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Boulmpou A, Boutou AK, Pella E, Sarafidis P, Papadopoulos CE, Vassilikos V. Cardiopulmonary Exercise Testing in Heart Failure With Preserved Ejection Fraction: Technique Principles, Current Evidence, and Future Perspectives. Cardiol Rev 2023; 31:299-317. [PMID: 36723460 DOI: 10.1097/crd.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a multifactorial clinical syndrome involving a rather complex pathophysiologic substrate and quite a challenging diagnosis. Exercise intolerance is a major feature of HFpEF, and in many cases, diagnosis is suspected in subjects presenting with exertional dyspnea. Cardiopulmonary exercise testing (CPET) is a noninvasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, hematopoietic, neuropsychological, and metabolic functions during maximal or submaximal exercise. The assessment is based on the principle that system failure typically occurs when the system is under stress, and thus, CPET is currently considered to be the gold standard for identifying exercise intolerance, allowing the differential diagnosis of underlying causes. CPET is used in observational studies and clinical trials in HFpEF; however, in most cases, only a few from a wide variety of CPET parameters are examined, while the technique is largely underused in everyday cardiology practice. This article discusses the basic principles and methodology of CPET and studies that utilized CPET in patients with HFpEF, in an effort to increase awareness of CPET capabilities among practicing cardiologists.
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Affiliation(s)
- Aristi Boulmpou
- From the Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Afroditi K Boutou
- Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Eva Pella
- Department of Nephrology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Sarafidis
- Department of Nephrology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christodoulos E Papadopoulos
- From the Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilios Vassilikos
- From the Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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2
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Hu X, Logan JG, Kwon Y, Lima JAC, Jacobs DR, Duprez D, Brumback L, Taylor KD, Durda P, Johnson WC, Cornell E, Guo X, Liu Y, Tracy RP, Blackwell TW, Papanicolaou G, Mitchell GF, Rich SS, Rotter JI, Van Den Berg DJ, Chirinos JA, Hughes TM, Garrett-Bakelman FE, Manichaikul A. Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA. Sci Rep 2023; 13:17680. [PMID: 37848499 PMCID: PMC10582077 DOI: 10.1038/s41598-023-44806-z] [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: 06/29/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023] Open
Abstract
Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH.
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Affiliation(s)
- Xiaowei Hu
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Younghoon Kwon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Joao A C Lima
- Department of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - David R Jacobs
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Lyndia Brumback
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Peter Durda
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - W Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Elaine Cornell
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA
| | - Russell P Tracy
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - Thomas W Blackwell
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - George Papanicolaou
- Epidemiology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | | | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - David J Van Den Berg
- Department of Preventive Medicine and Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julio A Chirinos
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy M Hughes
- Department of Internal Medicine - Section of Gerontology and Geriatric Medicine, and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Francine E Garrett-Bakelman
- Department of Biochemistry and Molecular Genetics, Department of Medicine, University of Virginia, 1340 Jefferson Park Ave., Pinn hall 6054, Charlottesville, VA, 22908, USA.
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA.
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3
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Zhong Y, Chen Y, Zhang X, Cai W, Zhao C, Zhao W. No evidence of a causal relationship between ankylosing spondylitis and cardiovascular disease: a two-sample Mendelian randomization study. Front Cardiovasc Med 2023; 10:1243867. [PMID: 37900560 PMCID: PMC10600491 DOI: 10.3389/fcvm.2023.1243867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023] Open
Abstract
Objective Observational studies have suggested an increased risk of cardiovascular disease in individuals with ankylosing spondylitis. However, these studies are prone to confounding factors and reverse causality. To address these limitations, we conducted a Mendelian randomization study to assess the causal relationship between AS and CVD. Methods The study population comprises 9,069 individuals with ankylosing spondylitis and 509,093 individuals with either of six common cardiovascular diseases and a related indicator. Causal analysis using summary effect estimates and inverse variance weighting were employed as the main methods. Results The CAUSE analysis showed no evidence of a causal relationship between AS and CVD. The odds ratios for total CVD, heart failure, myocardial infarction, valvular heart disease, ischemic heart disease, and venous thromboembolism, Arterial stiffness index, were as follows: OR, 1.01; 95% confidence interval, 0.96-1.05; P = 0.91; OR, 1.03; 95% CI, 0.99-1.08; P = 0.50; OR, 0.94; 95% CI, 0.86-1.03; P = 0.53; OR, 0.99; 95% CI, 0.94-1.04; P = 0.99; OR, 0.98; 95% CI, 0.91-1.04; P = 0.94; OR, 0.98; 95% CI, 0.91-1.04; P = 0.99; β, -0.0019; 95% CI, 0.97-1.01; P = 0.99. The IVW and weighted median methods also yielded consistent results, and no heterogeneity or pleiotropy was found. Likewise, a reverse Mendelian randomization analysis did not uncover a heritable causal relationship between AS and CVD. Conclusion This Mendelian randomization study does not support a causal relationship between AS and CVD. Further research is needed to confirm this association.
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Affiliation(s)
- Yan Zhong
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - YingWen Chen
- College of Traditional Chinese Medicine, Tianjin University of Chinese Medicine, Tianjin, China
| | - XinYue Zhang
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - WenJun Cai
- Department of Orthopedics, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - ChangWei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - WenHai Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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Januszek R, Kocik B, Siłka W, Gregorczyk-Maga I, Mika P. The Effects of Cardiac Rehabilitation including Nordic Walking in Patients with Chronic Coronary Syndromes after Percutaneous Coronary Interventions in Elective Mode. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1355. [PMID: 37512165 PMCID: PMC10384741 DOI: 10.3390/medicina59071355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Background: Percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is a worldwide method of coronary revascularisation. The aim of this study was to assess the immediate and long-term effects of Nordic Walking (NW) training added to a standard cardiac rehabilitation programme on physical activity (PA) and capacity and life quality, as well as selected proatherogenic risk factors. Methods: The studied group comprised 50 patients (considering exclusion criteria, 40 patients), aged 56-70, with CCS after elective PCI qualified them for a 6-weeks-long cardiac rehabilitation. The follow-up period lasted 4 months, and control visits occurred at 2 and 4 months. The studied patients were randomly divided into two groups: control group-standard cardiac rehabilitation programme and experimental group-standard cardiac rehabilitation programme additionally combined with NW training. Results: The cardiac rehabilitation programme in the experimental, compared to the control group, increased intense PA (from 731.43 ± 909.9 to 2740 ± 2875.96 vs. from 211.43 ± 259.43 to 582.86 ± 1289.74 MET min/week) and aerobic efficiency-VO2peak (from 8.67 ± 0.88 to 9.96 ± 1.35 vs. from 7.39 ± 2 to 7.41 ± 2.46 METs), as well as quality of life according to the WHOQOL-BREF questionnaire (from 3.57 ± 0.51 to 4.14 ± 0.36 vs. from 3.29 ± 0.47 to 3.57 ± 0.51 points). The walking distance assessed with the 6-min walk test did not differ between the groups before the beginning of the rehabilitation programme. Both at the I follow-up and II follow-up time points, a significant increase in the walking distance was noted in the control and experimental groups compared to baseline, and the difference between both groups was significant at the end of follow-up (378.57 ± 71.35 vs. 469.29 ± 58.07, p = 0.003). Moreover, NW had a positive effect on the modulation within selected biochemical risk factors of atherosclerosis, as well as subjective quality of life and well-being. Conclusions: Introducing NW training into the cardiac rehabilitation process proved to be a more effective form of therapy in patients with CCS treated via PCI, as compared to the standard cardiac rehabilitation programme alone.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
| | - Bożena Kocik
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Wojciech Siłka
- Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Piotr Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
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Manichaikul A, Hu X, Logan J, Kwon Y, Lima J, Jacobs D, Duprez D, Brumback L, Taylor K, Durda P, Johnson C, Cornell E, Guo X, Liu Y, Tracy R, Blackwell T, Papanicolaou G, Mitchell G, Rich S, Rotter J, Van Den Berg D, Chirinos J, Hughes T, Garrett-Bakelman F. Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA. RESEARCH SQUARE 2023:rs.3.rs-3125948. [PMID: 37502922 PMCID: PMC10371087 DOI: 10.21203/rs.3.rs-3125948/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kent Taylor
- The Institute for Translational Genomics and Population Sciences
| | | | | | | | | | | | | | | | | | | | - Stephen Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia
| | - Jerome Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
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Song X, Gong J, Yu SB, Yang H, Song Y, Zhang XH, Zhang J, Hack GD, Li TL, Chi YY, Zheng N, Sui HJ. The relationship between compensatory hyperplasia of the myodural bridge complex and reduced compliance of the various structures within the cranio-cervical junction. Anat Rec (Hoboken) 2023; 306:401-408. [PMID: 35808865 PMCID: PMC10084404 DOI: 10.1002/ar.25040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/24/2022] [Accepted: 06/30/2022] [Indexed: 01/25/2023]
Abstract
The myodural bridge complex (MDBC) is described as a functional anatomic structure that involves the dense connective tissue fibers, muscles, and ligaments in the suboccipital region. It has recently been proposed that the MDBC can influence cerebrospinal fluid (CSF) circulation. In the present study, bleomycin (BLM), a type of antibiotic that is poisonous to cells, was injected into the posterior atlanto-occipital interspace (PAOiS) of rats to induce fibrous hyperplasia of structures in PAOiS. Sagittal sections of tissues obtained from the posterior-occipital region of the rats were stained utilizing the Masson Trichrome staining method. Semiquantitative analysis evidenced that the collagen volume fraction of collagen fibers of the MDBC, as well as the sum of the area of the spinal dura mater and the posterior atlanto-occipital membrane in the BLM group were significantly increased (p < .05) compared to that of the other groups. This finding illustrates that the MDBC fibers as well as other tissues in the PAOiS of rats in the BLM group developed fibrotic changes which reduced compliance of the spinal dura mater. Indeed, the sectional area of the rectus capitis dorsal minor muscle in the BLM group was measured to be increased. These changes may further restrict CSF flow. The present research provides support for the recent hypothesis proposed by Labuda et al. concerning the pathophysiology observed in symptomatic adult Chiari malformation Type I patients, that there exists a relationship between the altered compliance of the anatomic structures within the craniocervical region and the resultant compensatory hyperplasia of the MDBC.
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Affiliation(s)
- Xue Song
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Jin Gong
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Heng Yang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Yang Song
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Xu-Hui Zhang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Jing Zhang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Gary D Hack
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Tai-Lai Li
- The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Nan Zheng
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, China
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7
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Diagnosing Arterial Stiffness in Pregnancy and Its Implications in the Cardio-Renal-Metabolic Chain. Diagnostics (Basel) 2022; 12:diagnostics12092221. [PMID: 36140621 PMCID: PMC9497660 DOI: 10.3390/diagnostics12092221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Cardio-renal and metabolic modifications during gestation are crucial determinants of foetal and maternal health in the short and long term. The cardio-renal metabolic syndrome is a vicious circle that starts in the presence of risk factors such as obesity, hypertension, diabetes, kidney disease and ageing, all predisposing to a status dominated by increased arterial stiffness and alteration of the vascular wall, which eventually damages the target organs, such as the heart and kidneys. The literature is scarce regarding cardio-renal metabolic syndrome in pregnancy cohorts. The present paper exposes the current state of the art and emphasises the most important findings of this entity, particularly in pregnant women. The early assessment of arterial function can lead to proper and individualised measures for women predisposed to hypertension, pre-eclampsia, eclampsia, and diabetes mellitus. This review focuses on available information regarding the assessment of arterial function during gestation, possible cut-off values, the possible predictive role for future events and modalities to reverse or control its dysfunction, a fact of crucial importance with excellent outcomes at meagre costs.
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Peng H, Wang S, Wang M, Ye Y, Xue E, Chen X, Wang X, Fan M, Gao W, Qin X, Wu Y, Chen D, Li J, Hu Y, Wang L, Wu T. Nonalcoholic fatty liver disease and cardiovascular diseases: A Mendelian randomization study. Metabolism 2022; 133:155220. [PMID: 35618017 DOI: 10.1016/j.metabol.2022.155220] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with cardiovascular diseases (CVDs). However, the results are inconsistent, and the causality remains to be established. OBJECTIVE We aimed to investigate the potential causal relationship between NAFLD and CVDs, including arterial stiffness, coronary artery disease, heart failure, stroke, ischemic stroke and its subtypes using two-sample Mendelian randomization (MR). METHODS Genetic instruments were used as proxies for NAFLD. Publicly available summary-level data were obtained from the UK Biobank, the CARDIoGRAMplusC4D Consortium, the MEGASTROKE Consortium, and other consortia. Six complementary MR methods were performed, including inverse variance weighted method (IVW), MR-Egger, weighted median, weighted mode, MR-PRESSO, and MR-RAPS. RESULTS NAFLD was significantly associated with arterial stiffness (β = 0.04 [95%CI, 0.02-0.06], P = 5.53E-04). Moreover, the results remained consistent and robust in the sensitivity analysis. As for heart failure, the IVW method suggested that NAFLD was significantly associated with heart failure (OR = 1.08, 95%CI: 1.02-1.14, P = 0.005) in the absence of pleiotropy. However, there were no significant associations of NAFLD with coronary artery disease, stroke, ischemic stroke, or any ischemic stroke subtype. CONCLUSION The MR study supported the causal effect of NAFLD on arterial stiffness. However, the study did not provide enough evidence suggesting the causal associations of NAFLD with heart failure, coronary artery disease, and any stroke subtypes.
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Affiliation(s)
- Hexiang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Ying Ye
- Department of Local Diseases Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - Enci Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xueheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Meng Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Wenjing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xueying Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Li Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences; School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, Beijing, 100005, China.
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
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9
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Melo X, Marôco JL, Pinto R, Angarten VG, Coimbra M, Correia D, Roque M, Reis JF, Santos V, Fernhall B, Santa-Clara H. The Acute Effect of Maximal Exercise on Arterial Stiffness in Adults with and without Intellectual and Developmental Disabilities. Appl Physiol Nutr Metab 2022; 47:1005-1013. [PMID: 35820183 DOI: 10.1139/apnm-2022-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We compared central and peripheral arterial stiffness response patterns between persons with and without intellectual and developmental disabilities (IDD) of different age groups at rest and following a cardiopulmonary exercise test (CPET). METHODS 15 young adults with and without IDD, and 15 middle-aged adults without IDD performed a CPET. Central and peripheral arterial stiffness were measured at rest and following CPET using estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-ankle (cdPWV) pulse wave velocity derived from piezoelectric mechano-transducers. RESULTS cfPWV remained unchanged following CPET in adults with and without IDD but increased in middle-aged adults (d= 0.85; 95% CI: 0.27 to 1.42 m.s-1, p= 0.005), whereas cdPWV was similarly reduced (d= -0.77; 95% CI: -1.06 to -0.48 m.s-1, p< 0.001) in all groups. crPWV remained unchanged in all groups. These results were independent of exercise-related changes in mean arterial pressure. Overall group differences suggested that persons with IDD (d = - 1.78; 95% CI: -3.20 to -0.37 m.s-1, p= 0.009) and without IDD (d = -1.84; 95% CI: -3.26 to -0.43 m.s-1, p= 0.007) had lower cfPWV than middle-aged adults. CONCLUSION We found no evidence of early vascular aging and diminished vascular reserve following CPET in adults with IDD.
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Affiliation(s)
- Xavier Melo
- Universidade de Lisboa Faculdade de Motricidade Humana, 70882, CIPER - Exercise and Health Laboratory, Cruz Quebrada, Lisboa, Portugal.,Ginásio Clube Português, Research & Development Department, GCP Lab, Lisboa, Portugal;
| | - João L Marôco
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisboa, Portugal.,University of Illinois Chicago College of Applied Health Sciences, 315410, Integrative Physiology Laboratory, Chicago, Illinois, United States;
| | - Rita Pinto
- Universidade de Lisboa Faculdade de Medicina, 37811, Exercise and Cardiovascular Rehabilitation Laboratory, Lisboa, Lisboa, Portugal;
| | - Vitor Giatte Angarten
- Universidade de Lisboa Faculdade de Motricidade Humana, 70882, Cruz Quebrada, Lisboa, Portugal;
| | - Manuel Coimbra
- CERCIOEIRAS - Cooperativa de Educação e Reabilitação dos Cidadãos com Incapacidade, Oeiras, Portugal;
| | - Duarte Correia
- CERCIOEIRAS - Cooperativa de Educação e Reabilitação dos Cidadãos com Incapacidade, Oeiras, Portugal;
| | - Mafalda Roque
- CERCIOEIRAS - Cooperativa de Educação e Reabilitação dos Cidadãos com Incapacidade, Oeiras, Portugal;
| | - Joana Filipa Reis
- Universidade de Lisboa Faculdade de Motricidade Humana, 70882, Physiology and Biochemistry of Exercise, Cruz Quebrada, Lisboa, Portugal;
| | - Vanessa Santos
- Faculdade de Motricidade Humana - Universidade de Lisboa, Centro Interdisciplinar de Estudo da Performance Humana , Exercise and Health, Cruz-Quebrada, Portugal;
| | - Bo Fernhall
- University of Illinois Chicago College of Applied Health Sciences, 315410, Integrative Physiology Laboratory, Chicago, Illinois, United States;
| | - Helena Santa-Clara
- Universidade de Lisboa Faculdade de Motricidade Humana, 70882, CIPER - Exercise and Health Laboratory, Cruz Quebrada, Lisboa, Portugal;
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10
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Nordenfur T, Caidahl K, Grishenkov D, Maksuti E, Marlevi D, Urban MW, Larsson M. Safety of arterial shear wave elastography- ex-vivoassessment of induced strain and strain rates. Biomed Phys Eng Express 2022; 8. [PMID: 35797069 DOI: 10.1088/2057-1976/ac7f39] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
Shear wave elastography (SWE) is a promising technique for characterizing carotid plaques and assessing local arterial stiffness. The mechanical stress to which the tissue is subjected during SWE using acoustic radiation force (ARF), leading to strain at a certain strain rate, is still relatively unknown. Because SWE is increasingly used for arterial applications where the mechanical stress could potentially lead to significant consequences, it is important to understand the risks of SWE- induced strain and strain rate. The aim of this study was to investigate the safety of SWE in terms of induced arterial strain and strain rateex-vivoand in a human carotid arteryin-vivo. SWE was performed on six porcine aortae as a model of the human carotid artery using different combinations of ARF push parameters (push voltage: 60/90 V, aperture width: f/1.0/1.5, push length: 100/150/200 μs) and distance to push position. The largest induced strain and strain rate were 1.46 % and 54 s-1(90 V, f/1.0, 200 μs), respectively. Moreover, the SWE-induced strains and strain rates increased with increasing push voltage, aperture, push length, and decreasing distance between the region of interest and the push. In the human carotid artery, the SWE-induced maximum strain was 0.06 % and the maximum strain rate was 1.58 s-1, compared with the maximum absolute strain and strain rate of 12.61 % and 5.12 s-1, respectively, induced by blood pressure variations in the cardiac cycle. Our results indicate thatex-vivoarterial SWE does not expose the artery to higher strain rate than normal blood pressure variations, and to strain one order of magnitude higher than normal blood pressure variations, at the push settings and distances from the region of interest used in this study.
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Affiliation(s)
- Tim Nordenfur
- Department of Biomedical Engineering and Health Systems, KTH, Kungliga Tekniska högskolan, Stockholm, 100 44, SWEDEN
| | - Kenneth Caidahl
- Department of Clinical Physiology, Karolinska University Hospital, Solnavägen 1, Solna, 171 77, SWEDEN
| | - Dmitry Grishenkov
- Department of Biomedical Engineering and Health Systems, KTH, KTH, Stockholm, 100 44, SWEDEN
| | - Elira Maksuti
- Dept. of Physiology and Pharmacology, Anaesthesiology and Intensive Care, Karolinska Institute, Solnavägen 1, Solna, 171 77, SWEDEN
| | - David Marlevi
- Dept. Molecular Medicine and Surgery, Karolinska Institute, Solnavägen 1, Solna, 171 77, SWEDEN
| | - Matthew W Urban
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, Minnesota, 55905, UNITED STATES
| | - Matilda Larsson
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, KTH, Stockholm, 100 44, SWEDEN
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11
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Matenchuk BA, Fujii KD, Skow RJ, Sobierajski FM, MacKay C, Steinback CD, Davenport MH. The Effects of Physical Activity on Arterial Stiffness during Pregnancy: An Observational Study. Appl Physiol Nutr Metab 2021; 47:234-242. [PMID: 34735778 DOI: 10.1139/apnm-2021-0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of the present study was to investigate the relationship between moderate-to-vigorous physical activity (MVPA) and arterial stiffness in pregnancy. Thirty-nine women participated in this study resulting in 68 measurements in non-pregnant (NP; n=21), first (TM1; n=8), second (TM2; n=20), and third trimesters (TM3; n=19). Compliance, distensibility, elasticity, β-stiffness, and carotid to femoral (central) and carotid to finger (peripheral) pulse wave velocity (PWV) were assessed. MVPA was measured using accelerometry. Multilevel linear regressions adjusted for multiple tests per participant using random effects to generate β coefficients and 95% confidence intervals (CI) were performed. Distensibility, elasticity, β-stiffness, central- and peripheral-PWV did not differ between pregnant and non-pregnant assessments. Carotid artery compliance was higher in TM2 compared to NP. Central PWV (β Coef: -0.14, 95% CI: -0.27, -0.02) decreased from early to mid-pregnancy and increased in late pregnancy. Meeting the MVPA guidelines was significantly associated with central-PWV (Adj. β Coef: -0.34, 95% CI: -0.62, -0.06, p=0.016), peripheral-PWV (Adj. β Coef: -0.54, 95% CI: -0.91, -0.16, p=0.005), and distensibility (Adj. β Coef: -0.001, 95% CI: -0.002, -0.0001, p=0.018), in pregnancy. These results suggest that MVPA may be associated with improved (i.e. reduced) arterial stiffness in pregnancy. Novelty Bullets • Central PWV, distensibility, compliance, elasticity, and ß-stiffness, but not peripheral PWV, exhibited curvilinear relationships with gestational age • Central and peripheral PWV were lower in pregnant women who met the physical activity guidelines of 150 minutes of moderate-to-vigorous physical activity per week.
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Affiliation(s)
| | | | - Rachel J Skow
- University of Alberta, 3158, Edmonton, Alberta, Canada;
| | | | | | - Craig D Steinback
- University of Alberta, 3158, Faculty of Kinesiology, Sport & Recreation, Edmonton, Alberta, Canada;
| | - Margie H Davenport
- University of Alberta, 3158, Faculty of Kinesiology, Sport, & Recreation, Edmonton, Alberta, Canada.,University of Alberta, 3158, Program for Pregnancy and Postpartum Health, Edmonton, Alberta, Canada;
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12
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Guo J, Jiang H, Oguntuyo K, Rios B, Boodram Z, Huebsch N. Interplay of Genotype and Substrate Stiffness in Driving the Hypertrophic Cardiomyopathy Phenotype in iPSC-Micro-Heart Muscle Arrays. Cell Mol Bioeng 2021; 14:409-425. [PMID: 34777601 PMCID: PMC8548480 DOI: 10.1007/s12195-021-00684-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION In clinical and animal studies, Hypertrophic Cardiomyopathy (HCM) shares many similarities with non-inherited cardiac hypertrophy induced by pressure overload (hypertension). This suggests a potential role for mechanical stress in priming tissues with mutation-induced changes in the sarcomere to develop phenotypes associated with HCM, including hypercontractility and aberrant calcium handling. Here, we tested the hypothesis that heterozygous loss of function of Myosin Binding Protein C (MYBCP3 +/- , mutations in which account for almost 50% of inherited HCM) combines with environmental stiffness to drive HCM phenotypes. METHODS We differentiated isogenic control (WTC) and MYBPC3 +/- iPSC into cardiomyocytes using small molecule manipulation of Wnt signaling, and then purified them using lactate media. The purified cardiomyocytes were seeded into "dog bone" shaped stencil molds to form micro-heart muscle arrays (μHM). To mimic changes in myocardial stiffness stemming from pressure overload, we varied the rigidity of the substrates μHM contract against. Stiffness levels ranged from those corresponding to fetal (5 kPa), healthy (15 kPa), pre-fibrotic (30 kPa) to fibrotic (65 kPa) myocardium. Substrates were embedded with a thin layer of fluorescent beads to track contractile force, and parent iPSC were engineered to express the genetic calcium indicator, GCaMP6f. High speed video microscopy and image analysis were used to quantify calcium handling and contractility of μHM. RESULTS Substrate rigidity triggered physiological adaptation for both genotypes. However, MYBPC3 +/- μHM showed a lower tolerance to substrate stiffness with the peak traction on 15 kPa, while WTC μHM had peak traction on 30 kPa. MYBPC3 +/- μHM exhibited hypercontractility, which was exaggerated by substrate rigidity. MYBPC3 +/- μHM hypercontractility was associated with longer rise times for calcium uptake and force development, along with higher overall Ca2+ intake. CONCLUSION We found MYBPC3 +/- mutations cause iPSC-μHM to exhibit hypercontractility, and also a lower tolerance for mechanical stiffness. Understanding how genetics work in combination with mechanical stiffness to trigger and/or exacerbate pathophysiology may lead to more effective therapies for HCM. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at (10.1007/s12195-021-00684-x).
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Affiliation(s)
- Jingxuan Guo
- Department of Mechanical Engineering and Material Science, Washington University in Saint Louis, Saint Louis, USA
| | - Huanzhu Jiang
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, USA
| | - Kasoorelope Oguntuyo
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, USA
| | - Brandon Rios
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, USA
| | - Zoë Boodram
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, USA
| | - Nathaniel Huebsch
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, USA
- NSF Science and Technology Center for Engineering Mechanobiology, McKelvey School of Engineering, Saint Louis, USA
- Center for Cardiovascular Research, Center for Regenerative Medicine, Center for Investigation of Membrane Excitability Diseases, Washington University in Saint Louis, Saint Louis, USA
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13
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Wang Y, Lee WN. Non-Invasive Estimation of Localized Dynamic Luminal Pressure Change by Ultrasound Elastography in Arteries With Normal and Abnormal Geometries. IEEE Trans Biomed Eng 2021; 68:1627-1637. [DOI: 10.1109/tbme.2020.3028186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Miotto DS, Dionizio A, Jacomini AM, Zago AS, Buzalaf MAR, Amaral SL. Identification of Aortic Proteins Involved in Arterial Stiffness in Spontaneously Hypertensive Rats Treated With Perindopril:A Proteomic Approach. Front Physiol 2021; 12:624515. [PMID: 33679438 PMCID: PMC7928294 DOI: 10.3389/fphys.2021.624515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
Arterial stiffness, frequently associated with hypertension, is associated with disorganization of the vascular wall and has been recognized as an independent predictor of all-cause mortality. The identification of the molecular mechanisms involved in aortic stiffness would be an emerging target for hypertension therapeutic intervention. This study evaluated the effects of perindopril on pulse wave velocity (PWV) and on the differentially expressed proteins in aorta of spontaneously hypertensive rats (SHR), using a proteomic approach. SHR and Wistar rats were treated with perindopril (SHRP) or water (SHRc and Wistar rats) for 8 weeks. At the end, SHRC presented higher systolic blood pressure (SBP, +70%) and PWV (+31%) compared with Wistar rats. SHRP had higher values of nitrite concentration and lower PWV compared with SHRC. From 21 upregulated proteins in the aortic wall from SHRC, most of them were involved with the actin cytoskeleton organization, like Tropomyosin and Cofilin-1. After perindopril treatment, there was an upregulation of the GDP dissociation inhibitors (GDIs), which normally inhibits the RhoA/Rho-kinase/cofilin-1 pathway and may contribute to decreased arterial stiffening. In conclusion, the results of the present study revealed that treatment with perindopril reduced SBP and PWV in SHR. In addition, the proteomic analysis in aorta suggested, for the first time, that the RhoA/Rho-kinase/Cofilin-1 pathway may be inhibited by perindopril-induced upregulation of GDIs or increases in NO bioavailability in SHR. Therefore, we may propose that activation of GDIs or inhibition of RhoA/Rho-kinase pathway could be a possible strategy to treat arterial stiffness.
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Affiliation(s)
- Danyelle S Miotto
- Joint Graduate Program in Physiological Sciences, Federal University of Sao Carlos and São Paulo State University, UFSCar/UNESP, São Carlos, Brazil
| | - Aline Dionizio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - André M Jacomini
- Post-Graduate Program in Movement Sciences, São Paulo State University, Bauru, Brazil
| | - Anderson S Zago
- Post-Graduate Program in Movement Sciences, São Paulo State University, Bauru, Brazil.,Department of Physical Education, School of Sciences, São Paulo State University, Bauru, Brazil
| | | | - Sandra L Amaral
- Joint Graduate Program in Physiological Sciences, Federal University of Sao Carlos and São Paulo State University, UFSCar/UNESP, São Carlos, Brazil.,Department of Physical Education, School of Sciences, São Paulo State University, Bauru, Brazil
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15
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Balani P, Lopez AR, Nobleza CMN, Siddiqui M, Shah PV, Khan S. Can Pioglitazone Safeguard Patients of Lichen Planus Against Homocysteine Induced Accelerated Cardiovascular Aging and Reduced Myocardial Performance: A Systematic Review. Cureus 2020; 12:e12372. [PMID: 33527053 PMCID: PMC7842239 DOI: 10.7759/cureus.12372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Lichen planus (L.P.) is a long-standing mucocutaneous inflammatory condition. A less familiar but essential illness association is increased arterial stiffness, endothelial dysfunction, and advanced atherosclerosis. Enhanced cardiac reconditioning and reduced performance of the heart have been suggested. Thiazolidinediones were commenced to manage hyperglycemia in diabetes mellitus. Recently, the class attained popularity after its action on vascular physiology was discovered. With this review, we attempted to explore whether an antidiabetic drug, pioglitazone (PIO), a peroxisome proliferator‑activated receptor γ (PPAR gamma) agonist, can defend patients of lichen planus against increased arterial stiffness and cardiac changes. We methodically screened numerous databases using focused words and phrases for relevant articles. After a comprehensive exploration, we applied the inclusion and exclusion criteria and performed a quality appraisal. Items retained were exhaustively studied. High homocysteine (HHcy) levels in lichen planus play a significant role in modifying the arteries and leading to their dysfunction. Not only does homocysteine affect the precursor cells, but it also increases the free radical damage. Arterial damage and upraised resistance encountered by the heart reduce its performance. After an exhaustive analysis, in our opinion, pioglitazone works in various miscellaneous ways to mitigate the homocysteine mediated changes. Early inclusion of the drug in managing patients with lichen planus seems promising in minimizing the harmful effects of high homocysteine. Evaluating the risk-benefit ratio, we believe that a trial of pioglitazone could be given to patients without underlying cardiac conditions.
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Affiliation(s)
- Prachi Balani
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Angel R Lopez
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chelsea Mae N Nobleza
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mariah Siddiqui
- Neurology, St. George's University, True Blue, GRD.,Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Parth V Shah
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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16
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Komutrattananont P, Palee P, Prasitwattanaseree S, Mahakkanukrauh P. The estimation of age from elastic fibers in the tunica media of the aortic wall in a thai population: a preliminary study using aorta image analysis. Anat Cell Biol 2020; 53:284-291. [PMID: 32727957 PMCID: PMC7527121 DOI: 10.5115/acb.20.094] [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: 04/19/2020] [Revised: 05/22/2020] [Accepted: 06/08/2020] [Indexed: 11/27/2022] Open
Abstract
Image analysis has an increasing role in the identification of individuals in forensic application. Beside the bones, microstructural of arteries can be used in age estimation study. Aorta is the largest elastic artery which consists of many elastic fibers. Elastin in arterial wall highly resist to chemical and physical influence. The purposes of the study were to quantify elastic fibers in tunica media in each location of the aorta and examine the correlation between elastic fibers and age by using image analysis program. A total of 36 human aortas were dissected in 4 locations. The aortas were obtained from cadavers with an age range of 20 to 90 years. Specimens were stained with Elastic Van Gieson staining. Histological images were investigated about elastic fibers using light microscope with cellSens program and aorta image analysis was used for the evaluation of data. The results showed that the mean percentage density of elastic fibers in the ascending aorta and the aortic arch increased. However, the mean percentage density of elastic fibers decreased in the 31 to 40 years age group in the thoracic aorta and the abdominal aorta and decreased in each location of aorta continuously until 81 to 90 years. The abdominal aorta showed the highest correlation with age (r=0.732) followed by the thoracic aorta, the aortic arch and the ascending aorta, respectively. Changes in the percentage density of elastic fibers in the tunica media of the aortic wall can be used to add information to age estimation for identification purposes.
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Affiliation(s)
- Pornhatai Komutrattananont
- PhD Degree Program in Anatomy, Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patison Palee
- College of Arts Media and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Sukon Prasitwattanaseree
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.,Forensic Osteology Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Forensic Osteology Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand
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17
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Pulse pressure correlates with coronary artery calcification and risk for coronary heart disease: a study of elderly individuals in the rural region of Southwest China. Coron Artery Dis 2020; 30:297-302. [PMID: 30888975 PMCID: PMC6504121 DOI: 10.1097/mca.0000000000000739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Aim This study aimed to define the relationship between pulse pressure (PP) and coronary artery calcification (CAC), a proven surrogate marker for coronary heart disease. Patients and methods A total of 170 participants 50–70 years of age from 11 villages of Yunnan Province of China were enrolled randomly into this study. They were examined routinely for diastolic and systolic blood pressure, PP, and CAC. Results The average PP in the CAC-positive group was significantly higher than that in the CAC-negative group. In the positive CAC group, there were significantly positive correlations between PP and CAC score, volume, mass, as well as density. The area under the receiver operating characteristic curve analysis showed that PP performed well in predicting CAC. Conclusion In conclusion, among the rural people of southwest of China, PP correlates positively with the coronary calcium Agatston score, volume, mass, and density. PP predicted CAC as well as Framingham Risk Score. The measurement of PP widening may serve as an alternative and convenient method for assessing CAC risk in rural populations with poor accessibility and economic disadvantage over coronary computed tomography scanning.
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18
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Mazoteras-Pardo V, Becerro-De-Bengoa-Vallejo R, Losa-Iglesias ME, Martínez-Jiménez EM, Calvo-Lobo C, Romero-Morales C, López-López D, Palomo-López P. QardioArm Blood Pressure Monitoring in a Population With Type 2 Diabetes: Validation Study. J Med Internet Res 2020; 22:e19781. [PMID: 32706672 PMCID: PMC7414407 DOI: 10.2196/19781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Home blood pressure monitoring has many benefits, even more so, in populations prone to high blood pressure, such as persons with diabetes. OBJECTIVE The purpose of this research was to validate the QardioArm mobile device in a sample of individuals with noninsulin-dependent type 2 diabetes in accordance with the guidelines of the second International Protocol of the European Society of Hypertension. METHODS The sample consisted of 33 patients with type 2 diabetes. To evaluate the validity of QardioArm by comparing its data with that obtained with a digital sphygmomanometer (Omron M3 Intellisense), two nurses collected diastolic blood pressure, systolic blood pressure, and heart rate with both devices. RESULTS The analysis indicated that the test device QardioArm met all the validation requirements using a sample population with type 2 diabetes. CONCLUSIONS This paper reports the first validation of QardioArm in a population of individuals with noninsulin-dependent type 2 diabetes. QardioArm for home monitoring of blood pressure and heart rate met the requirements of the second International Protocol of the European Society of Hypertension.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Eva María Martínez-Jiménez
- Departamento de Enfermería, Facultad de Fisioterapia y Enfermería, Universidad de Castilla la Mancha, Toledo, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
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19
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Flora GD, Nayak MK. A Brief Review of Cardiovascular Diseases, Associated Risk Factors and Current Treatment Regimes. Curr Pharm Des 2020; 25:4063-4084. [PMID: 31553287 DOI: 10.2174/1381612825666190925163827] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of premature death and disability in humans and their incidence is on the rise globally. Given their substantial contribution towards the escalating costs of health care, CVDs also generate a high socio-economic burden in the general population. The underlying pathogenesis and progression associated with nearly all CVDs are predominantly of atherosclerotic origin that leads to the development of coronary artery disease, cerebrovascular disease, venous thromboembolism and, peripheral vascular disease, subsequently causing myocardial infarction, cardiac arrhythmias or stroke. The aetiological risk factors leading to the onset of CVDs are well recognized and include hyperlipidaemia, hypertension, diabetes, obesity, smoking and, lack of physical activity. They collectively represent more than 90% of the CVD risks in all epidemiological studies. Despite high fatality rate of CVDs, the identification and careful prevention of the underlying risk factors can significantly reduce the global epidemic of CVDs. Beside making favorable lifestyle modifications, primary regimes for the prevention and treatment of CVDs include lipid-lowering drugs, antihypertensives, antiplatelet and anticoagulation therapies. Despite their effectiveness, significant gaps in the treatment of CVDs remain. In this review, we discuss the epidemiology and pathology of the major CVDs that are prevalent globally. We also determine the contribution of well-recognized risk factors towards the development of CVDs and the prevention strategies. In the end, therapies for the control and treatment of CVDs are discussed.
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Affiliation(s)
- Gagan D Flora
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, United States
| | - Manasa K Nayak
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, United States
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20
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Alidadi M, Jamialahmadi T, Cicero AF, Bianconi V, Pirro M, Banach M, Sahebkar A. The potential role of plant-derived natural products in improving arterial stiffness: A review of dietary intervention studies. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.03.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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21
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Sun P, Chen X, Zeng Z, Li S, Wang J, Yu F, Liu S, Li H, Fernhall B. Sex differences in lower-limb arterial stiffness following acute aerobic exercise. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Ghosh A, Dharmarajan A, Swain PK, Das D, Verma P, Tripathy PR. Impact of Cardiovascular Factors on Pulse Wave Velocity and T otal Vascular Resistance in Different Age Group Patients with Cardiovascular Disorders. Curr Aging Sci 2020; 11:261-268. [PMID: 30813882 PMCID: PMC6635425 DOI: 10.2174/1874609812666190226151500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/01/2019] [Accepted: 02/15/2019] [Indexed: 02/02/2023]
Abstract
Background: Pulse Wave Velocity (PWV) is the propagation speed of the wave-induced along the aorta and arterial tree, each time the heart beats. PWV increases with increased arterial stiffness, thus establishing it as a reliable prognostic marker for cardiovascular morbidity and mortality. On the other hand, Total Vascular Resistance (TVR) is the overall resistance offered by systemic circulation and pulmonary circulation. This resistance needs to be overcome in order to create the flow of blood through the circulatory system. The goal of this study was to investigate the influence of different cardiovascular factors on arterial stiffness and vascular resistance in CVD patient from eastern India population. Methods: Total of 782 patients with Cardiovascular Disease (CVD) like hypertension, Ischemic heart disease, Congestive cardiac failure and peripheral arterial disease were included to evaluate the cardiovascular hemodynamic and non-hemodynamic parameter by oscillometric method and investigated those factors on PWV and TVR in subjects of both sexes aged between 15 to 87 years. Results: The old age (> 55 years) was found to have greatest impact on PWV as compared with younger age group. Systolic Blood Pressure (SBP), Heart Rate (HR), augmentation pressure and Body Surface Area (BSA) had a positive association with the PWV. Augmentation Index and Body Mass Index (BMI) had a negative impact on the PWV. Conclusion: Despite the limitations, like unequal number of male and female participants, wide variation of the age of the subjects and analyzing association of many factors at a time, our large and community-based study show individual blood pressure and pulse pressure depending on complex interaction between large arteries and arterioles. This study sheds light on the relationship between proximal and distal part (PWV and TVR) of the arterial tree as well as their association with different hemodynamic and non-hemodynamic parameters.
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Affiliation(s)
- Amit Ghosh
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, India
| | - Abhijith Dharmarajan
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, India
| | | | - Debasish Das
- Department of Cardiology, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, India
| | - Poonam Verma
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, India
| | - Prabhas R Tripathy
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, India
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23
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Impairment of myocardial functions and arterial stiffness in patients with lichen planus. An Bras Dermatol 2020; 95:180-186. [PMID: 32146010 PMCID: PMC7175034 DOI: 10.1016/j.abd.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/30/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lichen planus is a chronic inflammatory mucocutaneous disease. Recent studies have suggested that it is associated with an increased risk of cardiovascular comorbidities. OBJECTIVE The purpose of this study was to assess and compare arterial stiffness and cardiovascular hemodynamics in patients with lichen planus and a healthy control group. METHODS Fifty-five patients with lichen planus and 42 healthy controls were enrolled. All patients underwent echocardiographic examination, and arterial stiffness was measured using applanation tonometry. RESULTS No statistically significant difference was determined between the patient and control groups in terms of arterial stiffness, but stiffness was markedly higher in patients with erosive lichen planus compared to the control group and other patients (p=0.006, and p=0.023, respectively). Moderate positive correlation was determined between duration of disease and arterial stiffness. Impairment of systolic and diastolic functions was also determined in patients with lichen planus compared to the control group (p<0.001, and p=0.005, respectively). STUDY LIMITATIONS Relatively low number of patients. CONCLUSION The positive correlation observed between duration of disease and arterial stiffness in patients with lichen planus suggests that these patients should be followed-up in terms of cardiovascular risk in the presence of resistant and long-term disease, particularly in case of erosive lichen planus.
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Ho TY, Redmayne GP, Tran A, Liu D, Butlin M, Avolio A, Boutcher SH, Boutcher YN. The effect of interval sprinting exercise on vascular function and aerobic fitness of post‐menopausal women. Scand J Med Sci Sports 2019; 30:312-321. [DOI: 10.1111/sms.13574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/24/2019] [Accepted: 10/08/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Tze Y. Ho
- School of Medical Sciences University of New South Wales Kensington NSW Australia
| | - Georgia P. Redmayne
- School of Medical Sciences University of New South Wales Kensington NSW Australia
| | - Aengus Tran
- School of Medical Sciences University of New South Wales Kensington NSW Australia
| | - Diana Liu
- School of Medical Sciences University of New South Wales Kensington NSW Australia
| | - Mark Butlin
- Department of Biomedical Sciences Faculty of Medicine and Health Sciences Macquarie University Sydney NSW Australia
| | - Alberto Avolio
- Department of Biomedical Sciences Faculty of Medicine and Health Sciences Macquarie University Sydney NSW Australia
| | - Stephen H. Boutcher
- School of Medical Sciences University of New South Wales Kensington NSW Australia
| | - Yati N. Boutcher
- School of Medical Sciences University of New South Wales Kensington NSW Australia
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Logan JG, Kim SS, Lee M, Byon HD, Yeo S. Effects of Static Stretching Exercise on Lumbar Flexibility and Central Arterial Stiffness. J Cardiovasc Nurs 2019; 33:322-328. [PMID: 29369122 DOI: 10.1097/jcn.0000000000000460] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies have demonstrated that arterial stiffness is associated with lumbar flexibility (LF). Stretching exercise targeted to improve LF may have a beneficial effect on reducing arterial stiffness. OBJECTIVES We examined the effects of a single bout of a structured, static stretching exercise on arterial stiffness, LF, peripheral and central blood pressure (BP), and heart rate (HR) and tested the association between LF and central arterial stiffness. METHOD The study had a pretest-posttest design without a control group. Thirty healthy women followed a video demonstration of a 30-minute whole-body stretching exercise. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index, LF, peripheral and central BP, and HR were measured before and after the stretching exercise. RESULTS One bout of a static stretching exercise significantly reduced cf-PWV (t29 = 2.708, P = .011) and HR (t29 = 7.160, P = .000) and increased LF (t29 = 12.248, P < .000). Augmentation index and peripheral and central BP also decreased but did not reach statistical significance. Despite no association found between cf-PWV and LF, the larger increase in LF the subjects had, the larger decrease in cf-PWV they had after exercise (r = 0.500, P = .005). CONCLUSIONS Study findings highlight the potential benefit of a static stretching exercise on central arterial stiffness, an independent predictor of cardiovascular morbidity. Static stretching exercise conducted in the sitting position may be used as an effective intervention to reduce cardiovascular risk after a cardiac event or for patients whose sympathetic function should not be overly activated or whose gaits are not stable.
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Affiliation(s)
- Jeongok G Logan
- Jeongok G. Logan, PhD, MSN, RN Assistant Professor, University of Virginia School of Nursing, Charlottesville. Suk-Sun Kim, PhD, MSN, RN Assistant Professor, Ewha Womans University College of Nursing, Seoul, Korea. Mijung Lee, PhD(c), MSN, RN Doctoral Student, University of Virginia School of Nursing, Charlottesville. Ha Do Byon, PhD, MS, MPH, RN Assistant Professor, University of Virginia School of Nursing, Charlottesville. SeonAe Yeo, PhD, WHNP-BC, FAAN Professor, University of North Carolina at Chapel Hill School of Nursing
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Johnson SA, Litwin NS, Seals DR. Age-Related Vascular Dysfunction: What Registered Dietitian Nutritionists Need to Know. J Acad Nutr Diet 2019; 119:1785-1796. [DOI: 10.1016/j.jand.2019.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/13/2019] [Accepted: 03/22/2019] [Indexed: 12/11/2022]
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27
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Sharma K, Lee HH, Gong DS, Park SH, Yi E, Schini-Kerth V, Oak MH. Fine air pollution particles induce endothelial senescence via redox-sensitive activation of local angiotensin system. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 252:317-329. [PMID: 31158660 DOI: 10.1016/j.envpol.2019.05.066] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/13/2019] [Accepted: 05/13/2019] [Indexed: 06/09/2023]
Abstract
Fine dust (FD) is a form of air pollution and is responsible for a wide range of diseases. Specially, FD is associated with several cardiovascular diseases (CVDs); long-term exposure to FD was shown to decrease endothelial function, but the underlying mechanism remains unclear. We investigated whether exposure to FD causes premature senescence-associated endothelial dysfunction in endothelial cells (ECs) isolated from porcine coronary arteries. The cells were treated with different concentrations of FD and senescence associated-beta galactosidase (SA-β-gal) activity, cell cycle progression, expression of endothelial nitric oxide synthase (eNOS), oxidative stress level, and vascular function were evaluated. We found that FD increased SA-β-gal activity, caused cell cycle arrest, and increased oxidative stress, suggesting the premature induction of senescence; on the other hand, eNOS expression was downregulated and platelet aggregation was enhanced. FD exposure impaired vasorelaxation in response to bradykinin and activated the local angiotensin system (LAS), which was inhibited by treatment with the antioxidant N-acetyl cysteine (NAC) and angiotensin II receptor type 1 (AT1) antagonist losartan (LOS). NAC and LOS also suppressed FD-induced SA-β-gal activity, increased EC proliferation and eNOS expression, and improved endothelial function. These results demonstrate that FD induces premature senescence of ECs and is associated with increased oxidative stress and activation of LAS. This study can serve as a pharmacological target for prevention and/or treatment of air pollution-associated CVD.
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Affiliation(s)
- Kushal Sharma
- College of Pharmacy, Mokpo National University 1666 Yeongsan-Ro, Cheonggye-Myeon, Muan-Gun, Jeonnam, 58554, Republic of Korea
| | - Hyun-Ho Lee
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Dal-Seong Gong
- College of Pharmacy, Mokpo National University 1666 Yeongsan-Ro, Cheonggye-Myeon, Muan-Gun, Jeonnam, 58554, Republic of Korea
| | - Sin-Hee Park
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Eunyoung Yi
- College of Pharmacy, Mokpo National University 1666 Yeongsan-Ro, Cheonggye-Myeon, Muan-Gun, Jeonnam, 58554, Republic of Korea
| | - Valérie Schini-Kerth
- UMR CNRS 7213, Laboratoire de Biophotonique et Pharmacologie, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Min-Ho Oak
- College of Pharmacy, Mokpo National University 1666 Yeongsan-Ro, Cheonggye-Myeon, Muan-Gun, Jeonnam, 58554, Republic of Korea.
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Tonhajzerova I, Olexova LB, Jurko A, Spronck B, Jurko T, Sekaninova N, Visnovcova Z, Mestanikova A, Kudela E, Mestanik M. Novel Biomarkers of Early Atherosclerotic Changes for Personalised Prevention of Cardiovascular Disease in Cervical Cancer and Human Papillomavirus Infection. Int J Mol Sci 2019; 20:E3720. [PMID: 31366035 PMCID: PMC6696433 DOI: 10.3390/ijms20153720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/18/2019] [Accepted: 07/27/2019] [Indexed: 12/13/2022] Open
Abstract
Cervical cancer is associated with a causative role of human papillomavirus (HPV), which is a highly prevalent infection. Recently, women with a genital HPV infection were found to have increased incidence of cardiovascular diseases (CVD), including severe cardiovascular events such as myocardial infarction and stroke. The pathomechanisms of this relation are not yet fully understood, and may significantly affect the health of a large part of the population. Accelerated atherosclerosis is assumed to play a key role in the pathophysiology of this relationship. To identify high-risk groups of the population, it is necessary to stratify the CVD risk. Current algorithms, as widely used for the estimation of CVD risk, seem to be limited by the individual misclassification of high-risk subjects. However, personalised prediction of cardiovascular events is missing. Regarding HPV-related CVD, identification of novel sensitive biomarkers reflecting early atherosclerotic changes could be of major importance for such personalised cardiovascular risk prediction. Therefore, this review focuses on the pathomechanisms leading to HPV-related cardiovascular diseases with respect to atherosclerosis, and the description of potential novel biomarkers to detect the earliest atherosclerotic changes important for the prevention of CVD in HPV infection and cervical cancer.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak.
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak.
| | - Lucia B Olexova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
| | - Alexander Jurko
- Pediatric Cardiology Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
| | - Bart Spronck
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Tomas Jurko
- Neonatology Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovak
| | - Nikola Sekaninova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
| | - Zuzana Visnovcova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
| | - Andrea Mestanikova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
| | - Erik Kudela
- Gynaecology Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovak
| | - Michal Mestanik
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak
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Tonhajzerova I, Mestanikova A, Jurko A, Grendar M, Langer P, Ondrejka I, Jurko T, Hrtanek I, Cesnekova D, Mestanik M. Arterial stiffness and haemodynamic regulation in adolescent anorexia nervosa versus obesity. Appl Physiol Nutr Metab 2019; 45:81-90. [PMID: 31163115 DOI: 10.1139/apnm-2018-0867] [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: 12/13/2022]
Abstract
Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa. We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with anorexia nervosa, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of R-R intervals and beat-to-beat blood pressure (BP), and arterial stiffness evaluated using cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, haemodynamic parameters (total peripheral resistance (TPR) cardiac output), CAVI, and anthropometric indices, including novel body roundness index (BRI). Adolescents with anorexia nervosa had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability compared with normal-weight peers (p = 0.03, p = 0.04, respectively) and obese adolescents (p < 0.01, p = 0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in the anorexia nervosa group (R2 = 0.724, p < 0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, and early arteriosclerotic, hemodynamic, and anthropometric changes in spectrum anorexia nervosa, normal weight, and obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty Girls with anorexia nervosa showed signs of early arteriosclerotic damage indexed by CAVI. Insufficient sympathetic cardiovascular control was found already in adolescents with anorexia nervosa. The effect of body composition on CAVI was best predicted by novel body roundness index.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Andrea Mestanikova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic
| | - Marian Grendar
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Peter Langer
- Research Center, St. Anne's University Hospital Brno, 656 91 Brno, Czech Republic; Institute of Scientific Instruments of the ASCR, v.v.i., Kralovopolska 147, 612 64 Brno, Czech Republic
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Tomas Jurko
- Department of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Michal Mestanik
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
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30
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Wang Y, Li H, Guo Y, Lee WN. Bidirectional Ultrasound Elastographic Imaging Framework for Non-invasive Assessment of the Non-linear Behavior of a Physiologically Pressurized Artery. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1184-1196. [PMID: 30876671 DOI: 10.1016/j.ultrasmedbio.2019.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
Studies of non-destructive bidirectional ultrasound assessment of non-linear mechanical behavior of the artery are scarce in the literature. We hereby propose derivation of a strain-shear modulus relationship as a new graphical diagnostic index using an ultrasound elastographic imaging framework, which encompasses our in-house bidirectional vascular guided wave imaging (VGWI) and ultrasound strain imaging (USI). This framework is used to assess arterial non-linearity in two orthogonal (i.e., longitudinal and circumferential) directions in the absence of non-invasive pressure measurement. Bidirectional VGWI estimates longitudinal (μL) and transverse (μT) shear moduli, whereas USI estimates radial strain (ɛr). Vessel-mimicking phantoms (with and without longitudinal pre-stretch) and in vitro porcine aortas under static and/or dynamic physiologic intraluminal pressure loads were examined. ɛr was found to be a suitable alternative to intraluminal pressure for representation of cyclic loading on the artery wall. Results revealed that μT values of all samples examined increased non-linearly with εr magnitude and more drastically than μL, whereas μL values of only the pre-stretched phantoms and aortas increased with ɛr magnitude. As a new graphical representation of arterial non-linearity and function, strain-shear modulus loops derived by the proposed framework over two consecutive dynamic loading cycles differentiated sample pre-conditions and corroborated direction-dependent non-linear mechanical behaviors of the aorta with high estimation repeatability.
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Affiliation(s)
- Yahua Wang
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - He Li
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Yuexin Guo
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong; Medical Engineering Programme, University of Hong Kong, Hong Kong.
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De Bruyne T, Steenput B, Roth L, De Meyer GRY, Santos CND, Valentová K, Dambrova M, Hermans N. Dietary Polyphenols Targeting Arterial Stiffness: Interplay of Contributing Mechanisms and Gut Microbiome-Related Metabolism. Nutrients 2019; 11:E578. [PMID: 30857217 PMCID: PMC6471395 DOI: 10.3390/nu11030578] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/15/2022] Open
Abstract
Increased arterial stiffness is a degenerative vascular process, progressing with age that leads to a reduced capability of arteries to expand and contract in response to pressure changes. This progressive degeneration mainly affects the extracellular matrix of elastic arteries and causes loss of vascular elasticity. Recent studies point to significant interference of dietary polyphenols with mechanisms involved in the pathophysiology and progression of arterial stiffness. This review summarizes data from epidemiological and interventional studies on the effect of polyphenols on vascular stiffness as an illustration of current research and addresses possible etiological factors targeted by polyphenols, including pathways of vascular functionality, oxidative status, inflammation, glycation, and autophagy. Effects can either be inflicted directly by the dietary polyphenols or indirectly by metabolites originated from the host or microbial metabolic processes. The composition of the gut microbiome, therefore, determines the resulting metabolome and, as a consequence, the observed activity. On the other hand, polyphenols also influence the intestinal microbial composition, and therefore the metabolites available for interaction with relevant targets. As such, targeting the gut microbiome is another potential treatment option for arterial stiffness.
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Affiliation(s)
- Tess De Bruyne
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Bieke Steenput
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Claudia Nunes Dos Santos
- Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal.
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Av. da República, 2780-157 Oeiras, Portugal.
- CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Kateřina Valentová
- Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague, Czech Republic.
| | - Maija Dambrova
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, LV-1006 Riga, Latvia.
| | - Nina Hermans
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
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Cândido JSA, Camelo LV, Mill JG, Lotufo PA, Ribeiro ALP, Duncan BB, Brant LCC, Barreto SM. Greater aortic stiffness is associated with renal dysfunction in participants of the ELSA-Brasil cohort with and without hypertension and diabetes. PLoS One 2019; 14:e0210522. [PMID: 30716076 PMCID: PMC6361418 DOI: 10.1371/journal.pone.0210522] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/22/2018] [Indexed: 12/15/2022] Open
Abstract
Background Arterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, particularly among individuals without hypertension and diabetes. We investigated the cross-sectional associations between arterial stiffness and renal function in adults without cardiovascular disease, and whether this association remained among subjects without hypertension and diabetes. Methods All eligible participants from ELSA-Brasil (2008–2010), aged 35 to 74 years (N = 13,586) were included, of whom 7,979 were free from hypertension and diabetes. The response variables were: 1) low glomerular filtration rate (eGFR<60ml/min/1.73m2) estimated by CKD-EPI; 2) increased albumin/creatinine ratio (ACR ≥30mg/g); and 3) chronic kidney disease (CKD). Arterial stiffness was ascertained by the carotid-femoral pulse wave velocity (PWV). The covariates were sex, age, race/color, level of schooling, smoking, body mass index, total cholesterol/HDL-c glycated hemoglobin, diabetes, systolic blood pressure, heart rate and use of antihypertensive drugs. Logistic regression was used to examine the associations. Results After all adjustments, 1 m/s increase in PWV was associated with ORs equal to 1.10 (95%CI: 1.04–1.16), 1.10 (95%CI: 1.05–1.16) and 1.12 (95%CI: 1.08–1.17) of low eGFR, high ACR, and CKD, respectively. In subjects without hypertension and diabetes, these ORs were 1.19 (95%CI: 1.07–1.33), 1.20 (95%CI: 1.07–1.32) and 1.21 (95%CI: 1.11–1.30), respectively. Conclusion The increase in PWV was associated with all renal dysfunction markers, even in individuals without hypertension and diabetes, suggesting a relation that is not completely mediated by the presence of these conditions.
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Affiliation(s)
- Júlia S. A. Cândido
- Medical School & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lidyane V. Camelo
- Medical School & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Universidade Federal do Espírito Santo, Vitória, Espirito Santo, Brazil
| | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio Luiz P. Ribeiro
- Medical School & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruce B. Duncan
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luisa C. C. Brant
- Medical School & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandhi Maria Barreto
- Medical School & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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Fu X, Liu Q, Zeng X, Huang S, Huang R, Gao Q. Association between Cerebral Arterial Stiffness and Large Artery Atherosclerosis in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2018; 27:2993-3000. [PMID: 30146389 DOI: 10.1016/j.jstrokecerebrovasdis.2018.06.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/15/2018] [Accepted: 06/23/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Carotid-cerebral pulse wave velocity (ccPWV) reflects the segment (C-M segment) stiffness between common carotid artery and ipsilateral middle cerebral artery. The C-M segment atherosclerosis (CMSA) is regarded as a most frequent cause of anterior circulation ischemic stroke. We therefore, attempted to investigate the relationship between cerebral arterial stiffness and CMSA, and provide reliable data for the early diagnosis of CMSA. METHODS Between June 2012 and August 2016, 81 acute ischemic stroke (AIS) patients with 154 C-M segments successfully evaluated with digital subtraction angiography and ccPWV were enrolled into this study. Patient demographics and clinical data were retrieved from our AIS databases. RESULTS Multivariate analyses showed that ccPWV was independently associated with CMSA (β = 39.6, P = .009) and Systolic blood pressure (β = 7.1, P < .001) in AIS patients. The values of ccPWV had a trend to be higher in the groups with more lesions (F = 45.9, P < .01) and severer stenosis (F = 102.6, P = .000), and was positively correlated with the number of lesions (r = .662, P = .000), and degree of stenosis (r = .858, P = .000) of CMSA. The fractional polynomial plots with 95% CIs also describe the close relationship between ccPWV and the number of lesions and degree of stenosis in CMSA. CONCLUSIONS Cerebral arterial stiffness is independently associated with the presence of CMSA, closely related to the vascular damage of C-M segment and reflects the vascular structure change of C-M segment in AIS patients. It may have the potential for assessment of CMSA in its initial stage.
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Affiliation(s)
- Xian Fu
- Department of Neurology and Institute of Neuroscience, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou
| | - Qi Liu
- New Era Stroke Care and Research Institute, General Hospital of the PLA Rocket Force, Beijing
| | - Xianfan Zeng
- Department of Neurology and Institute of Neuroscience, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou
| | - Shiyan Huang
- Department of Neurology and Institute of Neuroscience, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou
| | - Ruxun Huang
- Department of Neurology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qingchun Gao
- Department of Neurology and Institute of Neuroscience, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou.
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Bu Z, Ma J, Fan Y, Qiao Z, Kang Y, Zheng Y, Wang W, Du Y, Zheng Z, Shen X, He B, Pu J. Ascending Aortic Strain Analysis Using 2-Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris. J Am Heart Assoc 2018; 7:JAHA.118.008802. [PMID: 29982229 PMCID: PMC6064841 DOI: 10.1161/jaha.118.008802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Arterial stiffening and atherosclerosis tend to coexist. Strain imaging, using a 2‐dimensional speckle tracking (2D‐ST) method, has been used for arterial stiffness assessment and early identification of atherosclerosis. We investigated whether the ascending aortic strain assessed by 2D‐ST echocardiography at rest can predict the presence of coronary artery disease (CAD). Methods and Results Two hundred seventy‐one consecutive patients with suspected stable angina pectoris sequentially underwent exercise treadmill testing, 2‐dimensional echocardiography, M‐mode echocardiography, 2D‐ST echocardiography, and coronary angiography. Circumferential ascending aortic strain (CAAS) and radial ascending aortic strain were assessed by 2D‐ST echocardiography. Ninety‐two patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD. Global CAAS was significantly lower in patients with significant CAD (7.41±2.30% versus 11.54±4.03%; P<0.001) and remained an independent predictor of significant CAD (odds ratio, 0.64 [0.54–0.75]; P<0.001) after multivariate regression. Based on the receiver operating characteristic curve for diagnosing significant CAD, the optimal cut‐off value of global CAAS was ≤9.22% (sensitivity, 86%; specificity, 70%; area under curve=0.82; P<0.001). Global CAAS decreased with increasing severity of CAD and was significantly associated with 3‐vessel disease (odds ratio, 0.58 [0.42–0.79]; P<0.001). Diagnostics for significant CAD were remarkably better for global CAAS combined with exercise treadmill testing than for exercise treadmill testing alone (area under curve=0.88 versus 0.78; P<0.001). Conclusions Global CAAS assessed by 2D‐ST echocardiography at rest was able to predict the presence of significant CAD and identify multivessel disease. In addition, global CAAS combined with exercise treadmill testing remarkably improved the diagnostics for significant CAD.
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Affiliation(s)
- Zhaohui Bu
- Institute of Biomedical Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Ma
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yibo Fan
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqing Qiao
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Kang
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zheng
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yongping Du
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Zheng
- Institute of Biomedical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Xuedong Shen
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China .,Department of Cardiology, Shanghai Chest Hospital Shanghai Jiao Tong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Weech M, Altowaijri H, Mayneris-Perxachs J, Vafeiadou K, Madden J, Todd S, Jackson KG, Lovegrove JA, Yaqoob P. Replacement of dietary saturated fat with unsaturated fats increases numbers of circulating endothelial progenitor cells and decreases numbers of microparticles: findings from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study. Am J Clin Nutr 2018; 107:876-882. [PMID: 29741564 DOI: 10.1093/ajcn/nqy018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/18/2018] [Indexed: 01/07/2023] Open
Abstract
Background Endothelial progenitor cells (EPCs) and microparticles are emerging as novel markers of cardiovascular disease (CVD) risk, which could potentially be modified by dietary fat. We have previously shown that replacing dietary saturated fatty acids (SFAs) with monounsaturated or n-6 (ω-6) polyunsaturated fatty acids (MUFAs or PUFAs, respectively) improved lipid biomarkers, blood pressure, and markers of endothelial activation, but their effects on circulating EPCs and microparticles are unclear. Objective The Dietary Intervention and VAScular function (DIVAS) Study investigated the replacement of 9.5-9.6% of total energy (%TE) contributed by SFAs with MUFAs or n-6 PUFAs for 16 wk on EPC and microparticle numbers in United Kingdom adults with moderate CVD risk. Design In this randomized, controlled, single-blind, parallel-group dietary intervention, men and women aged 21-60 y (n = 190) with moderate CVD risk (≥50% above the population mean) consumed 1 of three 16-wk isoenergetic diets. Target compositions for total fat, SFAs, MUFAs, and n-6 PUFAs (%TE) were as follows: SFA-rich diet (36:17:11:4; n = 64), MUFA-rich diet (36:9:19:4; n = 62), and n-6 PUFA-rich diet (36:9:13:10; n = 66). Circulating EPC, endothelial microparticle (EMP), and platelet microparticle (PMP) numbers were analyzed by flow cytometry. Dietary intake, vascular function, and other cardiometabolic risk factors were determined at baseline. Results Relative to the SFA-rich diet, MUFA- and n-6 PUFA-rich diets decreased EMP (-47.3%, -44.9%) respectively and PMP (-36.8%, -39.1%) numbers (overall diet effects, P < 0.01). The MUFA-rich diet increased EPC numbers (+28.4%; P = 0.023). Additional analyses that used stepwise regression models identified the augmentation index (measuring arterial stiffness determined by pulse-wave analysis) as an independent predictor of baseline EPC and microparticle numbers. Conclusions Replacement of 9.5-9.6%TE dietary SFAs with MUFAs increased EPC numbers, and replacement with either MUFAs or n-6 PUFAs decreased microparticle numbers, suggesting beneficial effects on endothelial repair and maintenance. Further studies are warranted to determine the mechanisms underlying the favorable effects on EPC and microparticle numbers after SFA replacement. This trial was registered at www.clinicaltrials.gov as NCT01478958.
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Affiliation(s)
- Michelle Weech
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Hana Altowaijri
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Jordi Mayneris-Perxachs
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Katerina Vafeiadou
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Jacqueline Madden
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Susan Todd
- Department of Mathematics and Statistics, University of Reading, Whiteknights, Reading, United Kingdom
| | - Kim G Jackson
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
| | - Parveen Yaqoob
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research
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Yip A, Naicker S, Peters F, Libhaber E, Maharaj N, Mashabane M, Essop MR. Left ventricular twist before and after haemodialysis: an analysis using speckle-tracking echocardiography. Cardiovasc J Afr 2018; 29:231-236. [PMID: 29750229 PMCID: PMC6421550 DOI: 10.5830/cvja-2018-019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/11/2018] [Indexed: 12/01/2022] Open
Abstract
Background The most commonly used parameter of cardiac function in the chronic kidney disease (CKD) patient is ejection fraction (EF), using transthoracic echocardiography (TTE). EF is a highly load-dependent measurement, which varies considerably in CKD patients undergoing haemodialysis. The aim of this pilot study was to evaluate a novel measure of myocardial function, left ventricular twist, which is defined as the ‘wringing action of the heart’, using speckletracking echocardiography in CKD patients before and after haemodialysis. Methods Twenty-six patients were recruited from the Chris Hani Baragwanath Hospital haemodialysis unit. TTE was performed according to a detailed standardised protocol before and after a single haemodialysis session. Echocardiography was also performed on 26 age- and gendermatched healthy subjects. Results The mean age of the control versus CKD group was 44 ± 11.4 and 43.4 ± 12.2 years, respectively; 46% were male. Apical rotation was diminished in CKD patients compared to controls (4.83 ± 2.3 vs 6.31 ± 1.6 °; p = 0.01) despite no difference in EF (61.7 ± 6.2 vs 58.8 ± 13; p = 0.68). There were no differences in the components of twist: apical rotation, basal rotation and net twist before and after dialysis, despite an increase in EF (58.8 ± 13.7 vs 61.2 ± 13.6; p = 0.02) following dialysis. Conclusion Unlike EF, the components of twist are relatively independent of changes in haemodynamic load seen during dialysis. The decrease in apical rotation may represent an early marker of cardiac pathology in the late-stage CKD patient.
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Affiliation(s)
- Anthony Yip
- Division of Cardiology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Saraladevi Naicker
- Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ferande Peters
- Division of Cardiology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elena Libhaber
- Division of Cardiology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nirvathi Maharaj
- Division of Cardiology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mduduzi Mashabane
- Division of Nephrology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mohammed Rafique Essop
- Division of Cardiology, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Yoon JH, Han D, Kim S, Cho IJ, Sung JM, Lee J, Ryoo H, Shim CY, Hong GR, Chang HJ. Assessment of multidirectional movements of the common carotid artery in atherothrombotic stroke using dimensional speckle tracking carotid ultrasonography: A prospective, controlled cohort study. Echocardiography 2018; 35:957-964. [PMID: 29600550 DOI: 10.1111/echo.13881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM We aimed to explore the relevance of multidirectional movements of the common carotid artery in atherothrombotic stroke. METHODS AND RESULTS We prospectively enrolled 69 patients with atherothrombotic stroke (stroke group) and 69 age-matched and sex-matched controls (control group) who underwent carotid ultrasonography. Based on the speckle tracking technique, circumferential and radial movements of the common carotid artery were analyzed from transverse and longitudinal B-mode images of the common carotid artery. Peak longitudinal and radial displacements, strain, and strain rate were measured. Mean age of the overall population was 64 ± 11 years, and 57% (78 patients) were men. In the transverse image, circumferential strain was significantly lower in the stroke group than in the control group (5.6 ± 1.6 vs 4.2 ± 1.7, P < .001). In multivariate logistic regression analysis, circumferential strain was independently associated with stroke (odds ratio: 0.60, P = .001). Compared with conventional risk factors, as well as carotid intima-media thickness and carotid plaque, the addition of a strain parameter appeared to improve discrimination of a stroke event (area under the receiver operating characteristic curve: 0.65 and 0.75 vs 0.84, respectively; P < .05 for both). CONCLUSIONS Circumferential strain of the common carotid artery might serve as a novel surrogate marker of atherothrombotic stroke. Multidirectional strain imaging of the common carotid artery may provide more information than conventional carotid ultrasonography and identify clinical risk factors for risk stratification of an acute stroke event.
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Affiliation(s)
- Ji Hyun Yoon
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Donghee Han
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Sujin Kim
- Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - In-Jeong Cho
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea
| | - Ji Min Sung
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyong Lee
- Medical Imaging Research Group, Samsung Medison, Seoul, Korea
| | - Hojin Ryoo
- Medical Imaging Research Group, Samsung Medison, Seoul, Korea
| | - Chi Young Shim
- Cardiology Division, Department of Internal Medicine, Seoul, Korea
| | - Geu-Ru Hong
- Cardiology Division, Department of Internal Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Cardiology Division, Department of Internal Medicine, Seoul, Korea.,Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
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Streese L, Deiseroth A, Schäfer J, Schmidt-Trucksäss A, Hanssen H. Exercise, Arterial Crosstalk-Modulation, and Inflammation in an Aging Population: The ExAMIN AGE Study. Front Physiol 2018. [PMID: 29515458 PMCID: PMC5826378 DOI: 10.3389/fphys.2018.00116] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Age is a key determinant for the development of cardiovascular disease and higher age coincides with an increased prevalence of obesity and physical inactivity. The study examines the influence of physical activity on aging processes of physiological systems focusing on the mechanisms of vascular aging. Methods/Design: The study consists of two parts. The cross-sectional approach aims at examining the association of physical fitness and cardiovascular risk with large and small artery function in healthy older active (HOA, n = 40) and sedentary (HOS, n = 40) persons as well as older sedentary individuals with increased cardiovascular risk (OSR, n = 80) aged 50–80 years. In the interventional approach, the OSR group is randomized into a 12-week walking-based high intensity interval training (HIIT) group or a control condition, aiming at examining the effects of HIIT on arterial function in diseased older adults. Active lifestyle is defined as >9 metabolic equivalent of task (MET) per week and sedentary as ≤3 MET/week. Inclusion criteria for OSR are overweight or obesity (body mass index ≥30 kg/m2) plus at least one additional cardiovascular risk factor. The primary outcome is arterial stiffness as determined by aortic pulse wave velocity (PWV). The secondary outcomes are retinal arterial and venous diameters. Further cardiovascular assessments include peripheral PWV, central haemodynamics, retinal endothelial function, carotid intima media thickness, cardiac strain and diastolic function as well as autonomic function and inflammation. Physical fitness is measured by a treadmill-based spiroergometry to determine peak oxygen uptake. Discussion: The aim of the study is to demonstrate the importance of and need for specific physical activity programs for seniors to achieve healthier aging as a long-term goal. Vascular function defines disease- and age-related end organ damage and represents the potential to contain health at older age. This research will identify cardiovascular biomarkers that best resemble underlying cardiovascular risk in age and disease. The integrated approach will help define new recommendations for treatment guidance of exercise therapy in an aging population. ClinicalTrials. gov: NCT02796976; registered 02 June 2016 (retrospectively registered).
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Affiliation(s)
- Lukas Streese
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Arne Deiseroth
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Juliane Schäfer
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Chahine MN, Topouchian J, Zelveian P, Hakobyan Z, Melkonyan A, Azaki A, Diab R, Harb A, Asmar R. Validation of BP devices QardioArm ® in the general population and Omron M6 Comfort ® in type II diabetic patients according to the European Society of Hypertension International Protocol (ESH-IP). MEDICAL DEVICES-EVIDENCE AND RESEARCH 2017; 11:11-20. [PMID: 29343992 PMCID: PMC5749560 DOI: 10.2147/mder.s142126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Following the European Society of Hypertension International Protocol (ESH-IP) Revision 2010, QardioArm® and Omron M6 Comfort IT® oscillometric devices were evaluated in the general population and in patients with type II diabetes, respectively, for self-blood pressure (BP) measurement. METHODS Both devices, QardioArm® and Omron M6 Comfort®, measure BP at the brachial level. The ESH-IP Revision 2010 includes a total number of 33 subjects. For each measure, the difference between observer and device BP values was calculated. In all, 99 pairs of BP differences are classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely. RESULTS QardioArm® and Omron M6 Comfort® fulfilled the requirements of the ESH-IP and passed the validation process successfully. For QardioArm®, a total of 69 out of 99 comparisons for systolic blood pressure (SBP) showed an absolute difference within 5 mmHg and 82 out of 99 for diastolic blood pressure (DBP). As for Omron M6 Comfort®, a total of 83 out of 99 comparisons for SBP showed an absolute difference within 5 mmHg and 77 out of 99 for DBP. The mean differences between the device and mercury readings were 0.7±5.9 mmHg for SBP and 0.3±4.1 mmHg for DBP for QardioArm® and -1.4±4.7 mmHg for SBP and -2.1±4.3 mmHg for DBP for Omron M6 Comfort®. With regard to part 2 of ESH-IP 2010, 27 out of 33 subjects had a minimum of two out of three measurements within 5 mmHg difference for SBP and 31 out of 33 subjects for DBP for the QardioArm®, and 29 out of 33 patients had a minimum of two out of three measurements within 5 mmHg difference for SBP and 26 out of 33 patients for DBP for Omron M6 Comfort®. CONCLUSION QardioArm® and Omron M6 Comfort® readings differing from the mercury standard by <5, 10, and 15 mmHg fulfill the ESH-IP Revision 2010 requirements. Consequently, these two devices are suitable for use in the general population and non-insulin-dependent type II diabetic patients, respectively.
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Affiliation(s)
- Mirna N Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes (F-MRI), Beirut, Lebanon
| | - Jirar Topouchian
- Preventive Cardiology Center, Yerevan, Armenia
- Diagnostic Center, Hotel-Dieu Hospital, Paris, France
| | | | | | | | - Alaa Azaki
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Reem Diab
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Aya Harb
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Roland Asmar
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes (F-MRI), Beirut, Lebanon
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40
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Bunsawat K, Ranadive SM, Lane-Cordova AD, Yan H, Kappus RM, Fernhall B, Baynard T. The effect of acute maximal exercise on postexercise hemodynamics and central arterial stiffness in obese and normal-weight individuals. Physiol Rep 2017; 5:5/7/e13226. [PMID: 28364031 PMCID: PMC5392516 DOI: 10.14814/phy2.13226] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/03/2017] [Accepted: 03/05/2017] [Indexed: 12/11/2022] Open
Abstract
Central arterial stiffness is associated with incident hypertension and negative cardiovascular outcomes. Obese individuals have higher central blood pressure (BP) and central arterial stiffness than their normal‐weight counterparts, but it is unclear whether obesity also affects hemodynamics and central arterial stiffness after maximal exercise. We evaluated central hemodynamics and arterial stiffness during recovery from acute maximal aerobic exercise in obese and normal‐weight individuals. Forty‐six normal‐weight and twenty‐one obese individuals underwent measurements of central BP and central arterial stiffness at rest and 15 and 30 min following acute maximal exercise. Central BP and normalized augmentation index (AIx@75) were derived from radial artery applanation tonometry, and central arterial stiffness was obtained via carotid‐femoral pulse wave velocity (cPWV) and corrected for central mean arterial pressure (cPWV/cMAP). Central arterial stiffness increased in obese individuals but decreased in normal‐weight individuals following acute maximal exercise, after adjusting for fitness. Obese individuals also exhibited an overall higher central BP (P < 0.05), with no exercise effect. The increase in heart rate was greater in obese versus normal‐weight individuals following exercise (P < 0.05), but there was no group differences or exercise effect for AIx@75. In conclusion, obese (but not normal‐weight) individuals increased central arterial stiffness following acute maximal exercise. An assessment of arterial stiffness response to acute exercise may serve a useful detection tool for subclinical vascular dysfunction.
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Affiliation(s)
- Kanokwan Bunsawat
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | | | - Abbi D Lane-Cordova
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Huimin Yan
- Department of Exercise and Health Sciences University of Massachusetts Boston, Boston, Massachusetts
| | - Rebecca M Kappus
- Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina
| | - Bo Fernhall
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Tracy Baynard
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
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Yugar LBT, Moreno B, Moreno H, Vilela-Martin JF, Yugar-Toledo JC. Do thiazide diuretics reduce central systolic blood pressure in hypertension? J Clin Hypertens (Greenwich) 2017; 20:133-135. [PMID: 29106774 DOI: 10.1111/jch.13134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Lara B T Yugar
- Botucatu School of Medicine/São Paulo State University (FMB/UNESP), Botucatu, Brazil
| | - Beatriz Moreno
- Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Heitor Moreno
- Section of Cardiovascular Pharmacology and Hypertension, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - José F Vilela-Martin
- Department of Internal Medicine, Hypertension Clinic, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil
| | - Juan C Yugar-Toledo
- Department of Internal Medicine, Hypertension Clinic, State Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil
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Baldo MP, Cunha RS, Ribeiro ALP, Lotufo PA, Chor D, Barreto SM, Bensenor IM, Pereira AC, Mill JG. Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA-Brasil Study. J Am Heart Assoc 2017. [PMID: 28637779 PMCID: PMC5669170 DOI: 10.1161/jaha.117.005477] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Black people have a higher risk of developing hypertension and presenting higher vascular stiffening. Our aim was to investigate whether the association between race and aortic stiffness could be explained by differences in the primary risk factors. Methods and Results We analyzed data from 11 472 adults (mean age, 51.9±8.9; 53.8% female) self‐reported as white (n=6173), brown (n=3364), or black (n=1935). Their carotid‐to‐femoral pulse wave velocity (cf‐PWV) as well as clinical and anthropometric parameters were measured. cf‐PWV was higher in blacks than in whites or browns (men: white, 9.63±1.81; brown, 9.63±1.88; black, 9.98±1.99; women: white, 8.84±1.64; brown, 9.02±1.68; black, 9.34±1.91; P<0.05). However, this difference disappeared after adjustments for age, mean arterial pressure, heart rate, waist circumference, fasting glucose, and glomerular filtration rate (men: white, 9.68±1.54; brown, 9.68±1.50; black, 9.73±1.52; women: white, 8.93±1.32; brown, 8.98±1.29; black, 9.02±1.32; P>0.05). The association between race and arterial stiffness was significant for brown and black women in the highest cf‐PWV quartile, even after controlling for covariates. There were no differences in the age‐related increase in cf‐PWV among the racial groups after adjustment, confirming the strong effect of age and mean arterial pressure on cf‐PWV revealed by the multiple linear regression. Conclusions Racial differences in cf‐PWV were mainly attributed to differences in mean arterial pressure and age, although they cannot fully explain the association between race and cf‐PWV in women in the highest cf‐PWV values. This suggests that therapeutic approaches to overcome the effects of aging on the vascular system should focus on blood pressure control, especially in the black population.
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Affiliation(s)
- Marcelo P Baldo
- Department of Pathophysiology, Montes Claros State University, Montes Claros, MG, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Antônio L P Ribeiro
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Dora Chor
- Escola Nacional de Saúde Pública Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandhi M Barreto
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | | | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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BAYKARA M, GÜNDOĞDU SEÇEN Ö. The comparison of the effects of the cilostazol on the stiffness parameters in different arterial systems in the patients with peripheral arterial disease. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2017. [DOI: 10.17517/ksutfd.205501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Maksuti E, Bini F, Fiorentini S, Blasi G, Urban MW, Marinozzi F, Larsson M. Influence of wall thickness and diameter on arterial shear wave elastography: a phantom and finite element study. Phys Med Biol 2017; 62:2694-2718. [DOI: 10.1088/1361-6560/aa591d] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Fernandes LAB, Cestario EDES, Cosenso-Martin LN, Vilela-Martin JF, Yugar-Toledo JC, Fuchs FD. Chlorthalidone Plus Amiloride Reduces the Central Systolic Blood Pressure in Stage 1 Hypertension Patients. Cardiol Res 2017; 7:196-201. [PMID: 28197292 PMCID: PMC5295510 DOI: 10.14740/cr481w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hypertension reduction strategies use blood pressure in the brachial artery as the primary endpoint. Individuals who achieve the target blood pressure reduction with antihypertensive treatment have residual cardiovascular risk attributed to the difference in pressure between the aorta and brachial artery. Antihypertensive treatment affects the intrinsic properties of the vascular wall and arterial stiffness markers and consequently the central pressure. Recent publications stress the importance of adequate control of the central compared to peripheral blood pressure. Related clinical implications suggest that individuals with normal peripheral but high central blood pressure should not receive antihypertensive drugs that act on the central pressure. Therefore, they are at greater cardiovascular risk. The aim of the study was to evaluate the effect of treatment with a thiazide diuretic versus losartan on the central blood pressure in stage 1 hypertensive patients. METHODS Twenty-five patients were randomized to the chlorthalidone 25 mg/amiloride 5 mg group (q.d.) and 25 patients received losartan 50 mg (b.i.d). The central systolic blood pressure (CSBP) and augmentation index (AIx 75) were assessed using applanation tonometry. The paired t-test was used to compare the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), CSBP and AIx 75 between the thiazide and losartan groups at baseline and after 6 months of treatment. RESULTS Significant reductions in CSBP (123.3 ± 14.2 vs. 113.4 ± 111.4, P = 0.0103) and AIx 75 (87.7 ± 9.6 vs. 83.8 ± 8.9, P = 0.0289) were observed after 6 months of drug treatment with chlorthalidone 25 mg/amiloride 5 mg (q.d.). The administration of losartan 50 mg (b.i.d) did not reduce the CSBP and there were insignificant changes in the AIx 75. CONCLUSIONS Six-month treatment of chlorthalidone/amiloride but not losartan reduces the CSBP and AIx 75 in adults with stage 1 hypertension.
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Affiliation(s)
| | | | - Luciana Neves Cosenso-Martin
- Endocrinology Division of the Internal Medicine Department, State Medical School of Sao Jose Rio Preto, SP (FAMERP), Brazil
| | - Jose Fernando Vilela-Martin
- Hypertension Clinic, Department of Internal Medicine, State Medical School of Sao Jose do Rio Preto (FAMERP), Sao Paulo, Brazil
| | - Juan Carlos Yugar-Toledo
- Hypertension Clinic, Department of Internal Medicine, State Medical School of Sao Jose do Rio Preto (FAMERP), Sao Paulo, Brazil
| | - Flavio Danni Fuchs
- Division of Cardiology, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Widman E, Maksuti E, Amador C, Urban MW, Caidahl K, Larsson M. Shear Wave Elastography Quantifies Stiffness in Ex Vivo Porcine Artery with Stiffened Arterial Region. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2423-2435. [PMID: 27425151 DOI: 10.1016/j.ultrasmedbio.2016.05.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/17/2016] [Accepted: 05/31/2016] [Indexed: 06/06/2023]
Abstract
Five small porcine aortas were used as a human carotid artery model, and their stiffness was estimated using shear wave elastography (SWE) in the arterial wall and a stiffened artery region mimicking a stiff plaque. To optimize the SWE settings, shear wave bandwidth was measured with respect to acoustic radiation force push length and number of compounded angles used for motion detection with plane wave imaging. The mean arterial wall and simulated plaque shear moduli varied from 41 ± 5 to 97 ± 10 kPa and from 86 ± 13 to 174 ± 35 kPa, respectively, over the pressure range 20-120 mmHg. The results revealed that a minimum bandwidth of approximately 1500 Hz is necessary for consistent shear modulus estimates, and a high pulse repetition frequency using no image compounding is more important than a lower pulse repetition frequency with better image quality when estimating arterial wall and plaque stiffness using SWE.
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Affiliation(s)
- Erik Widman
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden.
| | - Elira Maksuti
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Carolina Amador
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Matthew W Urban
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, USA; Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Matilda Larsson
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
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Nandlall SD, Konofagou EE. Assessing the Stability of Aortic Aneurysms with Pulse Wave Imaging. Radiology 2016; 281:772-781. [PMID: 27276242 DOI: 10.1148/radiol.2016151407] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose To assess whether the stability of murine aortic aneurysms is associated with the homogeneity of pulse wave propagation within the saccular wall. Materials and Methods All animal procedures were approved by the institutional Animal Care and Use Committee. Apolipoprotein E and tissue inhibitor of metalloproteinases-1 knockout mice (n = 26) were infused with angiotensin II by using subcutaneously implanted osmotic pumps, with an additional control mouse used for histologic examination (n = 1). Pulse wave imaging (PWI) was performed just before infusion and 15 days after infusion by using 40-MHz ultrasonography at 8000 frames per second (with electrocardiographic gating). Aneurysm appearance on B-mode images was monitored every 2-3 days for 30 days. On the basis of B-mode images obtained after 30 days, aneurysms were deemed to have been unstable if they had ruptured; otherwise, they were deemed stable. Statistical significance was assessed by using two-tailed t tests. Results In normal aortas, the pulse waves propagated at relatively constant velocities (mean ± standard deviation, 2.8 m/sec ± 0.9). Fifteen days after infusion, all mice had developed aneurysms, with significant (P < .001/12) changes in maximum anterior-posterior diameter (increase of 54.9% ± 2.5) and pulse wave velocity (PWV) (decrease of 1.3 m/sec ± 0.8). While there was no significant difference in these parameters (P = .45 for diameter and P = .55 for PWV) between stable aneurysms (n = 12) and unstable aneurysms (n = 14), the standard deviation of the high-resolution PWV was significantly higher (P < .001/12) in unstable aneurysms (5.7 m/sec ± 1.6) than in stable ones (3.2 m/sec ± 0.9). Conclusion High-resolution PWI was used to measure the local homogeneity of pulse wave propagation within the saccular wall, which is lower in unstable aneurysms than in stable ones. Hence, if proven to add additional information beyond size and appearance in human studies, PWI could potentially be used to assess the stability of aneurysms by providing information that is complementary to the anatomic data obtained with conventional B-mode imaging. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Sacha D Nandlall
- From the Departments of Biomedical Engineering (S.D.N., E.E.K.) and Radiology (E.E.K.), Columbia University, 1210 Amsterdam Ave, ET 351, MC 8904, New York, NY 10027
| | - Elisa E Konofagou
- From the Departments of Biomedical Engineering (S.D.N., E.E.K.) and Radiology (E.E.K.), Columbia University, 1210 Amsterdam Ave, ET 351, MC 8904, New York, NY 10027
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The simulation of magnetic resonance elastography through atherosclerosis. J Biomech 2016; 49:1781-1788. [PMID: 27130475 DOI: 10.1016/j.jbiomech.2016.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 04/07/2016] [Accepted: 04/09/2016] [Indexed: 11/23/2022]
Abstract
The clinical diagnosis of atherosclerosis via the measurement of stenosis size is widely acknowledged as an imperfect criterion. The vulnerability of an atherosclerotic plaque to rupture is associated with its mechanical properties. The potential to image these mechanical properties using magnetic resonance elastography (MRE) was investigated through synthetic datasets. An image of the steady state wave propagation, equivalent to the first harmonic, can be extracted directly from finite element analysis. Inversion of this displacement data yields a map of the shear modulus, known as an elastogram. The variation of plaque composition, stenosis size, Gaussian noise, filter thresholds and excitation frequency were explored. A decreasing mean shear modulus with an increasing lipid composition was identified through all stenosis sizes. However the inversion algorithm showed sensitivity to parameter variation leading to artefacts which disrupted both the elastograms and quantitative trends. As noise was increased up to a realistic level, the contrast was maintained between the fully fibrous and lipid plaques but lost between the interim compositions. Although incorporating a Butterworth filter improved the performance of the algorithm, restrictive filter thresholds resulted in a reduction of the sensitivity of the algorithm to composition and noise variation. Increasing the excitation frequency improved the techniques ability to image the magnitude of the shear modulus and identify a contrast between compositions. In conclusion, whilst the technique has the potential to image the shear modulus of atherosclerotic plaques, future research will require the integration of a heterogeneous inversion algorithm.
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Fu X, Huang C, Wong KS, Chen X, Gao Q. A New Method for Cerebral Arterial Stiffness by Measuring Pulse Wave Velocity Using Transcranial Doppler. J Atheroscler Thromb 2016; 23:1004-10. [PMID: 27052663 DOI: 10.5551/jat.33555] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Pulse wave velocity (PWV) has been regarded as the "gold standard" measurement of arterial stiffness (AS), but it is still only used in the assessment of central and peripheral arteries. We constructed a new method to evaluate cerebral AS by measuring PWV using transcranial Doppler (TCD). METHODS In all, 90 healthy subjects who received annual health screening were consecutively enrolled in this study between January 2011 and June 2013. Data on clinical characteristics, brachium-ankle (ba) PWV, and carotid-cerebral (cc) PWV measured with our newly constructed method by two experienced operators were recorded. cc PWV was calculated as the distance between two points in the common carotid artery and proximal part of ipsilateral middle cerebral artery, which was divided by the pulse transit time between these two points where the pulse was measured using TCD. RESULTS The value of cc PWV was 499.3±78.6 cm/s. Correlation between cc PWV and ba PWV in the assessment of AS was r=0.794 (P<0.001). The concordance between both the above mentioned methods was good. Interobserver and intraobserver reliability using interclass correlation for measuring cc PWV were 0.815 (P<0.001) and 0.939 (P<0.001), respectively. In multivariable analysis, older age (β=4.51, P<0.001) and increased diastolic blood pressure (β=2.39, P<0.001) were independently associated with higher cc PWV. CONCLUSION cc PWV measured using TCD may be a promising method for the assessment of human cerebral AS, which is independently associated with age and diastolic blood pressure.
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Affiliation(s)
- Xian Fu
- Institute of Neuroscience, the Second Affiliated Hospital of Guangzhou Medical University
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Melo X, Fernhall B, Santos DA, Pinto R, Pimenta NM, Sardinha LB, Santa-Clara H. The acute effect of maximal exercise on central and peripheral arterial stiffness indices and hemodynamics in children and adults. Appl Physiol Nutr Metab 2016; 41:266-76. [PMID: 26842667 DOI: 10.1139/apnm-2015-0204] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η(2) = 0.394) increased more in adults after exercise (p < 0.05). Compliance (η(2) = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η(2) = 0.115) but apparently only in those with small MAP changes (η(2) = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults.
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Affiliation(s)
- Xavier Melo
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
| | - Bo Fernhall
- b College of Applied Health Sciences, University of Illinois at Chicago, 808 South Wood Street, CMET 169, MC 518, Chicago, IL 60612, USA
| | - Diana A Santos
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
| | - Rita Pinto
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
| | - Nuno M Pimenta
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal.,c Sport Sciences School of Rio Maior - Polytechnic Institute of Santarem, Health and Fitness, Av. Dr. Mário Soares, 2040-413 Rio Maior, Portugal
| | - Luís B Sardinha
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
| | - Helena Santa-Clara
- a Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
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