the high prevalence of HIV in pregnant South African women, little is known about the effects of ART on the cardiovascular health of the mother and offspring. Hence, the proposed study intends to investigate how HIV/ARTs may affect the cardiovascular health of the mother and offspring at different time points during the pregnancy and up to 2 years after birth. METHODS A longitudinal case-control study in HIV positive pregnant women on ART and HIV negative pregnant women will be conducted. All pregnant women will be assessed for cardio-metabolic risk factors and markers (lipids, anthropometric and glycaemic indies, oxidative stress), hemodynamic status (blood pressure parameters) and vascular function (arterial compliance, retinal microvasculature, uterine artery mean pulsatility index). Child health will be monitored in utero and postnatally via routine foetal health screening, placental integrity, anthropometry, blood pressure parameters, markers of oxidative stress and endothelial function in cord blood and cardiovascular epigenetic markers in urine. DISCUSSION There is a paucity of studies in South Africa and sub-Sahara Africa as a whole that utilised a longitudinal study model to assess the effects of ARTs on vascular endothelial changes in pregnant women living with HIV and the cardiometabolic health of their offspring. This study will therefore help to monitor changes in cardiometabolic risk during pregnancy and in children exposed in utero to HIV-infection and ART use. Findings from this study will provide useful information for developing guidelines on the use of ARTs in pregnancy and management of cardiometabolic health of the offspring of HIV positive mothers.
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Affiliation(s)
- Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, 5117 South Africa
| | - Godwill Azeh Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, 5117 South Africa
| | - Charles Businge
- Department of Obstetrics and Gynaecology, Walter Sisulu University, Nelson Mandela Academic Hospital, Mthatha, 5117 South Africa
| | - Mziwohlanga Mdondolo
- Department of Obstetrics and Gynaecology, Mthatha Regional Hospital, Private Bag x 5014, Mthatha, 5099 South Africa
| | - Magdevy Pajaro Medina
- Department of Peadiatrics, Mthatha Regional Hospital, Private Bag x 5014, Mthatha, 5099 South Africa
| | - Nandu Goswami
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, 8036 Graz, Austria
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Brix B, Sery O, Onorato A, Ure C, Roessler A, Goswami N. Biology of Lymphedema. BIOLOGY 2021; 10:biology10040261. [PMID: 33806183 PMCID: PMC8065876 DOI: 10.3390/biology10040261] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/15/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022]
Abstract
Simple Summary Lymphedema is a chronic, debilitating disease of the lymphatic vasculature. Although several reviews focus on the anatomy and physiology of the lymphatic system, this review provides an overview of the lymphatic vasculature and, moreover, of lymphatic system dysfunction and lymphedema. Further, we aim at advancing the knowledge in the area of lymphatic system function and how dysfunction of the lymphatic system—as seen in lymphedema—affects physiological systems, such as the cardiovascular system, and how those might be modulated by lymphedema therapy. Abstract This narrative review portrays the lymphatic system, a poorly understood but important physiological system. While several reviews have been published that are related to the biology of the lymphatic system and lymphedema, the physiological alternations, which arise due to disturbances of this system, and during lymphedema therapy, are poorly understood and, consequently, not widely reported. We present an inclusive collection of evidence from the scientific literature reflecting important developments in lymphedema research over the last few decades. This review aims at advancing the knowledge on the area of lymphatic system function as well as how system dysfunction, as seen in lymphedema, affects physiological systems and how lymphedema therapy modulates these mechanisms. We propose that future studies should aim at investigating, in-detail, aspects that are related to fluid regulation, hemodynamic responses, and endothelial and/or vascular changes due to lymphedema and lymphedema therapy.
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Affiliation(s)
- Bianca Brix
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 3810 Graz, Austria; (B.B.); (A.R.)
| | - Omar Sery
- Faculty of Science, Masaryk University, Kotlářská 2, 61137 Brno, Czech Republic;
| | | | - Christian Ure
- Wolfsberg Clinical Center for Lymphatic Disorders, Wolfsberg State Hospital, KABEG, 9400 Wolfsberg, Austria;
| | - Andreas Roessler
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 3810 Graz, Austria; (B.B.); (A.R.)
| | - Nandu Goswami
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, 3810 Graz, Austria; (B.B.); (A.R.)
- Correspondence: ; Tel.: +43-316-385-73852
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11
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Vaes AW, Spruit MA, Van Keer K, Barbosa-Breda J, Wouters EFM, Franssen FME, Theunis J, De Boever P. Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program. Sci Rep 2020; 10:31. [PMID: 31913345 PMCID: PMC6949286 DOI: 10.1038/s41598-019-56997-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular diseases are frequently present in chronic obstructive pulmonary disease (COPD). Population-based studies found associations between retinal vessel diameters and cardiovascular health, but it is unknown whether this also applies to COPD patients. Therefore, we measured retinal vessel diameters in COPD patients and aimed to determine the association with cardiovascular risk factors, lung function, and functional outcomes. In addition, we investigated whether an exercise-based pulmonary rehabilitation (PR) program would change retinal vessel diameters, as a proxy for improved microvascular health. Demographics and clinical characteristics, including pulmonary function, exercise capacity, blood pressure, blood measurements and level of systemic inflammation were obtained from 246 patients during routine assessment before and after PR. Retinal vessel diameters were measured from digital retinal images. Older age and higher systolic blood pressure were associated with narrower retinal arterioles (β: -0.224; p = 0.042 and β: -0.136; p < 0.001, respectively). Older age, higher systolic blood pressure and lower level of systemic inflammation were associated with narrower retinal venules (β: -0.654; -0.229; and -13.767, respectively; p < 0.05). No associations were found between retinal vessel diameters and lung function parameters or functional outcomes. After PR, no significant changes in retinal venular or arteriolar diameter were found. To conclude, retinal vessel diameters of COPD patients were significantly associated with systolic blood pressure and systemic inflammation, whilst there was no evidence for an association with lung function parameters, functional outcomes or other cardiovascular risk factors. Furthermore, an exercise-based PR program did not affect retinal vessel diameter.
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Affiliation(s)
- Anouk W Vaes
- Research and Education, Ciro, Horn, Netherlands.
- Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium.
| | - Martijn A Spruit
- Research and Education, Ciro, Horn, Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Karel Van Keer
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - João Barbosa-Breda
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Ophthalmology Department, Centro Hospitalar Sao Joao, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Emiel F M Wouters
- Research and Education, Ciro, Horn, Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Frits M E Franssen
- Research and Education, Ciro, Horn, Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Jan Theunis
- Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Patrick De Boever
- Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
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12
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Li Q, Lin F, Gao Z, Huang F, Zhu P. Sex-Specific Association Between Serum Uric Acid and Retinal Microvessels. Med Sci Monit 2019; 25:9973-9980. [PMID: 31875645 PMCID: PMC6944035 DOI: 10.12659/msm.919972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/08/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As epidemiological findings are still controversial, animal experiments have probed into the potential link between uric acid and damage to microvessels. The present study examined the association of serum uric acid (SUA) with the retinal vascular caliber and retinal vascular fractal dimension (Df) in males and females utilizing a cross-sectional study design. MATERIAL AND METHODS A total of 2169 subjects from 7 sampling units were enrolled. Retinal vascular parameters were analyzed with a semi-automated computer-based program. The central retinal arteriolar equivalent, central retinal venular equivalent, and Df were linearly and categorically measured in males and females and at various SUA levels. RESULTS The analysis revealed that per SD SUA increase was associated with an increase of 0.848 µm in the arteriolar caliber, and an increase of 1.618 µm in the venular caliber only in females. No significant correlation was found between Df and SUA in females or in males. Further adjusted for more cardiovascular risk factors did not change the results. CONCLUSIONS By exploring a Chinese coastal population, we elucidate the association between SUA with retinal arterioles and venules in females. Df, as a mathematical index of retinal blood vascular complexity, is not correlated with SUA or hyperuricemia.
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Affiliation(s)
- Qiaowei Li
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, The Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Fan Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, The Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Zhonghai Gao
- Department of Ophthalmology, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, The Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Feng Huang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, The Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Pengli Zhu
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, The Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P.R. China
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