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Martin ZT, Fields ND, Erving CL, Udaipuria S, Moore RH, Blevins KM, Murden RJ, Booker B, Culler L, Swanson S, Goodson J, Barinas-Mitchell E, Quyyumi AA, Vaccarino V, Lewis TT. Central Hemodynamics in African American Women: Examining the Role of Superwoman Schema Endorsement. J Am Heart Assoc 2024; 13:e033587. [PMID: 39149994 DOI: 10.1161/jaha.123.033587] [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: 01/13/2024] [Accepted: 04/19/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND African American women bear a disproportionate burden of cardiovascular diseases, potentially due to altered central hemodynamics. Racism and sexism often lead to African American women taking on numerous caretaking roles and overall increases their use of the Strong Black Woman (ie, Superwoman) mindset, which may have negative health consequences. We hypothesized that endorsing the Superwoman role and its Obligation to Help Others dimension would be associated with a deleterious central hemodynamics profile in African American women. METHODS AND RESULTS Using cross-sectional data, we examined central systolic blood pressure (mm Hg; n=408), augmentation index (percentage, adjusted for height and heart rate; n=408), and pulse wave velocity (m/s; n=368) in African American women aged 30 to 46 years. The Giscombe Superwoman Schema (SWS) questionnaire assessed endorsement of Overall SWS (range, 0-105) and SWS-Obligation to Help Others (range, 0-3). Multiple linear regression modeled associations between Overall SWS (10-unit increments) and SWS-Obligation to Help Others (1-unit increments) and central hemodynamics while adjusting for pertinent sociodemographic, clinical, and psychosocial factors. In fully adjusted models, central systolic blood pressure was significantly associated with Overall SWS (β=0.83 [95% CI, 0.19-1.47]) and SWS-Obligation to Help Others (β=2.03 [95% CI, 0.39-3.67]). Augmentation index was associated with Overall SWS (β=0.66 [95% CI, 0.02-1.30]) and SWS-Obligation to Help Others (β=2.21 [95% CI, 0.58-3.84]). Significant associations were not observed between pulse wave velocity and SWS. CONCLUSIONS Greater endorsement of the Superwoman role and prioritizing caregiving over self-care were associated with higher central systolic blood pressure and augmentation index, which may contribute to adverse cardiovascular health among African American women.
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Affiliation(s)
- Zachary T Martin
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
- Hubert Department of Global Health, Rollins School of Public Health Emory University Atlanta GA USA
| | - Christy L Erving
- Department of Sociology, College of Liberal Arts The University of Texas at Austin Austin TX USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Reneé H Moore
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health Drexel University Philadelphia PA USA
| | - Kennedy M Blevins
- Department of Psychological Science, School of Social Ecology University of California, Irvine Irvine CA USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta GA USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - LaKeia Culler
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Seegar Swanson
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta GA USA
| | - Jaylah Goodson
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh PA USA
| | - Arshed A Quyyumi
- Department of Medicine, School of Medicine Emory University Atlanta GA USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
- Department of Medicine, School of Medicine Emory University Atlanta GA USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
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Fields ND, Martin ZT, Hoggard LS, Erving CL, Udaipuria S, Blevins KM, Parker JE, Goodson J, Murden RJ, Moore RH, Parker R, Culler L, Booker B, Barinas-Mitchell E, Quyyumi A, Vaccarino V, Lewis TT. Does stress from incarceration of family and friends contribute to signs of early vascular ageing in African American women? J Epidemiol Community Health 2024:jech-2024-222227. [PMID: 39122410 DOI: 10.1136/jech-2024-222227] [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: 03/19/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Early vascular ageing (EVA) contributes to elevated risk of cardiovascular disease (CVD), which disproportionately affects African American women. Incarceration, an event disproportionately impacting African Americans, may be a stressor contributing to EVA in African American women. Further, the subjective perspective, commonly referred to as appraisal, of incarceration may also be important for health. We hypothesised that having family and/or friends incarcerated and appraising the incarceration as upsetting would be associated with indices of EVA. METHODS In a community-based cohort of African American women aged 30-46 living in Atlanta, Georgia (n=391), participants were asked, at baseline, about family and/or friend incarceration and to appraise how upsetting the incarceration was. Multivariable linear regression examined associations between: (1) family and/or friend incarceration and indices of EVA (pulse wave velocity, augmentation index, central systolic blood pressure (SBP) and pulse pressure amplification) and (2) appraisal of incarceration and EVA indices. RESULTS 45% of participants (n=174) reported having a loved one incarcerated, and 59% (n=102) reported the incarceration as upsetting. Having a loved one incarcerated was associated with a higher central SBP (b=4.30; 95% CI 1.61, 6.99) and augmentation index (b=2.29; 95% CI 0.26, 4.33). Appraisal of incarceration was only associated with central SBP. CONCLUSIONS Family or friend incarceration was highly prevalent in this cohort of African American women and associated with indices of EVA. Mass incarceration of others may affect the physical health of African American women which may contribute to CVD disparities.
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Affiliation(s)
- Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Zachary T Martin
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lori S Hoggard
- Department of Psychology, College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Christy L Erving
- Department of Sociology, College of Liberal Arts, The University of Texas at Austin, Austin, Texas, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kennedy M Blevins
- Department of Psychological Science, School of Social Ecology, UC Irvine, Irvine, California, USA
| | - Jordan E Parker
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| | - Jaylah Goodson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Renee H Moore
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - LaKeia Culler
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Arshed Quyyumi
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Xing C, Xie X, Wu Y, Xu L, Guan X, Li F, Zhan X, Yang H, Li J, Zhou Q, Mu Y, Zhou Q, Ding Y, Wang Y, Wang X, Zheng Y, Sun X, Li H, Zhang C, Zhao C, Qiu S, Yan G, Yang H, Mao Y, Zhan W, Ma C, Gu Y, Chen W, Xie M, Jiang T, Yuan L. Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study. Chin Med J (Engl) 2024; 137:1802-1810. [PMID: 38958034 DOI: 10.1097/cm9.0000000000003156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants. METHODS A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson's correlation, multiple linear regression, and analyses of covariance. RESULTS All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. CONCLUSIONS The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.
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Affiliation(s)
- Changyang Xing
- Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi 710038, China
| | - Xiujing Xie
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Yu Wu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Lei Xu
- Department of Ultrasound, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, Shaanxi 710021, China
| | - Xiangping Guan
- Ultrasound Medical Diagnosis Center, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
| | - Fan Li
- Department of Ultrasound, Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Xiaojun Zhan
- Department of Ultrasound, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi 710002, China
| | - Hengli Yang
- Department of Ultrasound Diagnosis, The Second Affiliated Hospital, Xi'an Medical College, Xi'an, Shaanxi 710038, China
| | - Jinsong Li
- Department of Ultrasound, Xi'an Gem Flower ChangQing Hospital, Xi'an, Shaanxi 710201, China
| | - Qi Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, China, Xi'an, Shaanxi 710004, China
| | - Yuming Mu
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Qing Zhou
- Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Yunchuan Ding
- Department of Ultrasound, Yan'an Hospital, The Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650051, China
| | - Yingli Wang
- Department of Ultrasound, Yan'an University Xianyang Hospital, Xianyang, Shaanxi 712000, China
| | - Xiangzhu Wang
- Department of Function Examination, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
| | - Yu Zheng
- Department of Ultrasound, Xi'an Central Hospital, Xi'an, Shaanxi 710004, China
| | - Xiaofeng Sun
- Cadre's Wards Ultrasound Department, Diagnostic Ultrasound Center, First Hospital of Jilin University, Changchun, Jilin 130000, China
| | - Hua Li
- Department of Echocardiography, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi, Xinjiang 830002, China
| | - Chaoxue Zhang
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Cheng Zhao
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Shaodong Qiu
- Department of Ultrasound, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China
| | - Guozhen Yan
- Department of Ultrasound, The First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014000, China
| | - Hong Yang
- Department of Medical Ultrasonics, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Yinjuan Mao
- Department of Ultrasound, The Fourth People's Hospital, Xi'an, Shaanxi 710043, China
| | - Weiwei Zhan
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Ying Gu
- Department of Ultrasound Center, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China
| | - Wu Chen
- Department of Ultrasound Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Tianan Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Lijun Yuan
- Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi 710038, China
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Day CA, Berkowsky RS, Zaleski AL, Chen MH, Taylor BA, Wu Y, Parducci PM, Zhang Y, Fernhall B, Fernandez AB, Pescatello LS. The influence of vigorous physical exertion on cardiac demand under conditions of daily living among firefighters with elevated blood pressure. Heart Lung 2024; 68:208-216. [PMID: 39047646 DOI: 10.1016/j.hrtlng.2024.07.008] [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: 04/12/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Firefighters have a high prevalence of cardiovascular disease. The poor heart health of firefighters is implicated in their increased risk of sudden cardiac death (SCD). Exercise may be protective against SCD partially due to the immediate blood pressure (BP) reductions of 5-8 mmHg following exercise, termed postexercise hypotension (PEH) OBJECTIVES: To examine PEH under ambulatory conditions after a maximal cardiopulmonary exercise test (CPET) among career firefighters METHODS: Firefighters (n = 19) completed a maximal CPET and non-exercise control (CONTROL) in random order on separate non-workdays and left the laboratory instrumented to an ambulatory BP (ABP) monitor. Ambulatory systolic BP (ASBP), diastolic BP (ADBP), and heart rate (AHR) were recorded at hourly intervals over 19hr. The ambulatory rate pressure product (ARPP) was calculated as ASBPxAHRx10-3 at each hourly interval. Repeated measures ANCOVA tested if the ABP, AHR, and ARPP responses differed after CPET vs CONTROL over 19hr RESULTS: Firefighters were middle-aged (39.5 ± 8.9 yr), overweight (29.2 ± 4.0 kg/m2) men with elevated BP (123.1 ± 9.6/79.8 ± 10.4 mmHg), while resting HR (67.7 ± 11.3 bpm) and RPP (8.4 ± 1.7mmHg*bpm*10-3) were in normal ranges. ASBP (16.6 ± 5.7 mmHg) and ADBP (3.1 ± 4.6 mmHg) increased after the CPET vs CONTROL over 19hr (ps<0.01), as did AHR (9.4 ± 7.9 bpm, p = 0.02) and ARPP (2.5 ± 1.1mmHg*bpm*10-3, p < 0.01). CONCLUSIONS Unexpectedly, the firefighters exhibited postexercise hypertension rather than PEH. The increases in ABP and AHR we observed indicated a sustained increase in cardiac demand. Further investigation is needed to confirm our findings and determine whether the adverse hemodynamic responses we observed contribute to the high prevalence of SCD that firefighters experience on the job.
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Affiliation(s)
- Christina A Day
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Rachel S Berkowsky
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA.
| | - Amanda L Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA; Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT 06268, USA
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA; Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Paul M Parducci
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Yiming Zhang
- Department of Statistics, University of Connecticut, Storrs, CT 06268, USA
| | - Bo Fernhall
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA 02125, USA
| | - Antonio B Fernandez
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
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Ozarli I, Yeter HH, Sener YZ, Cebrailov C, Yildirim T, Yilmaz R. Effects of a medium cut-off dialyzer on inflammation and cardiac and vascular function in hemodialysis patients with heart failure. Hemodial Int 2024; 28:326-335. [PMID: 38923655 DOI: 10.1111/hdi.13166] [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: 09/21/2023] [Revised: 05/20/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Expanded hemodialysis (HDx) could provide clearance of larger middle-molecule uremic toxins. We compared the effect of hemodialysis with medium cut-off membranes and high-flux (HFHD) membranes regarding changes in inflammation and vascular and left ventricular function. METHODS This was a single-center, prospective, parallel-group comparative study. Patients were divided into two groups (HDx: 25 patients and HFHD: 26 patients). All measurements were performed at baseline and 12 weeks. Serum c-reactive protein, interkelukin-18, pentraxin-3, β-2 microglobulin, and brain natriuretic peptide were measured. We used pulse wave velocity and augmentation index to assess arterial stiffness and echocardiography to evaluate left and right ventricular function. FINDINGS We enrolled 51 patients. Although serum c-reactive protein, interkelukin-18, pentraxin 3, and β-2 microglobulin were significantly decreased in the HDx group (p = 0.02, p < 0.001, p = 0.002, and p = 0.02, respectively), there was no significant change in HFHD group at 12th week. Serum c-reactive protein and interkelukin-18were significantly lower in the HDx group compared to the HFHD group in the 12th week (p = 0.007 and p = 0.03, respectively). We observed a significant decrease in pulse wave velocity in the HDx group at the end of the study (p = 0.03). Although there was no significant change in pulse wave velocity in the HFHD group, pulse wave velocity was similar between the HDx and HFHD groups in the 12th week. We detected a significant decrease in the mean isovolumetric relaxation time in the HDx group (p = 0.006). However, there was no significant difference in isovolumetric relaxation time between the HDx and HFHD groups in the 12th week. DISCUSSION HDx provides better clearance of middle molecular uremic toxins and inflammatory biomarkers, and it may be associated with better central hemodynamic parameters and diastolic functions.
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Affiliation(s)
- Irem Ozarli
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hacı Hasan Yeter
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yusuf Ziya Sener
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cebrail Cebrailov
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tolga Yildirim
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rahmi Yilmaz
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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West K, Spears K, Joyner B, Smith C, Jenkins NDM, Grosicki GJ, Siekirk NJ. The acute effect of passively assisted trunk stretching on central arterial stiffness and blood pressure in middle-aged to older adults. Eur J Appl Physiol 2024; 124:1683-1692. [PMID: 38217670 DOI: 10.1007/s00421-023-05389-9] [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: 07/20/2023] [Accepted: 11/29/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE We examined the effects of acute trunk stretching on central arterial stiffness and central and peripheral blood pressure in middle-aged to older adults. METHODS Twenty-eight middle-aged to older adults (14M/14F, 72 ± 7 years, 28.5 ± 5.3 kg/m2) completed this randomized, controlled, crossover design trial. We measured carotid-femoral pulse wave velocity (cf-PWV) and central and peripheral blood pressures (BP) before and after a single bout of passively assisted trunk stretching (i.e., five rounds of six 30-s stretches) and a time-matched seated control visit (i.e., 30-min). Changes (Δ; post - pre) in cf-PWV and central and peripheral BP were compared between visits and sexes using separate linear mixed-effects models controlling for baseline values. RESULTS Compared with seated control, central (systolic: - 3 ± 7 mmHg; diastolic: - 2 ± 5 mmHg) and peripheral (systolic: - 2 ± 8 mmHg; diastolic: - 1 ± 4 mmHg) BP were reduced following acute trunk stretching (ps ≤ 0.001). Between-visit differences for ∆cf-PWV (stretch: 0.09 ± 0.61 m/s; control: 0.37 ± 0.68 m/s, p = 0.038) were abolished when controlling for change in mean arterial pressure (∆MAP) (p = 0.687). The main effects of sex were detected for changes in systolic BPs (ps ≤ 0.029); more males (n = 13) saw BP reductions than females (n = 7). CONCLUSION These findings demonstrate the superiority of acute trunk stretching over passive sitting of equated duration for BP in middle-aged to older adults, with an appreciable effect in males compared to females.
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Affiliation(s)
- Kylee West
- Biomechanics Laboratory, Department of Health Sciences and Kinesiology, Georgia Southern University, P.O. Box 8076, Statesboro, GA, 30460, USA
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Savannah, GA, USA
| | - Kaelyn Spears
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Savannah, GA, USA
| | - Barry Joyner
- Center for Rehabilitation and Independent Living, Waters College of Health Professions, Georgia Southern University, Statesboro, GA, USA
| | - Collin Smith
- Internal Medicine, East Georgia Regional Medical Center, Statesboro, GA, USA
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
- Francois M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA
| | - Gregory J Grosicki
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University, Savannah, GA, USA
| | - Nicholas J Siekirk
- Biomechanics Laboratory, Department of Health Sciences and Kinesiology, Georgia Southern University, P.O. Box 8076, Statesboro, GA, 30460, USA.
- Center for Rehabilitation and Independent Living, Waters College of Health Professions, Georgia Southern University, Statesboro, GA, USA.
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Ottosson F, Engström G, Orho‐Melander M, Melander O, Nilsson PM, Johansson M. Plasma Metabolome Predicts Aortic Stiffness and Future Risk of Coronary Artery Disease and Mortality After 23 Years of Follow-Up in the General Population. J Am Heart Assoc 2024; 13:e033442. [PMID: 38639368 PMCID: PMC11179945 DOI: 10.1161/jaha.123.033442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/29/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Increased aortic stiffness (arteriosclerosis) is associated with early vascular aging independent of age and sex. The underlying mechanisms of early vascular aging remain largely unexplored in the general population. We aimed to investigate the plasma metabolomic profile in aortic stiffness (vascular aging) and associated risk of incident cardiovascular disease and mortality. METHODS AND RESULTS We included 6865 individuals from 2 Swedish population-based cohorts. Untargeted plasma metabolomics was performed by liquid-chromatography mass spectrometry. Aortic stiffness was assessed directly by carotid-femoral pulse wave velocity (PWV) and indirectly by augmentation index (AIx@75). A least absolute shrinkage and selection operator (LASSO) regression model was created on plasma metabolites in order to predict aortic stiffness. Associations between metabolite-predicted aortic stiffness and risk of new-onset cardiovascular disease, cardiovascular mortality, and all-cause mortality were calculated. Metabolite-predicted aortic stiffness (PWV and AIx@75) was positively associated particularly with acylcarnitines, dimethylguanidino valeric acid, glutamate, and cystine. The plasma metabolome predicted aortic stiffness (PWV and AIx@75) with good accuracy (R2=0.27 and R2=0.39, respectively). Metabolite-predicted aortic stiffness (PWV and AIx@75) was significantly correlated with age, sex, systolic blood pressure, body mass index, and low-density lipoprotein. After 23 years of follow-up, metabolite-predicted aortic stiffness (PWV and AIx@75) was significantly associated with increased risk of new-onset coronary artery disease, cardiovascular mortality, and all-cause mortality. CONCLUSIONS Aortic stiffness is associated particularly with altered metabolism of acylcarnitines, cystine, and dimethylguanidino valeric acid. These metabolic disturbances predict increased risk of new-onset coronary artery disease, cardiovascular mortality, and all-cause mortality after more than 23 years of follow-up in the general population.
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Affiliation(s)
- Filip Ottosson
- Department of Clinical Sciences in MalmöLund UniversityMalmöSweden
- Section for Clinical Mass SpectrometryStatens Serum InstitutCopenhagenDenmark
| | - Gunnar Engström
- Department of Clinical Sciences in MalmöLund UniversityMalmöSweden
| | | | - Olle Melander
- Department of Clinical Sciences in MalmöLund UniversityMalmöSweden
- Department of Internal MedicineSkåne University HospitalMalmöSweden
| | - Peter M. Nilsson
- Department of Clinical Sciences in MalmöLund UniversityMalmöSweden
- Department of Internal MedicineSkåne University HospitalMalmöSweden
| | - Madeleine Johansson
- Department of Clinical Sciences in MalmöLund UniversityMalmöSweden
- Department of CardiologySkåne University HospitalMalmöSweden
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Pilt K, Reiu A. Effect of transmural pressure on the estimation of arterial stiffness index from the photoplethysmographic waveform. Med Biol Eng Comput 2024; 62:1049-1059. [PMID: 38123887 DOI: 10.1007/s11517-023-02992-y] [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: 01/04/2022] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to find the effect of transmural pressure on the determination of the photoplethysmographic (PPG) waveform arterial stiffness index (PPGAI). The study was conducted on 51 subjects without diagnosis of cardiovascular disease, aged between 24 and 74 years. The relation between the transmural pressure, which is the difference between the arterial blood pressure and the PPG sensor contact pressure, and the PPGAI was determined. PPG, beat-to-beat blood pressure, and sensor contact pressure signals were recorded from the index, middle, and ring finger. The PPG sensor contact pressure of the index finger was increased from 20 to 120 mmHg. The aortic augmentation index (AIx@75) was estimated with a SphygmoCor device as a reference. High correlation coefficients r = 0.79 and r = 0.83 between PPGAI and AIx@75, and low PPGAI standard deviations were observed at the transmural pressures of 10 and 20 mmHg, respectively. Transmural pressure of 20 mmHg can be considered suitable for the PPG signal registration and PPGAI calculation for the assessment of arterial stiffness. In summary, the contact pressure of the sensor should be selected according to theblood pressure of the subject finger in order to achieve the transmural pressure suitable for the assessment of PPGAI and arterial stiffness.
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Affiliation(s)
- Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia.
| | - Andy Reiu
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia
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9
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Woolf EK, Lee SY, Ghanem N, Vazquez AR, Johnson SA. Protective effects of blueberries on vascular function: A narrative review of preclinical and clinical evidence. Nutr Res 2023; 120:20-57. [PMID: 37913730 DOI: 10.1016/j.nutres.2023.09.007] [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: 07/24/2023] [Revised: 09/18/2023] [Accepted: 09/23/2023] [Indexed: 11/03/2023]
Abstract
Blueberries are rich in nutrients and (poly)phenols, popular with consumers, and a major agricultural crop with year-round availability supporting their use in food-based strategies to promote human health. Accumulating evidence indicates blueberry consumption has protective effects on cardiovascular health including vascular dysfunction (i.e., endothelial dysfunction and arterial stiffening). This narrative review synthesizes evidence on blueberries and vascular function and provides insight into underlying mechanisms with a focus on oxidative stress, inflammation, and gut microbiota. Evidence from animal studies supports beneficial impacts on vascular function. Human studies indicate acute and chronic blueberry consumption can improve endothelial function in healthy and at-risk populations and may modulate arterial stiffness, but that evidence is less certain. Results from cell, animal, and human studies suggest blueberry consumption improves vascular function through improving nitric oxide bioavailability, oxidative stress, and inflammation. Limited data in animals suggest the gut microbiome mediates beneficial effects of blueberries on vascular function; however, there is a paucity of studies evaluating the gut microbiome in humans. Translational evidence indicates anthocyanin metabolites mediate effects of blueberries on endothelial function, though this does not exclude potential synergistic and/or additive effects of other blueberry components. Further research is needed to establish the clinical efficacy of blueberries to improve vascular function in diverse human populations in a manner that provides mechanistic information. Translation of clinical research to the community/public should consider feasibility, social determinants of health, culture, community needs, assets, and desires, barriers, and drivers to consumption, among other factors to establish real-world impacts of blueberry consumption.
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Affiliation(s)
- Emily K Woolf
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Sylvia Y Lee
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Nancy Ghanem
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Allegra R Vazquez
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
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Belmar Vega L, Pérez Canga JL, Heras Vicario M, Rodrigo Calabia E, Ruiz San Millán JC, Díaz López L, Martín Penagos L, Fernández Fresnedo G. Association of severe preeclampsia and vascular damage assessed by noninvasive markers of arterial stiffness. Nefrologia 2023; 43:703-713. [PMID: 38199838 DOI: 10.1016/j.nefroe.2023.12.001] [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: 04/18/2022] [Accepted: 07/23/2022] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with high maternal and fetal morbidity and mortality and increased future risk of cardiovascular complications. OBJECTIVE To analyze whether women who have had PE with severe features in their pregnancy have higher arterial stiffness (AS) parameters than those whose PE course was without signs of severity. METHODS Sixty-five women who developed PE during their gestation were evaluated, divided into two groups: PE group without severe features or non-severe PE (n=30) and PE group with severe features or severe PE (n=35). Carotid-femoral pulse wave velocity (cfPWV), central augmentation index corrected to a heart rate of 75 beats per minute (AIxc75) and central augmentation pressure (cAP) were determined one month and six months postpartum. Comparison of proportions was carried out using the chi-square test, comparison of means between groups using the Student's t-test or the Mann-Whitney test, and comparison of means of the same group at different evolutionary moments, using the t-test or the Wilcoxon test. Correlation, with and between hemodynamic parameters, was carried out with Spearman's correlation coefficient and the association between demographic variables, personal history and hemodynamic parameters, and altered arterial stiffness parameters was carried out using linear and logistic regression models. RESULTS Women with severe PE presented, both at 1 and 6 months postpartum, higher values of blood pressure, both central and peripheral, as well as AR and pulse amplification parameters, than those women whose PE was not severe. Central augmentation index (cAIx) values at 1 month and 6 months postpartum were higher, although not significantly, in the severe PE group compared to the non-severe PE group (24.0 (16.5-34.3) vs. 19.0% (14-29) and 24.0 (14.0-30.0) vs. 20.0% (12.3-26.8), respectively). Carotid-femoral pulse wave velocity (cfPWV) was significantly higher at both 1 and 6 months postpartum in the severe PE group compared to the non-severe PE group (10.2 (8.8-10.7) vs. 8.8m/s (8.3-9.6) and 10.0 (8.8-10.6) vs. 8.8m/s (8.3-9.3), respectively). Central systolic pressure and central pulse pressure amplification were also higher, although not significantly, in the severe PE group in comparison with the non-severe PE group. CONCLUSIONS Women who have had severe PE have more pronounced arterial stiffness parameters than those in whom PE was not particularly severe. The determination of cAIx and cfPWV, as a strategy for the assessment of cardiovascular risk, should be evaluated among women who have had PE.
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Affiliation(s)
- Lara Belmar Vega
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
| | - José Luis Pérez Canga
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Milagros Heras Vicario
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Emilio Rodrigo Calabia
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | | | - Laura Díaz López
- Servicio de Obstetricia y Ginecología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Luis Martín Penagos
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Gema Fernández Fresnedo
- Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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Swift DL, McGee JE, Grammer EE, Huff AC, Clunan MC, Hursey N, Brown TT, Osborne BG, Houmard JA, Carels RA, Pories WJ, Matarese LE. The effect of exercise training level on arterial stiffness after clinically significant weight loss. Clin Obes 2023; 13:e12584. [PMID: 36843503 PMCID: PMC11036368 DOI: 10.1111/cob.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/13/2023] [Accepted: 02/04/2023] [Indexed: 02/28/2023]
Abstract
Arterial stiffness is improved by weight loss. However, no data exist on the impact of aerobic exercise levels on arterial stiffness during weight maintenance. Adults who were overweight or with obesity (N = 39) participated in a 10-week weight loss program. Participants who achieved ≥7% weight loss were randomized to aerobic training at the minimum physical activity guidelines (PA-REC, 550 MET min/week) or weight maintenance guidelines (WM-REC, 970 MET min/week) for 18 additional weeks. Arterial stiffness (carotid-to-femoral pulse wave velocity [cfPWV], augmentation index normalized for 75 beats/min [AIX75]) and blood pressure [aortic and brachial]) were assessed at baseline, the end of the weight loss phase (week 10), and follow-up (week 28). There was a reduction in cfPWV in participants who met the weight loss goal (-0.34 m/s, p = .02) and approached significance for the entire sample (p = .051). Similarly, there were reductions in AIX75, brachial blood pressure, and aortic blood pressure (p < .05) in the full sample. In the weight maintenance phase, no differences were observed between the PA-REC and the WM-REC groups for change in arterial stiffness or blood pressure (p > .05). However, changes in cfPWV were independently associated with changes in LDL (r2 : 0.45, p = .004) and exercise intensity (r2 : 0.17, p = .033). Aerobic exercise level at the minimum physical activity guidelines or weight maintenance guidelines does not affect the change in PWV or the change in cfPWV after clinically significant weight loss. However, interventions which limit increases in LDL cholesterol and promote high-intensity aerobic exercise may prevent increases in stiffness during weight maintenance.
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Affiliation(s)
- Damon L. Swift
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Joshua E. McGee
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Emily E. Grammer
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Anna C. Huff
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Marie C. Clunan
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Nicole Hursey
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Taylor T. Brown
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | | | - Joseph A. Houmard
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Robert A. Carels
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Walter J. Pories
- Department of Surgery, East Carolina University, Greenville, North Carolina, USA
| | - Laura E. Matarese
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina, USA
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Lindseth KT, Gerdts E, Midtbø H, Pristaj N, Cramariuc D, Einarsen E. Myocardial Work in Middle-Aged Adults with Overweight and Obesity: Associations with Sex and Central Arterial Stiffness. J Clin Med 2023; 12:5676. [PMID: 37685743 PMCID: PMC10488455 DOI: 10.3390/jcm12175676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
We explored global myocardial work index (GWI), a novel measure of myocardial function that integrates left ventricular (LV) hemodynamic load, in relation to sex and increased body mass index (BMI). We used data from 467 individuals (61% women, average age 47 ± 9 years and BMI 31.2 kg/m2) without known cardiac disease. Central arterial function was analysed by applanation tonometry. GWI was calculated from global longitudinal strain (GLS) and post-echocardiography supine blood pressure (BP). Covariables of GWI were identified in linear regression analyses. Women had higher BMI, aortic augmentation pressure (12 ± 7 vs. 8 ± 6 mmHg), LV GLS (20.0 ± 2.8 vs. 18.8 ± 2.8%), and GWI (2126 ± 385 vs. 2047 ± 389 mmHg%) than men (all p < 0.05). In univariable analyses, higher GWI was associated with female sex, higher age, systolic BP, LV wall stress, LV ejection fraction, left atrial size, LV ejection time, and with lower waist circumference (all p < 0.05). In multivariable analysis, adjusting for these correlates, female sex remained independently associated with higher GWI (β = 0.13, p = 0.007). After additional adjustment for aortic augmentation pressure or central pulse pressure, this association became non-significant. In conclusion, the higher GWI in women compared to men was mainly explained by increased LV workload due to higher aortic augmentation pressure in women.
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Affiliation(s)
- Katrine Tryti Lindseth
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Eva Gerdts
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Helga Midtbø
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; (H.M.); (D.C.)
| | - Nadia Pristaj
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Dana Cramariuc
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; (H.M.); (D.C.)
| | - Eigir Einarsen
- Department of Medicine, Nordland Hospital Trust, Vesterålen Hospital, 8450 Stokmarknes, Norway;
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13
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Ranatunga S, Kulkarni B, Kinra S, Ebeling PR, Zengin A. Sex-specific associations between markers of arterial stiffness and bone mineral density in Indian men and women. Bone 2023; 169:116686. [PMID: 36720333 DOI: 10.1016/j.bone.2023.116686] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Osteoporosis and cardiovascular disease (CVD) share common risk factors, yet both are usually underdiagnosed in the absence of major complications. We investigated associations between arterial stiffness, cardiac workload, carotid intima media thickness (CIMT) and areal bone mineral density (aBMD) in Indian adults. METHODS Men and women aged >45 years from the Andhra Pradesh Children and Parents Study (APCAPS) were included for cross-sectional analysis (521 women and 696 men). Dual energy x-ray absorptiometry (DXA) measured aBMD at the whole body, total hip and lumbar spine. Supine blood pressure and heart rate were measured and used to calculate rate pressure product and pulse pressure; augmentation index, pulse wave velocity and CIMT were measured. Sex-interactions were tested (denoted as p-int); adjustments were made for confounders. Data were expressed as SD differences with 95 % confidence intervals. RESULTS There were significant negative associations between pulse pressure and aBMD at all sites in women only. In unadjusted analyses, for every 1SD increase in pulse pressure, women had greater negative differences in aBMD at the whole body (-0.13 vs 0.007), total hip (-0.20 vs -0.05) and lumbar spine (-0.12 vs 0.05) compared with men. After adjustments, sex differences remained. Similar negative associations were seen between pulse wave velocity and augmentation index with aBMD in women only. There were no sex differences between CIMT and rate pressure product with aBMD. CONCLUSIONS Markers of arterial stiffness are associated with poorer bone health in Indian women, but not in men. There is a need to identify the shared risk factors and markers of arterial stiffness and poor bone health to detect those who require co-management of these diseases to prevent cardiovascular events and fractures.
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Affiliation(s)
- Shasheni Ranatunga
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia
| | - Bharati Kulkarni
- Clinical Division, ICMR-National Institute of Nutrition, Jamai Osmania PO, Hyderabad, India
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia.
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14
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Gevaert AB, Böhm B, Hartmann H, Goovaerts I, Stoop T, Van De Heyning CM, Beckers PJ, Baldassarri F, Mueller S, Oberhoffer R, Duvinage A, Haykowsky MJ, Wisløff U, Adams V, Pieske B, Halle M, Van Craenenbroeck EM. Effect of Training on Vascular Function and Repair in Heart Failure With Preserved Ejection Fraction. JACC. HEART FAILURE 2023; 11:454-464. [PMID: 36892488 DOI: 10.1016/j.jchf.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 03/05/2023]
Abstract
BACKGROUND Exercise training improves peak oxygen uptake (V̇O2peak) in heart failure with preserved ejection fraction (HFpEF). Multiple adaptations have been addressed, but the role of circulating endothelium-repairing cells and vascular function have not been well defined. OBJECTIVES The authors investigated effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on vascular function and repair in HFpEF. METHODS This study is a subanalysis of the OptimEx-Clin Study randomizing patients with HFpEF (n = 180) to HIIT, MICT, or guideline control. At baseline, 3, and 12 months, the authors measured peripheral arterial tonometry (valid baseline measurement in n = 109), flow-mediated dilation (n = 59), augmentation index (n = 94), and flow cytometry (n = 136) for endothelial progenitor cells and angiogenic T cells. Abnormal values were defined as outside 90% of published sex-specific reference values. RESULTS At baseline, abnormal values (%) were observed for augmentation index in 66%, peripheral arterial tonometry in 17%, flow-mediated dilation in 25%, endothelial progenitor cells in 42%, and angiogenic T cells in 18%. These parameters did not change significantly after 3 or 12 months of HIIT or MICT. Results remained unchanged when confining analysis to patients with high adherence to training. CONCLUSIONS In patients with HFpEF, high augmentation index was common, but endothelial function and levels of endothelium-repairing cells were normal in most patients. Aerobic exercise training did not change vascular function or cellular endothelial repair. Improved vascular function did not significantly contribute to the V̇O2peak improvement after different training intensities in HFpEF, contrary to previous studies in heart failure with reduced ejection fraction and coronary artery disease. (Optimizing Exercise Training in Prevention and Treatment of Diastolic Heart Failure [OptimEx-Clin]; NCT02078947).
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Affiliation(s)
- Andreas B Gevaert
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium; Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium. https://twitter.com/AndreasGevaert
| | - Birgit Böhm
- Department of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Haley Hartmann
- Department Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Inge Goovaerts
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Tibor Stoop
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Caroline M Van De Heyning
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium; Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Paul J Beckers
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium; Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
| | - Flavia Baldassarri
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Stephan Mueller
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Renate Oberhoffer
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - André Duvinage
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Mark J Haykowsky
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Ulrik Wisløff
- Cardiac Exercise Research Group, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Volker Adams
- Heart Centre Dresden-University Hospital, Department of Internal Medicine and Cardiology, Technische Universität Dresden, Dresden, Germany
| | - Burkert Pieske
- Department Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium; Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
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15
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Orthostatic blood pressure adaptations, aortic stiffness, and central hemodynamics in the general population: insights from the Malmö Offspring Study (MOS). Clin Auton Res 2023; 33:29-40. [PMID: 36473959 PMCID: PMC9984326 DOI: 10.1007/s10286-022-00911-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Arterial stiffness is independently associated with orthostatic hypotension in older individuals. The relationship between orthostatic blood pressure adaptation and aortic stiffness has not been thoroughly examined in a younger population. We investigated the relationship between orthostatic blood pressure adaptations, central aortic hemodynamics, and aortic stiffness in a cohort of predominantly younger and middle-aged adults. METHODS We analyzed an observational, population-based study of 5259 individuals living in Malmö, Sweden. We related aortic stiffness and central hemodynamics assessed by carotid-femoral pulse wave velocity and pulse wave analysis at the arteria radialis using Sphygmocor to orthostatic blood pressure adaptation after 3 min standing. RESULTS The mean age of the population was 41.9 ± 14.5 years, and 52.1% were women. We observed the highest aortic stiffness and central aortic blood pressure measurements in the lowest and highest quartiles of orthostatic systolic blood pressure differences (p < 0.001). Aortic stiffness and central aortic blood pressure gradually decreased across increasing quartiles of orthostatic diastolic blood pressure difference (p < 0.001). After full adjustment, orthostatic diastolic blood pressure remained significantly associated with aortic stiffness (p = 0.001) and central aortic blood pressure (p < 0.001), whereas orthostatic systolic blood pressure was significantly associated only with central aortic systolic blood pressure (p = 0.009). No significant associations were found between subclinical orthostatic hypotension, aortic stiffness, and central hemodynamics. CONCLUSIONS Our findings demonstrate that altered blood pressure responses to orthostatic challenges, both blood pressure reductions and blood pressure increases, are independently and inversely associated with markers of aortic stiffness (vascular aging) in a predominantly young to middle-aged population.
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16
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Lobene AJ, Smiljanec K, Axler MR, Ramos-Gonzalez M, Lennon SL. Greater adherence to healthy dietary patterns is associated with lower diastolic blood pressure and augmentation index in healthy, young adults. Nutr Res 2022; 106:60-71. [PMID: 36126530 PMCID: PMC10335482 DOI: 10.1016/j.nutres.2022.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/20/2022]
Abstract
More than two-thirds of cardiovascular disease (CVD) deaths worldwide are attributable to dietary factors. Blood pressure variability (BPV), endothelial dysfunction, and arterial stiffness are important CVD risk factors. Although studies show a link between consuming a healthy diet and lower BPV and stiffness and improved endothelial function, research in young, healthy adults is scarce. We hypothesized that, in young, healthy adults, diet quality would be inversely associated with BPV and arterial stiffness and positively associated with endothelial function. This cross-sectional study included 56 healthy young adults (34 women/22 men, age 26.7 ± 0.8 years, body mass index 23.4 ± 0.4 kg/m2, blood pressure [BP] 113/69 mmHg). Three-day diet records were used to calculate two Dietary Approaches to Stop Hypertension (DASH) diet scores, the alternative Mediterranean Diet (aMED) score, and the Healthy Eating Index-2015 (HEI-2015) based on the 2015-2020 Dietary Guidelines for Americans. Twenty-four-hour ambulatory BP data were used to calculate average real variability of systolic and diastolic BP. Endothelial function was assessed by flow-mediated dilation, and arterial stiffness was assessed by pulse wave velocity and augmentation index (AIx). Overall, the HEI-2015 was inversely associated with 24-hour diastolic BP (DBP) and daytime DBP, and the aMED score was inversely associated with AIx. In our exploratory analyses, the Fung DASH score was inversely associated with 24-hour DBP and daytime DBP in women, but not men. These findings suggest that consuming a diet that aligns with the DASH diet, the Mediterranean diet, and/or the 2015-2020 Dietary Guidelines for Americans is associated with cardiovascular benefits in healthy, young adults.
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Affiliation(s)
- Andrea J Lobene
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Katarina Smiljanec
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Michael R Axler
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Macarena Ramos-Gonzalez
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
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Desbiens LC, Fortier C, Nadeau-Fredette AC, Madore F, Hametner B, Wassertheurer S, Agharazii M, Goupil R. Prediction of Cardiovascular Events by Pulse Waveform Parameters: Analysis of CARTaGENE. J Am Heart Assoc 2022; 11:e026603. [PMID: 36056725 PMCID: PMC9496446 DOI: 10.1161/jaha.122.026603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Waveform parameters provide approximate data about aortic wave reflection. However, their association with cardiovascular events remains controversial and their role in cardiovascular prediction is unknown. Methods and Results We analyzed participants aged between 40 and 69 from the population-based CARTaGENE cohort. Baseline pulse wave analysis (central pulse pressure, augmentation index) and wave separation analysis (forward pressure, backward pressure, reflection magnitude) parameters were derived from radial artery tonometry. Associations between each parameter and major adverse atherosclerotic events (MACE; cardiovascular death, stroke, myocardial infarction) were obtained using adjusted Cox models. The incremental predictive value of each parameter compared with the 10-year atherosclerotic cardiovascular disease score alone was assessed using hazard ratios, c-index differences, continuous net reclassification indexes, and integrated discrimination indexes. From 17 561 eligible patients, 2315 patients had a MACE during a median follow-up of 10.1 years. Central pulse pressure, forward pressure, and backward pressure, but not augmentation index and reflection magnitude, were significantly associated with MACE after full adjustment. All parameters except forward pressure statistically improved MACE prediction compared with the atherosclerotic cardiovascular disease score alone. The greatest prediction improvement was seen with augmentation index and reflection magnitude but remained small in magnitude. These 2 parameters enhanced predictive performance more strongly in patients with low baseline atherosclerotic cardiovascular disease scores. Up to 5.7% of individuals were reclassified into a different risk stratum by adding waveform parameters to atherosclerotic cardiovascular disease scores. Conclusions Some waveform parameters are independently associated with MACEs in a population-based cohort. Augmentation index and reflection magnitude slightly improve risk prediction, especially in patients at low cardiovascular risk.
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Affiliation(s)
| | - Catherine Fortier
- Department of Medicine Université de Montréal Montreal Canada.,Hôpital du Sacré-Coeur de Montréal Research Center Montreal Canada
| | - Annie-Claire Nadeau-Fredette
- Department of Medicine Université de Montréal Montreal Canada.,Hôpital Maisonneuve-Rosemont Université de Montréal Montréal Canada
| | - François Madore
- Department of Medicine Université de Montréal Montreal Canada.,Hôpital du Sacré-Coeur de Montréal Research Center Montreal Canada
| | | | | | - Mohsen Agharazii
- Department of Medicine Université Laval Quebec City Canada.,CHU de Quebec Université Laval Quebec City Canada
| | - Rémi Goupil
- Department of Medicine Université de Montréal Montreal Canada.,Hôpital du Sacré-Coeur de Montréal Research Center Montreal Canada
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18
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Christoforidis A, Georeli I, Dimitriadou M, Galli-Tsinopoulou A, Stabouli S. Arterial stiffness indices in children and adolescents with type 1 diabetes mellitus: A meta-analysis. Diabetes Metab Res Rev 2022; 38:e3555. [PMID: 35675380 DOI: 10.1002/dmrr.3555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
AIMS Cardiovascular disease (CVD) represents the most frequent cause of morbidity and mortality among patients with type 1 diabetes mellitus (T1DM). Our aim was to review the evidence and conduct a meta-analysis assessing measures of arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx) in children and adolescents with T1DM compared to healthy controls. METHODS PubMed and the Cochrane Library were searched for relevant studies published up to 10 May 2021. RESULTS Twenty-one studies were finally included in the meta-analysis. The T1DM group had significantly higher carotid to femoral PWV levels than that of the control group (mean difference [d]: 0.53 CI: 0.35-0.71, P < 0.00001) but with a fair heterogeneity (I 2:73%). By omitting one study with marked heterogeneity, mean difference in cfPWV remained significantly increased in the T1DM group compared to the control group (mean difference [d]: 0.37 CI: 0.27-0.48, P < 0.00001) but with improved heterogeneity (I2 = 26%). Regarding Aix, the T1DM group had a significantly higher AI@75 index than that of the control group (mean difference [d]: 0.28 CI: 0.17-0.39, P < 0.00001) and with no heterogeneity (I 2 = 8%). CONCLUSIONS Youths with T1DM show increased arterial stiffness, either as increased carotid-femoral pulse wave velocity or increased augmentation index, early in their course of life compared to healthy controls. PROSPERO REGISTRATION NUMBER CRD42021253236.
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Affiliation(s)
| | - Irene Georeli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | - Meropi Dimitriadou
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
| | | | - Stella Stabouli
- Department of Paediatric, Aristotle University, Ippokration General Hospital, Thessaloniki, Greece
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19
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Belmar Vega L, Pérez Canga JL, Heras Vicario M, Rodrigo Calabia E, Ruiz San Millán JC, Díaz López L, Martín Penagos L, Fernández Fresnedo G. Asociación de preeclampsia grave y daño vascular valorado por marcadores no invasivos de rigidez arterial. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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20
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Rossi-Monteiro EM, Sefair LR, Lima MC, Nascimento MFL, Mendes-Pinto D, Anschuetz L, Rodrigues-Machado MG. Pediatric obstructive sleep-disordered breathing is associated with arterial stiffness. Eur J Pediatr 2022; 181:725-734. [PMID: 34557975 DOI: 10.1007/s00431-021-04238-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 01/14/2023]
Abstract
The association between obstructive sleep-disordered breathing (oSDB) and arterial stiffness, an independent predictor of cardiovascular outcomes, is not well established in children. This study compared cardiovascular parameters between healthy and oSDB children and aimed to identify predictors of arterial stiffness indices in children with oSDB. Cross-sectional study realized in a tertiary hospital from June 2018 to January 2020. Forty-eight children (3 to 10 years old) with clinical diagnosis of oSDB and indication for adenotonsillectomy and 24 controls were evaluated. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main arterial stiffness indices assessed were augmentation index and pulse wave velocity, both derived from the aortic pulse wave. In the oSDB group, the questionnaires Obstructive Sleep Apnea-18 (OSA-18) and Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) were applied. The oSDB group had higher values of reflection coefficient (p = 0.044) and augmentation index (p = 0.003) than the control group. Stepwise multiple regression analysis revealed that age, female sex, reflection coefficient, and systolic volume were independent predictors of augmentation index. Higher pulse wave velocity values were associated with worse quality of life assessed by PedsQL 4.0 questionnaire. There was no association with OSA-18. The vascular and hemodynamic parameters were similar in both groups.Conclusion: Children with oSDB have increased augmentation index, an independent predictor of cardiovascular outcomes. The early identification of subclinical cardiovascular changes reinforces the importance of treating the disease, as well as changing lifestyle habits, to prevent complications in adulthood. What is Known: • The association between oSDB and cardiovascular risk in adults is well described in the literature. • Children with oSDB, regardless of their weight or sex, have higher PWV values when compared to non-snoring children. What is New: • Children with oSDB have augmented arterial stiffness, evidenced by the increase in AIx@75, measured non-invasively by brachial artery oscillometry with a portable device. • Low quality of life and therefore a high disease burden in children with oSDB may be a risk factor for arterial stiffness.
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Affiliation(s)
- Eduardo Machado Rossi-Monteiro
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, MG, Belo Horizonte, Brazil.,Department of Otorhinolaryngology, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | | | - Marcos Correia Lima
- Department of Otorhinolaryngology, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | | | - Daniel Mendes-Pinto
- Department of Vascular Surgery, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | - Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Maria Glória Rodrigues-Machado
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, MG, Belo Horizonte, Brazil.
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21
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Zócalo Y, Bia D. Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement. Front Physiol 2022; 12:774390. [PMID: 35126173 PMCID: PMC8811372 DOI: 10.3389/fphys.2021.774390] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/22/2021] [Indexed: 12/11/2022] Open
Abstract
Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.
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22
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Svensson C, Eriksson P, Bjarnegård N, Jonasson H, Strömberg T, Sjöwall C, Zachrisson H. Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus. Front Med (Lausanne) 2021; 8:722758. [PMID: 34790671 PMCID: PMC8591084 DOI: 10.3389/fmed.2021.722758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of microcirculation and pulse waves may provide additional information, compared to ultrasound (US) alone, for the detection of early vascular disease in SLE. Methods: Sixty well-characterized SLE-patients (52 women, eight men; mean age 43.21 ± 1.3 years) characterized by lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20) or skin and joint involvement (n = 20) and 60 healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) was evaluated using a novel combined laser Doppler flowmetry/diffuse reflectance spectroscopy method. Pulse waves were recorded in the radial artery by the aid of applanation tonometry in order to calculate central augmentation index (AIx75). Intima-media thickness (IMT) and plaque occurrence were evaluated using high frequency US, in carotid and central arteries. Results: Lower OxyP (84 ± 8 vs. 87 ± 5 %, p = 0.01) and higher AIx75 (17.3 ± 13.9 vs. 10.0 ± 14.2 %, p = 0.005) were seen in the SLE cohort. OxyP was inversely correlated with IMT in internal carotid artery (ICA), (R = -0.32, p = 0.01). AIx75 correlated with IMT in common carotid artery (CCA), (R = 0.36, p = 0.005), common femoral artery (CFA), (R = 0.43, p = 0.001), and ICA (R = 0.27, p = 0.04). AIx75 correlated negatively with OxyP (R = -0.29, p = 0.02). SLE-patients with plaque had lower OxyP values (80 ± 8 vs. 85 ± 7 %, p < 0.001) and higher AIx75 (23.0 ± 11.6 vs. 15.5 ± 14.2 %, p < 0.001) compared to those without plaque. Conclusion: Impaired microcirculation and vessel hemodynamics were observed in SLE. These methods correlated with IMT and plaque occurrence. The importance of early macro- and micro-circulatory vascular affection for increased risk of CVD in SLE will be followed-up in future studies.
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Affiliation(s)
- Christina Svensson
- Department of Clinical Physiology, University Hospital, Linköping, Sweden.,Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Per Eriksson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Niclas Bjarnegård
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Jonasson
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Tomas Strömberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Christopher Sjöwall
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Helene Zachrisson
- Department of Clinical Physiology, University Hospital, Linköping, Sweden.,Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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23
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Gómez-Sánchez M, Gómez-Sánchez L, Patino-Alonso C, Recio-Rodríguez JI, Alonso-Domínguez R, Sánchez-Aguadero N, Sánchez CL, Sánchez ER, García-Ortiz L, Gomez-Marcos MA. Reference values of central blood pressure and central haemodynamic parameters and their relationship with cardiovascular risk factors in a Spanish population: early vascular ageing study. J Hypertens 2021; 39:2147-2156. [PMID: 34343142 DOI: 10.1097/hjh.0000000000002916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Central blood pressure (BP) predicts mortality independent of office brachial BP. The aim was to describe reference values for central blood pressure and pulsatile hemodynamic parameters, and their relationship with cardiovascular risk factors in an adult Spanish population without cardiovascular disease. METHODS Cross-sectional study. We included 501 participants stratified by age and sex by random sampling, with a mean age of 56 years (50.3% women). The SphygmoCor System device's pulse wave analysis software was used to perform the measurements. RESULTS The following values were obtained: central blood pressure median (109/76 mmHg), central pulse pressure (33 mmHg), pulse pressure amplification (8.5 mmHg), ejection duration (130 ms) and subendocardial viability ratio (163%). All parameters were greater in men, except heart rate and ejection duration. In the logistic regression analysis, controlled for age, sex and taking antihypertensive drugs, being hypertensive was associated with cSBP (OR = 1.265), cDBP (OR = 1.307), cPP (OR = 1.067), pulse wave amplification (OR = 1.034) and SEVR (OR = 0.982); being diabetic was associated with SEVR (OR = 0.982); being obese was associated with cSBP (OR = 1.028) and cDBP (OR = 1.058) and being a smoker was associated with ejection duration (OR = 0.980) and SEVR (OR = 0.984). CONCLUSION This study provides reference values for central blood pressure and parameters derived from the pulse wave analysis in a random sample of the Spanish population. The only risk factor that is not associated with any of the parameters analysed is dyslipidaemia. TRIAL REGISTRATION NUMBER https://clinicaltrials.gov/ct2/show/NCT02623894.
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Affiliation(s)
- Marta Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Leticia Gómez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Carmen Patino-Alonso
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de estadística
| | - Jose I Recio-Rodríguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Rosario Alonso-Domínguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Natalia Sánchez-Aguadero
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Departamento de enfermería y fisioterapia, Universidad de Salamanca (USAL)
| | - Cristina Lugones Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
| | - Emiliano Rodríguez Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de Medicina
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de biomedicina y diagnóstico de la ciencia, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL)
- Servicio de Salud de Castilla y León (SACyL)
- Departamento de Medicina
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24
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Abstract
The aim of this study was to develop a robust algorithm to quantify pulse sharpness that can complement the limitations of radial augmentation index (rAIx) and explore the role of this quantitative sharpness index in reflecting vascular aging or arterial stiffness. The pulse sharpness index (PSI) was developed by combining the end point angle and virtual height, and 528 radial pulses were analyzed. The PSI could be uniformly applied to various waveform morphologies, even those with no or vague tidal waves, unlike the rAIx. Significant sex differences were identified in the rAIx and PSI (P < 0.01 for both), and significant age-dependent decreases in the PSI were observed (P < 0.01). In addition, the PSI and age were correlated (r = - 0.550) at least as strong as the rAIx and age (r = 0.532), and the PSI had a significant negative correlation with arterial stiffness (r = - 0.700). Furthermore, the multiple linear regression model for arterial stiffness using the PSI, age, sex and heart rate showed the excellent performance (cross-validated R2 = 0.701), and the PSI was found to have the greatest influence on arterial stiffness. This study confirmed that the PSI could be a quantitative index of vascular aging and has potential for use in inferring arterial stiffness with an advantage over the rAIx.
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Affiliation(s)
- Jang-Han Bae
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - Young Ju Jeon
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea.
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25
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Association of free fatty acid binding protein with central aortic stiffness, myocardial dysfunction and preserved ejection fraction heart failure. Sci Rep 2021; 11:16501. [PMID: 34389755 PMCID: PMC8363603 DOI: 10.1038/s41598-021-95534-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023] Open
Abstract
There is an established link between cardiometabolic abnormality, central arterial stiffness, and preserved ejection fraction heart failure (HFpEF). Adipocyte free fatty acid binding protein (a-FABP) has been shown to signal endothelial dysfunction through fatty acid toxicity, though its role in mediating ventricular-arterial dysfunction remains unclear. We prospectively examined the associations of a-FABP with central arterial pressure using non-invasive applanation tonometry (SphygmoCor) and cardiac structure/function (i.e., tissue Doppler imaging [TDI] and global longitudinal myocardial strain [GLS]) in patients with cardiometabolic (CM) risk (n = 150) and HFpEF (n = 50), with healthy volunteers (n = 49) serving as a control. We observed a graded increase of a-FABP across the healthy controls, CM individuals, and HFpEF groups (all paired p < 0.05). Higher a-FABP was independently associated with higher central systolic and diastolic blood pressures (CSP/CPP), increased arterial augmentation index (Aix), lower early myocardial relaxation velocity (TDI-e'), higher left ventricle (LV) filling (E/TDI-e') and worsened GLS (all p < 0.05). During a median of 3.85 years (interquartile range: 3.68-4.62 years) follow-up, higher a-FABP (cutoff: 24 ng/mL, adjusted hazard ratio: 1.01, 95% confidence interval: 1.001-1.02, p = 0.04) but not brain natriuretic peptide, and higher central hemodynamic indices were related to the incidence of heart failure (HF) in fully adjusted Cox models. Furthermore, a-FABP improved the HF risk classification over central hemodynamic information. We found a mechanistic pathophysiological link between a-FABP, central arterial stiffness, and myocardial dysfunction. In a population with a high metabolic risk, higher a-FABP accompanied by worsened ventricular-arterial coupling may confer more unfavorable outcomes in HFpEF.
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26
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Cheung CP, Coates AM, Currie KD, King TJ, Mountjoy ML, Burr JF. Examining the relationship between arterial stiffness and swim-training volume in elite aquatic athletes. Eur J Appl Physiol 2021; 121:2635-2645. [PMID: 34132871 DOI: 10.1007/s00421-021-04736-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Factors such as prone body position, hydrostatic pressure, and intermittent breath-holding subject aquatic athletes to unique physical and environmental stressors during swimming exercise. The relationship between exposure to aquatic exercise and both arterial stiffness and wave reflection properties is not well-understood. This study assessed central artery stiffness and wave reflection properties in elite pool-swimmers (SW), long-distance open-water swimmers (OW), and water polo players (WP) to examine the relationship between these variables and aquatic exercise. METHODS Athletes competing in SW, OW and WP events at the FINA World Championships were recruited. Carotid-femoral pulse wave velocity, and pulse wave analysis were used to quantify arterial stiffness, and central wave reflection properties. RESULTS Athletes undertook differing amounts of weekly swimming distance in training according to their discipline (SW: 40.2 ± 21.1 km, OW: 59.7 ± 28.4 km, WP: 11.4 ± 6.3 km; all p < 0.05). Pulse wave velocity (Males [SW: 6.0 ± 0.6 m/s, OW: 6.5 ± 0.8 m/s, WP: 6.7 ± 0.9 m/s], Females [SW: 5.4 ± 0.6 m/s, OW: 5.3 ± 0.5 m/s, WP: 5.2 ± 0.8 m/s; p = 0.4]) was similar across disciplines for females but was greater in male WP compared to male SW (p = 0.005). Augmentation index (Males [SW: - 3.4 ± 11%, OW: - 9.6 ± 6.4%, WP: 1.7 ± 10.9%], Females [SW: 3.5 ± 13.5%, OW: - 13.2 ± 10.7%, WP: - 2.8 ± 10.7%]) was lower in male OW compared to WP (p = 0.03), and higher in female SW compared to OW (p = 0.002). Augmentation index normalized to a heart rate of 75 bpm was inversely related to weekly swim distance in training (r = - 0.27, p = 0.004). CONCLUSIONS This study provides evidence that the central vasculature of elite aquatic athletes differs by discipline, and this is associated with training load.
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Affiliation(s)
- Christian P Cheung
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | - Alexandra M Coates
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | | | - Trevor J King
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada
| | | | - Jamie F Burr
- Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road E, Guelph, ON, N1G2W1, Canada.
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27
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Liu YY, Hung CL, Sun FJ, Huang PH, Cheng YF, Yeh HI. Augmentation Index Predicts the Sweat Volume in Young Runners. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:448-456. [PMID: 34267584 DOI: 10.52082/jssm.2021.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/13/2021] [Indexed: 11/24/2022]
Abstract
Sweating during exercise is regulated by objective parameters, body weight, and endothelial function, among other factors. However, the relationship between vascular arterial stiffness and sweat volume in young adults remains unclear. This study aimed to identify hemodynamic parameters before exercise that can predict sweat volume during exercise, and post-exercise parameters that can be predicted by the sweat volume. Eighty-nine young healthy subjects (aged 21.9 ± 1.7 years, 51 males) were recruited to each perform a 3-km run on a treadmill. Demographic and anthropometric data were collected and hemodynamic data were obtained, including heart rate, blood pressure and pulse wave analysis using non-invasive tonometry. Sweat volume was defined as pre-exercise body weight minus post-exercise body weight. Post-exercise hemodynamic parameters were also collected. Sweat volume was significantly associated with gender, body surface area (BSA) (b = 0.288, p = 0.010), peripheral systolic blood pressure (SBP), peripheral and central pulse pressure (PP), and was inversely associated with augmentation index at an HR of 75 beats/min (AIx@HR75) (b = -0.005, p = 0.019) and ejection duration. While BSA appeared to predict central PP (B = 19.271, p ≤ 0.001), central PP plus AIx@HR75 further predicted sweat volume (B = 0.008, p = 0.025; B = -0.009, p = 0.003 respectively). Sweat volume was associated with peripheral SBP change (B = -17.560, p = 0.031). Sweat volume during a 3-km run appears to be influenced by hemodynamic parameters, including vascular arterial stiffness and central pulse pressure. Results of the present study suggest that vascular arterial stiffness likely regulates sweat volume during exercise.
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Affiliation(s)
- Yen-Yu Liu
- Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
| | - Chung-Lieh Hung
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fang-Ju Sun
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan
| | - Po-Han Huang
- General Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Fan Cheng
- General Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hung-I Yeh
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
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Jones DR, Chew DP, Horsfall MJ, Sinhal AR, Joseph MX, Baker RA, Bennetts JS, Selvanayagam JB, Russell AE, De Pasquale CG, Lehman SJ. Impact of increased augmentation index and valvuloarterial impedance on symptom recovery after aortic valve replacement for severe aortic stenosis. IJC HEART & VASCULATURE 2021; 32:100705. [PMID: 33457492 PMCID: PMC7797943 DOI: 10.1016/j.ijcha.2020.100705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/05/2020] [Accepted: 12/12/2020] [Indexed: 12/03/2022]
Abstract
Background Aortic stenosis (AS) is a common valvular disorder with a large symptomatic burden resulting from increased myocardial workload due to valvular obstruction. The contribution of increased afterload from arterial stiffness on symptoms is uncertain. The purpose of this analysis was to determine the symptomatic impact of arterial stiffness as determined by Applanation Tonometry. Methods Eighty-eight patients with severe AS undergoing intervention with transcatheter aortic valve replacement (TAVR) (n = 65) or surgical aortic valve replacement (SAVR) (n = 23) were prospectively enrolled. Symptoms were recorded using the NYHA Class, Kansas City Cardiomyopathy Questionnaire (KCCQ) and a 6 min walk test (6MWT) at baseline, and 1- and 6-months post intervention. Pulse Wave Analysis (PWA) using Applanation Tonometry was performed at all reviews, including the augmentation index (AIx). Results Patients undergoing TAVR were older, with worse renal function and lower aortic valve areas, but were otherwise similar. There was no significant difference between the augmentation index of our AS population compared with an age matched reference population (p = 0.89). Symptoms significantly improved after intervention according to NYHA Class, KCCQ and 6MWT. Additionally, with adjustment, the initial augmentation index correlated with the final KCCQ (Coeff. = −0.383, p = 0.02) and NYHA Class (Coeff. = 0.012, p = 0.03) and a baseline AIx value in the top quartile resulted in a significantly worse final KCCQ (95.1 v 85.2, p = 0.048) relative to the bottom 3 quartiles. Conclusions According to our analysis, an elevated baseline AIx is associated with a poorer symptomatic recovery after aortic valve intervention and so is worthy of consideration when assessing potential symptomatic benefit.
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Affiliation(s)
- Dylan R Jones
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Derek P Chew
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Matthew J Horsfall
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | | | | | - Robert A Baker
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Jayme S Bennetts
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Joseph B Selvanayagam
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | | | - Carmine G De Pasquale
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
| | - Sam J Lehman
- Flinders University, Adelaide, SA, Australia.,Flinders Medical Centre, Adelaide, SA, Australia
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Kroker-Lobos MF, Ford ND, Gonzalez-Casanova I, Martorell R, Ramirez-Zea M, Stein AD. Improved nutrition in early life and pulse wave velocity and augmentation index in mid-adulthood: Follow-up of the INCAP Nutrition Supplementation Trial Longitudinal Study. PLoS One 2020; 15:e0239921. [PMID: 33108379 PMCID: PMC7591084 DOI: 10.1371/journal.pone.0239921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
Nutrition in pregnancy and early childhood affects later blood pressure and precursors of atherosclerosis, but its influence on arterial stiffness is unexplored. This study determines whether exposure to improved nutrition during early life influences Augmentation index (AI) and pulse wave velocity (PWV) in mid-adulthood. We included 1221 adults (37-54y) who participated in a cluster-randomized nutritional supplementation trial of a protein-energy beverage (Atole), conducted between 1969–1977 in Guatemala. The comparison group received Fresco, a low-calorie protein-free beverage. In 2015–17, we measured anthropometry (weight, height, and waist-to-height ratio); AI and PWV (using carotid—femoral tonometry); blood pressure; fasting plasma glucose and serum lipids; and sociodemographic characteristics. Based on patterns of exposure, we characterized participants as fully, partially or unexposed to the intervention from conception to their second birthday (the ‘first 1000 days’). We fit pooled and sex-specific models using intention-to-treat, difference-in-difference regression analysis to test whether exposure to the supplement in the first 1000 days was associated with AI and PWV in adulthood adjusting for basal and current sociodemographic variables and current life-style and cardio-metabolic risk factors. Prevalence of obesity in men and women was 39.6% and 19.6%, and prevalence of hypertension was 44.0% and 36.0%, respectively. Women had higher AI (34.4±9.6%) compared to men (23.0± 9.8%), but had similar PWV (7.60±1.13 m/s and 7.60±1.31, respectively). AI did not differ significantly across intervention groups. PWV was lower in individuals with full exposure to the supplement during the first 1000 days (-0.39m/s, 95% CI -0.87, 0.09; p = 0.1) compared to unexposed individuals. This difference was similar after adjusting for cardio-metabolic risk factors (-0.45m/s; 95%C-0.93, 0.01; p = 0.06). Exposure to improved nutrition during the first 1000 days was marginally associated with lower PWV, but not with AI.
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Affiliation(s)
- Maria F. Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Nicole D. Ford
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
- * E-mail:
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Roeder M, Thiel S, Baumann F, Sievi NA, Rohrbach M, Kohler M, Gaisl T. Increased augmentation index in patients with Ehlers-Danlos syndrome. BMC Cardiovasc Disord 2020; 20:417. [PMID: 32933483 PMCID: PMC7493396 DOI: 10.1186/s12872-020-01684-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/25/2020] [Indexed: 01/06/2023] Open
Abstract
Background Ehlers-Danlos Syndrome (EDS) comprises a heterogeneous group of diseases characterized by joint hypermobility, connective tissue friability, and vascular fragility. Reliable prognostic factors predicting vascular disease progression (e.g. arterial aneurysms, dissections, and ruptures) in EDS patients are still missing. Recently, applanation tonometry derived augmentation index (AIx), an indirect marker of arterial stiffness, has shown to be positively associated with progression of aortic disease in Marfan syndrome. In this study, we assessed aortic AIx in patients with EDS and matched healthy controls. Methods We performed noninvasive applanation tonometry in 61 adults with EDS (43 women and 18 men aged 39.3 ± 14.6 years) and 61 age-, gender-, height-, and weight-matched healthy controls. Radial artery pulse waveforms were recorded and analyzed using the SphygmoCor System (AtCor Medical, Sydney, NSW, Australia). Calculated AIx was adjusted to a heart rate of 75/min. Groups were compared and association between AIx and EDS was determined by univariate and multivariate regression analysis. Results EDS patients were categorized in classical type EDS (34%), hypermobile type EDS (43%), vascular type EDS (5%), or remained unassignable (18%) due to overlapping features. EDS patients showed a significantly increased aortic AIx compared to healthy controls (22.8% ± 10.1 vs 14.8% ± 14.0, p < 0.001). EDS showed a positive association with AIx; independent of age, sex, height, blood pressure, medication, and pack years of smoking. Conclusions Patients with EDS showed elevated AIx, indicating increased arterial stiffness when compared to healthy controls. Further investigations are needed in order to assess the prognostic value of increased AIx for cardiovascular outcomes in patients with EDS.
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Affiliation(s)
- Maurice Roeder
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Sira Thiel
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Frederic Baumann
- Clinical and Interventional Angiology, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Marianne Rohrbach
- Division of Metabolism and Children's Research Center University Children's Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. .,Centre for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland.
| | - Thomas Gaisl
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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Sun X, Chen R, Yan G, Chen Z, Yuan H, Huang W, Lu Y. Gender-specific associations between apolipoprotein A1 and arterial stiffness in patients with nonalcoholic fatty liver disease. PeerJ 2020; 8:e9757. [PMID: 32874784 PMCID: PMC7441919 DOI: 10.7717/peerj.9757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background Lipid metabolism factors may play an important role in the progression of nonalcoholic fatty liver disease (NAFLD) and its related cardiovascular dysfunctions. The study aims to assess whether Apolipoprotein A-1 (ApoA1) was associated with vascular stiffness in NAFLD patients. Methods From 2012 to 2013, we included 2,295 non-alcohol users with fatty liver disease (1,306 male patients) and completely excluded subjects who drank any alcohol ever to eliminate the effect of alcohol intake. The serum ApoA1 levels and the brachial-ankle pulse wave velocity (baPWV) were measured. Results The baPWV in men was much higher than in female patients (1,412.79 cm/s vs. 1,358.69 cm/s, P < 0.001). ApoA1 level was positively associated with baPWV odd ratio (OR), 4.18; 95% confidence interval (CI) [1.16-15.1], P < 0.05) in patients with AST/ALT < 1 and (OR, 4.70; 95% CI [1.36-16.23], P < 0.05) in patients with AST/ALT ≥ 1 respectively. Only arterial stiffness in men was associated with ApoA1 (OR, 3.96; 95% CI [1.29-12.30], P < 0.05) in logistics regression models adjusted for age, gender, body mass index, education attainment, physical activity, smoking, history of hypertension and high-density lipoprotein. The relationship between ApoA1 and baPWV in male NAFLD patients remained significant (confidence, 156.42; 95% CI [49.34-263.50], P < 0.05) in the fully adjusted linear regression model. Conclusion The serum ApoA1 was associated with arterial stiffness in male NAFLD patients. Increased ApoA1 level should be considered as an independent risk factor for arterial stiffness in male NAFLD patients, suggesting that NAFLD may alter arterial stiffness by "ApoA1-related" mechanism in men.
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Affiliation(s)
- Xulong Sun
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China.,Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ruifang Chen
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guangyu Yan
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhiheng Chen
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hong Yuan
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei Huang
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yao Lu
- Clinical Research Center, The Third Xiangya Hospital of Central South University, Changsha, China.,Department of Life Science and Medicine, King's College London, London, UK
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32
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Increased aortic augmentation index is associated with reduced exercise capacity after heart transplantation. J Hypertens 2020; 38:1777-1785. [PMID: 32649621 DOI: 10.1097/hjh.0000000000002455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Exercise capacity is often reduced after heart transplantation. We aimed to investigate the association between aortic stiffness and exercise capacity after heart transplantation. METHODS We retrospectively analyzed the data of patients who underwent a cardiopulmonary exercise test and central hemodynamic measurements over 1 year following heart transplantation, from Janary 2011 to June 2018. RESULTS A total of 54 patients (mean age, 49 years; 72% men) were analyzed. The median peak oxygen uptake level was 21.1 ml/kg per min at a median time of 13 months after heart transplantation. In univariate linear regression, recipient age, pulmonary arterial pressure, pulmonary capillary wedge pressure, hemoglobin level, estimated glomerular filtration rate, aortic augmentation index, and pulse wave velocity were significant predictors for peak oxygen uptake level. After adjustment for other confounding variables, heart rate-corrected aortic augmentation index was a significant predictor for peak oxygen uptake (β = -0.141, 95% confidence interval, -0.263 to -0.058, P = 0.003). CONCLUSION In the present study, increased aortic augmentation index was associated with reduced exercise capacity after heart transplantation. Therefore, this simple measurement of aortic stiffness should be periodically used for the evaluation of exercise capacity after heart transplantation.
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Moe K, Sugulle M, Dechend R, Angel K, Staff AC. Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy. Pregnancy Hypertens 2020; 21:23-29. [DOI: 10.1016/j.preghy.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
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Reference values of office central blood pressure, pulse wave velocity, and augmentation index recorded by means of the Mobil-O-Graph PWA monitor. Hypertens Res 2020; 43:1239-1248. [PMID: 32533101 DOI: 10.1038/s41440-020-0490-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/27/2020] [Accepted: 05/17/2020] [Indexed: 11/08/2022]
Abstract
Assessment of central blood pressure (BP), pulse wave velocity (PWV), and augmentation index (AIx) measurements may improve cardiovascular risk stratification. This study aimed to establish reference office values for central BP, PWV, and AIx by means of a Mobil-O-Graph PWA monitor and to evaluate the impact of cardiovascular risk factors (CVRFs) on these measurements. We cross-sectionally evaluated clinical characteristics, central BP, PWV, AIx, and peripheral BP measurements among 867 apparently healthy individuals (age = 46.0 ± 15.5 years, 39% males) who were free of obesity, hypertension, active smoking, dyslipidemia, and diabetes (CVRF-No) and 5632 individuals (age = 57.0 ± 14.7 years, 44% males) with at least one of these major CVRFs (CVRF-Yes). Reference values for central BP, PWV, and AIx were provided for the CVRF-No and CVRF-Yes groups, stratified by age and sex. PWV and AIx exhibited curvilinear increases with age, and there was an interaction between age and sex for central systolic BP and PWV in both the CVRF-No and CVRF-Yes groups. The results of a multivariable analysis including the whole sample (n = 6499) showed that obesity had a direct association with central BP, while diabetes was directly related to PWV. In addition, alcohol intake was directly associated with central BP, while performance of physical activity was inversely related to AIx. In conclusion, values of office-measured central BP, PWV, and AIx obtained in an apparently healthy population and in a population with CVRFs are now available according to age and sex and may be useful to build thresholds for use in clinical practice.
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35
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Babici D, Kudej RK, McNulty T, Zhang J, Oydanich M, Berkman T, Nishimura K, Bishop SP, Vatner DE, Vatner SF. Mechanisms of increased vascular stiffness down the aortic tree in aging, premenopausal female monkeys. Am J Physiol Heart Circ Physiol 2020; 319:H222-H234. [PMID: 32530752 DOI: 10.1152/ajpheart.00153.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Protection against increased vascular stiffness in young women is lost after menopause. However, little is known about vascular stiffness in older, premenopausal females, because most of the prior work has been conducted in rodents, which live for only 1-3 yr and do not go through menopause. The goal of the current investigation was to quantitate differences in stiffness down the aortic tree and the mechanisms mediating those differences in older, premenopausal (24 ± 0.7 yr) versus young adult (7 ± 0.7 yr) female nonhuman primates. Aortic stiffness (β), calculated from direct and continuous measurements of aortic diameter and pressure in chronically instrumented, conscious macaque monkeys, increased 2.5-fold in the thoracic aorta and fivefold in the abdominal aorta in old premenopausal monkeys. The aortic histological mechanisms mediating increased vascular stiffness, i.e., collagen/elastin ratio, elastin, and collagen disarray, and the number of breaks in elastin and collagen fibers were greater in the old premenopausal versus young monkeys and greater in the abdominal versus the thoracic aorta and greatest in the iliac artery. In addition, more immature and less cross-linked fibers of collagen were found in the aortas of young females. Aortic stiffness increased in old premenopausal female monkeys, more so in the abdominal aorta than in the thoracic aorta. Histological mechanisms mediating the increased aortic stiffness were augmented in the old premenopausal females, greater in the abdominal versus the thoracic aorta, and greatest in the iliac artery.NEW & NOTEWORTHY This is the first study to examine vascular stiffness down the aortic tree in aging premenopausal females (24 ± 0.7 yr old), whereas prior work studied mainly rodents, which are short-lived and do not undergo menopause. Histological mechanisms mediating vascular stiffness in older premenopausal females increased progressively down the aortic tree, with greater increases in the abdominal aorta compared with the thoracic aorta and with the greatest increases and differences observed in the iliac artery.
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Affiliation(s)
- Denis Babici
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Raymond K Kudej
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts
| | - Tara McNulty
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Jie Zhang
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Marko Oydanich
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Tolga Berkman
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Koichi Nishimura
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Sanford P Bishop
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dorothy E Vatner
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
| | - Stephen F Vatner
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers, New Jersey Medical School, Newark, New Jersey
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Özdemir ZC, Köşger P, Uçar B, Bör Ö. Myocardial functions, blood pressure changes, and arterial stiffness in children with severe hemophilia A. Thromb Res 2020; 189:102-107. [PMID: 32197138 DOI: 10.1016/j.thromres.2020.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/17/2020] [Accepted: 03/05/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Prolonging the life span of patients with hemophilia has led to the emergence of comorbidities. Cardiovascular diseases are one of the important causes of mortality in patients with hemophilia. This study investigated the myocardial functions, blood pressure changes, arterial stiffness, and risk factors associated with cardiovascular diseases in children with hemophilia. MATERIAL AND METHODS In total, 17 children with severe hemophilia A and 23 healthy children were included in the study. Myocardial functions were evaluated using standard and tissue Doppler echocardiography. Peripheral and central blood pressure measurements were performed, and arterial stiffness was evaluated. Carotid intima-media thicknesses (CIMT) serum glucose, insulin, insulin resistance index, and lipoprotein levels were measured. RESULTS There were no differences between the two groups in terms of age, and biochemical parameters (P > 0.05). The HDL-C levels in the hemophilia group were lower than those in the control group (P < 0.05). Five of the patients had insulin resistance (29.4%), whereas four had low HDL-C levels (23.5%). There were no differences between the groups in terms of the CIMT, peripheral blood pressure, and central systolic blood pressure (P > 0.05). In the hemophilia group, central diastolic blood pressure (cDBP), arterial stiffness, and myocardial performance index were higher (P < 0.05, P = 0.01, P < 0.01), whereas the ejection time was shorter than in the control group (P < 0.05). CONCLUSIONS Compared with the control group, there is an onset of arterial stiffness, cDBP values tend to increase, and serum HDL-C levels are lower in the hemophilia group. Moreover, myocardial systolic functions demonstrate a deterioration that becomes more prominent with the increase in arterial stiffness.
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Affiliation(s)
- Zeynep Canan Özdemir
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Eskişehir Osmangazi University, Faculty of Medicine, 26480 Eskişehir, Turkey.
| | - Pelin Köşger
- Division of Pediatric Cardiology, Department of Pediatrics, Eskişehir Osmangazi University, Faculty of Medicine, 26480 Eskişehir, Turkey
| | - Birsen Uçar
- Division of Pediatric Cardiology, Department of Pediatrics, Eskişehir Osmangazi University, Faculty of Medicine, 26480 Eskişehir, Turkey
| | - Özcan Bör
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Eskişehir Osmangazi University, Faculty of Medicine, 26480 Eskişehir, Turkey.
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Schmidt KMT, Hansen KM, Johnson AL, Gepner AD, Korcarz CE, Fiore MC, Baker TB, Piper ME, Stein JH. Longitudinal Effects of Cigarette Smoking and Smoking Cessation on Aortic Wave Reflections, Pulse Wave Velocity, and Carotid Artery Distensibility. J Am Heart Assoc 2019; 8:e013939. [PMID: 31795823 PMCID: PMC6951052 DOI: 10.1161/jaha.119.013939] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023]
Abstract
Background We evaluated the effects of smoking and smoking cessation on aortic wave reflections (augmentation index), aortic pulse wave velocity, and carotid artery distensibility and stiffness (distensibility coefficient, Young's elastic modulus). Methods and Results Current smokers underwent carotid, radial, and femoral artery tonometry and carotid ultrasound at baseline and 3 years after a quit attempt. Baseline associations of smoking heaviness markers (exhaled carbon monoxide and cigarettes smoked/d) and effects of smoking cessation at year 3 on changes in arterial measures were assessed using multivariable linear regression models. The 1417 smokers (54% female) were mean (SD) 49.3 (11.6) years old and smoked 17.2 (8.3) cigarettes/d (exhaled carbon monoxide 14.7 [8.2] parts per million). Arterial measures were associated more strongly with age, blood pressure (BP), and waist circumference than with smoking heaviness markers. Augmentation index was associated independently with carbon monoxide (P=0.004). Pulse wave velocity, distensibility coefficient, and Young's elastic modulus had small, inconsistent associations with smoking heaviness markers. At year 3, augmentation index improved with smoking cessation (P=0.006) despite more weight gain (2.54 vs 0.36 kg, P<0.001) and insulin resistance (P=0.001) among abstainers, but distensibility coefficient decreased (P=0.004). Changes in arterial measures were related more strongly to changes in BP than smoking cessation. Conclusions Arterial wave reflection and stiffness measures were associated more strongly with age, BP, and waist circumference than smoking heaviness. Smoking cessation was associated with weight gain and increased insulin resistance. Changes in arterial measures were predicted by changes in BP, highlighting the need to address weight gain and BP changes during a quit attempt.
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Affiliation(s)
| | - Kristin M. Hansen
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | | | - Adam D. Gepner
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | | | - Michael C. Fiore
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Timothy B. Baker
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Megan E. Piper
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - James H. Stein
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
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Charlton PH, Mariscal Harana J, Vennin S, Li Y, Chowienczyk P, Alastruey J. Modeling arterial pulse waves in healthy aging: a database for in silico evaluation of hemodynamics and pulse wave indexes. Am J Physiol Heart Circ Physiol 2019; 317:H1062-H1085. [PMID: 31442381 PMCID: PMC6879924 DOI: 10.1152/ajpheart.00218.2019] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/09/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022]
Abstract
The arterial pulse wave (PW) is a rich source of information on cardiovascular (CV) health. It is widely measured by both consumer and clinical devices. However, the physical determinants of the PW are not yet fully understood, and the development of PW analysis algorithms is limited by a lack of PW data sets containing reference CV measurements. Our aim was to create a database of PWs simulated by a computer to span a range of CV conditions, representative of a sample of healthy adults. The typical CV properties of 25-75 yr olds were identified through a literature review. These were used as inputs to a computational model to simulate PWs for subjects of each age decade. Pressure, flow velocity, luminal area, and photoplethysmographic PWs were simulated at common measurement sites, and PW indexes were extracted. The database, containing PWs from 4,374 virtual subjects, was verified by comparing the simulated PWs and derived indexes with corresponding in vivo data. Good agreement was observed, with well-reproduced age-related changes in hemodynamic parameters and PW morphology. The utility of the database was demonstrated through case studies providing novel hemodynamic insights, in silico assessment of PW algorithms, and pilot data to inform the design of clinical PW algorithm assessments. In conclusion, the publicly available PW database is a valuable resource for understanding CV determinants of PWs and for the development and preclinical assessment of PW analysis algorithms. It is particularly useful because the exact CV properties that generated each PW are known.NEW & NOTEWORTHY First, a comprehensive literature review of changes in cardiovascular properties with age was performed. Second, an approach for simulating pulse waves (PWs) at different ages was designed and verified against in vivo data. Third, a PW database was created, and its utility was illustrated through three case studies investigating the determinants of PW indexes. Fourth, the database and tools for creating the database, analyzing PWs, and replicating the case studies are freely available.
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Affiliation(s)
- Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Jorge Mariscal Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Ye Li
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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40
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Du Y, Taylor CG, Zahradka P. Modulation of endothelial cell responses and vascular function by dietary fatty acids. Nutr Rev 2019; 77:614-629. [PMID: 31228246 DOI: 10.1093/nutrit/nuz026] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Healthy and functional endothelial cells play important roles in maintaining vascular homeostasis, whereas endothelial dysfunction initiates and exacerbates vascular disease progression. Interventional studies with dietary fatty acids have shown that these molecules have varying effects on vascular function. It is hypothesized that the actions of dietary fatty acids on vascular function may be mediated in part through endothelial cells. This review summarizes the results of studies that have examined the acute and chronic effects of dietary fatty acids on endothelial function and vascular properties in humans, as well as the potential mechanisms by which n-3 polyunsaturated fatty acids regulate endothelial function. Altogether, this article provides an extensive review of how fatty acids contribute to vascular function through their ability to modulate endothelial cells and discusses relationships between dietary fatty acids and endothelial cells in the context of vascular dysfunction.
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Affiliation(s)
- Youjia Du
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, St Boniface Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Carla G Taylor
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, St Boniface Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Peter Zahradka
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, St Boniface Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
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Perrault R, Omelchenko A, Taylor CG, Zahradka P. Establishing the interchangeability of arterial stiffness but not endothelial function parameters in healthy individuals. BMC Cardiovasc Disord 2019; 19:190. [PMID: 31387535 PMCID: PMC6685177 DOI: 10.1186/s12872-019-1167-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 07/23/2019] [Indexed: 12/15/2022] Open
Abstract
Background Development of instruments capable of detecting early stage vascular disease has increased interest in employing arterial stiffness (e.g. pulse wave velocity (PWV), augmentation index (AIx)) and endothelial dysfunction (e.g. reactive hyperemia index (RHI)) to diagnose atherosclerotic disease before occurrence of a cardiovascular event. However, amongst the equipment designed for this purpose, there is insufficient information regarding each of these parameters to establish appropriate cutoffs to distinguish between healthy and unhealthy blood vessels. To address these limitations, the study was designed to establish the upper arterial stiffness and endothelial function thresholds in a healthy population, by comparing the outputs from different instruments capable of measuring PWV, AIx and RHI. Methods A systematic comparison of PWV, AIx and RHI was conducted to determine the inter-relationships between these parameters of vascular functionality. Outputs were obtained non-invasively using three instruments, the VP-1000 (VP), SphygmoCor (SC), and EndoPAT (EP), in 40 apparently healthy males and females. Results Correlations were found between the brachial-ankle PWV and radial-ankle PWV (by VP and SC), and PWV (VP) with AIx (SC). The interchangeability of these outputs was demonstrated by the Bland Altman test, making it feasible to extrapolate cut-offs for radial-ankle PWV and AIx equivalent to brachial-ankle PWV that signify healthy vessels. In contrast, RHI showed no association with AIx, suggesting these endothelial and arterial parameters are functionally distinct. Conclusions It was concluded that it is possible to compare the vascular function outputs of different instruments and identify healthy from unhealthy vessels, even though the approaches for quantifying the underlying physiological processes may differ. In this way, non-invasive determination of arterial function could be a new paradigm for detecting existing early stage asymptomatic atherosclerotic disease in individuals using techniques that are amenable to the clinical setting. Electronic supplementary material The online version of this article (10.1186/s12872-019-1167-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raissa Perrault
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Alexander Omelchenko
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada
| | - Carla G Taylor
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Canada
| | - Peter Zahradka
- Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada. .,Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. .,Department of Food and Human Nutritional Sciences, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Canada.
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Mendes-Pinto D, Ribeiro JM, Rodrigues-Machado MDG. Association between critical limb ischemia and arterial stiffness measured by brachial artery oscillometry. J Vasc Bras 2019; 18:e20180073. [PMID: 31258553 PMCID: PMC6582766 DOI: 10.1590/1677-5449.007318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/03/2018] [Indexed: 11/22/2022] Open
Abstract
Background Elevated arterial stiffness is associated with increased cardiovascular mortality. The relationship between arterial stiffness and critical limb ischemia (CLI) is not well established. Objectives The objective of this study is to analyze the relationship between arterial stiffness indices and the degree of limb ischemia measured by the ankle-brachial index (ABI). Methods A cross-sectional study comparing patients with CLI and controls. Arterial stiffness was measured using brachial artery oscillometry. The arterial stiffness indices pulse wave velocity (PWV) and augmentation index normalized to 75 beats/min (AIx@75) were determined. Multiple linear regression was applied to identify predictors of arterial stiffness indices. Results Patients in the CLI group had higher PWV (12.1±1.9 m/s vs. 10.1±1.9 m/s, p < 0.01) and AIx@75 (31.8±7.8% vs. 17.5±10.8%, p < 0.01) than controls. Central systolic pressure was higher in the CLI group (129.2±18.4 mmHg vs. 115.2±13.1 mmHg, p < 0.01). There was an inverse relationship between AIx@75 and ABI (Pearson coefficient = 0.24, p = 0.048), but there was no relationship between ABI and PWV (Pearson coefficient = 0.19, p = 0.12). In multiple regression analysis, reduced ABI was a predictor of elevated levels of AIx@75 (β = -25.02, p < 0.01). Conclusions Patients with CLI have high arterial stiffness measured by brachial artery oscillometry. The degree of limb ischemia, as measured by the ABI, is a predictor of increased AIx@75. The increased AIx@75 observed in CLI may have implications for the prognosis of this group of patients with advanced atherosclerosis.
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Affiliation(s)
- Daniel Mendes-Pinto
- Hospital Felício Rocho, Departamento de Cirurgia Vascular, Belo Horizonte, MG, Brasil.,Faculdade de Ciências Médicas de Minas Gerais - FCM-MG, Belo Horizonte, MG, Brasil
| | - José Márcio Ribeiro
- Faculdade de Ciências Médicas de Minas Gerais - FCM-MG, Belo Horizonte, MG, Brasil.,Hospital Felício Rocho, Departamento de Cardiologia, Belo Horizonte, MG, Brasil
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Nguyen MT, Vryer R, Ranganathan S, Lycett K, Grobler A, Dwyer T, Juonala M, Saffery R, Burgner D, Wake M. Telomere Length and Vascular Phenotypes in a Population-Based Cohort of Children and Midlife Adults. J Am Heart Assoc 2019; 8:e012707. [PMID: 31140354 PMCID: PMC6585377 DOI: 10.1161/jaha.119.012707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022]
Abstract
Background Telomere length has been inversely associated with cardiovascular disease in adulthood, but its relationship to preclinical cardiovascular phenotypes across the life course remains unclear. We investigated associations of telomere length with vascular structure and function in children and midlife adults. Methods and Results Population-based cross-sectional CheckPoint (Child Health CheckPoint) study of 11- to 12-year-old children and their parents, nested within the LSAC (Longitudinal Study of Australian Children). Telomere length (telomeric genomic DNA [T]/β-globin single-copy gene [S] [T/S ratio]) was measured by quantitative polymerase chain reaction from blood-derived genomic DNA. Vascular structure was assessed by carotid intima-media thickness, and vascular function was assessed by carotid-femoral pulse-wave velocity and carotid elasticity. Mean (SD) T/S ratio was 1.09 (0.55) in children (n=1206; 51% girls) and 0.81 (0.38) in adults (n=1343; 87% women). Linear regression models, adjusted for potential confounders, revealed no evidence of an association between T/S ratio and carotid intima-media thickness, carotid-femoral pulse-wave velocity, or carotid elasticity in children. In adults, longer telomeres were associated with greater carotid elasticity (0.14% per 10-mm Hg higher per unit of T/S ratio; 95% CI, 0.04%-0.2%; P=0.007), but not carotid intima-media thickness (-0.9 μm; 95% CI, -14 to 13 μm; P=0.9) or carotid-femoral pulse-wave velocity (-0.10 m/s; 95% CI, -0.3 to 0.07 m/s; P=0.2). In logistic regression analysis, telomere length did not predict poorer vascular measures at either age. Conclusions In midlife adults, but not children, there was some evidence that telomere length was associated with vascular elasticity but not thickness. Associations between telomere length and cardiovascular phenotypes may become more evident in later life, with advancing pathological changes.
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Affiliation(s)
- Minh Thien Nguyen
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Regan Vryer
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Sarath Ranganathan
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Respiratory MedicineRoyal Children's HospitalParkvilleAustralia
| | - Kate Lycett
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Anneke Grobler
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Terence Dwyer
- George Institute for Global HealthUniversity of OxfordUnited Kingdom
- Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Markus Juonala
- Department of MedicineUniversity of TurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
| | - Richard Saffery
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - David Burgner
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Department of PediatricsMonash UniversityClaytonAustralia
- Infectious DiseasesRoyal Children's HospitalParkvilleAustralia
| | - Melissa Wake
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Department of Pediatrics and Liggins InstituteUniversity of AucklandNew Zealand
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von Stebut E, Reich K, Thaçi D, Koenig W, Pinter A, Körber A, Rassaf T, Waisman A, Mani V, Yates D, Frueh J, Sieder C, Melzer N, Mehta NN, Gori T. Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks. J Invest Dermatol 2019; 139:1054-1062. [DOI: 10.1016/j.jid.2018.10.042] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/12/2018] [Accepted: 10/30/2018] [Indexed: 12/12/2022]
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Scheppach JB, Raff U, Toncar S, Ritter C, Klink T, Störk S, Wanner C, Schlieper G, Saritas T, Reinartz SD, Floege J, Janka R, Uder M, Schmieder RE, Eckardt KU, Schneider MP. Blood Pressure Pattern and Target Organ Damage in Patients With Chronic Kidney Disease. Hypertension 2019; 72:929-936. [PMID: 30354716 DOI: 10.1161/hypertensionaha.118.11608] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In patients with chronic kidney disease, data on blood pressure (BP) pattern and its association with target organ damage, which indicates elevated cardiovascular risk, are sparse. In 305 treated hypertensive chronic kidney disease patients, we assessed BP pattern, left ventricular mass (magnetic resonance imaging), intima-media thickness (ultrasound), 24-hour-pulse wave velocity and 24-hour-central augmentation index (Mobil-O-Graph). Controlled hypertension (normal office and ambulatory BP) was found in 41% and sustained uncontrolled hypertension (elevated office and ambulatory BP) in 30% of patients. Misclassification of BP status occurred in 29%: white coat uncontrolled hypertension (elevated office but normal ambulatory BP) was detected in 11% and masked uncontrolled hypertension (normal office but elevated ambulatory BP) in 18% of patients. Left ventricular mass was increased in white coat uncontrolled hypertension (+11.2 g), masked uncontrolled hypertension (+9.4 g), and sustained uncontrolled hypertension (+16.6 g) compared with controlled hypertension. Intima-media thickness was similar across all 4 BP groups. Twenty-four hour-pulse wave velocity and 24-hour-central augmentation index were increased in masked uncontrolled hypertension (+0.5 m/sec and +2.5%) and sustained uncontrolled hypertension (+0.5 m/sec and +2.9%) compared with controlled hypertension. In conclusion, based on office BP measurements, misclassification of true BP status occurred in almost one-third of chronic kidney disease patients. Both types of misclassification (white coat uncontrolled hypertension and masked uncontrolled hypertension) were associated with parameters of target organ damage. Ambulatory BP monitoring should be used routinely to identify chronic kidney disease patients at high cardiovascular risk.
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Affiliation(s)
- Johannes B Scheppach
- From the Department of Nephrology and Hypertension (J.B.S., U.R., R.E.S., K.-U.E., M.P.S.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Ulrike Raff
- From the Department of Nephrology and Hypertension (J.B.S., U.R., R.E.S., K.-U.E., M.P.S.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Sebastian Toncar
- Division of Nephrology, Department of Medicine, University of Würzburg, Germany (S.T., C.W.)
| | - Christian Ritter
- Department of Diagnostic and Interventional Radiology, University Medicine Göttingen, Germany (C.R.)
| | - Thorsten Klink
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany (T.K.)
| | - Stefan Störk
- Comprehensive Heart Failure Center, University of Würzburg and Department of Medicine I, Cardiology, University Hospital Würzburg, Germany (S.S.)
| | - Christoph Wanner
- Division of Nephrology, Department of Medicine, University of Würzburg, Germany (S.T., C.W.)
| | - Georg Schlieper
- Division of Nephrology and Clinical Immunology (G.S., T.S., J.F.), University Hospital RWTH Aachen, Germany
| | - Turgay Saritas
- Division of Nephrology and Clinical Immunology (G.S., T.S., J.F.), University Hospital RWTH Aachen, Germany
| | - Sebastian D Reinartz
- Department of Diagnostic and Interventional Radiology (S.D.R.), University Hospital RWTH Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology (G.S., T.S., J.F.), University Hospital RWTH Aachen, Germany
| | - Rolf Janka
- Department of Radiology (R.J., M.U.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Michael Uder
- Department of Radiology (R.J., M.U.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Roland E Schmieder
- From the Department of Nephrology and Hypertension (J.B.S., U.R., R.E.S., K.-U.E., M.P.S.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Kai-Uwe Eckardt
- From the Department of Nephrology and Hypertension (J.B.S., U.R., R.E.S., K.-U.E., M.P.S.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.,Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Germany (K.-U.E.)
| | - Markus P Schneider
- From the Department of Nephrology and Hypertension (J.B.S., U.R., R.E.S., K.-U.E., M.P.S.), Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.,Department of Nephrology and Hypertension, Klinikum Nürnberg, Paracelsus Private Medical University, Germany (M.P.S.)
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Theorell-Haglöw J, Hoyos CM, Phillips CL, Yee BJ, Melehan KL, Liu PY, Cistulli PA, Grunstein RR. Associations Between Obstructive Sleep Apnea and Measures of Arterial Stiffness. J Clin Sleep Med 2019; 15:201-206. [PMID: 30736873 DOI: 10.5664/jcsm.7616] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/25/2018] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES The aim of this study was to determine whether severity measures of obstructive sleep apnea (OSA) are associated with arterial stiffness and central blood pressure (two important cardiovascular risk factors) in a large group of patients with OSA. METHODS Baseline data from six studies on OSA in which arterial stiffness and central aortic blood pressure measures were determined using applanation tonometry were pooled. Associations between measures of arterial stiffness (heart rate corrected augmentation index [AI75]), central aortic blood pressure (central systolic pressure [CSP] and heart rate corrected central augmentation pressure [CAP75]) and measures of OSA severity were explored using stepwise regression modelling. RESULTS Data from 362 participants (M:F ratio 13:1) with mean (standard deviation) age 49.2 (11.0) years, body mass index 31.9 (5.3) kg/m2, apnea-hypopnea index (AHI) 35.7 (20.7) events/h were included in the analyses. The AHI, oxygen desaturation index (ODI3%), and sleep time with SpO2 < 90% (T90) were all associated with arterial stiffness (AI75), (AHI: adj. β = .069; P = .01; ODI3%: adj. β = .072; P = .01; T90: adj. β = .18; P < .0001) and CAP75 (AHI: adj. β = .030; P = .01; ODI3%: adj. β = .027; P = .02; T90: adj. β = .080; P < .0001). AHI was also associated with CSP (AHI: adj. β = .11; P = .002). CONCLUSIONS OSA severity was significantly associated with augmentation index and CAP75 although the relationships were not strong.
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Affiliation(s)
- Jenny Theorell-Haglöw
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,School of Psychology, University of Sydney, New South Wales, Australia
| | - Craig L Phillips
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, New South Wales, Australia
| | - Brendon J Yee
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Kerri L Melehan
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Peter Y Liu
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California
| | - Peter A Cistulli
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, New South Wales, Australia.,Sleep Research Group, Charles Perkins Centre, University of Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology (CIRUS), Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Németh B, Kiss I, Ajtay B, Péter I, Kreska Z, Cziráki A, Horváth IG, Ajtay Z. Transcutaneous Carbon Dioxide Treatment Is Capable of Reducing Peripheral Vascular Resistance in Hypertensive Patients. In Vivo 2019; 32:1555-1559. [PMID: 30348716 DOI: 10.21873/invivo.11414] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 12/31/2022]
Abstract
AIM We aimed to investigate the effects of a single carbon dioxide (CO2) treatment on arterial stiffness by monitoring the changes of aortic pulse-wave velocity (PWV) and aortic augmentation index (AIXao), which are indicators of arterial stiffness. PATIENTS AND METHODS PWV and AIXao were measured by an invasively validated oscillometric device. The measurements of stiffness parameters were performed before the CO2 treatment, and at 1, 4 and 8 h after the first treatment. RESULTS Thirty-one patients were included. No significant changes were found in PWV. AIXao decreased significantly 1 h and 4 h after CO2 treatment compared to baseline values (p=0.034 and p<0.001). AIXao increased 8 h after the CO2 treatment, but remained significantly lower than baseline AIXao values (p=0.016). CONCLUSION CO2 treatment is capable of reducing peripheral vascular resistance. We hypothesize that CO2 is not only a temporal vasodilator but is also capable of activating vasodilation pathways.
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Affiliation(s)
- Balázs Németh
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary .,Zsigmondy Vilmos SPA Hospital, Harkány, Hungary
| | - István Kiss
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Bella Ajtay
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Iván Péter
- Zsigmondy Vilmos SPA Hospital, Harkány, Hungary
| | - Zita Kreska
- Zsigmondy Vilmos SPA Hospital, Harkány, Hungary
| | - Attila Cziráki
- Heart Institute, Medical School, University of Pécs, Pécs, Hungary
| | - Iván G Horváth
- Heart Institute, Medical School, University of Pécs, Pécs, Hungary
| | - Zénó Ajtay
- Zsigmondy Vilmos SPA Hospital, Harkány, Hungary.,Heart Institute, Medical School, University of Pécs, Pécs, Hungary
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49
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Kim S, Lee SJ, Kim YH, Kim JS, Lim SY, Kim SH, Ahn JC, Song WH, Jee SH, Park CG. Irreversible effects of long-term chronic smoking on arterial stiffness: An analysis focusing on ex-smokers among otherwise healthy middle-aged men. Clin Exp Hypertens 2018; 41:766-773. [PMID: 30582369 DOI: 10.1080/10641963.2018.1557677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: Smoking is a modifiable cardiovascular risk factor closely related to arterial stiffness (AS). However, data are lacking regarding the chronic effects of smoking on AS, especially in ex-smoker (ES) who faces remnant cardiovascular risk when compared to never-smokers (NS).Methods: Among 1722 health screening participants, we retrospectively evaluated 652 healthy men with different smoking history [240 current smoker (CS) vs. 228 ES vs. 184 NS]. To assess AS, augmentation index (AIx), pulse pressure amplification (PPamp), and carotid-femoral pulse wave velocity (cfPWV) were measured and compared.Results: Baseline characteristics were similar except age and triglyceride level. AIx was lowest in NS, followed by ES, and was highest in CS. PPamp was highest in NS, lowest in CS, and ES was of intermediate level. The differences were more robust after adjustment for baseline covariates (AIx, p = 0.005; PPamp: p = 0.001). On the other hand, no significant intergroup difference was observed for cfPWV in our middle-aged population. With the regression analyses revealing an independent association between smoking duration and AS in ES, subgroup analysis demonstrated that long-term ES (smoking duration ≥20 years) had significantly higher AS than short-term ES (<20 years) and NS, approaching levels comparable to CS (AIx and PPamp: p < 0.0001).Conclusions: Our study demonstrated impaired arterial elastic properties in long-term ES, suggesting that AS caused by chronic smoking might be irreversible even after smoking cessation. Further longitudinal studies are warranted to determine the impacts of past smoking on AS and its clinical relevance.
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Affiliation(s)
- Sunwon Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sun Ju Lee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea
| | - Yong-Hyun Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Jin-Seok Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sang-Yup Lim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Seong Hwan Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Jeong-Cheon Ahn
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Woo-Hyuk Song
- Department of Cardiology, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
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50
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Ismaeel A, Brumberg RS, Kirk JS, Papoutsi E, Farmer PJ, Bohannon WT, Smith RS, Eidson JL, Sawicki I, Koutakis P. Oxidative Stress and Arterial Dysfunction in Peripheral Artery Disease. Antioxidants (Basel) 2018; 7:antiox7100145. [PMID: 30347720 PMCID: PMC6210426 DOI: 10.3390/antiox7100145] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease characterized by a narrowing of the arteries in the lower extremities. Disease manifestations are the result of more than just reduced blood flow, and include endothelial dysfunction, arterial stiffness, and inflammation. Growing evidence suggests that these factors lead to functional impairment and decline in PAD patients. Oxidative stress also plays an important role in the disease, and a growing amount of data suggest a link between arterial dysfunction and oxidative stress. In this review, we present the current evidence for the involvement of endothelial dysfunction, arterial stiffness, and inflammation in the pathophysiology of PAD. We also discuss the links between these factors and oxidative stress, with a focus on nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2)-derived reactive oxygen species (ROS) and decreased nitric oxide (NO) bioavailability. Finally, the potential therapeutic role of NOX2 antioxidants for improving arterial function and functional status in PAD patients is explored.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Robert S Brumberg
- Department of Surgery, Vascular Surgery Associates, Florida State University School of Medicine, Tallahassee Memorial Hospital, Tallahassee, FL 32308, USA.
| | - Jeffrey S Kirk
- Department of Surgery, Capital Regional Medical Center, Tallahassee, FL 32308, USA.
| | - Evlampia Papoutsi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
| | - Patrick J Farmer
- Department of Chemistry and Biochemistry, Baylor University, Waco, TX 76798, USA.
| | - William T Bohannon
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Robert S Smith
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Jack L Eidson
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Ian Sawicki
- Department of Surgery, Baylor Scott and White Medical Center, Temple, TX 76508, USA.
| | - Panagiotis Koutakis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA.
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