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Mobadersany N, Liang P, Kemper P, Konofagou EE. Polyvinyl Alcohol Phantoms With Heterogeneous Plaques: Estimation of Pulse Wave Velocity at the Stenotic Region Using Pulse Wave Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:91-98. [PMID: 37838523 PMCID: PMC11102764 DOI: 10.1016/j.ultrasmedbio.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE Plaque characterization is essential for stroke prevention. In the study reported herein, we describe a heterogeneous phantom manufacturing technique with varying plaque compositions of different stiffness using polyvinyl alcohol (PVA) to emulate stenotic arteries and evaluated the use of pulse wave imaging (PWI) to assess plaque stiffness by comparing derived pulse wave velocities, with the goal of assessing plaque vulnerability and identifying high-risk patients for stroke. METHODS Five stenotic phantoms (50% stenosis) were fabricated by pouring PVA solutions into 3-D-printed molds. Two of the phantoms had heterogeneous plaque compositions of soft (E0 = 13 kPa) and intermediate (E0 = 40 kPa) materials and of stiff (E0 = 54 kPa) and intermediate materials. Ultrasound sequences were acquired as the arterial phantoms were connected to a pulsating pump, and PWI was performed on the ultrasound acquisition using normalized cross-correlation to track the pulse-induced phantom wall distension propagations. Pulse wave velocities were estimated by fitting a linear regression line between the arrival time of the peak acceleration of the wall distension waveform and the corresponding location. RESULTS Arterial phantoms with heterogeneous plaque stiffness were successfully fabricated. Pulse wave velocities of 2.06, 2.21, 2.49, 2.67 and 3.31 m/s were found in the phantom experiments using PWI for homogeneous soft plaque, the heterogeneous soft and intermediate plaque, homogeneous intermediate plaque, the heterogeneous stiff and intermediate plaque and homogeneous stiff plaque, respectively. CONCLUSION A novel arterial phantom building technique was reported with varying heterogenous plaque compositions of different stiffness. The feasibility of using PWI to evaluate plaque stiffness in stenotic arteries was determined and found that PWI can distinguish between plaques of distinct stiffness and composition.
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Affiliation(s)
- Nima Mobadersany
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Pengcheng Liang
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Paul Kemper
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY, USA; Department of Radiology, Columbia University, New York, New York, NY, USA.
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Corral P, Aguilar Salinas CA, Matta MG, Zago V, Schreier L. Stratification in Heterozygous Familial Hypercholesterolemia: Imaging, Biomarkers, and Genetic Testing. Curr Atheroscler Rep 2023; 25:899-909. [PMID: 37921916 DOI: 10.1007/s11883-023-01160-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE OF REVIEW Heterozygous familial hypercholesterolemia (HeFH) is the most common monogenic autosomal dominant disorder. However, the condition is often underdiagnosed and undertreated. The objective of this review is to provide an update on the risk stratification in patients with HeFH, incorporating new cardiovascular imaging techniques, various biomarkers, and genetic studies. RECENT FINDINGS The diagnosis of HeFH places patients in a high cardiovascular risk category due to the increased incidence of premature atherosclerotic cardiovascular disease. However, the level of risk varies significantly among different individuals with HeFH. Achieving an optimal stratification of cardiovascular risk is crucial for establishing appropriate and accurate treatment and management strategies. Different new tools such as risk scores have emerged in recent years, aiding physicians in assessing the risk stratification for HeFH using imaging, biomarkers, and genetics. This review emphasizes that not all patients with HeFH face the same cardiovascular risk. By utilizing different assessment tools, we can identify those who require more intensive monitoring, follow-up, and treatment.
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Affiliation(s)
- Pablo Corral
- Universidad FASTA, Facultad de Medicina, Cátedra de Farmacología Especial y Toxicología, Mar del Plata, Argentina.
| | - Carlos A Aguilar Salinas
- Direction of Nutrition Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, México
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - María Gabriela Matta
- Universidad FASTA, Facultad de Medicina, Cátedra de Farmacología Especial y Toxicología, Mar del Plata, Argentina
| | - Valeria Zago
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Lab. de Lípidos y Aterosclerosis, Hospital de Clínicas. INFIBIOC-UBA, Buenos Aires, Argentina
| | - Laura Schreier
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Lab. de Lípidos y Aterosclerosis, Hospital de Clínicas. INFIBIOC-UBA, Buenos Aires, Argentina
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Mobadersany N, Meshram NH, Kemper P, Sise CV, Karageorgos GM, Liang P, Ateshian GA, Konofagou EE. Pulse wave imaging of a stenotic artery model with plaque constituents of different stiffnesses: Experimental demonstration in phantoms and fluid-structure interaction simulation. J Biomech 2023; 149:111502. [PMID: 36842406 PMCID: PMC10392770 DOI: 10.1016/j.jbiomech.2023.111502] [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: 08/08/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
Vulnerable plaques associated with softer components may rupture, releasing thrombotic emboli to smaller vessels in the brain, thus causing an ischemic stroke. Pulse Wave Imaging (PWI) is an ultrasound-based method that allows for pulse wave visualization while the regional pulse wave velocity (PWV) is mapped along the arterial wall to infer the underlying wall compliance. One potential application of PWI is the non-invasive estimation of plaque's mechanical properties for investigating its vulnerability. In this study, the accuracy of PWV estimation in stenotic vessels was investigated by computational simulation and PWI in validation phantoms to evaluate this modality for assessing future stroke risk. Polyvinyl alcohol (PVA) phantoms with plaque constituents of different stiffnesses were designed and constructed to emulate stenotic arteries in the experiment, and the novel fabrication process was described. Finite-element fluid-structure interaction simulations were performed in a stenotic phantom model that matched the geometry and parameters of the experiment in phantoms. The peak distension acceleration of the phantom wall was tracked to estimate PWV. PWVs of 2.57 ms-1, 3.41 ms-1, and 4.48 ms-1 were respectively obtained in the soft, intermediate, and stiff plaque material in phantoms during the experiment using PWI. PWVs of 2.10 ms-1, 3.33 ms-1, and 4.02 ms-1 were respectively found in the soft, intermediate, and stiff plaque material in the computational simulation. These results demonstrate that PWI can effectively distinguish the mechanical properties of plaque in phantoms as compared to computational simulation.
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Affiliation(s)
- Nima Mobadersany
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Nirvedh H Meshram
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Paul Kemper
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - C V Sise
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | | | - Pengcheng Liang
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Gerard A Ateshian
- Department of Biomedical Engineering, Columbia University, New York, NY, United States; Department of Mechanical Engineering, Columbia University, New York, NY, United States
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY, United States; Department of Radiology, Columbia University, New York, New York, NY, United States.
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Liu B, Gao L, Zheng B, Yang Y, Jia J, Sun P, Jiang Y, Li K, Liu J, Chen C, Li J, Fan F, Zhang Y, Huo Y. Comparison of carotid-femoral and brachial-ankle pulse wave velocity in association with carotid plaque in a Chinese community-based population. J Clin Hypertens (Greenwich) 2022; 24:1568-1576. [PMID: 36428228 PMCID: PMC9731589 DOI: 10.1111/jch.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/28/2022]
Abstract
Pulse wave velocity (PWV) is the most widely used measurement of arterial stiffness in clinical practice. This study aimed to evaluate and compare the relationships between carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle PWV (baPWV) and the presence of carotid plaque. This study was designed cross-sectionally and included 6027 participants from a community-based cohort in Beijing. Logistic regression analyses were performed to evaluate and compare the associations of cfPWV and baPWV with the presence of carotid plaque. The mean (SD) cfPWV and baPWV were 8.55 ± 1.83 and 16.79 ± 3.36, respectively. The prevalence of carotid plaque was 45.26% (n = 2728). Both cfPWV (per 1 m/s increase: OR = 1.11, 95% CI: 1.07-1.16) and baPWV (OR = 1.04, 95% CI: 1.02-1.06) were independently associated with carotid plaque after adjusting for various confounders. Compared with bottom quartile (cfPWV ≤7.31 m/s and baPWV ≤14.44 m/s), the top quartile of cfPWV and baPWV had a significantly higher prevalence of carotid plaque (for cfPWV: OR = 1.59, 95% CI: 1.32-1.92; for baPWV: OR = 1.53, 95% CI: 1.26-1.86). However, the relationship of baPWV and carotid plaque was nonlinear, with a positive trend only when baPWV < 16.85 m/s. When comparing relationships between PWV indices and carotid plaque in one model, both cfPWV and baPWV were significantly associated with carotid plaque in participants with baPWV < 16.85 m/s; however, only cfPWV was independently associated with carotid plaque in participants with baPWV ≥16.85 m/s. Both cfPWV and baPWV were significantly associated with carotid plaque in the Chinese community-based population. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV ≥16.85 m/s.
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Affiliation(s)
- Bo Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Lan Gao
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Bo Zheng
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Ying Yang
- Department of CardiologyPeking University First HospitalBeijingChina,Echocardiography Core LabInstitute of Cardiovascular Disease at Peking University First HospitalBeijingChina
| | - Jia Jia
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Pengfei Sun
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yimeng Jiang
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Kaiyin Li
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jiahui Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Chuyun Chen
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jianping Li
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Fangfang Fan
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yan Zhang
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
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Cai WB, Wang Y, Wang J, Guo WG, Duan YY, Zhang L. Preliminary study of carotid variables under ultrasound analysis as predictors for the risk of coronary arterial atherosclerosis. Echocardiography 2022; 39:1054-1063. [PMID: 35781700 PMCID: PMC9544001 DOI: 10.1111/echo.15404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 12/01/2022] Open
Abstract
Background Carotid atherosclerosis by ultrasound scanning can be considered as an ideal window to reflect systemic artery atherosclerosis, which has aroused wide concern for predicting the severity of coronary artery atherosclerosis clinically. Ultrasound radio frequency (RF) data technology has enabled us to evaluate the carotid structure and elastic function precisely, for predicting the severity of coronary artery atherosclerosis. Methods Patients with suspected coronary artery disease (CAD) underwent coronary angiography and were assigned to four groups according to whether atherosclerotic plaque was found or not and it caused stenosis. Carotid artery intima‐media thickness (IMT) and arterial stiffness were investigated by quality intima‐media thickness (QIMT) and quality arterial stiffness (QAS) techniques during ultrasound scanning. Univariable and multivariable modeling were used to investigate correlations of carotid parameters to coronary artery atherosclerosis. Receive operating characteristic (ROC) curves were used to evaluate diagnostic performance of these ultrasound variables. Results Carotid IMT and stiffness variables pulse wave velocity (PWV), α, β and compliance coefficient (CC) were statistically different between every two‐group's comparisons. IMT correlated with stiffness variables significantly with r = 0.70, 0.77, 0.63, and −0.39, respectively. All variables correlated with the severity of coronary atherosclerosis with the odd ratio (OR) of 1.73, 1.67, 1.19, 1.23, and 0.56 accordingly as IMT, PWV, α, β and CC were concerned. The AUC of IMT, PWV, α, β and CC were 0.9257, 0.8910, 0.8016, 0.9383, 0.8581 with correctly classified rate of 88.16%, 83.77%, 78.07%, 86.84%, and 81.58%, respectively. Conclusions Carotid artery IMT and stiffness variable PWV, α, β and CC presented favorable predicting and differentiating values for patients with coronary atherosclerosis of different severity.
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Affiliation(s)
- Wen-Bin Cai
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Department of Ultrasound Diagnostics, General Hospital of Tibet Military Region, Lhasa, China
| | - Yi Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Disease Surveillance Division, Jiangsu International Travel Healthcare Center, Nanjing, China
| | - Jia Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wan-Gang Guo
- Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Yun-You Duan
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Li Zhang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
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Toscano A, Cinquegrani M, Scuruchi M, Di Pino A, Piro S, Ferrara V, Morace C, Lo Gullo A, Imbalzano E, Purrello F, Squadrito G, Scicali R, Mandraffino G. PCSK9 Plasma Levels Are Associated with Mechanical Vascular Impairment in Familial Hypercholesterolemia Subjects without a History of Atherosclerotic Cardiovascular Disease: Results of Six-Month Add-On PCSK9 Inhibitor Therapy. Biomolecules 2022; 12:biom12040562. [PMID: 35454151 PMCID: PMC9033040 DOI: 10.3390/biom12040562] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Proprotein convertase subtilisin/kexin type-9 (PCSK9) is a key regulator of low-density lipoprotein (LDL) metabolism involved in the degradation of the low-density lipoprotein receptor (LDLR) through complex mechanisms. The PCSK9 plasma levels change according to lipid lowering therapy (LLT). Few data exist regarding the role of PCSK9 in vascular damage. We aimed to evaluate the impact of PCSK9 plasma levels on pulse wave velocity (PWV) and the effect of PCSK9 inhibitors (PCSK9-i) on circulating PCSK9 and PWV in a cohort of heterozygous familial hypercholesterolemia (HeFH) subjects. In a previous step, HeFH patients were enrolled and LLT was prescribed according to guidelines. Biochemical analyses and PWV assessment were performed at baseline (T0), after 6 months of high-efficacy statin plus ezetimibe (T1) and after 6 months of PCSK9-i (T2). The PCSK9 levels were evaluated in 26 selected HeFH subjects at the three time points and 26 healthy subjects served as controls for the reference value for PCSK9 plasma levels. The PWV values decreased at each time point in HeFH subjects after LLT starting (8.61 ± 2.4 m/s, −8.7%; p < 0.001 vs. baseline at T1, and 7.9 ± 2.1 m/s, −9.3%; p < 0.001 vs. both T1 and baseline) and it was correlated to PCSK9 (r = 0.411, p = 0.03). The PCSK9 levels increased on statin/EZE therapy (+42.8% at T1) while it decreased after PCSK9-i was started (−34.4% at T2). We noted a significant relationship between PCSK9 levels and PWV changes at T1 and T2. In conclusion, PCSK9 levels were associated with baseline PWV values in HeFH subjects; moreover, we found that PCSK9 level variations seemed to be correlated with PWV changes on LLT. A longer observation time and wider sample size are needed to assess the potential role of PCSK9 plasma levels on the vascular function and remodelling, and to clarify the effects of PCSK9-i in these pathways.
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Affiliation(s)
- Arianna Toscano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Michele Scuruchi
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Carmela Morace
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS Garibaldi Hospital, 95122 Catania, Italy;
| | - Egidio Imbalzano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Giovanni Squadrito
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
- Correspondence:
| | - Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
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He D, Gao L, Yang Y, Jia J, Jiang Y, Sun P, Liu B, Li J, Fan F, Zhang Y, Huo Y. Brachial-ankle pulse wave velocity as a measurement for increased carotid intima-media thickness: A comparison with carotid-femoral pulse wave velocity in a Chinese community-based cohort. J Clin Hypertens (Greenwich) 2022; 24:409-417. [PMID: 35213771 PMCID: PMC8989757 DOI: 10.1111/jch.14448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/02/2023]
Abstract
Carotid‐femoral pulse wave velocity (cfPWV) and brachial‐ankle pulse wave velocity (baPWV) act as two most frequently applied indicators to evaluate arterial stiffness. Limited studies have systematically compared the relationships between cfPWV/baPWV and increased carotid intima‐media thickness (cIMT). This study aimed to investigate the associations of the two PWV indices with cIMT in a Chinese community‐based population. A total of 6026 Chinese participants from an atherosclerosis cohort were included in our analysis. Increased cIMT was defined as the maximum of cIMT > 0.9 mm in end‐systolic period of carotid artery. Mean (SD) cfPWV and baPWV were 8.55±1.83 and 16.79±3.35 m/s, respectively. The prevalence of increased cIMT was 59.58%. In multivariable logistic regression, both PWVs were independently associated with increased cIMT after adjustment for various confounders (for 1 m/s increase of cfPWV: OR = 1.07, 95% CI: 1.02‐1.11; for 1 m/s increase of baPWV: OR = 1.03, 95% CI: 1.00‐1.05). The highest cfPWV and baPWV quartile groups had higher prevalence of increased cIMT when compared with the lowest quartile groups (for cfPWV: OR = 1.28, 95% CI: 1.06‐1.55; for baPWV: OR = 1.23, 95% CI: 1.00‐1.50). However, when both PWVs were added into multivariable model simultaneously, only cfPWV was associated with odds of increased cIMT. Subgroup analyses further showed cfPWV was more strongly associated with increased cIMT than baPWV in males, participants aged ≥65 years, and those with other cardiovascular risk factors. In conclusion, both cfPWV and baPWV are associated with increased cIMT in a Chinese community‐based population. Furthermore, cfPWV is more strongly correlated with increased cIMT compared to baPWV.
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Affiliation(s)
- Danmei He
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Pengfei Sun
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bo Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
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Büber İ, Aykota MR, Sevgican Cİ, Adalı MK. The Effects of Laparoscopic Sleeve Gastrectomy on Cardiac Diastolic Function, Aortic Elasticity, and Atrial Electromechanics Delay. Obes Surg 2021; 31:3571-3578. [PMID: 33877507 DOI: 10.1007/s11695-021-05431-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Obesity is a well-known risk factor for cardiovascular diseases. The aim of this study was to prospectively investigate the short-term effects of laparoscopic sleeve gastrectomy (LSG) on cardiac functions. METHODS Forty-four morbidly obese patients who underwent LSG were included in the study. The aortic systolic and diastolic diameters, left ventricular (LV) diameter, LV cardiac output and cardiac index, LV ejection fraction, LV septal and lateral wall velocities, deceleration time of the E wave, the LA volume index and atrial mechanic functions, and atrial conduction times were evaluated. RESULTS The patients' aortic stiffness index showed a significant improvement at postoperative control: 3.23 ± 0.58, 2.49 ± 0.36; p<0.001 for preoperative and postoperative aortic stiffness index, respectively. A significant reduction was observed in the LV mass and relative wall thickness (RWT) of the patients: 182.41 ± 36.87 g, 154.85 ± 24.32 g; p<0.001 and 0.42 ± 0.07, 0.39 ± 0.05; p=0.010 for the preoperative and postoperative LV mass and RWT, respectively. A statistically significant decrease was observed in total atrial conduction time and interatrial and intraatrial conduction time in the postoperative period: 120.95 ± 22.27 ms, 106.57 ± 20.46 ms; p=0.001; 13.82 ± 8.21 ms, 10.66 ± 6.78 ms; p=0.038, and 29.64 ± 14.18 ms, 24.09 ± 10.95 ms; p=0.047 for preoperative and postoperative total atrial conduction time, intraatrial electromechanical delay, and interatrial electromechanical delay, respectively. CONCLUSIONS Weight loss reduced aortic stiffness, IVS and posterior wall thickness, LAV, LAVi, LA passive emptying fraction, and atrial electromechanical delays in morbidly obese patients.
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Affiliation(s)
- İpek Büber
- Department of Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Muhammed Rasid Aykota
- Department of General Surgery, Faculty of Medicine, Pamukkale University School of Medicine, Denizli, Turkey.
| | - Cihan İlyas Sevgican
- Department of Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Mehmet Koray Adalı
- Department of Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Barroso WKS, Melo MDA, Vitorino PV, Gonçalves C, Berigó JA, Arantes AC, Rezende J, Jardim TV, Souza ALL, Jardim PCV. Carotid Intima and Media Thickness Correlation with Central Blood Pressure Measurements by Tonometric and Oscillometric Methods: A Proof of Concept. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20190117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Del Brutto OH, Del Brutto VJ, Mera RM, Costa AF, Peñaherrera R, Peñaherrera E, Matcha G, Generale LM, Torpey AP, Peralta LD, Hill JP, Rundek T, Romano JG, Sedler MJ. The association between aortic arterial stiffness, carotid intima-media thickness and carotid plaques in community-dwelling older adults: A population-based study. Vascular 2020; 28:405-412. [PMID: 32228175 DOI: 10.1177/1708538120913738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Information on the associations among arterial stiffness, carotid intima-media thickness (cIMT) and carotid plaques as biomarkers of atherosclerosis is limited in diverse populations. We aimed to assess whether aortic pulse wave velocity (aPWV) - as a surrogate of arterial stiffness - is associated with increased cIMT and the presence of carotid plaques in a cohort of older adults of Amerindian ancestry. METHODS Atahualpa residents aged ≥60 years (n = 320) underwent aPWV determinations, and carotid ultrasounds for cIMT and plaque assessment. Multivariate models were fitted to assess the independent association between the aPWV, and cIMT and carotid plaques, after adjusting for relevant confounders. Differences in risk factors across these biomarkers were investigated. RESULTS Mean values of aPWV were 10.3 ± 1.8 m/s, and those of cIMT were 0.91 ± 0.21 mm (24% had a cIMT >1 mm). Carotid plaques were observed in 118 (37%) subjects. In univariate analyses, risk factors associated with an increased aPWV included age, female gender, poor physical activity and high blood pressure. An increased cIMT was associated with age, male gender, a poor diet, high blood pressure and severe tooth loss. The presence of carotid plaques was associated with increasing age, poor physical activity and high blood pressure. Multivariate models showed a significant association between aPWV and cIMT (β: 0.028; 95% C.I.: 0.001-0.056; p = 0.047) but not between aPWV and carotid plaques (OR: 1.14; 95% C.I.: 0.83-1.56; p = 0.423). CONCLUSIONS This study shows an independent association between aPWV and cIMT but not with carotid plaques. These biomarkers may indicate distinct phenotypes for atherosclerosis.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Victor J Del Brutto
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA
| | - Aldo F Costa
- Community Center, the Atahualpa Project, Atahualpa, Ecuador
| | | | | | - Gautam Matcha
- Internal Medicine Department, Mayo Clinic School of Medicine, Jacksonville, FL, USA
| | | | - Andrew P Torpey
- School of Medicine, Stony Brook University, New York, NY, USA
| | | | - John P Hill
- School of Medicine, Stony Brook University, New York, NY, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - José G Romano
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mark J Sedler
- School of Medicine, Stony Brook University, New York, NY, USA
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Harari F, Barregard L, Östling G, Sallsten G, Hedblad B, Forsgard N, Borné Y, Fagerberg B, Engström G. Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:127002. [PMID: 31808705 PMCID: PMC6957277 DOI: 10.1289/ehp5057] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce. OBJECTIVES Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrations and the prevalence of atherosclerotic plaque in the carotid artery. METHODS We used cross-sectional data from the Malmö Diet and Cancer Study cardiovascular cohort (MDCS-CC; recruitment in 1991-1994) covering 4,172 middle-aged men and women. B-Pb at baseline, measured by inductively coupled plasma mass spectrometry, was used as the exposure biomarker. The presence of atherosclerotic plaque in the carotid artery was determined by B-mode ultrasonography. We used logistic regression to estimate odds ratios (ORs) for prevalence of plaque in the carotid artery according to B-Pb quartiles. RESULTS The median B-Pb was 25μg/L (range: 1.5-258), and 36% of the cohort had any atherosclerotic plaque. After controlling for confounders and known cardiovascular risk factors, the OR for prevalence of plaque in the highest quartile (Q4) of B-Pb compared with the lowest quartile (Q1) was 1.35 (95% CI: 1.09, 1.66) in the total group, 1.58 (95% CI: 1.20, 2.08) among women, and 1.18 (95% CI: 0.83, 1.69) among men. Among women, associations were limited to those who were postmenopausal [OR for Q4 vs. Q1=1.72 (95% CI: 1.26, 2.34) vs. OR=0.96 (95% CI: 0.49, 1.89 in premenopausal women)]. Associations were weak and nonsignificant in never-smokers [OR for Q4 vs. Q1=1.14 (95% CI: 0.81, 1.61)]. DISCUSSION Our study shows an association between B-Pb concentrations and occurrence of atherosclerotic plaque in the carotid artery, adding evidence for an underlying pro-atherogenic role of lead in cardiovascular disease. Associations appeared to be limited to postmenopausal (vs. premenopausal) women. https://doi.org/10.1289/EHP5057.
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Affiliation(s)
- Florencia Harari
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Gerd Östling
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yan Borné
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
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12
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Li Q, Lin F, Ke D, Cheng Q, Gui Y, Zhou Y, Wu Y, Wang Y, Zhu P. Combination of Endoglin and ASCVD Risk Assessment Improves Carotid Subclinical Atherosclerosis Recognition. J Atheroscler Thromb 2019; 27:331-341. [PMID: 31406054 PMCID: PMC7192815 DOI: 10.5551/jat.50898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim: Our study investigated the association between soluble endoglin and carotid subclinical atherosclerosis. Methods: We used endoglin as an adjunct to atherosclerotic cardiovascular disease (ASCVD) risk, in recognition of carotid clinical atherosclerosis, in order to explore a new model to refine risk assessment. Out of 3,452 participants, 978 subjects with detected soluble endoglin were enrolled in a cross-sectional investigation in Fujian Province were enrolled. Soluble endoglin concentration in serum samples was evaluated using an enzyme-linked immunosorbent assay method. Carotid ultrasonography was used to detect intima-media thickness and carotid plaque. Results: The mean 10-year ASCVD risk by the new Pooled Cohort Equations accounted for 10.04% (± 12.35). The mean soluble endoglin level was 15.35 ng/ml (± 6.64). Multivariable regression demonstrated that age, systolic blood pressure, diastolic blood pressure, total cholesterol, high density lipoprotein cholesterol, and serum uric acid were independent determinants of soluble endoglin. Adding tests of ASCVD and endoglin together, in parallel, will increase the sensitivity and decrease specificity in recognizing carotid subclinical atherosclerosis. Evaluating the added value of endoglin to the ASCVD risk model showed significantly improved discrimination with analysis of C-statistics, continuous net reclassification index and integrated discrimination index. Both ASCVD risk and soluble endoglin showed positively linear correlation with carotid intima-media thickness (cIMT) (β = 0.006, P < 0.001; β = 0.485, P < 0.001). Even with adjustment for other factors, the relationship between log-transformed soluble endoglin with cIMT was still significant (β = 0.369, P < 0.001). Conclusions: The combination of ASCVD risk and endoglin levels increases carotid atherosclerosis recognition.
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Affiliation(s)
- Qiaowei Li
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Fan Lin
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Douli Ke
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Qiong Cheng
- Department of Neurology, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Shengli Clinical Medical College of Fujian Medical University
| | - Yongzhi Gui
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Yuyan Zhou
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Yicheng Wu
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
| | - Yinzhou Wang
- Department of Neurology, Fujian Provincial Hospital, Fujian Provincial Center for Geriatrics, Shengli Clinical Medical College of Fujian Medical University
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Institute of Clinical Geriatrics, Fujian Provincial Center for Geriatrics
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Tomiyama H. Is the Carotid Intima-Media Thickness a Reliable Predictor of Future Cardiovascular Events? J Atheroscler Thromb 2019; 27:6-7. [PMID: 31231082 PMCID: PMC6976718 DOI: 10.5551/jat.ed113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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14
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 DOI: 10.3389/fcvm.2019.00041/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 05/25/2023] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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15
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 PMCID: PMC6465321 DOI: 10.3389/fcvm.2019.00041] [Citation(s) in RCA: 207] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Differential Associations for Salivary Sodium, Potassium, Calcium, and Phosphate Levels with Carotid Intima Media Thickness, Heart Rate, and Arterial Stiffness. DISEASE MARKERS 2018; 2018:3152146. [PMID: 30647796 PMCID: PMC6311732 DOI: 10.1155/2018/3152146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Abstract
Salivary biomarkers may offer a noninvasive and easy sampling alternative in cardiovascular risk evaluation. The aim of the present study was to establish associations of salivary potassium, sodium, calcium, and phosphate levels with the cardiovascular phenotype determined by carotid ultrasound and carotid-femoral pulse wave velocity and to identify possible covariates for these associations. N = 241 samples of nonstimulated whole buccal saliva were obtained from subjects with (n = 143; 59%) or without (n = 98; 41%) hypertension. The potassium concentrations were 10-fold higher in saliva compared with plasma, whereas sodium concentrations exhibited the reverse relation between saliva and blood. There were no significant correlations between the levels of sodium, potassium, or calcium in saliva and plasma. All salivary electrolytes, except sodium, were significantly associated with age. In age-adjusted analyses, salivary potassium was significantly associated with carotid artery intima media thickness (cIMT) and carotid-femoral pulse wave velocity, and these associations were at the limit of significance in multivariate analyses including prevalent cardiovascular disease and risk factors. Body mass index was a significant confounder for salivary potassium. Salivary phosphate was significantly associated with cIMT in the multivariate analysis. Salivary potassium, calcium, and phosphate levels were significantly associated with heart rate in the univariate age-adjusted as well as in two different multivariate models, whereas no significant associations between sodium and heart rate were observed. In conclusion, the differential association of salivary electrolytes with cardiovascular phenotypes indicates that these electrolytes should be further studied for their predictive value as noninvasive biomarkers for cardiovascular risk evaluation.
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17
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Distinct factors are related to lower limb atherosclerosis in smokers and nonsmokers. J Hypertens 2018; 36:2390-2397. [DOI: 10.1097/hjh.0000000000001820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Wang X, Sheng L, Ye P, Cao R, Yang X, Xiao W, Zhang Y, Bai Y, Wu H. The association between Hepcidin and arterial stiffness in a community-dwelling population. Lipids Health Dis 2018; 17:244. [PMID: 30373612 PMCID: PMC6206657 DOI: 10.1186/s12944-018-0866-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background An association of hepcidin with cardiovascular (CV) disease and atherosclerosis has been reported in different patient groups. However, it has not been well described clinically the association between hepcidin and arterial stiffness. In this study,We analysed the possible mechanism of Hepcidin and arterial stiffness. Methods This article related measurements of plasma hepcidin and arterial stiffness (carotid–femoral pulse wave velocity [PWV]) in a community-based sample. Results After a median follow-up interval of 4.8 years, multiple linear regression analysis revealed that hepcidin was independently associated with carotid–femoral PWV (β = 1.498, P < 0.001). In a multivariable linear regression analysis, HDL3-C levels were negatively and independently associated with hepcidin at baseline (β = − 0.857, P = 0.024). HDL2-C was not associated with hepcidin at baseline (β = − 1.121, P = 0.133). Conclusions We found an association between baseline hepcidin and follow-up arterial stiffness that was independent of age, gender and other vascular risk factors. We also identified an association between hepcidin and HDL3-C at baseline, which indicates that the HDL3-C level may reflect the change in cholesterol efflux from peripheral arteries and partly explain the relationship between hepcidin and the change of arterial stiffness.
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Affiliation(s)
- Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Li Sheng
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China.
| | - Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Xu Yang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Wenkai Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Yun Zhang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
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Sumbul HE, Koc AS, Demirtas D. Increased carotid-femoral pulse wave velocity and common carotid artery intima-media thickness obtained to assess target organ damage in hypertensive patients are closely related. Clin Exp Hypertens 2018; 41:466-473. [PMID: 30141974 DOI: 10.1080/10641963.2018.1506471] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Increased carotid-femoral pulse wave velocity (CF-PWV) and increased carotid intima-media thickness (IMT) in hypertension (HT) patients are indicators of asymptomatic organ damage. The relationship between carotid IMT and CF-PWV has been shown; studies comparing CF-PWV and IMT values within different vascular regions are limited. We aimed to investigate the relationship between IMT value measured from different anatomical regions and CF-PWV, and the localization of IMT that determines increased CF-PWV best. METHODS This study included 312 patients with HT. CF-PWV measurements with Doppler ultrasonography (USG). Vascular IMTs were measurements of common-internal carotid, brachial, and femoral arteries with B-mode USG (CC-IMT, IC-IMT, B-IMT, and F-IMT, respectively). Patients were divided into two groups according to their CF-PWV value (Increased CF-PWV >10 m/s and normal CF-PWV ≤10m/s). RESULTS Increased CF-PWV was detected in 54 (17.3%) of HT patients. The patient group with increased CF-PWV was older, and their CC-IMT, IC-IMT and F-IMT values were found to be higher. The other 3 IMT increases excluding B-IMT were closely related to the CF-PWV increase. Only age and CC-IMT values were found to be most closely related to CF-PWV. CC-IMT and age were found to be independently associated with increased CF-PWV. CC-IMT (each-0.1 mm) and age (each year) were found to augment the development of increased CF-PWV by 50.3% and 14.6%, respectively. CONCLUSION There is a close relationship between CC-IMT and CF-PWV increase in HT. It was thought that it would still be more useful to look at the increase of CC-IMT compared to other vascular regions for screening asymptomatic organ damage.
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Affiliation(s)
- Hilmi Erdem Sumbul
- a Department of Internal Medicine , University of Health Sciences - Adana Health Practice and Research Center , Adana , Turkey
| | - Ayse Selcan Koc
- b Department of Radiology , University of Health Sciences - Adana Health Practice and Research Center , Adana , Turkey
| | - Derya Demirtas
- a Department of Internal Medicine , University of Health Sciences - Adana Health Practice and Research Center , Adana , Turkey
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Bian L, Xia L, Wang Y, Jiang J, Zhang Y, Li D, Li W, He Y. Risk Factors of Subclinical Atherosclerosis and Plaque Burden in High Risk Individuals: Results From a Community-Based Study. Front Physiol 2018; 9:739. [PMID: 29988372 PMCID: PMC6023999 DOI: 10.3389/fphys.2018.00739] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/28/2018] [Indexed: 12/16/2022] Open
Abstract
China is going through major change and the incidence of first-ever stroke has increased dramatically. In this study, we aim to determine the ultrasound characteristics of carotid intima-media thickness (CIMT) and carotid plaques (CP) in the Chinese community-based population with high risk of stroke. 1009 stroke-free participants from Datun community were classified at high risk of stroke and included in this cross-sectional study. We performed B-mode carotid ultrasound imaging in all of the study subjects to measure the CIMT in the common carotid artery (CCA) far wall and CP in the CCA, bifurcation and internal carotid artery. Stepwise logistic regression analyses were used to determine factors associated with elevated CIMT and subclinical atherosclerosis, as well as plaque burden (≥2 plaques). Our results showed that traditional risk factors including aging, hypertension, current smoking and the level of high density lipoprotein cholesterol are associated with subclinical atherosclerosis and plaque burden in high-risk community residents. To improve primary prevention in this population, we may consider intense blood pressure and lipid management, and smoking cessation.
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Affiliation(s)
- Lianduo Bian
- Department of General Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lili Xia
- Editorial Office of Hepatobiliary and Pancreatic Diseases International, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
| | - Yixin Wang
- Department of General Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiajia Jiang
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
| | - Yonghui Zhang
- Department of General Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dongxue Li
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Li
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
| | - Yan He
- Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China
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Cecelja M, Jiang B, Keehn L, Hussain T, Silva Vieira M, Phinikaridou A, Greil G, Spector TD, Chowienczyk P. Arterial stiffening is a heritable trait associated with arterial dilation but not wall thickening: a longitudinal study in the twins UK cohort. Eur Heart J 2018; 39:2282-2288. [PMID: 29590330 PMCID: PMC6012080 DOI: 10.1093/eurheartj/ehy165] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/15/2017] [Accepted: 03/07/2018] [Indexed: 01/19/2023] Open
Abstract
Aims Vascular ageing is characterized by arterial stiffening, dilation, and arterial wall thickening. We investigated the extent to which these changes are related and their heritability during 5 year follow-up in the Twins UK cohort. Methods and results Carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) were measured in 762 female twins (mean age 57.9 ± 8.6 years) at two time-points over an average follow-up of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWVaorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. Annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. In regression analysis, predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). Predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. Progression of PWV and distensibility correlated with progression in carotid diameter but not with IMT. Heritability of progression of PWVcf, diameter, and IMT was 55%, 21%, and 8%, respectively. In a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWVaorta. Conclusion Arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. Genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.
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Affiliation(s)
- Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Benyu Jiang
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Tarique Hussain
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Miguel Silva Vieira
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Alkystis Phinikaridou
- Division of Imaging Sciences and Biomedical Engineering, King’s College London, St Thomas’ Hospital, London, UK
| | - Gerald Greil
- Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital, Lambeth Palace Road, London, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital, Lambeth Palace Road, London, UK
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Iorgoveanu C, Zaghloul A, Desai A, Krishnan AM, Balakumaran K. Bilateral Earlobe Crease as a Marker of Premature Coronary Artery Disease. Cureus 2018; 10:e2616. [PMID: 30027008 PMCID: PMC6044484 DOI: 10.7759/cureus.2616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Cardiovascular diseases, including heart disease and stroke, are the world’s largest killers. More than 800,000 people die from cardiovascular disease each year in the United States (US). Heart disease is estimated to cost 200 billion US Dollars (USD) annually. Early identification of an inexpensive marker which allows for early intervention is the need of the hour. We present a case describing one such marker which can be easily appreciated on physical examination. Several studies have shown, not only the association between the presence of the diagonal earlobe crease (DELC) and coronary artery disease (CAD) but also a correlation with the extent and severity of CAD, independent of cardiovascular risk factors. Our patient who had no known CAD or risk factors presented with an acute coronary syndrome (ACS). On exam, he was noted to have bilateral DELC. Over the course of his workup, he was noted to have severe triple vessel disease and eventually underwent surgical revascularization. We seek to increase awareness of this valuable physical sign which has far-reaching consequences in the prognostication and risk stratification of patients.
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Affiliation(s)
- Corina Iorgoveanu
- Internal Medicine, University of Connecticut Health Center, Farmington, USA
| | - Ahmed Zaghloul
- Internal Medicine, University of Connecticut Health Center, Farmington, USA
| | - Aakash Desai
- Internal Medicine, University of Connecticut Health Center, Farmington, USA
| | - Anand M Krishnan
- Internal Medicine, University of Connecticut Health Center, Farmington, USA
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Influence of carotid atherosclerotic plaques on pulse wave assessment with arterial tonometry. J Hypertens 2018; 35:1609-1617. [PMID: 28350575 DOI: 10.1097/hjh.0000000000001366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Aortic stiffness and central pressure measurements have become increasingly important for the overall estimation of cardiovascular risk. The aim of this study is to verify whether the presence of stenosis in the carotid arteries due to atherosclerotic plaques may induce a bias in the measurement of carotid-femoral pulse wave velocity (PWV) and in the analysis of central pulse waveform variables assessed by carotid tonometry. METHODS Eighty-four patients (age: 67.1 ± 12.4 years) undergoing screening for carotid atherosclerosis were enrolled, divided into three groups according to carotid ultrasound findings (NASCET criteria): 28 patients without significant stenosis, 30 patients with bilateral plaques, and 26 patients with right or left monolateral stenosis. PWV and other variables derived from the central pulse waveform analysis (central blood pressure, augmentation index and forward and backward waves) were measured at both right and left carotid arteries by a validated PulsePen tonometer. A repeatability study was performed in 28 young healthy patients (age: 25.4 ± 2.9 years). RESULTS A high degree of correlation was found between bilateral measurements in all groups, and particularly in groups with monolateral carotid stenosis, with no significant difference attributable to lateralized stenosis. Right-left differences in asymmetric groups were 0.35 ± 5.12 mmHg (R = 0.960) for central blood pressure, -2.12 ± 7.39% (R = 0.743) for augmentation index, 0.64 ± 1.56 m/s (R = 0.947) for PWV, 0.08 ± 8.48 mmHg for forward wave (R = 0.742) and 0.35 ± 2.35 mmHg for backward wave (R = 0.907). CONCLUSION Measurement of PWV and of variables derived from the central pulse waveform analysis by carotid tonometry is not biased by the presence of local atherosclerotic plaques.
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Pasha EP, Birdsill AC, Oleson S, Tanaka H, Haley AP. Associations of carotid arterial compliance and white matter diffusion metrics during midlife: modulation by sex. Neurobiol Aging 2018. [PMID: 29533790 DOI: 10.1016/j.neurobiolaging.2018.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sex differences in cerebral white matter (WM) aging have been debated extensively over the past 2 decades without unequivocal resolution. We aimed to determine if the effects of age and arterial stiffness on WM microstructure differ between sexes. Artery elasticity via carotid artery compliance (CAC) and WM diffusion metrics via diffusion tensor image-derived fractional anisotropy (FA) and mean diffusivity (MD) were measured in 155 (87 females) middle-aged (40-62 years) adults. Males demonstrated poorer water diffusion metrics in WM than women in the corpus callosum body, cingulum, and cingulum (hippocampal). Age and CAC had greater effects on WM water diffusion in males than females in midlife independent of education and cardiovascular risk factors. Sex-moderated age (cingulum FA, cingulum [hippocampal] MD, and uncinate MD, all p < 0.05) and CAC (cingulum FA, p < 0.05) related reductions in regional WM diffusion metrics. CAC mediated age-related associations in regional WM diffusion metrics (cingulum FA, cingulum MD, superior corona radiata MD, and uncinate MD, all p < 0.05) in males but not in females. Age and CAC were associated with WM diffusion metrics independent of cardiovascular risk factors. These associations appear to be stronger in males than in females.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education.
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA; Imaging Research Center, The University of Texas at Austin, Austin, TX, USA
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Njoum H, Kyriacou PA. In vitro validation of measurement of volume elastic modulus using photoplethysmography. Med Eng Phys 2018; 52:10-21. [PMID: 29290498 DOI: 10.1016/j.medengphy.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/18/2017] [Accepted: 11/21/2017] [Indexed: 11/25/2022]
Abstract
Arterial stiffness (AS) is one of the earliest detectable symptoms of cardiovascular diseases and their progression. Current AS measurement methods provide an indirect and qualitative estimation of AS. The purpose of this study is to explore the utilisation of Photoplethysmography (PPG) as a measure of volumetric strain in providing a direct quantification of the Volume Elastic modulus (Ev). An in vitro experimental setup was designed using an arterial model to simulate the human circulation in health (Model 2) and disease (Model 1). Flow, pressure, and PPG signals were recorded continuously under varied conditions of flow dynamics. The obtained Ev values were validated with the gold standard mechanical testing techniques. Values obtained from both methods had no significant difference for both models with a percent error of 0.26% and 1.9% for Model 1 and Model 2, respectively. This study shows that PPG and pressure signals can provide a direct measure of AS in an in vitro setup. With emerging noninvasive pressure measurement methods, this research paves the way for the direct quantification of AS in vivo.
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Affiliation(s)
- Haneen Njoum
- Research Centre for Biomedical Engineering, School of Mathematics Computer Science and Engineering, City, University of London, London, UK.
| | - Panayiotis A Kyriacou
- Research Centre for Biomedical Engineering, School of Mathematics Computer Science and Engineering, City, University of London, London, UK.
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Courand PY, Harbaoui B, Fay H, Grandjean A, Milon H, Lantelme P. Aortic atherosclerosis is a key modulator of the prognostic value of postural blood pressure changes. Atherosclerosis 2017; 268:108-116. [PMID: 29202333 DOI: 10.1016/j.atherosclerosis.2017.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/01/2017] [Accepted: 11/21/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Orthostatic blood pressure decrease or increase has been related to cardiovascular events in hypertensive patients. Large blood pressure changes after orthostatic stress are associated with autonomic and neurohormonal abnormalities; aortic atherosclerosis (ATS) may also play a role. METHODS We investigated the interaction of ATS on the prognostic value of postural blood pressure changes. In a cohort of 958 hypertensive patients with an aortography (mean ± standard deviation age 44 ± 11 years, 61% men, mean blood pressure 182/110 mmHg), blood pressure was measured after 10 min of rest in the supine position. Systolic blood pressure (SBP) was also measured in standing position, 1 min after the supine position. Blood pressure changes were calculated as supine SBP minus standing SBP and analyzed as absolute or arithmetic means. ATS was assessed using an aortography score. RESULTS After 15 years of follow-up, 280 all-cause and 167 cardiovascular deaths occurred. In a multivariable Cox regression analysis adjusted for major cardiovascular risk factors and stratified according to ATS status, SBP changes were statistically associated with all-cause and cardiovascular mortality only in the presence of ATS: tertile 3 versus 1, 2.99 (1.37-6.49) and 4.08 (1.55-10.72) respectively, tertile 3 versus 2, 2.89 (1.29-6.46) and 4.82 (1.79-12.98), respectively (p for interaction: 0.003 for all-cause and 0.003 for cardiovascular mortality) for absolute changes. The hazard associated with the magnitude of SBP changes was more important than that associated with its direction. CONCLUSIONS The prognostic significance of postural SBP changes is markedly influenced by ATS in hypertensive patients.
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Affiliation(s)
- Pierre-Yves Courand
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, France.
| | - Brahim Harbaoui
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, France
| | - Helène Fay
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France
| | - Adrien Grandjean
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France
| | - Hugues Milon
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France
| | - Pierre Lantelme
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, F-69004, Lyon, France; Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, France
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Lefferts WK, Sperry SD, Jorgensen RS, Kasprowicz AG, Skilton MR, Figueroa A, Heffernan KS. Carotid stiffness, extra-media thickness and visceral adiposity in young adults. Atherosclerosis 2017; 265:140-146. [DOI: 10.1016/j.atherosclerosis.2017.08.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/14/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
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Yu AR, Hasjim B, Yu LE, Gabriel C, Anshus A, Lee JB, Louthan MJ, Kim EC, Lee K, Tse C, Keown T, Lahham S, Alvarado M, Bunch S, Gari A, Fox JC. Comparison of ultrasound-measured properties of the common carotid artery to tobacco smoke exposure in a cohort of Indonesian patients. World J Emerg Med 2017; 8:177-183. [PMID: 28680513 DOI: 10.5847/wjem.j.1920-8642.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The purpose of this study was to use point-of-care ultrasound (POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery (CCA). The effect of both primary and secondary smoking on CCA properties was evaluated. METHODS We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness (CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease. RESULTS We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness. CONCLUSION Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confirm the utility of ultrasound findings of cardiovascular disease and stroke.
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Affiliation(s)
- Allen R Yu
- School of Medicine, University of California, Irvine, USA
| | - Bima Hasjim
- School of Medicine, University of California, Irvine, USA
| | - Luke E Yu
- School of Medicine, University of California, Irvine, USA
| | | | | | - Jonathan B Lee
- School of Medicine, University of California, Irvine, USA
| | | | - Esther C Kim
- School of Medicine, University of California, Irvine, USA
| | - Katrina Lee
- School of Medicine, University of California, Irvine, USA
| | - Christina Tse
- School of Medicine, University of California, Irvine, USA
| | - Thomas Keown
- School of Medicine, University of California, Irvine, USA
| | - Shadi Lahham
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Maili Alvarado
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Steven Bunch
- Department of Emergency Medicine, University of California, Irvine, USA
| | - Abdulatif Gari
- Department of Emergency Medicine, University of California, Irvine, USA
| | - J Christian Fox
- School of Medicine, University of California, Irvine, USA.,Department of Emergency Medicine, University of California, Irvine, USA
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29
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Bjarnegråd N, Bengtsson C, Brodszki J, Sturfelt G, Nived O, Länne T. Increased aortic pulse wave velocity in middle aged women with systemic lupus erythematosus. Lupus 2016; 15:644-50. [PMID: 17120590 DOI: 10.1177/0961203306071402] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus (SLE) is a connective tissue disease where inflammatory activity affects several organ systems. An increased risk of cardiovascular disease has been identified in these patients, even after correction for traditional risk factors. The aim of the present study was to evaluate arterial stiffness and central hemodynamics in women with SLE in comparison to controls. Arterial tonometry was used to measure aortic (carotid-femoral) and arm (carotid-radial) pulse wave velocity (PWV), reflected pressure waves, and aortic augmentation index (AIx) in 27 women with SLE (52 to 68 years) and 27 controls. Aortic PWV was higher in women with SLE than controls, 9.8 m/s versus 8.2 m/s ( P 0.01), after correction for mean arterial pressure and body mass index, 9.5 m/s versus 8.5 m/s ( P 0.05). Other parameters were similar, arm PWV, 8.4 versus 8.5 m/s, AIx 34 versus 33% and calculated central aortic pulse pressure 48 versus 43 mmHg, in SLE and controls, respectively (NS). Aortic PWV was positively associated to C-reactive protein (CRP) and complement factor 3 (C3). Women with SLE have increased stiffness of their elastic central arteries. This may be one factor contributing to the increased cardiovascular risk seen in this cohort.
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Affiliation(s)
- N Bjarnegråd
- Department of Medicine and Care, University of Linköping, Jonköping Hospital, Sweden.
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30
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Wang X, Ye P, Cao R, Yang X, Xiao W, Zhang Y, Bai Y, Wu H. Triglycerides are a predictive factor for arterial stiffness: a community-based 4.8-year prospective study. Lipids Health Dis 2016; 15:97. [PMID: 27192979 PMCID: PMC4870778 DOI: 10.1186/s12944-016-0266-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 05/11/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Epidemiological studies have disclosed an independent effect of triglycerides on coronary heart disease despite achievement of low-density lipoprotein cholesterol goals with statin therapy. Arterial stiffness has been increasingly recognized as a strong predictor of cardiovascular disease and atherosclerotic disease. The association between triglycerides and arterial stiffness is not well characterized. We aimed to determine the relationship between triglycerides and arterial stiffness in a community-based longitudinal sample from Beijing, China. METHODS We related levels of plasma TGs to measures of arterial stiffness (carotid-femoral pulse wave velocity [PWV] and carotid-radial PWV) in 1447 subjects (mean age, 61.3 years) from a community-based population in Beijing, China. RESULTS After a median follow-up interval of 4.8 years, multiple linear regression analysis revealed that TGs were independently associated with carotid-femoral PWV (β = 0.747, P < 0.001) and carotid-radial PWV (β = 0.367, P = 0.001). In the group older than 65 years, the association between baseline TG levels and follow-up carotid-femoral PWV (β = 1.094, P = 0.001) and carotid-radial PWV (β = 0.524, P = 0.002) were strengthened. In forward stepwise multivariate logistic regression analysis, every SD increase in TGδ was associated with a 1.296-increased likelihood of the presence of carotid-femoral PWVδII (OR [per SD increase in TGδ]: 1.296; 95% CI: 1.064 ~ 1.580; P = 0.010) in Model 2, whereas the relationship between TGδ and carotid-radial PWVδII disappeared. In addition, the relationship was strengthened between TGδ and the presence of carotid-femoral PWVδII (OR 1.526, 95% CI: 1.088-2.141, P = 0.014) in the group older than 65 years but not carotid-radial PWVδII. No association was noted in subjects younger than 65 years. CONCLUSIONS Lower triglyceride levels were significantly associated with decreases in carotid-femoral PWV, indicating that achieving low TG levels may be an additional therapeutic consideration in subjects with atherosclerotic disease.
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Affiliation(s)
- Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China.
| | - Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Xu Yang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Wenkai Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Yun Zhang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Fuxing Road #28, Beijing, 100853, China
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Samsuddin N, Rampal KG, Ismail NH, Abdullah NZ, Nasreen HE. Pesticides Exposure and Cardiovascular Hemodynamic Parameters Among Male Workers Involved in Mosquito Control in East Coast of Malaysia. Am J Hypertens 2016; 29:226-33. [PMID: 26112865 DOI: 10.1093/ajh/hpv093] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/29/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Research findings have linked exposure to pesticides to an increased risk of cardiovascular (CVS) diseases. Therefore, this study aimed to assess the impact of chronic mix-pesticides exposure on CVS hemodynamic parameters. METHODS A total of 198 male Malay pesticide-exposed and 195 male Malay nonexposed workers were examined. Data were collected through exposure-matrix assessment, questionnaire, blood analyses, and CVS assessment. Explanatory variables comprised of lipid profiles, paraoxonase 1 (PON1), and oxidized low-density lipoprotein (ox-LDL). Outcome measures comprised of brachial and aortic diastolic blood pressure (DBP) and systolic BP (SBP), heart rate, and pulse wave velocity (PWV). Linear regressions identified the B coefficient showing how many units of CVS parameters are associated with each unit of covariates. RESULTS Diazoxonase was significantly lower and ox-LDL was higher among pesticide-exposed workers than the comparison group. The final multivariate linear regression model revealed that age, body mass index (BMI), smoking, and pesticide exposure were independent predictors of brachial and aortic DBP and SBP. Pesticide exposure was also associated with heart rate, but not with PWV. Lipid profiles, PON1 enzymes, and ox-LDL showed no association with any of the CVS parameters. CONCLUSIONS Chronic mix-pesticide exposure among workers involved in mosquito control has possible association with depression of diazoxonase and the increase in ox-LDL, brachial and aortic DBP and SBP, and heart rate. This study raises concerns that those using pesticides may be exposed to hitherto unrecognized CVS risks among others. If this is confirmed by further studies, greater efforts will be needed to protect these workers.
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Affiliation(s)
- Niza Samsuddin
- Department of Biomedical Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia;
| | - Krishna Gopal Rampal
- Perdana University Graduate School of Medicine, Serdang, Selangor Darul Ehsan, Malaysia
| | - Noor Hassim Ismail
- Department of Community Health, Malaysia National University, Medical Faculty, UKM Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Nor Zamzila Abdullah
- Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia
| | - Hashima E Nasreen
- Department of Community Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia
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Inflammatory mediators in saliva associated with arterial stiffness and subclinical atherosclerosis. J Hypertens 2015; 31:2251-8; discussion 2258. [PMID: 23868086 PMCID: PMC3819311 DOI: 10.1097/hjh.0b013e328363dccc] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Whereas circulating levels of C-reactive protein (CRP) have been associated with, for example, arterial stiffness, subclinical atherosclerosis and metabolic syndrome, other inflammatory biomarkers with potential interest for these conditions may not be measurable systemically. The predictive value of salivary biomarkers in these contexts has remained largely unexplored. The aim of the present study was to establish the association of different salivary biomarkers of inflammation with subclinical cardiovascular disease. METHODS Two hundred and fifty-nine individuals were included in the study. Saliva and plasma samples were collected, and each individual underwent carotid ultrasound and measures of pulse wave velocity and blood pressure. Medical history of previous cardiovascular disease, current medications and smoking were collected by questionnaire. RESULTS Salivary levels of CRP, leukotriene B4 (LTB4), prostaglandin E2 (PGE2), matrix metalloproteinase 9 (MMP-9), creatinine and lysozyme were measured. Salivary levels of CRP were significantly correlated with plasma levels (r = 0.73, P < 0.0001). In an age-adjusted and sex-adjusted analysis, salivary CRP was significantly and positively correlated with mean arterial blood pressure, pulse pressure, pulse wave velocity, BMI, metabolic syndrome, waist-to-hip ratio and intima-media thickness. Increasing age and sex-adjusted salivary CRP tertiles were in addition associated with carotid plaques. In a multivariate analysis, CRP and MMP-9 were associated with intima-media thickness, LTB4 and PGE2 with arterial stiffness, and lysozyme with hypertension. CONCLUSION Saliva may represent an alternative mean for evaluation of cardiovascular risk.
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van Sloten TT, Sedaghat S, Laurent S, London GM, Pannier B, Ikram MA, Kavousi M, Mattace-Raso F, Franco OH, Boutouyrie P, Stehouwer CD. Carotid Stiffness Is Associated With Incident Stroke. J Am Coll Cardiol 2015; 66:2116-2125. [DOI: 10.1016/j.jacc.2015.08.888] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 08/26/2015] [Indexed: 12/31/2022]
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Liabeuf S, Desjardins L, Diouf M, Temmar M, Renard C, Choukroun G, Massy ZA. The Addition of Vascular Calcification Scores to Traditional Risk Factors Improves Cardiovascular Risk Assessment in Patients with Chronic Kidney Disease. PLoS One 2015; 10:e0131707. [PMID: 26181592 PMCID: PMC4504701 DOI: 10.1371/journal.pone.0131707] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Although a variety of non-invasive methods for measuring cardiovascular (CV) risk (such as carotid intima media thickness, pulse wave velocity (PWV), coronary artery and aortic calcification scores (measured either by CT scan or X-ray) and the ankle brachial index (ABI)) have been evaluated separately in chronic kidney disease (CKD) cohorts, few studies have evaluated these methods simultaneously. Here, we looked at whether the addition of non-invasive methods to traditional risk factors (TRFs) improves prediction of the CV risk in patients at different CKD stages. Methods We performed a prospective, observational study of the relationship between the outputs of non-invasive measurement methods on one hand and mortality and CV outcomes in 143 patients at different CKD stages on the other. During the follow-up period, 44 patients died and 30 CV events were recorded. We used Cox models to calculate the relative risk for outcomes. To assess the putative clinical value of each method, we also determined the categorical net reclassification improvement (NRI) and the integrated discrimination improvement. Results Vascular calcification, PWV and ABI predicted all-cause mortality and CV events in univariate analyses. However, after adjustment for TRFs, only aortic and coronary artery calcification scores were found to be significant, independent variables. Moreover, the addition of coronary artery calcification scores to TRFs improved the specificity of prediction by 20%. Conclusion The addition of vascular calcification scores (especially the coronary artery calcification score) to TRFs appears to improve CV risk assessment in a CKD population.
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Affiliation(s)
- Sophie Liabeuf
- INSERM U1088, Jules Verne University of Picardy Amiens, France
- Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Hospital and the Jules Verne University of Picardy, Amiens, France
| | - Lucie Desjardins
- INSERM U1088, Jules Verne University of Picardy Amiens, France
- Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Hospital and the Jules Verne University of Picardy, Amiens, France
| | - Momar Diouf
- Department of Biostatistics, Amiens University Hospital, Amiens, France
| | - Mohamed Temmar
- INSERM U1088, Jules Verne University of Picardy Amiens, France
- Clinical Research Centre and Division of Clinical Pharmacology, Amiens University Hospital and the Jules Verne University of Picardy, Amiens, France
| | - Cédric Renard
- Division of Radiology, Amiens University Hospital, Amiens, France
| | - Gabriel Choukroun
- INSERM U1088, Jules Verne University of Picardy Amiens, France
- Division of Nephrology, Amiens University Hospital, Amiens, France
| | - Ziad A. Massy
- INSERM U1088, Jules Verne University of Picardy Amiens, France
- Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-Saint-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt/Paris, France
- * E-mail:
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van den Bosch HCM, Westenberg JJM, Setz-Pels W, Wondergem J, Wolterbeek R, Duijm LEM, Teijink JAW, de Roos A. Site-specific association between distal aortic pulse wave velocity and peripheral arterial stenosis severity: a prospective cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2015; 17:2. [PMID: 25600313 PMCID: PMC4298121 DOI: 10.1186/s12968-014-0095-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/14/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vascular disease expression in one location may not be representative for disease severity in other vascular territories, however, strong correlation between disease expression and severity within the same vascular segment may be expected. Therefore, we hypothesized that aortic stiffening is more strongly associated with disease expression in a vascular territory directly linked to that aortic segment rather than in a more remote segment. We prospectively compared the association between aortic wall stiffness, expressed by pulse wave velocity (PWV), sampled in the distal aorta, with the severity of peripheral arterial occlusive disease (PAOD) as compared to atherosclerotic markers sampled in remote vascular territories such as PWV in the proximal aorta and the normalized wall index (NWI), representing the vessel wall thickness, of the left common carotid artery. METHODS Forty-two patients (23 men; mean age 64±10 years) underwent velocity-encoded cardiovascular magnetic resonance (CMR) in the proximal and distal aorta, whole-body contrast-enhanced MR angiography (CE-MRA) and carotid vessel wall imaging with black-blood CMR in the work-up for PAOD. Strength of associations between aortic stiffness, carotid NWI and peripheral vascular stenosis grade were assessed and evaluated with multiple linear regression. RESULTS Stenosis severity correlated well with PWV in the distal aorta (Pearson rP=0.64, p<0.001, Spearman rS=0.65, p<0.001) but to a lesser extent with PWV in the proximal aorta (rP=0.48, p=0.002, rS=0.22, p=0.18). Carotid NWI was not associated with peripheral stenosis severity (rP=0.17, p=0.28, rS=0.14, p=0.37) nor with PWV in the proximal aorta (rP=0.22, p=0.17) nor in the distal aorta (rP=0.21, p=0.18). Correlation between stenosis severity and distal aortic PWV remained statistically significant after correction for age and gender. CONCLUSIONS Distal aortic wall stiffness is more directly related to peripheral arterial stenosis severity than markers from more remote vascular territories such as proximal aortic wall stiffness or carotid arterial wall thickness. Site-specific evaluation of vascular disease may be required for full vascular risk estimation.
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Affiliation(s)
- Harrie C M van den Bosch
- />Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - Jos J M Westenberg
- />Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wikke Setz-Pels
- />Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - John Wondergem
- />Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands
| | - Ron Wolterbeek
- />Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lucien E M Duijm
- />Department of Radiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Joep A W Teijink
- />Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Albert de Roos
- />Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Kawada T, Andou T, Fukumitsu M. The cardio-ankle vascular index and carotid ultrasound data reflect different concepts of vascular damage. J Atheroscler Thromb 2014; 21:1098-100. [PMID: 25230754 DOI: 10.5551/jat.26476] [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
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School
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Tolezani EC, Costa-Hong V, Correia G, Mansur AJ, Drager LF, Bortolotto LA. Determinants of Functional and Structural Properties of Large Arteries in Healthy Individuals. Arq Bras Cardiol 2014; 103:426-432. [PMID: 25211201 PMCID: PMC4262104 DOI: 10.5935/abc.20140124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/05/2014] [Indexed: 01/11/2023] Open
Abstract
Background Changes in the properties of large arteries correlate with higher cardiovascular
risk. Recent guidelines have included the assessment of those properties to detect
subclinical disease. Establishing reference values for the assessment methods as
well as determinants of the arterial parameters and their correlations in healthy
individuals is important to stratify patients. Objective To assess, in healthy adults, the distribution of the values of pulse wave
velocity, diameter, intima-media thickness and relative distensibility of the
carotid artery, in addition to assessing the demographic and clinical determinants
of those parameters and their correlations. Methods This study evaluated 210 individuals (54% women; mean age, 44 ± 13 years) with no
evidence of cardiovascular disease. The carotid-femoral pulse wave velocity was
measured with a Complior® device. The functional and structural
properties of the carotid artery were assessed by using radiofrequency ultrasound.
Results The means of the following parameters were: pulse wave velocity, 8.7 ± 1.5 m/s;
diameter, 6,707.9 ± 861.6 μm; intima-media thickness, 601 ± 131 μm; relative
distensibility, 5.3 ± 2.1%. No significant difference related to sex or ethnicity
was observed. On multiple linear logistic regression, the factors independently
related to the vascular parameters were: pulse wave velocity, to age (p < 0.01)
and triglycerides (p = 0.02); intima-media thickness, to age (p < 0.01);
diameter, to creatinine (p = 0.03) and age (p = 0.02); relative distensibility, to
age (p < 0.01) and systolic and diastolic blood pressures (p = 0.02 and p =
0.01, respectively). Pulse wave velocity showed a positive correlation with intima
media thickness (p < 0.01) and with relative distensibility (p < 0.01),
while diameter showed a positive correlation with distensibility (p = 0.03). Conclusion In healthy individuals, age was the major factor related to aortic stiffness,
while age and diastolic blood pressure related to the carotid functional measure.
The carotid artery structure was directly related to aortic stiffness, which was
inversely related to the carotid artery functional property.
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Affiliation(s)
- Elaine Cristina Tolezani
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Valéria Costa-Hong
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gustavo Correia
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alfredo José Mansur
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciano Ferreira Drager
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luiz Aparecido Bortolotto
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Uremic toxicity and sclerostin in chronic kidney disease patients. Nephrol Ther 2014; 10:463-70. [PMID: 25070604 DOI: 10.1016/j.nephro.2014.04.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 04/10/2014] [Accepted: 04/10/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Sclerostin is a circulating inhibitor of the Wnt/β-catenin pathway and may have a role in chronic kidney disease (CKD)-mineral and bone disorder. Blood sclerostin levels are known to be elevated in patients undergoing maintenance dialysis. The aims of the present study were to evaluate sclerostin levels in patients at different CKD stages and study potential associations between sclerostin levels and (i) biochemical parameters that are disturbed in CKD, (ii) markers of vascular disease and (iii) mortality. METHODS One hundred and forty patients at CKD stages 2-5D were included in the present study. Routine clinical biochemistry tests and assays for sclerostin, protein-bound uremic toxins (indoxylsulphate [IS] and p-cresyl sulphate [PCS]) and the toxin β2 microglobulin (β2M) were performed. Aortic and coronary calcification and arterial stiffness were assessed by multislice spiral computed tomography and pulse wave velocity measurements. The enrolled patients were prospectively monitored for mortality. RESULTS Sclerostin levels were found to be elevated in CKD patients (especially those on hemodialysis). Furthermore, sclerostin levels were positively correlated with inflammation markers, phosphate, fibroblast growth factor 23, IS, PCS, β2M and arterial stiffness. A multivariate linear regression analysis indicated that sclerostin levels were independently associated with IS, PCS and β2M levels. Elevated serum sclerostin appeared to be associated with mortality (independently of age and inflammation). However, this association disappeared after adjustment for a propensity score including age, phosphate, interleukin-6, CKD stage and PCS. CONCLUSION Our results indicate that sclerostin levels are elevated in CKD patients and are associated with inflammation, vascular lesions, uremia and (potentially) mortality.
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Barone-Rochette G, Vanzetto G, Detante O, Quesada JL, Hommel M, Mallion JM, Baguet JP. Imaging of functional and structural alterations of large arteries after acute ischaemic atherothrombotic stroke or acute coronary syndromes. Arch Cardiovasc Dis 2014; 107:443-51. [PMID: 25023004 DOI: 10.1016/j.acvd.2014.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 03/23/2014] [Accepted: 05/12/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Non-invasive methods allow the evaluation of structural and functional arterial abnormalities. So far, no study has focused on the comparison of vascular parameters by type of cardiovascular event. METHODS In this pilot study, cardiovascular risk factors, carotid parameters, carotid-to-femoral pulse wave velocity (PWV), brachial flow-mediated dilation and ambulatory blood pressure were assessed in patients who presented with acute coronary syndromes (ACS) or ischaemic atherothrombotic stroke (IAS). Groups were matched for age and gender. RESULTS Prevalences of hypertension, diabetes and dyslipidaemia and heredity, smoking and body mass index were similar in the ACS (n=50) and IAS (n=50) groups. Carotid intima-media thickness (IMT) and PWV were significantly higher in the IAS vs. ACS group (769±180 vs. 701±136 μm; P=0.039 and 12.5±3.5 vs. 10.7±2.4 m/s; P=0.006). Carotid distensibility was significantly lower in the IAS vs. ACS group (16.2±3.2 vs. 18.9±7.6 10(-3)/kPa; P=0.02). These differences persisted after adjustment for blood pressure for carotid distensibility but not for PWV. The prevalences of endothelial dysfunction and carotid plaques were not significantly different in the ACS and IAS groups (86% and 74%; 80% and 78%). In a multivariable model, carotid distensibility remained associated with ACS (odds ratio 1.19; 95% confidence interval 1.03-1.38; P=0.016). CONCLUSIONS Stiffness and carotid wall thickness were higher in IAS than in ACS patients. These differences may support the interest in new therapeutic targets for cardiovascular secondary prevention. NCT NO NCT00926874.
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Affiliation(s)
- Gilles Barone-Rochette
- Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France.
| | - Gerald Vanzetto
- Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France
| | - Olivier Detante
- Department of Neurology (Stroke Unit), University Hospital, Grenoble, France
| | - Jean-Louis Quesada
- Clinical Research Center INSERM CIC03, University Hospital, Grenoble, France
| | - Marc Hommel
- Department of Neurology (Stroke Unit), University Hospital, Grenoble, France
| | | | - Jean-Philippe Baguet
- Department of Cardiology, University Hospital, Grenoble, France; INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble, France
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Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging 2014; 7:1025-38. [PMID: 25051948 DOI: 10.1016/j.jcmg.2013.11.014] [Citation(s) in RCA: 393] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/11/2013] [Accepted: 11/15/2013] [Indexed: 12/12/2022]
Abstract
Carotid intima-media thickness (CIMT) has been shown to predict cardiovascular (CV) risk in multiple large studies. Careful evaluation of CIMT studies reveals discrepancies in the comprehensiveness with which CIMT is assessed-the number of carotid segments evaluated (common carotid artery [CCA], internal carotid artery [ICA], or the carotid bulb), the type of measurements made (mean or maximum of single measurements, mean of the mean, or mean of the maximum for multiple measurements), the number of imaging angles used, whether plaques were included in the intima-media thickness (IMT) measurement, the report of adjusted or unadjusted models, risk association versus risk prediction, and the arbitrary cutoff points for CIMT and for plaque to predict risk. Measuring the far wall of the CCA was shown to be the least variable method for assessing IMT. However, meta-analyses suggest that CCA-IMT alone only minimally improves predictive power beyond traditional risk factors, whereas inclusion of the carotid bulb and ICA-IMT improves prediction of both cardiac risk and stroke risk. Carotid plaque appears to be a more powerful predictor of CV risk compared with CIMT alone. Quantitative measures of plaques such as plaque number, plaque thickness, plaque area, and 3-dimensional assessment of plaque volume appear to be progressively more sensitive in predicting CV risk than mere assessment of plaque presence. Limited data show that plaque characteristics including plaque vascularity may improve CV disease risk stratification further. IMT measurement at the CCA, carotid bulb, and ICA that allows inclusion of plaque in the IMT measurement or CCA-IMT measurement along with plaque assessment in all carotid segments is emerging as the focus of carotid artery ultrasound imaging for CV risk prediction.
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Affiliation(s)
- Tasneem Z Naqvi
- Echocardiography Laboratory, Mayo Clinic, Scottsdale, Arizona; Cardiac Noninvasive Laboratories, Keck School of Medicine, University of Southern California, Los Angeles, California.
| | - Ming-Sum Lee
- Cardiac Noninvasive Laboratories, Keck School of Medicine, University of Southern California, Los Angeles, California
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Local pulse wave velocity directly reflects increased arterial stiffness in a restricted aortic region with progression of atherosclerotic lesions. Hypertens Res 2014; 37:892-900. [DOI: 10.1038/hr.2014.96] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 03/07/2014] [Accepted: 04/05/2014] [Indexed: 11/08/2022]
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Heinzel S, Liepelt-Scarfone I, Roeben B, Nasi-Kordhishti I, Suenkel U, Wurster I, Brockmann K, Fritsche A, Niebler R, Metzger FG, Eschweiler GW, Fallgatter AJ, Maetzler W, Berg D. A neurodegenerative vascular burden index and the impact on cognition. Front Aging Neurosci 2014; 6:161. [PMID: 25071568 PMCID: PMC4088338 DOI: 10.3389/fnagi.2014.00161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/20/2014] [Indexed: 12/21/2022] Open
Abstract
A wide range of vascular burden factors has been identified to impact vascular function and structure as indicated by carotid intima–media thickness (IMT). On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI). Since many vascular factors increase the risk of Alzheimer’s disease (AD), a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages. We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102) for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication, and/or blood marker data) were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT) and the consortium to establish a registry for Alzheimer’s disease (CERAD) neuropsychological battery. IMT was significantly predicted by age (standardized β = 0.26), sex (0.09; males > females) and the factors included in the VBI: obesity (0.18), hypertension (0.14), smoking (0.08), diabetes (0.07), and atherosclerosis (0.05), whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT ( ≥ 1.0 mm). The VBI showed an impact on executive control [log(TMT B−A), p = 0.047] and a trend toward decreased global cognitive function (CERAD total score, p = 0.057) independent of age, sex, and education. A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and AD.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabella Nasi-Kordhishti
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Andreas Fritsche
- Department of Internal Medicine IV, University of Tübingen , Tübingen , Germany
| | - Raphael Niebler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Florian G Metzger
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
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Selwaness M, van den Bouwhuijsen Q, Mattace-Raso FU, Verwoert GC, Hofman A, Franco OH, Witteman JC, van der Lugt A, Vernooij MW, Wentzel JJ. Arterial Stiffness Is Associated With Carotid Intraplaque Hemorrhage in the General Population. Arterioscler Thromb Vasc Biol 2014; 34:927-32. [DOI: 10.1161/atvbaha.113.302603] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
The relation between arterial stiffness and atherosclerosis, and specifically the influence of arterial stiffness on plaque composition, is largely unknown. In a population-based study, we investigated the association between arterial stiffness and the presence and composition of carotid atherosclerotic plaques.
Approach and Results—
Arterial stiffness was measured in 6527 participants (67.0±8.6 years) using aortic pulse wave velocity (PWV). Presence of carotid atherosclerotic plaques was assessed with ultrasound. Subsequently, 1059 subjects with carotid plaques (>2.5 mm) underwent MRI to assess plaque composition (presence of intraplaque hemorrhage, lipid, and calcification). Generalized estimation equation analyses adjusted for age, sex, mean arterial pressure, heart rate, carotid wall thickening, pulse pressure, and traditional cardiovascular risk factors were used to study the association between PWV and the presence and composition of carotid atherosclerotic plaques. In multivariable analysis, higher PWV was independently related to higher prevalence of carotid atherosclerotic plaque on ultrasound (odds ratio for highest quartile of PWV compared with lowest quartile, 1.24 [95% confidence interval, 1.02–1.51]). Furthermore, higher PWV was associated with intraplaque hemorrhage (age- and sex-adjusted odds ratio per SD increase in PWV, 1.20 [1.04–1.38] and calcification, 1.18 [1.03–1.35]), but not with lipid. After adjustment for cardiovascular risk factors, PWV remained significantly associated with intraplaque hemorrhage (1.20 [1.01–1.43]). Additional adjustment for pulse pressure did not materially affect the effect estimate (1.19 [1.00–1.42]).
Conclusions—
Higher PWV is associated with presence and composition of carotid atherosclerotic plaques, in particular with intraplaque hemorrhage. These findings provide further clues for understanding the development of vulnerable atherosclerotic plaque.
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Affiliation(s)
- Mariana Selwaness
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Quirijn van den Bouwhuijsen
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Francesco U.S. Mattace-Raso
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Germaine C. Verwoert
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Albert Hofman
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Oscar H. Franco
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Jacqueline C.M. Witteman
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Aad van der Lugt
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Meike W. Vernooij
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
| | - Jolanda J. Wentzel
- From the Departments of Epidemiology (M.S., G.C.V., A.H., O.H.F., J.C.M.W., M.W.V.), Radiology (Q.v.d.B., A.v.d.L., M.W.V.), Internal Medicine (F.U.S.M.-R.), and Cardiology, Biomedical Engineering (J.J.W.), Erasmus MC, Rotterdam, The Netherlands
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Association between free light chain levels, and disease progression and mortality in chronic kidney disease. Toxins (Basel) 2013; 5:2058-73. [PMID: 24217396 PMCID: PMC3847714 DOI: 10.3390/toxins5112058] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 10/28/2013] [Accepted: 10/29/2013] [Indexed: 11/17/2022] Open
Abstract
Immunoglobulin free light chains (FLCs) form part of the middle molecule group of uremic toxins. Accumulation of FLCs has been observed in patients with chronic kidney disease (CKD). The aim of the present study was to measure FLC levels in patients at different CKD stages and to assess putative associations between FLC levels on one hand and biochemical/clinical parameters and mortality on the other. One hundred and forty patients at CKD stages 2-5D were included in the present study. Routine clinical biochemistry assays and assays for FLC kappa (κ) and lambda (λ) and other uremic toxins were performed. Vascular calcification was evaluated using radiological techniques. The enrolled patients were prospectively monitored for mortality. Free light chain κ and λ levels were found to be elevated in CKD patients (especially in those on hemodialysis). Furthermore, FLC κ and λ levels were positively correlated with inflammation, aortic calcification and the levels of various uremic toxins levels. A multivariate linear regression analysis indicated that FLC κ and λ levels were independently associated with CKD stages and β2 microglobulin levels. Elevated FLC κ and λ levels appeared to be associated with mortality. However, this association disappeared after adjustment for a propensity score including age, CKD stage and aortic calcification. In conclusion, our results indicate that FLC κ and λ levels are elevated in CKD patients and are associated with inflammation, vascular calcification and levels of other uremic toxins. The observed link between elevated FLC levels and mortality appears to depend on other well-known factors.
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The impact of serum uric acid level on arterial stiffness and carotid atherosclerosis: The Korean Multi-Rural Communities Cohort study. Atherosclerosis 2013; 231:145-51. [DOI: 10.1016/j.atherosclerosis.2013.08.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 02/07/2023]
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Vranes M, Davidovic L, Vasic D, Radmili O. Coexistence of internal carotid artery stenosis in patients with abdominal aortic aneurysm. Korean Circ J 2013; 43:550-6. [PMID: 24044014 PMCID: PMC3772300 DOI: 10.4070/kcj.2013.43.8.550] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/08/2013] [Accepted: 07/26/2013] [Indexed: 11/11/2022] Open
Abstract
Background and Objectives Abdominal Aortic Aneurysm (AAA) and carotid disease have medical and social significance, considering their morbidity, disability, and economic consequences. The study objectives were to determine the prevalence of asymptomatic internal carotid artery (ICA) lesions ≥70% in patients with AAA, the correlation of AAA diameter with the degree of ICA stenosis and symptoms, and the importance of preventive ultrasound checkups. Subjects and Methods A prospective non-randomized controlled study including 740 patients, aged from 18-85 years, who were suitable for the inclusion and exclusion criteria and reported at the vascular laboratory of the Institute for Vascular and Endovascular Surgery, Clinical Center of Serbia from 1st of December 2011 to the 1st of November 2012. Results The prevalence of asymptomatic ICA stenosis ≥70% in patients with AAA is 10.8%. Male representatives have more symptomatic ICA stenosis ≥70%. Patients with small aneurysms more often have asymptomatic ICA stenosis ≥70%. The occurrence of symptoms of carotid disease was more prevalent among patients with ICA stenosis ≥70% compared to the group with stenosis <70%. There was no correlation found between the grade of ICA stenosis with the size of AAA. Conclusion The prevalence of asymptomatic ICA stenosis ≥70% in patients with AAA is found to be 10.8%. Male patients with ICA stenosis ≥70% more often had symptoms of carotid disease. In the smaller aneurysms, ICA stenosis ≥70% occurs frequently, but without the symptoms of carotid disease, and there was no correlation between the size of AAA and the grade of ICA stenosis. Clinical implications of ICA imaging in patients with previously diagnosed AAA is necessary.
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Affiliation(s)
- Milica Vranes
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia
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Akdoğan RA, Durakoğlugil ME, Kocaman SA, Çiçek Y, Durakoğlugil T, Ergül E, Rakıcı H. Increased pulse wave velocity and carotid intima-media thickness in patients with ulcerative colitis. Dig Dis Sci 2013; 58:2293-300. [PMID: 23508984 DOI: 10.1007/s10620-013-2634-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/02/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ulcerative colitis (UC) is characterized with chronic, progressive inflammation of the gastrointestinal tract. The association of UC with cardiovascular disease is still a matter of debate. AIM The aim of this study was to investigate whether carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) as surrogates of atherosclerosis and arterial stiffness are increased in patients with UC. METHODS Our study was cross-sectional and observational in design. Baseline characteristics were recorded during interview with the patient. Patients with previous cardiovascular disease, rheumatoid arthritis, chronic renal failure, and infectious and inflammatory disorders other than UC were excluded. Thirty-seven consecutive patients with UC and 30 control participants underwent cf-PWV assessment and CIMT measurement. The diagnosis of UC was based on clinical, radiologic, endoscopic, and histological findings. RESULTS CIMT, cf-PWV, and C reactive protein were significantly higher in patients with UC. Although linear regression analyses identified UC as an independent predictor of CIMT (β ± SE, 0.39 ± 0.08; p < 0.001), only age independently predicted cf-PWV (β ± SE, 0.08 ± 0.03; p = 0.003) in our study population. Moreover, we revealed higher CIMT and PWV values in patients with higher disease activity and more extensive involvement, compared to patients with mild activity and limited disease. CONCLUSION We revealed increased pulse wave velocity and CIMT in patients with UC. UC appears to be associated with arterial stiffness and atherosclerotic burden, but the underlying mechanisms require further studies to be identified.
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Affiliation(s)
- Remzi Adnan Akdoğan
- Department of Gastroenterology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Site-specific coupling between vascular wall thickness and function: an observational MRI study of vessel wall thickening and stiffening in hypertension. Invest Radiol 2013; 48:86-91. [PMID: 23262794 DOI: 10.1097/rli.0b013e31827f6410] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate associations between aortic pulse wave velocity (PWV) and aortic and carotid vessel wall thickness (VWT) using cardiovascular magnetic resonance imaging (MRI) in patients with hypertension as compared with healthy adult volunteers. MATERIALS AND METHODS Local medical ethics approval was obtained and the participants gave informed consent. Fifteen patients with hypertension (5 men and 10 women; mean [SD] age, 49 [14] years) and 15 age- and sex-matched healthy volunteers were prospectively included and compared. All participants underwent MRI examination for measuring aortic and carotid VWT and aortic PWV with well-validated MRI techniques at 1.5- and 3-T MRI systems: PWV was assessed from velocity-encoded MRI and VWT was assessed by using dual-inversion black-blood gradient-echo imaging techniques. Paired t tests were used for testing differences between the volunteers and the patients and Pearson correlation (r) and univariable and multivariable stepwise linear regression analyses were used to test associations between aortic and carotid arterial wall thickness and stiffness. RESULTS Mean values for aortic PWV and aortic and carotid VWT (indexed for body surface area [BSA]) were all significantly higher in patients with hypertension as compared with the healthy volunteers (ie, aortic PWV, 7.0 ± 1.4 m/s vs 5.7 ± 1.3 m/s; aortic VWT/BSA, 0.12 ± 0.03 mL/m vs 0.10 ± 0.03 mL/m; carotid VWT/BSA, 0.04 ± 0.01 mL/m vs 0.03 ± 0.01 mL/m; all P < 0.01). Aortic PWV was highly correlated with aortic VWT/BSA (r = 0.76 and P = 0.002 in the patients vs r = 0.63 and P = 0.02 in the volunteers), and in the patients, aortic PWV was moderately correlated with carotid VWT/BSA (r = 0.50; P = 0.04). In the volunteers, correlation between aortic PWV and carotid VWT/BSA was not significant (r = 0.40; P = 0.13). In addition, aortic VWT/BSA was significantly correlated with carotid VWT/BSA, in both the patients (r = 0.60; P = 0.005) and volunteers (r = 0.57; P = 0.007). CONCLUSIONS In the patients with hypertension and the healthy volunteers, the aortic PWV is associated more strongly with aortic wall thickness than with carotid wall thickness, reflecting site-specific coupling between vascular wall thickness and function.
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Aortic pulse wave velocity results depend on which carotid artery is used for the measurements. J Hypertens 2013; 31:117-22. [PMID: 23221934 DOI: 10.1097/hjh.0b013e32835b051b] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Aortic pulse wave velocity (aPWV) is a gold standard noninvasive marker of arterial stiffness. aPWV is usually obtained as carotid-femoral pulse wave velocity by measurements on the common carotid artery and the femoral artery. The carotid arteries branch slightly differently from the aorta towards the right and left side of the neck. Theoretically, using the right or left carotid artery could influence aPWV results and there are no clear guidelines to support the choice of side. The aim of this study was to investigate whether aPWV results depend on right or left side carotid artery measurements in a group of healthy individuals. METHODS AND RESULTS Two different observers examined 50 individuals without known cardiovascular disease between 23 and 66 years of age. The measurements were performed with the SphygmoCor equipment using both right and left carotid arteries. We found that use of the right carotid artery provided significantly higher aPWV values compared with the left carotid artery, also when using different methods to estimate the travel length of the pulse wave (pooled data, subtracted distance: 0.2 ± 0.4 m/s, P = 0.003; direct distance: 0.2 ± 0.5 m/s, P = 0.001). CONCLUSION Using right or left carotid artery affects aPWV, as right-side measurements provided higher values. Attention to this side difference and use of the same carotid artery will increase the strength of intervention studies using aPWV as a surrogate endpoint.
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Particle numbers of lipoprotein subclasses and arterial stiffness among middle-aged men from the ERA JUMP study. J Hum Hypertens 2013; 28:111-7. [PMID: 23823580 PMCID: PMC3800263 DOI: 10.1038/jhh.2013.60] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/22/2013] [Accepted: 06/03/2013] [Indexed: 01/10/2023]
Abstract
We examined the association between serum lipoprotein subclasses and the three measures of arterial stiffness, that is, (i) carotid-femoral pulse wave velocity (cfPWV), which is a gold standard measure of central arterial stiffness, (ii) brachial-ankle PWV (baPWV), which is emerging as a combined measure of central and peripheral arterial stiffness and (iii) femoral-ankle PWV (faPWV), which is a measure of peripheral arterial stiffness. Among a population-based sample of 701 apparently healthy Caucasian, Japanese American and Korean men aged 40-49 years, concentrations of lipoprotein particles were assessed by nuclear magnetic resonance (NMR) spectroscopy, and the PWV was assessed with an automated waveform analyzer (VP2000, Omron, Japan). Multiple linear regressions were performed to analyse the association between each NMR lipoprotein subclasses and PWV measures, after adjusting for cardiovascular risk factors and other confounders. A cutoff of P<0.01 was used for determining significance. All PWV measures had significant correlations with total and small low-density lipoprotein particle number (LDL-P) (all P<0.0001) but not LDL cholesterol (LDL-C) (all P>0.1), independent of race and age. In multivariate regression analysis, no NMR lipoprotein subclass was significantly associated with cfPWV (all P>0.01). However, most NMR lipoprotein subclasses had significant associations with both baPWV and faPWV (P<0.01). In this study of healthy middle-aged men, as compared with cfPWV, both baPWV and faPWV had stronger associations with particle numbers of lipoprotein subclasses. Our results may suggest that both baPWV and faPWV are related to arterial stiffness and atherosclerosis, whereas cfPWV may represent arterial stiffness alone.
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