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Zhu H, Liang W, Zhu J, He X, Zou P, Yang K, Li G, Liao B, Deng H, Liang Z, Zhao J, Zhao Z, Chen J, He Q, Ning W. Nomogram to predict ventilator-associated pneumonia in large vessel occlusion stroke after endovascular treatment: a retrospective study. Front Neurol 2024; 15:1351458. [PMID: 38803642 PMCID: PMC11129686 DOI: 10.3389/fneur.2024.1351458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background Ventilator-Associated Pneumonia (VAP) severely impacts stroke patients' prognosis after endovascular treatment. Hence, this study created a nomogram to predict the occurrence of VAP after endovascular treatment. Methods The individuals with acute ischemic stroke and large vessel occlusion (AIS-LVO) who received mechanical ventilation and endovascular therapy between July 2020 and August 2023 were included in this retrospective study. The predictive model and nomogram were generated by performing feature selection optimization using the LASSO regression model and multifactor logistic regression analysis and assessed the evaluation, verification and clinical application. Results A total of 184 individuals (average age 61.85 ± 13.25 years, 73.37% male) were enrolled, and the rate of VAP occurrence was found to be 57.07%. Factors such as the Glasgow Coma Scale (GCS) score, duration of stay in the Intensive Care Unit (ICU), dysphagia, Fazekas scale 2 and admission diastolic blood pressure were found to be associated with the occurrence of VAP in the nomogram that demonstrating a strong discriminatory power with AUC of 0.862 (95% CI, 0.810-0.914), and a favorable clinical net benefit. Conclusion This nomogram, comprising GCS score, ICU duration, dysphagia, Fazekas scale 2 and admission diastolic blood pressure, can aid clinicians in predicting the identification of high-risk patients for VAP following endovascular treatment in large vessel occlusion stroke.
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Affiliation(s)
- Huishan Zhu
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Wenfei Liang
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Jingling Zhu
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Xiaohua He
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Pengjuan Zou
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Kangqiang Yang
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Guoshun Li
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Bin Liao
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Huiquan Deng
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Zichong Liang
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Jiasheng Zhao
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Zhan Zhao
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Jingyi Chen
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Qiuxing He
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weimin Ning
- Department of Neurology, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
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Huang J, Li W, Sun Y, Huang Z, Cong R, Yu C, Tao H. Preserved Ratio Impaired Spirometry (PRISm): A Global Epidemiological Overview, Radiographic Characteristics, Comorbid Associations, and Differentiation from Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:753-764. [PMID: 38505581 PMCID: PMC10949882 DOI: 10.2147/copd.s453086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
Preserved Ratio Impaired Spirometry (PRISm) manifests notable epidemiological disparities across the globe, with its prevalence and influential factors showcasing pronounced diversities among various geographical territories and demographics. The prevalence of PRISm fluctuates considerably among regions such as Latin America, the United States, and Asian nations, potentially correlating with a myriad of determinants, including socioeconomic status, environmental factors, and lifestyle modalities. Concurrently, the link between PRISm and health risks and other disorders, especially its distinction and interrelation with chronic obstructive pulmonary disease (COPD), has become a pivotal subject of scientific enquiry. Radiographic anomalies, such as perturbations in the pulmonary parenchyma and structural alterations, are posited as salient characteristics of PRISm. Furthermore, PRISm unveils intricate associations with multiple comorbidities, inclusive of hypertension and type 2 diabetes, thereby amplifying the intricacy in comprehending and managing this condition. In this review, we aim to holistically elucidate the epidemiological peculiarities of PRISm, its potential aetiological contributors, its nexus with COPD, and its association with radiographic aberrations and other comorbidities. An integrative understanding of these dimensions will provide pivotal insights for the formulation of more precise and personalised preventative and therapeutic strategies.
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Affiliation(s)
- Jia Huang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Wenjun Li
- Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Yecheng Sun
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Zhutang Huang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Rong Cong
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Chen Yu
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China
| | - Hongyan Tao
- Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
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Takase M, Yamada M, Nakamura T, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Kanno I, Nochioka K, Tsuchiya N, Hirata T, Hamanaka Y, Sugawara J, Kobayashi T, Fuse N, Uruno A, Kodama EN, Kuriyama S, Tsuji I, Hozawa A. The Association of Lung Function and Carotid Intima-Media Thickness in a Japanese Population: The Tohoku Medical Megabank Community-Based Cohort Study. J Atheroscler Thromb 2023; 30:1022-1044. [PMID: 36328568 PMCID: PMC10406635 DOI: 10.5551/jat.63826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/21/2022] [Indexed: 08/04/2023] Open
Abstract
AIM Impaired lung function is associated with atherosclerotic vascular events. Carotid intima-media thickness (cIMT) is a marker for subclinical atherosclerosis. However, few studies have examined the association between lung function and cIMT among never smokers or individuals stratified by age. We investigated the association between lung function and cIMT in the Japanese population. METHODS We conducted a cross-sectional study of 3,716 men and 8,765 women aged 20 years or older living in Miyagi Prefecture, Japan. Lung function was evaluated using forced expiratory volume at 1 s (FEV1) and forced vital capacity (FVC) was measured using spirometry. The maximum common carotid artery was measured using high-resolution B-mode ultrasound. An analysis of covariance was used to assess associations between lung function and cIMT and adjusted for potential confounders. A linear trend test was conducted by scoring the categories from 1 (lowest) to 4 (highest) and entering the score as a continuous term in the regression model. RESULTS After adjusting for potential confounders including passive smoking, lower FEV1 and FVC were associated with higher cIMT in both men and women (P<0.001 for linear trend). This association was confirmed even when we restricted our study to never smokers. Furthermore, even when we stratified by age, an inverse association between lung function and cIMT was confirmed in middle-aged (40-64 years) and elderly participants (65-74 years). CONCLUSIONS Lower lung function was associated with higher cIMT in the Japanese population independent of age and smoking. Assessment of atherosclerosis or lung function may be required for individuals with lower lung function or atherosclerosis.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | | | - Tomohiro Nakamura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
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Okamoto T, Hashimoto Y, Ogawa M. Central Haemodynamics Are Associated With Pulmonary Function in Postmenopausal Women. Heart Lung Circ 2021; 30:1778-1784. [PMID: 34456129 DOI: 10.1016/j.hlc.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Increased arterial stiffness predicts cardiovascular disease, which is associated with deteriorated pulmonary function and worsened chronic obstructive pulmonary disease. The present study examined whether arterial function was associated with pulmonary function in postmenopausal women. METHODS This study evaluated 41 postmenopausal women (age range: 59-85 years). Arterial function was measured as central systolic blood pressure (cSBP), central pulse pressure (cPP), brachial systolic BP (bSBP), brachial diastolic BP (bDBP), brachial PP (bPP), brachial mean arterial pressure (bMAP) and the augmentation index (AIx). AIx was adjusted for a heart rate of 75 beats per minute (bpm) (AIx@75) and served as the index of arterial stiffness determined by the reflected wave at the central artery. Pulmonary function was measured as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and the FEV1/FVC ratio. RESULTS Univariate regression analysis demonstrated that cPP, bDBP and bPP were correlated with FVC and FEV1 (p<0.05, respectively), while AI@75 was correlated with FVC, FEV1 and FEV1/FVC ratio (p<0.01, respectively). A stepwise multivariate regression analysis revealed that bDBP was independently associated with FVC (p=0.032), while AI@75 was independently associated with FVC, FEV1 and FEV1/FVC ratio (p=0.001, p=0.003 and p=0.017, respectively). The FVC, FEV1 and FEV1/FVC ratio were lower in participants with a high AIx versus with a low AIx (p=0.0001, p=0.001 and p=0.044, respectively). CONCLUSION These results suggest that increased AIx is associated with lower pulmonary function in postmenopausal women.
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Affiliation(s)
- Takanobu Okamoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan; Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan.
| | - Yuto Hashimoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Madoka Ogawa
- Department of Sports Sociology and Health Sciences, Kyoto Sangyo University, Kyoto, Japan; Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan
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Kim J, Lee CH, Lee HY, Kim H. Association between Comorbidities and Preserved Ratio Impaired Spirometry: Using the Korean National Health and Nutrition Examination Survey IV-VI. Respiration 2021; 101:25-33. [PMID: 34320510 DOI: 10.1159/000517599] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Preserved ratio impaired spirometry (PRISm) patients have more frequent respiratory symptoms and an increased risk of mortality. However, studies on comorbidities in these patients are lacking. OBJECTIVES We investigated the association between PRISm and comorbidities using the Korea National Health and Nutrition Examination Survey (KNHANES). METHOD This cross-sectional study included participants aged ≥50 years from the KNHANES (2007-2015). Participants who did not undergo spirometry or performed inadequately were excluded. We classified participants into 3 groups according to spirometry: PRISm (forced expiratory volume in one second [FEV1] /forced vital capacity [FVC] ≥ 0.7 and FEV1 <80%), chronic obstructive pulmonary disease (COPD) (FEV1/ FVC <0.7), and normal. Multivariate logistic regression analyses were used to evaluate the risk of comorbidities in the PRISm group compared to that in the normal group. RESULT The study included 17,515 participants: 12,777 (73.0%), 1,563 (8.9%), and 3,175 (18.1%) in normal, PRISm, and COPD groups, respectively. After adjustment for known risk factors of each disease, hypertension (adjusted odds ratio [95% confidence interval]; 1.31 [1.14-1.50]), diabetes (1.51 [1.29-1.78]), hypercholesterolemia (1.20 [1.04-1.37]), obesity (1.31 [1.15-1.48]), ischemic heart disease (1.58 [1.13-2.22]), chronic renal disease (2.31 [1.09-4.88]), and thyroid disease (1.41 [1.09-1.83]) risks were significantly higher in the PRISm group than in the normal group. The average number of comorbidities was 2.45 in the PRISm group, which was higher than that in the normal (2.1) and COPD (2.03) groups (p < 0.05). CONCLUSION The number of comorbidities was significantly higher in the PRISm group than in others. Hypertension, diabetes, obesity, ischemic heart disease, chronic renal disease, and thyroid disease were associated with PRISm after adjustment for risk factors.
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Affiliation(s)
- Joohae Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea, .,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea,
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Youn Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Serim Hospital, Incheon, Republic of Korea
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.,Institute for Sustainable Development, Seoul National University, Seoul, Republic of Korea
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Lorincz-Comi N, Zhu X. Cardiometabolic risks of SARS-CoV-2 hospitalization using Mendelian Randomization. Sci Rep 2021; 11:7848. [PMID: 33846372 PMCID: PMC8042041 DOI: 10.1038/s41598-021-86757-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/19/2021] [Indexed: 01/31/2023] Open
Abstract
Many cardiometabolic conditions have demonstrated associative evidence with COVID-19 hospitalization risk. However, the observational designs of the studies in which these associations are observed preclude causal inferences of hospitalization risk. Mendelian Randomization (MR) is an alternative risk estimation method more robust to these limitations that allows for causal inferences. We applied four MR methods (MRMix, IMRP, IVW, MREgger) to publicly available GWAS summary statistics from European (COVID-19 GWAS n = 2956) and multi-ethnic populations (COVID-19 GWAS n = 10,908) to better understand extant causal associations between Type II Diabetes (GWAS n = 659,316), BMI (n = 681,275), diastolic and systolic blood pressure, and pulse pressure (n = 757,601 for each) and COVID-19 hospitalization risk across populations. Although no significant causal effect evidence was observed, our data suggested a trend of increasing hospitalization risk for Type II diabetes (IMRP OR, 95% CI 1.67, 0.96-2.92) and pulse pressure (OR, 95% CI 1.27, 0.97-1.66) in the multi-ethnic sample. Type II diabetes and Pulse pressure demonstrates a potential causal association with COVID-19 hospitalization risk, the proper treatment of which may work to reduce the risk of a severe COVID-19 illness requiring hospitalization. However, GWAS of COVID-19 with large sample size is warranted to confirm the causality.
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Affiliation(s)
- Noah Lorincz-Comi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Wolstein Research Building Room 1317, 2103 Cornell Rd, Cleveland, OH, 44106, USA.
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7
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Zekavat SM, Honigberg M, Pirruccello JP, Kohli P, Karlson EW, Newton-Cheh C, Zhao H, Natarajan P. Elevated Blood Pressure Increases Pneumonia Risk: Epidemiological Association and Mendelian Randomization in the UK Biobank. MED 2021; 2:137-148.e4. [PMID: 33283203 PMCID: PMC7703520 DOI: 10.1016/j.medj.2020.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/22/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Small studies have correlated hypertension with pneumonia risk; whether this is recapitulated in larger prospective studies, and represents a causal association, is unclear. METHODS We estimated the risk for prevalent hypertension with incident respiratory diseases over mean follow-up of 8 years among 377,143 British participants in the UK Biobank. Mendelian randomization of blood pressure on pneumonia was implemented using 75 independent, genome-wide significant variants associated with systolic and diastolic blood pressures among 299,024 individuals not in the UK Biobank. Secondary analyses with pulmonary function tests were performed. FINDINGS In total, 107,310 participants (30%) had hypertension at UK Biobank enrollment, and 9,969 (3%) developed pneumonia during follow-up. Prevalent hypertension was independently associated with increased risk for incident pneumonia (HR: 1.36; 95% CI: 1.29-1.43; p < 0.001), as well as other incident respiratory diseases. Genetic predisposition to a 5 mm Hg increase in blood pressure was associated with increased risk for incident pneumonia for systolic blood pressure (HR: 1.08; 95% CI: 1.04-1.13; p < 0.001) and diastolic blood pressure (HR: 1.11; 95% CI: 1.03-1.20; p = 0.005). Additionally, consistent with epidemiologic associations, increased blood pressure genetic risk was significantly associated with reduced performance on pulmonary function tests (p < 0.001). CONCLUSIONS These results suggest that elevated blood pressure increases risk for pneumonia. Maintaining adequate blood pressure control, in addition to other measures, may reduce risk for pneumonia. FUNDING S.M.Z. (1F30HL149180-01), M.H. (T32HL094301-07), and P.N. (R01HL1427, R01HL148565, and R01HL148050) are supported by the National Institutes of Health. J.P. is supported by the John S. LaDue Memorial Fellowship.
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Affiliation(s)
- Seyedeh M Zekavat
- Yale School of Medicine, New Haven, CT, USA
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Honigberg
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - James P Pirruccello
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Puja Kohli
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vertex Pharmaceuticals, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth W Karlson
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Allergy, Immunology, and Rheumatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher Newton-Cheh
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hongyu Zhao
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Pradeep Natarajan
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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8
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Yoon H. Association between Pulse Pressure and Impaired Pulmonary Function in Non-Smoking Adults. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2020. [DOI: 10.15324/kjcls.2020.52.2.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hyun Yoon
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan, Korea
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9
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Lee SY, Mac Aogáin M, Fam KD, Chia KL, Binte Mohamed Ali NA, Yap MMC, Yap EPH, Chotirmall SH, Lim CL. Airway microbiome composition correlates with lung function and arterial stiffness in an age-dependent manner. PLoS One 2019; 14:e0225636. [PMID: 31770392 PMCID: PMC6879132 DOI: 10.1371/journal.pone.0225636] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022] Open
Abstract
Objective To investigate age-associated changes in airway microbiome composition and their relationships with lung function and arterial stiffness among genetically matched young and elderly pairs. Methods Twenty-four genetically linked family pairs comprised of younger (≤40 years) and older (≥60 years) healthy participants were recruited (Total n = 48). Lung function and arterial stiffness (carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx)) were assessed. Sputum samples were collected for targeted 16S rRNA gene amplicon sequencing and correlations between microbiome composition, lung function and arterial stiffness were investigated. Results Elderly participants exhibited reductions in lung function (FEV1 (p<0.001), FVC (p<0.001) and percentage FEV1/FVC (p = 0.003)) and a 1.3–3.9-fold increase in arterial stiffness (p<0.001) relative to genetically related younger adults. Elderly adults had a higher relative abundance of Firmicutes (p = 0.035) and lower relative abundance of Proteobacteria (p = 0.014), including specific genera Haemophilus (p = 0.024) and Lautropia (p = 0.020) which were enriched in the younger adults. Alpha diversity was comparable between young and elderly pairs (p>0.05) but was inversely associated with lung function (FEV1%Predicted and FVC %Predicted) in the young (p = 0.006 and p = 0.003) though not the elderly (p = 0.481 and p = 0.696). Conversely, alpha diversity was negatively associated with PWV in the elderly (p = 0.01) but not the young (p = 0.569). Specifically, phylum Firmicutes including the genus Gemella were correlated with lung function (FVC %Predicted) in the young group (p = 0.047 and p = 0.040), while Fusobacteria and Leptotrichia were associated with arterial stiffness (PWV) in the elderly (both p = 0.004). Conclusion Ageing is associated with increased Firmicutes and decreased Proteobacteria representation in the airway microbiome among a healthy Asian cohort. The diversity and composition of the airway microbiome is independently associated with lung function and arterial stiffness in the young and elderly groups respectively. This suggests differential microbial associations with these phenotypes at specific stages of life with potential prognostic implications.
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Affiliation(s)
- Shuen Yee Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Micheál Mac Aogáin
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kai Deng Fam
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kar Ling Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Margaret M. C. Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Eric P. H. Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Chin Leong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- * E-mail:
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10
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Cuttica MJ, Colangelo LA, Dransfield MT, Bhatt SP, Rana JS, Jacobs DR, Thyagarajan B, Sidney S, Lewis CE, Liu K, Lloyd-Jones D, Washko G, Kalhan R. Lung Function in Young Adults and Risk of Cardiovascular Events Over 29 Years: The CARDIA Study. J Am Heart Assoc 2019; 7:e010672. [PMID: 30561252 PMCID: PMC6405620 DOI: 10.1161/jaha.118.010672] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Diminished peak lung function in young adulthood is a risk factor for future chronic obstructive pulmonary disease. The association between lung disease and cardiovascular disease later in life is well documented. Whether peak lung function measured in young adulthood is associated with risk of future cardiovascular events is unknown. Methods and Results CARDIA (The Coronary Artery Risk Development in Young Adults) study is a prospective, multicenter, community‐based, longitudinal cohort study including 4761 participants aged 18 to 30 years with lung function testing we investigated the association between lung health in young adulthood and risk of subsequent cardiovascular events. We performed Cox proportional hazards regression to test the association between baseline and years 10 and 20 pulmonary function with incident cardiovascular events. Linear and logistic regression was performed to explore the associations of lung function with development of risk factors for cardiovascular disease as well as carotid intima‐media thickness and coronary artery calcified plaque. At baseline, mean age (±SD) was 24.9±3.6 years. Baseline forced expiratory volume in 1 second (hazard ratio) per −10‐unit decrement in percent predicted forced expiratory volume in 1 second (hazard ratio, 1.18; 95% CI, 1.06–1.31 [P=0.002]) and FVC per −10‐unit decrement in percent predicted FVC (hazard ratio, 1.19; 95% CI, 1.06–1.33 [P=0.003]) were associated with future cardiovascular events independent of traditional cardiovascular risk factors. Baseline lung function was associated with heart failure and cerebrovascular events but not coronary artery disease events. Conclusions Lung function in young adulthood is independently associated with cardiovascular events into middle age. This association appears to be driven by heart failure and cerebrovascular events rather than coronary heart disease. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005130.
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Affiliation(s)
- Michael J Cuttica
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Laura A Colangelo
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Mark T Dransfield
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Surya P Bhatt
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Jamal S Rana
- 4 Division of Cardiology Kaiser Permanente Northern California Oakland CA.,6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - David R Jacobs
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Bharat Thyagarajan
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Stephen Sidney
- 6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - Cora E Lewis
- 7 Division of Preventive Medicine Department of Medicine University of Alabama at Birmingham AL
| | - Kiang Liu
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Donald Lloyd-Jones
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - George Washko
- 8 Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital Boston MA
| | - Ravi Kalhan
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL.,2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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11
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Miele CH, Grigsby MR, Siddharthan T, Gilman RH, Miranda JJ, Bernabe-Ortiz A, Wise RA, Checkley W. Environmental exposures and systemic hypertension are risk factors for decline in lung function. Thorax 2018; 73:1120-1127. [PMID: 30061168 PMCID: PMC7289445 DOI: 10.1136/thoraxjnl-2017-210477] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/01/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic lung disease is a leading contributor to the global disease burden; however, beyond tobacco smoke, we do not fully understand what risk factors contribute to lung function decline in low-income and middle-income countries. METHODS We collected sociodemographic and clinical data in a randomly selected, age-stratified, sex-stratified and site-stratified population-based sample of 3048 adults aged ≥35 years from four resource-poor settings in Peru. We assessed baseline and annual pre-bronchodilator and post-bronchodilator lung function over 3 years. We used linear mixed-effects models to assess biological, socioeconomic and environmental risk factors associated with accelerated lung function decline. RESULTS Mean±SD enrolment age was 55.4±12.5 years, 49.2% were male and mean follow-up time was 2.36 (SD 0.61) years. Mean annual pre-bronchodilator FEV1 decline was 30.3 mL/year (95% CI 28.6 to 32.0) and pre-bronchodilator FVC decline was 32.2 mL/year (30.0 to 34.4). Using multivariable linear mixed-effects regression, we found that urban living, high-altitude dwelling and having hypertension accounted for 25.9% (95% CI 15.7% to 36.1%), 21.3% (11.1% to 31.5%) and 15.7% (3.7% to 26.9%) of the overall mean annual decline in pre-bronchodilator FEV1/height2, respectively. Corresponding estimates for pre-bronchodilator FVC/height2 were 42.1% (95% CI% 29.8% to 54.4%), 36.0% (23.7% to 48.2%) and 15.8% (2.6% to 28.9%) of the overall mean annual decline, respectively. CONCLUSION Urbanisation, living at high altitude and hypertension were associated with accelerated lung function decline in a population with low daily smoking prevalence.
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Affiliation(s)
- Catherine H Miele
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Matthew R Grigsby
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Trishul Siddharthan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Robert H Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Medicina, Escuela de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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12
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Keet CA, McCormack M. Cardiac Asthma: An Old Term That May Have New Meaning? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 4:924-5. [PMID: 27587322 DOI: 10.1016/j.jaip.2016.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Corinne A Keet
- Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine, Baltimore, Md.
| | - Meredith McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Md
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13
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Understanding the relationship between lung function and cardiovascular phenotypes in the young. J Hypertens 2017; 35:2171-2174. [DOI: 10.1097/hjh.0000000000001541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Bhatia S, Qualls C, Crowell TA, Arynchyn A, Thyagarajan B, Smith LJ, Kalhan R, Jacobs DR, Kramer H, Duprez D, Celli B, Sood A. Rapid decline in lung function in healthy adults predicts incident excess urinary albumin excretion later in life. BMJ Open Respir Res 2017; 4:e000194. [PMID: 29071073 PMCID: PMC5647541 DOI: 10.1136/bmjresp-2017-000194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/15/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Chronic lung disease, often characterised by rapid decline in lung function, is associated with vascular endothelial dysfunction (characterised by moderate to severe excess urinary albumin excretion (eUAE) but their longitudinal relationship is inadequately studied. In a bidirectional longitudinal examination of healthy adults, we analysed the following two hypotheses: (1) rapid decline (ie, highest tertile of lung function decline) predicts eUAE and (2) eUAE predicts rapid decline. Methods We performed a secondary data analysis from 3052 eligible participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. For analysis 1, the predictor was rapid decline in lung function between the peak value (attained at or before CARDIA visit year 10 or Y10 at a mean age of 35 years) and Y20; and the outcome was incident eUAE at Y20 and/or Y25. For analysis 2, the predictor was eUAE at Y10 and the outcome was rapid decline between Y10 and Y20. Results After adjustment for covariates in analysis 1, rapid decline in FEV1 or FVC between peak and Y20 predicted incident eUAE at Y20 and/or Y25 (OR 1.51 and 1.44, respectively; p≤0.05 for both analyses). In analysis 2, eUAE at Y10 did not predict subsequent rapid decline. Conclusions Healthy adults with rapid decline in lung function are at risk for developing vascular endothelial dysfunction, as assessed by incident eUAE, later in life.
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Affiliation(s)
- Sapna Bhatia
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Clifford Qualls
- Office of Research, Clinical Translational Science Center,University of New Mexico, Albuquerque, New Mexico, USA
| | - Thomas A Crowell
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Alexander Arynchyn
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, USA
| | - Lewis J Smith
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ravi Kalhan
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Holly Kramer
- Department of Medicine, Loyola University School of Medicine, Maywood, Illinois, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, USA
| | | | - Akshay Sood
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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15
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Li L, Hu B, Gong S, Yu Y, Yan J. Age and cigarette smoking modulate the relationship between pulmonary function and arterial stiffness in heart failure patients. Medicine (Baltimore) 2017; 96:e6262. [PMID: 28272233 PMCID: PMC5348181 DOI: 10.1097/md.0000000000006262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to assess the relationship between arterial stiffness and pulmonary function in chronic heart failure (CHF).Outpatients previously diagnosed as CHF were enrolled between April 2008 and March 2010, and submitted to arterial stiffness measurement and lung function assessment. Spirometry was performed by measuring forced vital capacity (FVC), the fraction of predicted FVC, forced expiratory volume in 1 second (FEV1), the percentage of predicted FEV1 in 1 second, FEV1 to FVC ratio, and the percentage of predicted FEV1/FVC. Cardio-ankle vascular index (CAVI) was considered for the estimation of arterial stiffness.The 354 patients assessed included 315 nonsmokers, and were 68.2 ± 7.2 years' old. Unadjusted correlation analyses demonstrated CAVI was positively related to age (r = 0.3664, P < 0.0001), and negatively related to body mass index (BMI, r = -0.2040, P = 0.0001), E/A ratio (r = -0.1759, P = 0.0010), and FEV1 (r = -0.2987, P < 0.0001). Stepwise multivariate regression analyses showed age (r = 0.2391, P < 0.0001), BMI (r = -0.2139, P < 0.0001), smoking (r = 0.1211, P = 0.0130), E/A ratio (r = -0.1082, P = 0.0386), and FEV1 (r = -0.2550, P < 0.0001) were independent determinants of CAVI. In addition, there is a significant interaction between CAVI and forced expiratory volume in 1 second (FEV1) in relation to age (Pint < 0.0001) and smoking (Pint = 0.0001). Meanwhile, pulmonary function was not associated with BMI or E/A ratio.These findings demonstrated that reduced pulmonary function is associated with the increased CAVI, and had an interactive effect with age and smoking on CAVI in patients with CHF.
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Affiliation(s)
- Li Li
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Bangchuan Hu
- Intensive Care Unit, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Shijin Gong
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Yihua Yu
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Jing Yan
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
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16
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Pulmonary Function and Arterial Stiffness in Chronic Heart Failure. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5478394. [PMID: 28097138 PMCID: PMC5209595 DOI: 10.1155/2016/5478394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/28/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022]
Abstract
Arterial stiffness contributes to heart failure and is decreased by angiotensin receptor blockers (ARBs). This cross-sectional study aimed to assess associations of lung function and ARB with arterial stiffness in patients with chronic heart failure. 354 outpatients (168 males; 186 females; 68.2 ± 7.2 years old) with chronic heart failure were evaluated. Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1 to FVC ratio (FEV1/FVC), were assessed. The cardio-ankle vascular index (CAVI) was used to estimate arterial stiffness. Unadjusted correlation analyses revealed a positive association of CAVI with ARB but not ACEI, and a negative correlation with FEV1 (r = −0.2987, p < 0.0001). Multiple stepwise regression analyses showed that ARB and FEV1 (p < 0.0001) were independent predicting factors for CAVI. These findings suggest that reduced pulmonary function is associated with increased CAVI. Pulmonary function protection could be used to improve the prognosis in heart failure, but additional studies are necessary.
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17
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Association of pulse wave velocity with total lung capacity: A cross-sectional analysis of the BOLD London study. Respir Med 2015; 109:1569-75. [PMID: 26553156 PMCID: PMC4687496 DOI: 10.1016/j.rmed.2015.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/15/2015] [Accepted: 10/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low lung function, measured using spirometry, has been associated with mortality from cardiovascular disease, but whether this is explained by airflow obstruction or restriction is a question that remains unanswered. OBJECTIVES To assess the association of total lung capacity (TLC), forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) with several cardio-metabolic and inflammatory markers. METHODS In the follow up of the Burden of Lung Disease (BOLD) study in London, acceptable post-bronchodilator spirometric, pulse rate, pulse wave velocity and blood pressure data were obtained from 108 participants. Blood samples for measurement of cardio-metabolic and inflammatory markers were also collected from these participants. Association of lung function and volume with the different biomarkers was examined in multivariable linear regression models adjusted for potential confounders. RESULTS Following adjustment for age, sex, height, and ethnicity, TLC (adjusted coefficient = -1.53; 95% CI: -2.57, -0.49) and FVC (adjusted coefficient = -2.66; 95% CI: -4.98, -0.34) were inversely associated with pulse wave velocity, and further adjustment for smoking status, pack-years and body mass index (BMI) did not materially change these results. FEV1 was inversely associated with systolic blood pressure, and adjustment for smoking status, pack-years and BMI made this association stronger (adjusted coefficient = -9.47; 95% CI: -15.62, -3.32). CONCLUSION The inverse association of pulse wave velocity, which is a marker of cardiovascular disease, with TLC suggests that the association of the former with low FVC is independent of airflow obstruction. The association between FEV1 with systolic blood pressure after adjustment for FVC suggests an association with airflow obstruction rather than with restricted spirometry.
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18
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Eising JB, van der Ent CK, van der Gugten AC, Grobbee DE, Evelein AMV, Numans ME, Uiterwaal CSPM. Life-course of cardio-respiratory associations. Eur J Prev Cardiol 2013; 22:140-9. [DOI: 10.1177/2047487313510410] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Jacobien B Eising
- Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands
| | - Cornelis K van der Ent
- Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands
| | - Anne C van der Gugten
- Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, The Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Annemieke MV Evelein
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Mattijs E Numans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Cuno SPM Uiterwaal
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
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19
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Duprez DA, Hearst MO, Lutsey PL, Herrington DM, Ouyang P, Barr RG, Bluemke DA, McAllister D, Carr JJ, Jacobs DR. Associations among lung function, arterial elasticity, and circulating endothelial and inflammation markers: the multiethnic study of atherosclerosis. Hypertension 2013; 61:542-8. [PMID: 23283358 DOI: 10.1161/hypertensionaha.111.00272] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
A parallel physiological pathway for elastic changes is hypothesized for declines in arterial elasticity and lung function. Endothelial dysfunction and inflammation could potentially decrease elasticity of both vasculature and lung tissue. We examined biomarkers, large arterial elasticity and small arterial elasticity (SAE), and forced vital capacity (FVC) in a period cross-sectional design in the multiethnic study of atherosclerosis, which recruited 1823 women and 1803 men, age range 45 to 84 years, black, white, Hispanic, and Chinese, free of clinically recognized cardiovascular disease. Radial artery tonometric pulse waveform registration was performed and large arterial elasticity and SAE were derived from diastole. Spirometric data and markers of endothelial dysfunction and inflammation (soluble intracellular adhesion molecule-1, fibrinogen, hs-C-reactive protein, and interleukin-6) were obtained. Mean large arterial elasticity was 13.7 ± 5.5 mL/mm Hg × 10 and SAE was 4.6 ± 2.6 mL/mm Hg × 100. Mean FVC was 3192 ± 956.0 mL and forced expiratory volume in 1 second was 2386 ± 734.5 mL. FVC was about 40 ± 5 mL higher per SD of SAE, stronger in men than women. The association was slightly weaker with large arterial elasticity, with no sex interaction. After regression adjustment for demographic, anthropometric, and cardiovascular risk factors, the biomarkers tended to be related to reduced SAE and FVC, particularly in men. These biomarker associations suggest important cardiovascular disease risk alterations that occur concurrently with lower arterial elasticity and lung function. The observed positive association of SAE with FVC and with forced expiratory volume in 1 second in middle-aged to older free-living people is consistent with the hypothesis of parallel physiological pathways for elastic changes in the vasculature and in lung parenchymal tissue.
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Affiliation(s)
- Daniel A Duprez
- Cardiovascular Division, University of Minnesota, 420 Delaware St Se, MMC 508, Minneapolis, MN, USA.
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20
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Cockcroft JR, Pedersen ME. β-blockade: benefits beyond blood pressure reduction? J Clin Hypertens (Greenwich) 2012; 14:112-120. [PMID: 22277144 PMCID: PMC8108973 DOI: 10.1111/j.1751-7176.2011.00553.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 09/07/2011] [Accepted: 09/15/2011] [Indexed: 12/20/2022]
Abstract
Hypertension is a major cardiovascular (CV) risk factor, but several other common conditions, including chronic obstructive pulmonary disease (COPD), osteoporosis, and peripheral arterial disease (PAD), have been shown to independently increase the risk of CV events and death. The physiological basis for an increased CV risk in those conditions probably lies in the augmentations of oxidative stress, endothelial dysfunction, systemic inflammation, and arterial stiffness, which all are also hallmarks of hypertension. β-Blockers have been used for the treatment of hypertension for more than 40 years, but a number of meta-analyses have demonstrated that treatment with these agents may be associated with an increased risk of CV events and mortality. However, the majority of primary prevention β-blocker trials employed atenolol, an earlier-generation β(1) -selective blocker whose mechanism of action is based on a reduction of cardiac output. Available evidence suggests that vasodilatory β-blockers may be free of the deleterious effects of atenolol. The purpose of this review is to summarize pathophysiologic mechanisms thought to be responsible for the increased CV risk associated with COPD, osteoporosis, and PAD, and examine the possible benefits of vasodilatory β-blockade in those conditions. Our examination focused on nebivolol, a β(1) -selective agent with vasodilatory effects most likely mediated via β(3) activation.
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Affiliation(s)
- John R. Cockcroft
- From the Department of Cardiology, University of Cardiff, University Hospital, Cardiff, UK;
and the
Royal Brompton Hospital, London, UK
| | - Michala E. Pedersen
- From the Department of Cardiology, University of Cardiff, University Hospital, Cardiff, UK;
and the
Royal Brompton Hospital, London, UK
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O'Clock GD, Lee YW, Lee J, Warwick WJ. High-frequency and low-frequency chest compression: effects on lung water secretion, mucus transport, heart rate, and blood pressure using a trapezoidal source pressure waveform. IEEE Trans Biomed Eng 2011; 59:106-14. [PMID: 21775255 DOI: 10.1109/tbme.2011.2161608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
High-frequency chest compression (HFCC), using an appropriate source (pump) waveform for frequencies at or above 3 Hz, can enhance pulmonary clearance for patients with cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). Using a trapezoidal HFCC source pressure waveform, secretion of water from epithelial tissue and transport of mucus through lung airways can be enhanced for patients with CF and COPD. At frequencies below 3 Hz, low-frequency chest compression (LFCC) appears to have a significant impact on the cardiovascular system. For a trapezoidal source pressure waveform at frequencies close to 1 Hz, LFCC produces amplitude or intensity variations in various components of the electrocardiogram time-domain waveform, produces changes at very low frequencies associated with the electrocardiogram frequency spectra (indicating enhanced parasympathetic nervous system activity), and promotes a form of heart rate synchronization. It appears that LFCC can also provide additional cardiovascular benefits by reducing peak and average systolic and diastolic blood pressure for patients with hypertension.
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Affiliation(s)
- George D O'Clock
- Defense of the Lungs Project, Pulmonary Disease/Critical Care, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
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22
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Dransfield MT, Cockcroft JR, Townsend RR, Coxson HO, Sharma SS, Rubin DB, Emmett AH, Cicale MJ, Crater GD, Martinez FJ. Effect of fluticasone propionate/salmeterol on arterial stiffness in patients with COPD. Respir Med 2011; 105:1322-30. [PMID: 21696934 DOI: 10.1016/j.rmed.2011.05.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/26/2011] [Accepted: 05/29/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND COPD is associated with increased arterial stiffness which may in part explain the cardiovascular morbidity observed in the disease. A causal relationship between arterial stiffness and cardiovascular events has not been established, though their strong association raises the possibility that therapies that reduce arterial stiffness may improve cardiovascular outcomes. Prior studies suggest that fluticasone propionate/salmeterol (FSC) may improve cardiovascular outcomes in COPD and we hypothesized that FSC would reduce arterial stiffness in these patients. METHODS This multicenter, randomized, double-blind, placebo-controlled study compared the effects of FSC 250/50 μg twice-daily and placebo on aortic pulse wave velocity (aPWV) as determined by ECG-gated carotid and femoral artery waveforms. The primary endpoint was aPWV change from baseline at 12-weeks (last measure for each patient). RESULTS 249 patients were randomized; the mean FEV(1) in each group was similar (55% predicted) and 60% of patients reported a cardiovascular disorder. At 12-weeks, aPWV between FSC and placebo was -0.42 m/s (95%CI -0.88, 0.03; p = 0.065). A statistically significant reduction in aPWV between FSC and placebo was observed in those who remained on study drug throughout the treatment period [-0.49 m/s (95%CI -0.98, -0.01; p = 0.045)]. A post hoc analysis suggested the effect of FSC was greater in patients with higher baseline aPWV. CONCLUSION FSC does not reduce aPWV in all patients with moderate to severe COPD, but may have effects in those with elevated arterial stiffness. Additional studies are required to determine if aPWV could serve as a surrogate for cardiovascular events in COPD.
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Affiliation(s)
- Mark T Dransfield
- University of Alabama Birmingham Lung Health Center, University of Alabama at Birmingham, The Birmingham VA Medical Center, Birmingham, AL, USA.
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