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Sheppard R, Gan WK, Onambele‐Pearson GL, Young HS. Increased physical activity promotes skin clearance, improves cardiovascular and psychological health, and increases functional capacity in patients with psoriasis. SKIN HEALTH AND DISEASE 2024; 4:e426. [PMID: 39355754 PMCID: PMC11442072 DOI: 10.1002/ski2.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/15/2024] [Accepted: 07/06/2024] [Indexed: 10/03/2024]
Abstract
Background Patients with psoriasis are less physically active compared to age-matched controls, due to psoriasis-specific barriers, which significantly limits their ability to benefit from health-promoting levels of physical activity (PA). In addition, long-term health outcomes for people with psoriasis are poor and include depression, metabolic syndrome and cardiovascular disease (CVD); presenting a significant challenge to healthcare services. Objectives We designed a PA intervention in partnership with patients with psoriasis hypothesising this may have therapeutic utility in the management of psoriasis. Methods Participants with chronic plaque psoriasis were recruited to a single-centre, 20-week, prospective cohort study. A wrist-worn accelerometer (GENEActiv Original; Activinsights Ltd) and a hip-worn pedometer (Onwalk 900; Decathlon Group) were used objectively measure levels of PA. Our 10-week PA intervention comprised twice weekly 60-min walks within three different greenspaces in Greater Manchester, each led by a Sports and Exercise Scientist to deliver a pre-specified volume/dose of activity. During weeks-11-20 of the study, participants followed independent activities. Clinical evaluation, including assessment of psoriasis severity, cardiometabolic parameters, psychological wellbeing and functional capacity was made at baseline, week-10 and -20. Results Sixteen patients with psoriasis completed the study. We observed significantly reduced Psoriasis Area and Severity Index at week-10 (p = 0.01) and -20 (p = 0.001) compared to baseline, with 50% of participants achieving PASI-50 at week-20. Dermatology Life Quality Index (DLQI) was significantly reduced at week-20 (p = 0.04), compared to baseline. Significant reduction in blood pressure at week-10 (systolic: -7.4 mmHg, p = 0.002; diastolic: -4.2 mmHg, p = 0.03) and -20 (systolic: -8.8 mmHg, p = 0.001; diastolic: 4.1 mmHg, p = 0.008) was observed and pulse wave velocity was significantly reduced by week-20 (p = 0.02), suggesting improvement in cardiovascular health. Despite high prevalence of anxiety and depression at baseline, we documented a significant improvement in wellbeing and psychological health. Functional capacity was significantly enhanced following completion of the study. Conclusion Increasing PA constitutes a promising therapeutic intervention in the management of psoriasis. Evaluation of our intervention in a clinical trial would help determine clinical utility and establish PA guidelines for patients with psoriasis.
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Affiliation(s)
- Rory Sheppard
- Division of Musculoskeletal and Dermatological SciencesSchool of Biological SciencesThe University of ManchesterManchesterUK
- The Dermatology CentreSalford Royal HospitalManchester Academic Health Science CentreThe University of ManchesterManchesterUK
| | - Weh K. Gan
- The Dermatology CentreSalford Royal HospitalManchester Academic Health Science CentreThe University of ManchesterManchesterUK
| | - Gladys L. Onambele‐Pearson
- Department of Sport and Exercise SciencesMusculoskeletal Science and Sports Medicine Research CentreManchester Metropolitan UniversityManchesterUK
| | - Helen S. Young
- Division of Musculoskeletal and Dermatological SciencesSchool of Biological SciencesThe University of ManchesterManchesterUK
- The Dermatology CentreSalford Royal HospitalManchester Academic Health Science CentreThe University of ManchesterManchesterUK
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Baroutidou A, Arvanitaki A, Pagkopoulou E, Anyfanti P, Ziakas A, Kamperidis V, Giannakoulas G, Dimitroulas T. Nailfold videocapillaroscopy as a non-invasive tool for the assessment of peripheral microangiopathy in cardiovascular diseases. J Hypertens 2024:00004872-990000000-00543. [PMID: 39288254 DOI: 10.1097/hjh.0000000000003873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Cardiovascular disease (CVD) remains the main cause of morbidity and mortality worldwide. Accumulating evidence supports the presence of endothelial and microvascular dysfunction in CVD, which can be assessed using several methods in peripheral organs and tissues. Naifold videocapillaroscopy (NVC) is an established, noninvasive, easily applicable technique for the assessment of peripheral microcirculation. There is limited capillaroscopic data in the field of CVD, though, and the diagnostic or possible prognostic significance of the capillaroscopic alterations in this population is still a matter of research. This review aims to summarize the current knowledge on the capillaroscopic findings in patients with cardiovascular risk factors or established atherosclerotic and nonatherosclerotic CVD, focusing on the possible correlations of these alterations with clinical and laboratory markers of cardiac function.
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Affiliation(s)
| | | | - Eleni Pagkopoulou
- Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School
| | - Panagiota Anyfanti
- Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School
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Scicali R, Bosco G, Scamporrino A, Di Mauro S, Filippello A, Di Giacomo Barbagallo F, Spampinato S, Pavanello C, Ossoli A, Di Pino A, Calabresi L, Purrello F, Piro S. Evaluation of high-density lipoprotein-bound long non-coding RNAs in subjects with familial hypercholesterolaemia. Eur J Clin Invest 2024; 54:e14083. [PMID: 37571980 DOI: 10.1111/eci.14083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/27/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Long non-coding RNAs (lncRNAs) could be attractive circulating biomarkers for cardiovascular risk stratification in subjects at high atherosclerotic cardiovascular disease risk such as familial hypercholesterolaemia (FH). Our aim was to investigate the presence of lncRNAs carried by high-density lipoprotein (HDL) in FH subjects and to evaluate the associations of HDL-lncRNAs with lipoproteins and mechanical vascular impairment assessed by pulse wave velocity (PWV). METHODS This was a retrospective observational study involving 94 FH subjects on statin treatment. Biochemical assays, HDL purification, lncRNA and PWV analyses were performed in all subjects. RESULTS LncRNA HIF1A-AS2, LASER and LEXIS were transported by HDL; moreover, HDL-lncRNA LEXIS was associated with Lp(a) plasma levels (p < .01). In a secondary analysis, the study population was stratified into two groups based on the Lp(a) median value. The high-Lp(a) group exhibited a significant increase of PWV compared to the low-Lp(a) group (9.23 ± .61 vs. 7.67 ± .56, p < .01). While HDL-lncRNA HIF1A-AS2 and LASER were similar in the two groups, the high-Lp(a) group exhibited a significant downregulation of HDL-lncRNA LEXIS compared to the low-Lp(a) group (fold change -4.4, p < .0001). Finally, Lp(a) and HDL-lncRNA LEXIS were associated with PWV (for Lp(a) p < .01; for HDL-lncRNA LEXIS p < .05). CONCLUSIONS LncRNA HIF1A-AS2, LASER and LEXIS were transported by HDL; moreover, significant relationships of HDL-lncRNA LEXIS with Lp(a) levels and PWV were found. Our study suggests that HDL-lncRNA LEXIS may be useful to better identify FH subjects with more pronounced vascular damage.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giosiana Bosco
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Stefania Di Mauro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Salvatore Spampinato
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Chiara Pavanello
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Alice Ossoli
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura Calabresi
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Biber JC, Sullivan A, Brazzo JA, Heo Y, Tumenbayar BI, Krajnik A, Poppenberg KE, Tutino VM, Heo SJ, Kolega J, Lee K, Bae Y. Survivin as a mediator of stiffness-induced cell cycle progression and proliferation of vascular smooth muscle cells. APL Bioeng 2023; 7:046108. [PMID: 37915752 PMCID: PMC10618027 DOI: 10.1063/5.0150532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
Stiffened arteries are a pathology of atherosclerosis, hypertension, and coronary artery disease and a key risk factor for cardiovascular disease events. The increased stiffness of arteries triggers a phenotypic switch, hypermigration, and hyperproliferation of vascular smooth muscle cells (VSMCs), leading to neointimal hyperplasia and accelerated neointima formation. However, the mechanism underlying this trigger remains unknown. Our analyses of whole-transcriptome microarray data from mouse VSMCs cultured on stiff hydrogels simulating arterial pathology identified 623 genes that were significantly and differentially expressed (360 upregulated and 263 downregulated) relative to expression in VSMCs cultured on soft hydrogels. Functional enrichment and gene network analyses revealed that these stiffness-sensitive genes are linked to cell cycle progression and proliferation. Importantly, we found that survivin, an inhibitor of apoptosis protein, mediates stiffness-dependent cell cycle progression and proliferation as determined by gene network and pathway analyses, RT-qPCR, immunoblotting, and cell proliferation assays. Furthermore, we found that inhibition of cell cycle progression did not reduce survivin expression, suggesting that survivin functions as an upstream regulator of cell cycle progression and proliferation in response to ECM stiffness. Mechanistically, we found that the stiffness signal is mechanotransduced via the FAK-E2F1 signaling axis to regulate survivin expression, establishing a regulatory pathway for how the stiffness of the cellular microenvironment affects VSMC behaviors. Overall, our findings indicate that survivin is necessary for VSMC cycling and proliferation and plays a role in regulating stiffness-responsive phenotypes.
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Affiliation(s)
- John C. Biber
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Andra Sullivan
- Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, New York 14260, USA
| | - Joseph A. Brazzo
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | | | - Bat-Ider Tumenbayar
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Amanda Krajnik
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | | | | | - Su-Jin Heo
- Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - John Kolega
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14203, USA
| | - Kwonmoo Lee
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts 02115, USA
| | - Yongho Bae
- Author to whom correspondence should be addressed:
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Dogan Z, Ileri C, Kay EA, Sunbul M, Gurel EY, Özben Sadıc B, Sayar N, Ergun T, Tigen KM. Evaluation of Arterial Stiffness Parameters and the Growth Differentiation Factor-15 Level in Patients with Premature Myocardial Infarction. J Pers Med 2023; 13:1489. [PMID: 37888100 PMCID: PMC10608472 DOI: 10.3390/jpm13101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) is increasing at a younger age. Growth differentiation factor-15 (GDF-15) has been implicated in several key mechanisms of atherogenesis. Arterial stiffness parameters, including pulse wave velocity (PWV) and the augmentation index (AIx), can indicate the presence or progression of atherosclerosis. The aim of this study is to evaluate the GDF-15 level and arterial stiffness parameters in patients with premature MI. METHOD Thirty patients aged ≤45 years (mean age: 39 ± 5 years, 23 male) who recovered from a MI and 15 age and sex-matched subjects were consecutively included. The serum GDF-15 concentration levels and arterial stiffness parameters of the patients and controls were measured. RESULTS GDF-15 levels were significantly higher in patients with premature MI, while there were no significant differences in PWV and AIx between the groups. The GDF-15 level was correlated negatively with high-density lipoprotein (HDL) cholesterol and positively with uric acid levels. Both GDF-15 (p = 0.046, odds ratio: 1.092, 95% confidence interval: 1.003-1.196) and HDL cholesterol (p = 0.037, odds ratio: 0.925, 95% confidence interval: 0.859-0.995) were found as independent factors associated with premature MI. CONCLUSIONS GDF-15 could be a risk factor for premature MI. Further studies are needed to elucidate the central role of GDF-15 in the pathophysiology of early atherosclerosis and MI in the young population.
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Affiliation(s)
- Zekeriya Dogan
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Cigdem Ileri
- Department of Cardiology, Kosuyolu Education and Research Hospital, Istanbul 34865, Turkey;
| | - Esin A. Kay
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Murat Sunbul
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Emre Y. Gurel
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Beste Özben Sadıc
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Nurten Sayar
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
| | - Tulin Ergun
- Department of Dermatology, Marmara University School of Medicine, Istanbul 34890, Turkey;
| | - Kursat M. Tigen
- Department of Cardiology, Marmara University School of Medicine, Istanbul 34890, Turkey; (E.A.K.); (M.S.); (E.Y.G.); (B.Ö.S.); (N.S.); (K.M.T.)
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Zhou Y, Chen C, Bai L, Jia L, Lu B, Gu G, Cui W. Positive association between alkaline phosphatase and arteriosclerosis: a cross-sectional study. J Cardiovasc Med (Hagerstown) 2023; 24:721-728. [PMID: 37605904 DOI: 10.2459/jcm.0000000000001550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
AIMS Serum alkaline phosphatase (ALP) is known to be associated with cardiovascular events and cerebral arteriosclerosis. However, the link between ALP and early arteriosclerosis remains unclear. This study investigated the relationship between ALP and early arteriosclerosis assessed by brachial-ankle pulse wave velocity (Ba-PWV). METHODS This retrospective analysis included 5011 participants who underwent health examinations, including ALP and Ba-PWV measurement, at the Second Hospital of Hebei Medical University from 2012 to 2017. Regression analysis, smoothing function analysis in the generalized additive model (GAM), threshold effect analysis, and subgroup analyses were performed. RESULTS Multivariate regression analysis identified a significantly positive association between serum ALP and arteriosclerosis [odds ratio (OR) = 1.008, 95% confidence interval (CI) 1.004-1.011, P < 0.001]. Smoothing function analysis indicated a two-stage association between ALP and arteriosclerosis. Furthermore, threshold effect analysis determined an inflection point at 135 U/l, below which the relationship was linearly positive and above which the risk of arteriosclerosis did not increase prominently with increasing ALP (OR = 1.009, 95% CI: 1.005-1.013, P < 0.001; OR = 0.976, 95% CI: 0.952-1.002, P = 0.068). However, ALP was not associated with arteriosclerosis only in participants with diabetes (OR = 0.996, 95% CI: 0.979-1.014, P = 0.690). A positive association between Ba-PWV and arteriosclerosis was observed for both the arteriosclerosis and nonarteriosclerosis groups ( β = 9.10, 95% CI: 4.67-13.54, P < 0.001; β = 8.02, 95% CI: 5.67-10.37, P < 0.001). CONCLUSION In this study, the serum ALP level was positively associated with early arteriosclerosis, with a saturation effect beyond ALP = 135 U/l. However, the positive association between ALP and arteriosclerosis was unclear in adults with diabetes.
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Affiliation(s)
- Yaqing Zhou
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang
| | - Chen Chen
- The Third Ward of the Department of Cardiology, Baoding No. 1 Central Hospital, Baoding, Hebei Province
| | - Long Bai
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Limei Jia
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang
| | - Baojin Lu
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang
| | - Guoqiang Gu
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Wei Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
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Laimoud M, Alanazi MN, Maghirang MJ, Al-Mutlaq SM, Althibait S, Ghamry R, Qureshi R, Alanazi B, Alomran M, Bakheet Z, Al-Halees Z. Impact of Chronic Kidney Disease on Clinical Outcomes during Hospitalization and Five-Year Follow-Up after Coronary Artery Bypass Grafting. Crit Care Res Pract 2023; 2023:9364913. [PMID: 37795473 PMCID: PMC10547561 DOI: 10.1155/2023/9364913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/29/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023] Open
Abstract
Background Chronic kidney disease (CKD) is often associated with multiple comorbidities including diabetes mellitus, and each has its own complications and impact after cardiac surgery including coronary revascularization. The objective of this work was to study the impact of CKD on clinical outcomes after coronary artery bypass grafting (CABG) and to compare outcomes in patients with different grades of renal functions. We retrospectively reviewed all patients who underwent CABG from January 2016 to August 2020 at our tertiary care hospital using electronic medical records. Results The study included 410 patients with a median age of 60 years, and 28.6% of them had CKD and hospital mortality of 2.7%. About 71.4% of the patients had GFR > 60 mL/min per 1.73 m2, 18.1% had early CKD (GFR 30-60), 2.7% had late CKD (GFR < 30), and 7.8% of them had end-stage renal disease (ESRD) requiring dialysis. The CKD group had significantly more frequent hospital mortality (p = 0.04), acute cerebrovascular stroke (p = 0.03), acute kidney injury (AKI) (p < 0.001), longer ICU stay (p = 0.002), post-ICU stay (p = 0.001), and sternotomy wound debridement (p = 0.03) compared to the non-CKD group. The frequencies of new need for dialysis were 2.4% vs. 14.9% vs. 45.5% (p < 0.001) in the patients with GFR > 60 mL/min per 1.73 m2, early CKD, and late CKD, respectively. Acute cerebral stroke (OR: 10.29, 95% CI: 1.82-58.08, and p = 0.008), new need for dialysis (OR: 25.617, 95% CI: 13.78-85.47, and p < 0.001), and emergency surgery (OR: 3.1, 95% CI: 1.82-12.37, and p = 0.036) were the independent predictors of hospital mortality after CABG. The patients with CKD had an increased risk of strokes (HR: 2.14, 95% CI: 1.20-3.81, and p = 0.01) but insignificant mortality increase (HR: 1.44, 95% CI: 0.42-4.92, and p = 0.56) during follow-up. Conclusion The patients with CKD, especially the late grade, had worse postoperative early and late outcomes compared to non-CKD patients after CABG. Patients with dialysis-independent CKD had increased risks of needing dialysis, hospital mortality, and permanent dialysis after CABG.
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Affiliation(s)
- Mohamed Laimoud
- Cardiovascular Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
| | - Mosleh Nazzel Alanazi
- Cardiovascular Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mary Jane Maghirang
- Cardiovascular Nursing Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shatha Mohamed Al-Mutlaq
- Cardiac Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Suha Althibait
- Cardiac Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Rasha Ghamry
- Nephrology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Rehan Qureshi
- Cardiovascular Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Boshra Alanazi
- College of Medicine, Almaarefa University, Riyadh, Saudi Arabia
| | - Munirah Alomran
- Cardiovascular Nursing Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zeina Bakheet
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zohair Al-Halees
- Cardiac Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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8
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Makavos G, Ikonomidis I, Lambadiari V, Koliou GA, Pavlidis G, Thymis J, Rafouli-Stergiou P, Kostelli G, Katogiannis K, Stamoulis K, Kountouri A, Korakas E, Theodoropoulos K, Frogoudaki A, Katsimbri P, Papadavid E. Additive prognostic value of longitudinal myocardial deformation to SCORE2 in psoriasis. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead016. [PMID: 36942108 PMCID: PMC10023827 DOI: 10.1093/ehjopen/oead016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023]
Abstract
Aims Psoriasis has been associated with increased cardiovascular (CV) risk. We investigated whether markers of CV function and their change after treatment have a prognostic value for adverse outcomes. Methods and results In a prospective study, at baseline and after 6 months of treatment with biological agents, we assessed in 298 psoriasis patients (i) left ventricular global longitudinal strain (GLS) and (ii) carotid-femoral pulse wave velocity (PWV), to evaluate their prognostic value for major adverse cardiovascular events (MACEs), including coronary artery disease, stroke, hospitalization for heart failure, and all-cause death over a 4-year follow-up period. During follow-up, 26 (8.7%) MACEs were recorded. By univariate analysis, decreasing absolute GLS values [hazard ratio (HR): 0.73, P < 0.001], decreasing GLS change after treatment (HR: 0.53, P = 0.008), and increasing PWV values (HR: 1.16, P = 0.049) were associated with adverse outcomes. Baseline GLS and its change post-treatment remained independent predictors of adverse events after adjusting for several confounders (P < 0.05). The addition of baseline GLS and its absolute change post-treatment to SCORE2 increased Harrell's C from 0.882 to 0.941. By multivariable analysis, for each 1% increase in absolute baseline GLS values, the risk of MACE decreased by 33% and for each 1% absolute increase of GLS post-treatment compared with the baseline value, the risk of MACE decreased by 58%. Conclusion Global longitudinal strain has an independent and additive prognostic value to SCORE2 for adverse CV events in psoriasis, providing timely decision-making for intensive anti-inflammatory treatment and aggressive modification of risk factors to reduce CV risk.
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Affiliation(s)
- George Makavos
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Ignatios Ikonomidis
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Vaia Lambadiari
- 2nd Department of Internal Medicine Propaedeutic, Research Institute and Diabetes Center, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Georgia-Angeliki Koliou
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - George Pavlidis
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - John Thymis
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Pinelopi Rafouli-Stergiou
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Gavriella Kostelli
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Konstantinos Katogiannis
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Konstantinos Stamoulis
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Aikaterini Kountouri
- 4th Department of Internal Medicine, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Emmanouil Korakas
- 4th Department of Internal Medicine, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Kostas Theodoropoulos
- 2nd Department of Dermatology and Venereology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Alexandra Frogoudaki
- 2nd Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Pelagia Katsimbri
- 4th Department of Internal Medicine, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
| | - Evangelia Papadavid
- 2nd Department of Dermatology and Venereology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1, Haidari, Athens 12462, Greece
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9
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The role of arterial stiffness in the onset of Takotsubo cardiomyopathy observed with noradrenaline administration and intracranial blood injection in rabbits. Heart Vessels 2023; 38:740-748. [PMID: 36629930 DOI: 10.1007/s00380-022-02223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023]
Abstract
Takotsubo cardiomyopathy (TCM) has been reported to occur after subarachnoid hemorrhage, and the involvement of a critical activity of catecholamines has been mentioned, but the details of its onset have not been fully clarified. Recently, proper arterial stiffness could be measured with cardio-ankle vascular index. Therefore, we aimed to clarify the role of arterial stiffness in onset of TCM using rabbits under infusion of noradrenaline and injection of blood into brain ventricle. Rabbits were divided into three groups: infusion of noradrenaline (group A), infusion of noradrenaline + injection of saline into the brain ventricle (group B), infusion of noradrenaline + injection of blood in the brain ventricle (group C). Aortic arterial stiffness beta (Aβ) and femoral arterial stiffness beta (Fβ) were defined according to definition of the cardio-ankle vascular index. Blood pressure (BP), Aβ, Fβ, and femoral vessel resistance (FVR) were measured. Left ventricular movement were monitored with echocardiography. BP increased uniformly in all three groups. Fβ in the group A, B and C increased from 3.6 ± 3.2, 3.6 ± 3.6 and 3.9_ ± 4.2 to 15 ± 2, 17.9 ± 2.4, 34.8 ± 9.1 due to the ICP enhancements in addition to noradrenaline administration, respectively. Fβ in groups B and C was significantly larger than that in group A. On echocardiography, a much higher akinesic area of the apex was observed in group C compared with group A and B. Cardiac movements similar to TCM were observed slightly in group B and definitely in group C. Noradrenaline administration infusion and blood injection into the brain ventricle induced TCM accompanying with enhanced femoral arterial stiffness. These results suggested that elevated arterial stiffness might be involved in the formation of TCM in addition to a critical activity of catecholamines and an increase in intracranial pressure with blood injection.
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10
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Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcon-Braga EA, Mosquera-Rojas MD, Campos-Aspajo A, Salazar-Valdivia FE, Valdez-Cornejo VA, Benites-Zapata VA, Herrera-Añazco P, Valenzuela-Rodríguez G, Hernandez AV. Atherogenic index of plasma and coronary artery disease: A systematic review. Open Med (Wars) 2022; 17:1915-1926. [PMID: 36561845 PMCID: PMC9730543 DOI: 10.1515/med-2022-0590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/06/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
Various studies suggest that the atherogenic index of plasma (AIP) is associated with the risk of coronary artery disease (CAD) in different clinical scenarios. This review aimed to synthesize evidence of the association between AIP values and CAD. A literature search was carried out on four databases, namely, PubMed, Scopus, Web of Science, and Ovid-Medline. A handsearch was performed on preprint repositories (MedRxiv and Research Square). The effect measurements were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (CI). For the quantitative synthesis, we employed a random-effects model. We analyzed 14 articles (with 40,902 participants) from seven different countries. The quantitative analysis revealed that an increase in one unit of AIP was associated with higher odds of developing CAD (OR 2.11; 95% CI 1.65-2.69; P < 0.001; I 2 = 98%). We conducted subgroup analyses of Chinese (OR 1.89; 95% CI 1.40-2.56; P < 0.001) and non-Chinese studies (OR 2.51; 95% CI 1.42-4.42; P < 0.001). The sensitivity analysis by risk of bias continued to demonstrate an association, and the heterogeneity remained unchanged (OR 1.75; 95% CI 1.33-2.31; P < 0.001; I 2 = 98%). Higher AIP values were associated with higher odds of developing CAD.
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Affiliation(s)
- Juan R. Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Enrique A. Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Perú,Grupo Peruano de Investigación Epidemiológica, Unidad Para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - Esteban A. Alarcon-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Melany D. Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Alvaro Campos-Aspajo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Farley E. Salazar-Valdivia
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Valeria A. Valdez-Cornejo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú,Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Avenida La Fontana #750 La Molina, Lima, Perú
| | - Percy Herrera-Añazco
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Trujillo, Perú,Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru
| | - Germán Valenzuela-Rodríguez
- Clínica Delgado, Servicio de Medicina Interna y Cardiología, Lima, Perú,Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Perú
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta- análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú,Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, United States of America
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11
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Iaquinta FS, Grosso R, Di Napoli S, Cassano V, Naty S, Armentaro G, Massimino M, Condoleo V, Barbara K, Crescibene D, Caroleo B, Miceli S, Sciacqua A, Grembiale RD. Decreased Pulse Wave Velocity in a Systemic Sclerosis Population: Preliminary Results from a Cross-Sectional Study. J Pers Med 2022; 12:jpm12121952. [PMID: 36556173 PMCID: PMC9787664 DOI: 10.3390/jpm12121952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Systemic Sclerosis (SSc) is an autoimmune disorder characterized by organ and tissue fibrosis in which the incidence of atherosclerosis and cardiovascular events is increased, although the exact underlying mechanism remains unclear. Arterial stiffness is a marker of vascular damage that can predict cardiovascular events; therefore, this study aimed to assess the augmentation index (AIx) and pulse wave velocity (PWV), markers of stiffness, in a Systemic Sclerosis population and to detect potentially associated variables. Fourteen female Systemic Sclerosis patients and 14 age- and sex-matched controls were enrolled. Demographic, anthropometric, sero-hematological parameters and disease characteristics were collected for each participant. Arterial stiffness was evaluated using an applanation tonometry system. No differences were found between groups, except for BMI, fasting blood glucose, red blood cells count, hemoglobin, and treatment. Patients had increased augmentation index than the controls (p = 0.008). PWV was significantly decreased in SSc patients compared with the controls (p = 0.007). PWV was correlated with age (r = 0.462; p = 0.048) and BMI (r = 0.458; p = 0.050). Finally, patients with no specific auto-antibody pattern had greater AIx than those expressing anticentromere antibodies. Our study demonstrated that SSc patients had greater AIx, but lower PWV than the controls. In addition, few variables were correlated to arterial stiffness. Further studies are necessary to validate these findings and to establish medication's role in modifying cardiovascular risk.
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Affiliation(s)
- Francesco Salvatore Iaquinta
- Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: (F.S.I.); (R.D.G.)
| | - Roberta Grosso
- Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Stefania Di Napoli
- Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Saverio Naty
- Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Mattia Massimino
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Valentino Condoleo
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Keti Barbara
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Daniele Crescibene
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Benedetto Caroleo
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Rosa Daniela Grembiale
- Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: (F.S.I.); (R.D.G.)
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12
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Santos V, Massuça LM, Angarten V, Melo X, Pinto R, Fernhall B, Santa-Clara H. Arterial Stiffness following Endurance and Resistance Exercise Sessions in Older Patients with Coronary Artery Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14697. [PMID: 36429412 PMCID: PMC9690428 DOI: 10.3390/ijerph192214697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Arterial stiffness (AS) is associated with coronary artery disease (CAD). Acute endurance training decreases AS, whereas acute resistance training increases it. However, these results are from studies in apparently healthy adults, and there is no information on the effects of such afterload AS in elderly patients with CAD. We aimed to investigate the effect of acute endurance or resistance training on the time course of changes in the indices of AS in elderly patients with CAD in order to understand how stiffness responds after training. We tested 18 trained men with CAD. AS was measured using central and peripheral pulse wave velocity (PWV) after 15 min of rest and after 5, 15, and 30 min of endurance and resistance training sessions. The endurance session consisted of high-intensity interval walking at 85-90% of maximum heart rate, and the resistance session consisted of 70% of the maximum of one repetition. An interaction effect was found for central and peripheral PWV (p ≤ 0.001; carotid, η2 = 0.72; aortic, η2 = 0.90; femoral, η2 = 0.74), which was due to an increase in PWV after resistance and a decrease in central and peripheral PWV after endurance. This study demonstrates that training mode influences the time course of AS responses to acute exercise in these patients. Acute endurance training decreased AS, whereas resistance training significantly increased it.
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Affiliation(s)
- Vanessa Santos
- CIPER, Exercise and Health Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, 1649-004 Lisbon, Portugal
- KinesioLab, Research Unit in Human Movement Analysis, Instituto Piaget, 2805-059 Almada, Portugal
| | - Luís Miguel Massuça
- ICPOL Research Center, Higher Institute of Police Sciences and Internal Security, 1349-040 Lisbon, Portugal
- CIDEFES—Research Center in Sport, Physical Education, Exercise and Health, Lusófona University, 1749-024 Lisbon, Portugal
| | - Vitor Angarten
- CIPER, Exercise and Health Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, 1649-004 Lisbon, Portugal
| | - Xavier Melo
- CIPER, Exercise and Health Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, 1649-004 Lisbon, Portugal
- Egas Moniz Interdisciplinary Research Center (CiiEM), Egas Moniz School of Health, 2829-511 Almada, Portugal
| | - Rita Pinto
- Structural and Coronary Heart Disease Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculty of Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
| | - Bo Fernhall
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393, USA
| | - Helena Santa-Clara
- CIPER, Exercise and Health Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, 1649-004 Lisbon, Portugal
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13
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Huang S, Luo Y, Liang L, Guo N, Duan X, Zhou Q, Ge L. The baseline and repeated measurements of DBP to assess in-hospital mortality risk among critically ill patients with acute myocardial infarction: A retrospective cohort study. Medicine (Baltimore) 2022; 101:e30980. [PMID: 36221379 PMCID: PMC9543008 DOI: 10.1097/md.0000000000030980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/06/2022] [Indexed: 01/05/2023] Open
Abstract
Changes in diastolic blood pressure (DBP) are common in patients with acute myocardial infarction (AMI). The relationship between the dynamic change of DBP and in-hospital mortality among patients with AMI remains unclear. This study aimed to explore the importance of DBP during disease development among patients with AMI. We performed a retrospective cohort study involving patients from the Medical Information Mart for Intensive Care III database, which included > 40,000 patients admitted to the intensive care unit (ICU). Overall, 3209 adult AMI admissions were identified. We extracted the clinical and laboratory information in the patients with AMI. Cox proportional hazards models were used to evaluate the prognostic values of baseline DBP. We used the generalized additive mixed model (GAMM) to compare trends in DBP over time among survivors and non-survivors, after adjusting for potential confounders. During the ICU stay, 189 patients died (mortality rate, 6.36%). The age of each non-survivor together with the variations in DBP over time from admission to the time of death is of great importance to the scientific community. Cox multivariable regression analysis displayed that after adjusting for confounding factors, ascended baseline DBP was an important hazard factor for hospital deaths (hazard ratio, 1.02; 95% confidence interval, 1.01-1.03; P = .003). Based on GAMM, DBP in the death group was markedly lower than that of the surviving group. Moreover, the difference between the two groups showed an increasing trend within 3 days after ICU admission. After adjusting for various variables, the results were stable. DBP significantly contributed to in-hospital mortality among patients with AMI. There was a nonlinear correlation between baseline DBP and in-hospital mortality among patients with AMI, and the DBP of the non-survivors decreased within the first 3 days after ICU admission. However, the causality cannot be deduced from our data.
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Affiliation(s)
- Sulan Huang
- Cardiovascular Medicine Department, The First People’s Hospital of Changde City, Changde City, Hunan Province, People’s Republic of China
| | - Yanlan Luo
- Cardiovascular Medicine Department, The First People’s Hospital of Changde City, Changde City, Hunan Province, People’s Republic of China
| | - Li Liang
- Cardiovascular Medicine Department, The First People’s Hospital of Changde City, Changde City, Hunan Province, People’s Republic of China
| | - Ning Guo
- Cardiovascular Medicine Department, The First People’s Hospital of Changde City, Changde City, Hunan Province, People’s Republic of China
| | - Xiangjie Duan
- Infectious Disease Department, The First People’s Hospital of Changde, Changde City, Hunan Province, People’s Republic of China
| | - Quan Zhou
- Department of Science and Education Section, The First People’s Hospital of Changde, Changde City, Hunan Province, 415000, People’s Republic of China
| | - Liangqing Ge
- Cardiovascular Medicine Department, The First People’s Hospital of Changde City, Changde City, Hunan Province, People’s Republic of China
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14
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Zhou Y, Dan H, Bai L, Jia L, Lu B, Cui W. Nonlinear relationship with saturation effect observed between neutrophil to high-density lipoprotein cholesterol ratio and atherosclerosis in a health examination population: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:424. [PMID: 36162980 PMCID: PMC9513987 DOI: 10.1186/s12872-022-02869-2] [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: 05/17/2022] [Accepted: 09/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background The relationships between inflammatory indexes and atherosclerosis as well as those between blood lipid indexes and atherosclerosis have been widely studied, but the relationship between the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and atherosclerosis had not been investigated until the present study. Methods For this cross‐sectional study, we continuously collected data from a health examination population in the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 1978). The collected data included clinical data, hematological indexes, and brachial-ankle pulse wave velocity (Ba-PWV). Atherosclerosis was defined as Ba-PWV ≥ 1400 cm/s. The relationship between the NHR and atherosclerosis was explored via univariate regression analysis, multivariate regression analysis, smoothing function analysis, and analysis of a threshold saturation effect. Results Among 1978 participants, the mean age was 54 years, 1189 participants (60.11%) were male, and 1103 (55.76%) had a history of atherosclerosis. Univariate analysis showed a positive association between the NHR and atherosclerosis [odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.11–1.27, P < 0.01], and this positive association remained significant on multivariate analyses with adjustments for confounding factors (OR = 1.14, 95% CI: 1.06–1.24, P < 0.01). Generalized additive model results revealed a non-linear relationship with a saturation effect between the NHR and atherosclerosis, with a threshold at 3.32. At values ≤ 3.32, the NHR was positively associated with atherosclerosis, but the association was not statistically significant for values > 3.32. Conclusion A nonlinear relationship with a certain saturation effect was observed between the NHR and atherosclerosis in a health examination population.
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Affiliation(s)
- Yaqing Zhou
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China
| | - Haijun Dan
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Long Bai
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China
| | - Limei Jia
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Baojin Lu
- Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Wei Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, Shijiazhuang, 050000, China.
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15
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Li G, Lv Y, Su Q, You Q, Yu L. The effect of aerobic exercise on pulse wave velocity in middle-aged and elderly people: A systematic review and meta-analysis of randomized controlled trials. Front Cardiovasc Med 2022; 9:960096. [PMID: 36061566 PMCID: PMC9433655 DOI: 10.3389/fcvm.2022.960096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
A growing body of research examines the effect of aerobic exercise on pulse wave velocity (PWV) in middle-aged and elderly people, while findings of available studies were conflicting. The aim of this study was to explore the effect of aerobic exercise on PWV in middle-aged and elderly people. Searches were performed in PubMed, Web of Science, and EBSCO databases. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. We included studies that satisfied the following criteria: (1) eligible studies should be randomized controlled trials (RCTs); (2) eligible studies should include both an intervention and a control group; (3) eligible studies should use the middle-aged or elderly people as subjects; and (4) eligible studies should use PWV as the outcome measure. From 972 search records initially identified, 11 studies with a total of 12 exercise groups (n = 245) and 11 control groups (n = 239) were eligible for meta-analysis. There was a significant effect of aerobic exercise on reducing PWV in middle-aged and elderly people [weighted mean difference (WMD), –0.75 (95% CI, –1.21 to –0.28), p = 0.002]. Specifically, a higher intensity [vigorous-intensity, –0.74 (–1.34 to –0.14), p = 0.02; moderate-intensity, –0.68 (–1.49 to 0.12), p = 0.10], a younger age [45 years ≤ age < 60 years, –0.57 (–0.78 to –0.37), p < 0.00001; age ≥ 60 years, –0.91 (–2.10 to 0.27), p = 0.13], a better health status [healthy, –1.19 (–2.06 to –0.31), p = 0.008; diseased, –0.32 (–0.64 to –0.01), p = 0.04], and a lower basal body mass index (BMI) [BMI < 25, –1.19 (–2.06 to –0.31), p = 0.008; 25 ≤ BMI < 30, –0.52 (–0.92 to –0.12), p = 0.01; BMI ≥ 30, –0.09 (–0.93 to 0.76), p = 0.84] were associatedwith larger reductions in PWV. Aerobic exercise, especially vigorous-intensity aerobic exercise, contributed to reducing PWV in middle-aged and elderly people. The effect of aerobic exercise on improving PWV was associated with characteristics of the participants. Specifically, a younger age, a better health status, and a lower basal BMI contributed to more significant reductions in PWV.
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Affiliation(s)
- Gen Li
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Qing Su
- Ersha Sports Training Center of Guangdong Province, Guangzhou, China
| | - Qiuping You
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Training, Beijing Sport University, Beijing, China
- *Correspondence: Laikang Yu,
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16
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Long-Term Prognosis after Coronary Artery Bypass Grafting: The Impact of Arterial Stiffness and Multifocal Atherosclerosis. J Clin Med 2022; 11:jcm11154585. [PMID: 35956199 PMCID: PMC9369624 DOI: 10.3390/jcm11154585] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/24/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to study the effect of arterial stiffness and multifocal atherosclerosis on the 10-year prognosis of patients after coronary artery bypass grafting. Methods. Patients with coronary artery disease (n = 274) who underwent coronary artery bypass grafting (CABG), in whom cardio-ankle vascular index (CAVI) was assessed using the VaSera VS-1000 device and the presence of peripheral atherosclerosis in Doppler ultrasound. Groups were distinguished with normal CAVI (<9.0, n = 163) and pathological CAVI (≥9.0, n = 111). To assess the prognosis, coronary and non-coronary death, myocardial infarction, acute cerebrovascular accident/transient ischemic attack, repeated CABG, percutaneous coronary intervention, carotid endarterectomy, peripheral arterial surgery, pacemaker implantation were analyzed. Results. During the observation period, mortality was 27.7%. A fatal outcome from all causes was in 37 (22.7%) patients in the group with normal CAVI and in 39 (35.14%) in the group with pathological CAVI (p = 0.023). Death from cardiac causes was more common in the group with CAVI ≥ 9.0—in 25 cases (22.52%) than in the group with CAVI < 9.0—in 19 (11.6%, p = 0.016). The combined endpoint in patients with pathological CAVI was detected in 66 (59.46%) cases, with normal CAVI values—in 76 (46.63%) cases (p = 0.03). The presence of diabetes mellitus, multifocal atherosclerosis (p = 0.004), pathological CAVI (p = 0.063), and male gender were independent predictors of death at 10-year follow-up after CABG. The presence of multifocal atherosclerosis and pathological CAVI during the preoperative examination of patients were independent predictors of the combined endpoint development. Findings. Patients with coronary artery disease with pathological CAVI before CABG were more likely to experience adverse events and death in the long-term follow-up than patients with normal CAVI. Further studies are needed to investigate the possibility of correcting pathological CAVI after CABG after secondary prevention and the possible impact of this correction on prognosis.
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17
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Li W, Wang Y, Chen S, Zhao J, Su Q, Fan Y, Wu S, Li J, Hong J. Evaluation of Carotid Artery Atherosclerosis and Arterial Stiffness in Cardiovascular Disease Risk: An Ongoing Prospective Study From the Kailuan Cohort. Front Cardiovasc Med 2022; 9:812652. [PMID: 35586658 PMCID: PMC9108697 DOI: 10.3389/fcvm.2022.812652] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To assess whether carotid artery ultrasonography and brachial-ankle pulse wave velocity (baPWV) measurement can accurately predict cardiovascular and cerebrovascular events, and all-cause mortality in patients with cardiovascular diseases (CVD). Methods Patients from the Kailuan Study Stroke Cohort (Tangshan, China) who underwent carotid artery ultrasonography and baPWV measurement between June 2010 and June 2011 were included in this study. The effects of carotid plaque, baPWV, and their combination on cardiovascular events, including myocardial infarction (MI), cerebral ischemic stroke, cerebrovascular events, and all-cause mortality, were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression. Results A total of 4,899 participants (59.7% males; 54.18 ± 11.52 years old) were analyzed. During a mean follow-up of 5.68 ± 0.66 years, the incidence of cardiovascular events and all-cause mortality were 4.94‰ person-years and 7.02‰ person-years, respectively; 32.8% of participants had both carotid artery atherosclerosis and increased arterial stiffness. A high baPWV alone was associated with an increased risk of CVD events [hazard ratio (HR): 2.68; 95% confidence interval (95% CI): 1.20–6.00; P = 0.007] and cerebral infarction (HR: 5.92; 95% CI: 1.76–19.93; P = 0.004), but not with MI or all-cause death. The presence of both carotid plaque and high baPWV was highly associated with an increased risk of CVD events (HR: 4.65; 95% CI: 2.06–10.45; P < 0.001) and cerebral infarction (HR: 9.21; 95% CI: 2.71–31.19; P < 0.001), but not with MI or all-cause death. Similar results were obtained by the Kaplan-Meier analyses. Conclusion The presence of carotid plaque and high baPWV were associated with a high risk of CVD events and ischemic stroke. Moreover, the combination of carotid artery ultrasonography and baPWV measurement could predict the risk for CVD ability more accurately than a single measurement alone.
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Affiliation(s)
- Wen Li
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yan Wang
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
| | - Jianqiu Zhao
- Department of Anesthesiology, Anting Hospital, Shanghai, China
| | - Qi Su
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai, China
| | - Yanfeng Fan
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, China
- *Correspondence: Shouling Wu
| | - Jun Li
- Department of Cardiology, Shanghai General Hospital, Shanghai, China
- Jun Li
| | - Jiang Hong
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai, China
- Jiang Hong
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18
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Liu X, Shao Y, Sun J, Tu J, Wang Z, Tao J, Chen J. Egg consumption improves vascular and gut microbiota function without increasing inflammatory, metabolic, and oxidative stress markers. Food Sci Nutr 2022; 10:295-304. [PMID: 35035930 PMCID: PMC8751450 DOI: 10.1002/fsn3.2671] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Egg consumption is one of the many inconsistencies in evidence linking dietary cholesterol to cardiovascular disease (CVD). In addition, the gut microbiota and its metabolite, trimethylamine-N-oxide (TMAO), have been shown to play a crucial role in the development of CVD. The fact that egg is rich in choline suggests that excessive egg consumption may increase TMAO production by altering the gut microbiota. However, the effects of egg consumption on vascular function and gut microbiota remain unclear. Here, the diet of nine young male subjects was supplemented with two boiled eggs daily for 2 weeks. Changes in vascular function, inflammation, metabolism, oxidative stress, and gut microbiota were examined. We found that egg consumption increased flow-mediated dilation and decreased brachial-ankle pulse wave velocity. Furthermore, egg consumption positively modulated the gut microbiota function but had no effects on the levels of C-reactive protein, glucose, lipid profile, malondialdehyde, superoxide dismutase, or TMAO. The current study provides evidence that egg consumption improves vascular function, which may be related to the alterations seen in the gut microbiota. Therefore, moderate egg consumption may help to improve vascular and intestinal function in individuals at low risk of developing CVD and other metabolic disorders.
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Affiliation(s)
- Xiang Liu
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Yijia Shao
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jiapan Sun
- Department of GeriatricsPeking University Shenzhen HospitalShenzhen Peking University‐The Hong Kong University of Science and Technology Medical CenterShenzhenChina
| | - Jiazichao Tu
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Zhichao Wang
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jun Tao
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jimei Chen
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
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19
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AYDIN OZTURK P, ÖZTÜRK Ü, ÖZTÜRK Ö. The relationship between aortic stiffness index and stroke severity in patients with acute ischemic stroke. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.976695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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20
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Auker L, Cordingley L, Griffiths CEM, Young HS. Physical activity is important for cardiovascular health and cardiorespiratory fitness in patients with psoriasis. Clin Exp Dermatol 2021; 47:289-296. [PMID: 34368977 PMCID: PMC9291751 DOI: 10.1111/ced.14872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/09/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
Background Patients with psoriasis have a level of physical activity below that recommended for cardiovascular health, which is significantly limited by disease severity and other psoriasis‐specific barriers. We hypothesized that physical activity is important for cardiovascular health in patients with psoriasis and that its objective measurement could have clinical utility. Aim To explore whether physical activity influences the risk of cardiovascular disease (CVD) in patients with psoriasis. Methods In total, 242 patients with chronic plaque psoriasis were recruited. History, examination and physical activity were assessed and arteriography, the noninvasive measurement of arterial function, was performed for each participant. Results We observed a significant relationship between volume of physical activity and the likelihood of future CVD as measured by pulse wave velocity (PWV; P < 0.02). We identified a significant relationship between the diastolic reflection area (DRA) and health‐promoting levels of physical activity (P < 0.001), in addition to a significant correlation between DRA and the likelihood of future CVD (P < 0.001). The DRA is a complex, dimensionless variable that describes the intensity of diastolic wave reflection and the duration of diastole, which are key determinants of the blood supply to the left ventricle. Our data suggest that DRA may represent a surrogate marker for cardiorespiratory fitness. Conclusion Our study describes a significant relationship between exercise, cardiorespiratory fitness and PWV, a preclinical indicator of future CVD risk, in patients with psoriasis. The DRA offers a noninvasive, objective measurement of exercise adherence, which could have clinical utility in the future.
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Affiliation(s)
- L Auker
- Centre for Dermatology Research, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - L Cordingley
- Centre for Dermatology Research, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - C E M Griffiths
- Centre for Dermatology Research, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - H S Young
- Centre for Dermatology Research, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
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21
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Sun J, Wang S, Li M, Su Y, Ma S, Zhang Y, Zhang A, Cai S, Cheng B, Bao Q, Zhu P. The high normal ankle brachial index is associated with left ventricular hypertrophy in hypertension patients among the Han Chinese. J Clin Hypertens (Greenwich) 2021; 23:1758-1766. [PMID: 34297892 PMCID: PMC8678752 DOI: 10.1111/jch.14328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/22/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
Left ventricular hypertrophy (LVH) is the most common target organs damage in the hypertension patients. Abnormal low (≤0.9) or high (≥1.40) ankle brachial index (ABI) are associated with an increased risk of cardiovascular events. However, the relationships between a high ABI in the normal range (0.9–1.4) and LVH in Han Chinese hypertension are not entirely elucidated. This study included 3953 hypertension patients aged 40–75 years among Han Chinese. Hypertension was defined as systolic blood pressure≥140 mm Hg, diastolic blood pressure≥90 mm Hg, or history of antihypertensive drug use. Left ventricular mass (LVM) was measured by transthoracic echocardiography. LVH was diagnosed by using the criteria of LVM ≥49.2 g/m2.7 for men and 46.7 g/m2.7 for women. Our study suggested that the ABI was higher in patients with LVH than in those without (1.13±0.11, 1.11±0.11, p < 0.001). The prevalence of LVH in patients with the lowest (0.9 < ABI≤1.03), second (1.04≤ABI≤1.11), the third (1.12≤ABI≤1.20), and the highest quartile (1.21≤ABI < 1.40) of ABI was 37.2%, 38.2%, 45.5%, 45.7%, respectively. Logistic regression analysis suggested that the highest and third quartile of ABI were significantly associated with increased LVH risk (multivariate‐adjusted OR of highest group:1.83; third group:1.61). The association of ABI at second quartile with LVH was nonsignificant. Similar results were observed in less than 60 years and without coronary heart disease or diabetes group. Our observations in Chinese patients with hypertension indicated high ABI may be an important risk factor for LVH in hypertension patients among Han Chinese, even in the normal range.
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Affiliation(s)
- Jin Sun
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shuxia Wang
- Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Man Li
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yongkang Su
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shouyuan Ma
- Department of Geriatric Cardiology, The second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yan Zhang
- Department of Outpatient, The first Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Anhang Zhang
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shuang Cai
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Bokai Cheng
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qiligeer Bao
- Medical School of Chinese PLA, Beijing, China.,Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ping Zhu
- Department of Geriatrics, The second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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Effects of Anti-Inflammatory Treatment and Surgical Intervention on Endothelial Glycocalyx, Peripheral and Coronary Microcirculatory Function and Myocardial Deformation in Inflammatory Bowel Disease Patients: A Two-Arms Two-Stage Clinical Trial. Diagnostics (Basel) 2021; 11:diagnostics11060993. [PMID: 34070768 PMCID: PMC8227308 DOI: 10.3390/diagnostics11060993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 02/06/2023] Open
Abstract
Sixty inflammatory bowel disease (IBD) patients (45 Crohn disease and 15 ulcerative colitis, 40 ± 13 years, 53% male) were examined at baseline and 4 months after intervention (surgical (35 patients) or anti-TNFa treatment (25 patients)). IBD severity, using Mayo score, Harvey–Bradshaw Index (HBI) and biomarkers, was correlated with cardiovascular markers. At baseline, the disease severity, the white blood cells (WBC) values and the reducing power (RP) were significantly correlated with the aortic pulse wave velocity (PWV) (r = 0.4, r = 0.44 and r = 0.48, p < 0.05) and the lateral mitral E’ velocity (r = 0.35, p < 0.05 and r = 0.3, p < 0.05). Four months after intervention, there was a reduction of WBC (1962.8/mm3 ± 0.425/mm3, p < 0.001), C-reactive protein (CRP) (8.1 mg/L ± 1.7 mg/L, p < 0.001), malondialdehyde (MDA) (0.81 nmol/mg ± 0.37, p < 0.05) and glycocalyx perfused boundary region (PBR 5-25) (0.24 μm ± 0.05 μm, p < 0.01). Moreover, the brachial flow mediated dilatation (FMD), the coronary flow reserve (CFR) and the left ventricle global longitudinal strain (LV GLS) were significantly improved for both groups (4.5% ± 0.9%, 0.55 ± 0.08, 1.4% ± 0.35%, p < 0.01), while a more significant improvement of PWV/GLS was noticed in the anti-TNFa group. IBD severity is associated with vascular endothelial, cardiac diastolic, and coronary microcirculatory dysfunction. The systemic inflammatory inhibition and the local surgical intervention lead to significant improvement in endothelial function, coronary microcirculation and myocardial deformation.
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23
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Kim ST, Ko Y, Beom JW, Boo KY, Lee JG, Choi JH, Kim SY, Joo SJ. Association of changes of pulse wave velocity and augmentation index after isometric handgrip exercise with coronary lesion extent and revascularization. Clin Hypertens 2021; 27:5. [PMID: 33931135 PMCID: PMC8088004 DOI: 10.1186/s40885-021-00163-5] [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: 10/14/2020] [Accepted: 01/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Arterial stiffness is associated with myocardial ischemia and incident coronary artery disease (CAD), and indexes of arterial stiffness are usually increased in patients with CAD. However, these indexes are often increased in elderly without CAD. Arterial stiffness in patients with CAD may become more evident after isometric handgrip exercise which increases systolic pressure and ventricular afterload. We investigated the association of the change of stiffness indexes after isometric handgrip exercise with the lesion extent of CAD and the necessity for coronary revascularization. Methods Patients who were scheduled a routine coronary angiography via a femoral artery were enrolled. Arterial waveforms were traced at aortic root and external iliac artery using coronary catheters at baseline and 3 min after handgrip exercise. Augmentation index (AIx) was measured on the recorded aortic pressure waveform, and pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and distance between aortic root and external iliac artery. Results Total 37 patients were evaluated. Both PWV and AIx increased after handgrip exercise. ΔPWV was significantly correlated with ΔAIx (r = 0.344, P = 0.037). Patients were divided into higher and lower ΔPWV or ΔAIx groups based on the median values of 0.4 m/sec and 3.3%, respectively. Patients with higher PWV had more 2- or 3-vessel CAD (69% vs. 27%, P = 0.034), and underwent percutaneous coronary intervention (PCI) more frequently (84% vs. 50%, P = 0.038), but higher ΔAIx was not associated with either the lesion extent or PCI. Area under curve (AUC) of ΔPWV in association with PCI by C-statistics was 0.70 (95% confidence interval [CI] 0.51–0.88; P = 0.056). In multiple logistic regression analysis, ΔPWV was significantly associated with PCI (odds ratio 7.78; 95% CI 1.26–48.02; P = 0.027). Conclusions Higher ΔPWV after isometric handgrip exercise was associated with the lesion extent of CAD and the necessity for coronary revascularization, but higher ΔAIx was not.
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Affiliation(s)
- Seong Taeg Kim
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Yeekyoung Ko
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Jong-Wook Beom
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Ki Yung Boo
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Jae-Geun Lee
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea.,Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Joon-Hyouk Choi
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea.,Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Song-Yi Kim
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea.,Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea
| | - Seung-Jae Joo
- Department of Internal Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea. .,Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea. .,Institute of Medical Science, Jeju National University, 15 Aran 13-gil, Jeju City, Jeju Province, 63241, Republic of Korea.
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24
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Mahrooz A, Shokri Y, Variji A, Zargari M, Alizadeh A, Mehtarian E. Improved risk assessment of coronary artery disease by substituting paraoxonase 1 activity for HDL-C: Novel cardiometabolic biomarkers based on HDL functionality. Nutr Metab Cardiovasc Dis 2021; 31:1166-1176. [PMID: 33579580 DOI: 10.1016/j.numecd.2020.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/28/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Developing laboratory assays to evaluate HDL functions and improve cardiovascular disease (CVD) risk assessment has recently emerged as a challenge. The present study was conducted to help predict the risk of coronary artery disease (CAD) by investigating new cardiometabolic risk factors based on substituting paraoxonase 1 (PON1) as a critical enzyme in the functionality of HDL for that of HDL-C. METHODS AND RESULTS The present study recruited 274 subjects undergoing diagnostic coronary angiography, 92 without significant CAD (non-CAD), and 182 with a severe CAD. The diagnostic accuracy of the new biomarkers in non-CAD versus multi-vessel disease was obtained in descending order of AUC as 0.72 (P < 0.001) for log (TG/PON1), 0.70 (P < 0.001) for nonHDL-C/PON1, and 0.67 (P < 0.001) for LDL-C/PON1. After performing a multivariate adjustment for age, gender, BMI, statin therapy, and diabetes mellitus, the increased odds of CAD remained significant for the new cardiometabolic ratios as independent variables [adjusted OR = 1.47 (1.15-1.88), p = 0.002 for LDL-C/PON1; adjusted OR = 2.15 (1.41-3.5), p = 0.009 for nonHDL-C/PON1; adjusted OR = 5.03 (2.14-13.02), p = 0.004 for log (TG/PON1)]. CAD was diagnosed with an optimal discriminating cutoff of 1.84 for LDL-C/PON1, 2.8 for nonHDL-C/PON1, and 0.48 for log (TG/PON1). CONCLUSIONS To improve CAD's risk assessment, the PON1 activity was proposed as an alternative to HDL-C in the commonly used atherogenic lipid ratios. Substituting the PON1 activity for the HDL-C concentration can provide an index of the HDL activity. The present study sought to exploit the lipoprotein-related risk factors of CAD from a more effective perspective.
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Affiliation(s)
- Abdolkarim Mahrooz
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Yasaman Shokri
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Atena Variji
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehryar Zargari
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahad Alizadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Ehsan Mehtarian
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Wang X, Fu Y, Xie Z, Cao M, Qu W, Xi X, Zhong S, Piao M, Peng X, Jia Y, Meng L, Tian J. Establishment of a Novel Mouse Model for Atherosclerotic Vulnerable Plaque. Front Cardiovasc Med 2021; 8:642751. [PMID: 33796572 PMCID: PMC8007762 DOI: 10.3389/fcvm.2021.642751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/23/2021] [Indexed: 12/23/2022] Open
Abstract
Background and Aims: Acute coronary syndrome (ACS) is a group of clinical syndromes characterized by rupture or erosion of atherosclerotic unstable plaques. Effective intervention for vulnerable plaques (VP) is of great significance to reduce adverse cardiovascular events. Methods: Fbn1C1039G+/− mice were crossbred with LDLR−/− mice to obtain a novel model for atherosclerotic VP. After the mice were fed with a high-fat diet (HFD) for 12 or 24 weeks, pathological staining and immunohistochemistry analyses were employed to evaluate atherosclerotic lesions. Results: Compared to control mice, Fbn1C1039G+/−LDLR−/− mice developed more severe atherosclerotic lesions, and the positive area of oil red O staining in the aortic sinus was significantly increased after 12 weeks (21.7 ± 2.0 vs. 6.3 ± 2.1) and 24 weeks (32.6 ± 2.5 vs. 18.7 ± 2.6) on a HFD. Additional vulnerable plaque characteristics, including significantly larger necrotic cores (280 ± 19 vs. 105 ± 7), thinner fiber caps (14.0 ± 2.8 vs. 32.6 ± 2.7), apparent elastin fiber fragmentation and vessel dilation (3,010 ± 67 vs. 1,465 ± 49), a 2-fold increase in macrophage number (8.5 ± 1.0 vs. 5.0 ± 0.6), obviously decreased smooth muscle cell number (0.6 ± 0.1 vs. 2.1 ± 0.2) and an ~25% decrease in total collagen content (33.6 ± 0.3 vs. 44.9 ± 9.1) were observed in Fbn1C1039G+/−LDLR−/− mice compared with control mice after 24 weeks. Furthermore, spontaneous plaque rupture, neovascularization, and intraplaque hemorrhage were detected in the model mouse plaque regions but not in those of the control mice. Conclusions: Plaques in Fbn1C1039G+/−LDLR−/− mice fed a HFD show many features of human advanced atherosclerotic unstable plaques. These results suggest that the Fbn1C1039G+/−LDLR−/− mouse is a novel model for investigating the pathological and physiological mechanisms of advanced atherosclerotic unstable plaques.
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Affiliation(s)
- Xueyu Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Yahong Fu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Zulong Xie
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Muhua Cao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Wenbo Qu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Xiangwen Xi
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Shan Zhong
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Minghui Piao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Xiang Peng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Ying Jia
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Lingbo Meng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jinwei Tian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Mourouzis K, Siasos G, Oikonomou E, Zaromitidou M, Tsigkou V, Antonopoulos A, Bletsa E, Stampouloglou P, Vlasis K, Vavuranakis M, Tousoulis D. Lipoprotein-associated phospholipase A2 levels, endothelial dysfunction and arterial stiffness in patients with stable coronary artery disease. Lipids Health Dis 2021; 20:12. [PMID: 33583415 PMCID: PMC7883455 DOI: 10.1186/s12944-021-01438-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/27/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Lipoprotein-associated Phospholipase A2 (Lp-PLA2), can exert proinflammatory as well as proatherogenic properties on the vascular wall. The current study sought to evaluate the influence of high Lp-PLA2 levels on indices of arterial wall properties in patients with stable coronary artery disease (CAD). METHODS Three hundred seventy-four consecutive patients with stable CAD (mean age 61 ± 11 years, 89% males) were enrolled in this single-center cross-sectional study. Flow-mediated dilation (FMD) was used to assess endothelial function and augmentation index (AIx) of the central aortic pressure was used to assess reflected waves. ELISA was used to determine Lp-PLA2 serum levels. RESULTS After dividing the participants in 3 equal groups based on the tertiles of circulating Lp-PLA2 values, no significant differences were demonstrated between those in the 3rd tertile with Lp-PLA2 values > 138 μg/L, in the 2nd tertile with Lp-PLA2 values between 101 and 138 μg/L and in the 1st tertile (Lp-PLA2 values < 101 μg/L) regarding age, male gender, smoking habits, family history of CAD or history of a previous myocardial infarction, diabetes mellitus, arterial hypertension, hyperlipidemia, duration of CAD and treatment with relevant medication. Importantly, subjects with Lp-PLA2 values in the highest tertile, had significantly reduced FMD values compared to the middle and lower tertile (4.43 ± 2.37% vs. 4.61 ± 1.97% vs. 5.20 ± 2.52% respectively, P = 0.03). Patients in the highest tertile of Lp-PLA2 values had significantly higher AIx values (24.65 ± 8.69% vs. 23.33 ± 9.65%, P = 0.03), in comparison to the lowest tertile, with Lp-PLA2 values < 101 μg/L. A linear regression analysis showed that Lp-PLA2 values > 138 μg/L negatively correlated to FMD [b = - 0.45 (95% CI: - 0.79 - -0.11), P = 0.01] and AIx values [b = 1.81 (95% CI: 0.57-3.05), P < 0.001] independently of cofounders like gender, age, diabetes mellitus, arterial hypertension, dyslipidemia, smoking habits, family history of CAD, history of previous myocardial infarction, serum glucose, circulating lipid levels, duration of CAD, antihypertensive medication, antidiabetic drugs, statin therapy and treatment with β-blockers. CONCLUSIONS Elevated Lp-PLA2 levels relate to endothelial dysfunction and arterial stiffness in patients with stable CAD independently from classical risk factors for CAD, statin use, antihypertensive treatment, and duration of the disease.
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Affiliation(s)
- Konstantinos Mourouzis
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany
| | - Gerasimos Siasos
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece. .,Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Evangelos Oikonomou
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marina Zaromitidou
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vicky Tsigkou
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexis Antonopoulos
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evanthia Bletsa
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Stampouloglou
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Vlasis
- Department of Anatomy, Laiko General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Manolis Vavuranakis
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, Hippokration Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Hsu PC, Huang JC, Lee WH, Chen YC, Wu PY, Tsai WC, Chen SC, Su HM. Usefulness of Ankle-Brachial Index Calculated Using Diastolic Blood Pressure and Mean Arterial Pressure in Predicting Overall and Cardiovascular Mortality in Hemodialysis Patients. Int J Med Sci 2021; 18:65-72. [PMID: 33390774 PMCID: PMC7738967 DOI: 10.7150/ijms.50831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 10/13/2020] [Indexed: 12/02/2022] Open
Abstract
No study has investigated the predictive ability of ankle-brachial index (ABI) calculated using diastolic blood pressure (DBP) (ABIdbp) and mean arterial pressure (MAP) (ABImap) for overall and cardiovascular (CV) mortality in hemodialysis (HD) patients. Our study was aimed to investigate the issue. Two hundred and seven routine HD patients were enrolled. ABI values were measured by ABI-form device. During the follow-up period (122 months), 124 of the 207 patients (59.0%) died, and 59 deaths due to CV cause. Multivariate analysis showed that low ABIsbp, ABIdbp, and ABImap were all significantly associated with increased overall (p ≤ 0.015) and CV mortality (p ≤ 0.015) in whole study patients. A subgroup analysis after excluding 37 patients with ABIsbp < 0.9 or > 1.3 found ABIsbp and ABIsbp < 0.9 were not associated with overall and CV mortality. However, ABImap and ABIdbp < 0.87 were significantly associated with overall mortality (p ≤ 0.042). Furthermore, ABIdbp and ABIdbp < 0.87 were significantly associated with CV mortality (p ≤ 0.030). In conclusion, ABIsbp, ABIdbp, and ABImap were all useful in predicting overall and CV mortality in our HD patients. In the subgroup patients with normal ABIsbp, ABIsbp and ABIsbp < 0.9 were not useful to predict overall and CV mortality. Nevertheless, ABImap and ABIdbp < 0.87 could still predict overall mortality, and ABIdbp and ABIdbp < 0.87 could predict CV mortality. Hence, calculating ABI using DBP and MAP may provide benefit in survival prediction in HD patients, especially in the patients with normal ABIsbp.
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Affiliation(s)
- Po-Chao Hsu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsien Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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El-Naggar H, Anwar H, Helmy H, Demitry S. Aortic elasticity indices as predictors of coronary artery disease severity assessed by SYNTAX score. J Cardiovasc Echogr 2021; 31:234-241. [PMID: 35284220 PMCID: PMC8893111 DOI: 10.4103/jcecho.jcecho_31_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/24/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Aortic elastic properties have been related to coronary artery disease (CAD) morbidity and mortality. We aimed to assess the relation of aortic elasticity indices to the severity and complexity of CAD assessed using the SYNTAX Score (SS), evaluating which of these indices have better predictivity for CAD severity. Materials and Methods: We prospectively enrolled 150 individuals who underwent elective coronary angiography for suspected CAD, out of them 29 (19.3%) had normal or nonsignificant angiographic findings (Group I), whereas 121 (80.7%) had significant CAD (Group II) for whom the SS was calculated. Echo-derived aortic elasticity indices were performed for all patients. Results: Logistic regression analyses showed that each of aortic distensibility, stiffness index, elastic modulus, aortic strain, and aortic peak early diastolic velocity were predictors for significant CAD and further for more complex CAD as indicated by intermediate-high SS. Receiver operator characteristic curves-derived cutoff points were performed for each of the aortic elasticity indices. Along with diabetes, decreased aortic strain ≤10.2% was the only independent predictor of intermediate-high SS (odds ratio = 4.31, 95% confidence interval = 1.38–13.50, P = 0.01). Conclusion: Simple M-mode derived aortic elasticity indices, particularly aortic strain ≤10.2%, might predict patients with more severe and complex CAD.
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Alatas E, Biteker M, Alatas O. Aortic stiffness in hidradenitis suppurativa: A case-control study. DERMATOL SIN 2021. [DOI: 10.4103/ds.ds_39_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Scicali R, Russo GI, Di Mauro M, Manuele F, Di Marco G, Di Pino A, Ferrara V, Rabuazzo AM, Piro S, Morgia G, Purrello F. Analysis of Arterial Stiffness and Sexual Function after Adding on PCSK9 Inhibitor Treatment in Male Patients with Familial Hypercholesterolemia: A Single Lipid Center Real-World Experience. J Clin Med 2020; 9:jcm9113597. [PMID: 33171638 PMCID: PMC7695132 DOI: 10.3390/jcm9113597] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022] Open
Abstract
Familial hypercholesterolemia (FH) subjects have high low-density lipoprotein cholesterol (LDL-C) and may be at high risk of erectile dysfunction and atherosclerotic cardiovascular diseases. We evaluated the effect of PCSK9-i on sexual function evaluated by the Male Sexual Health Questionnaire (MSHQ) and the International Index of Erectile Function (IIEF-5) questionnaire and on pulse wave velocity (PWV) in FH male subjects. In this prospective observational study, we evaluated 30 FH male patients on high-intensity statins plus ezetimibe and with an LDL-C off-target. All patients added PCSK9-i treatment and obtained clinical assessment at baseline and after six months of PCSK9-i. As expected, LDL-C significantly decreased after adding-on PCSK9-i (-48.73%, p < 0.001). MSHQ and PWV significantly improved after adding-on PCSK9-i (for MSHQ 93.63 ± 6.28 vs. 105.41 ± 5.86, p < 0.05; for PWV 9.86 ± 1.51 vs. 7.7 ± 1.42, p < 0.05); no significant change of IIEF-5 was found. Finally, a simple regression showed that ∆ MSHQ was significantly associated with ∆ LDL-C and ∆ PWV (p value for both <0.05). In conclusion, PCSK9-i therapy significantly improves lipid profile, PWV, and sexual function in FH male patients; our results support the favorable function of PCSK9-i on these parameters.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
- Correspondence: ; Tel.: +39-0957598401; Fax: +39-0957598421
| | - Giorgio Ivan Russo
- Urology Section, Department of Surgery, University of Catania, 95100 Catania, Italy; (G.I.R.); (M.D.M.); (G.M.)
| | - Marina Di Mauro
- Urology Section, Department of Surgery, University of Catania, 95100 Catania, Italy; (G.I.R.); (M.D.M.); (G.M.)
| | - Flavia Manuele
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Grazia Di Marco
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
| | - Giuseppe Morgia
- Urology Section, Department of Surgery, University of Catania, 95100 Catania, Italy; (G.I.R.); (M.D.M.); (G.M.)
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (F.M.); (G.D.M.); (A.D.P.); (V.F.); (A.M.R.); (S.P.); (F.P.)
- Internal Medicine, Garibaldi Hospital, 95122 Catania, Italy
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31
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Hsu PC, Lee WH, Chiu CA, Chen YC, Chang CT, Tsai WC, Chu CY, Lin TH, Voon WC, Lai WT, Sheu SH, Su HM. Usefulness of ankle-brachial index calculated using diastolic blood pressure for prediction of mortality in patients with acute myocardial infarction. J Clin Hypertens (Greenwich) 2020; 22:2044-2050. [PMID: 33086427 DOI: 10.1111/jch.14032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Abstract
A low ankle-brachial index (ABI) calculated using systolic blood pressure (SBP) (ABIsbp) is associated with poor cardiovascular outcome in patients with acute myocardial infarction (AMI). ABI is always calculated using SBP clinically. However, there was no study investigating ABI calculated using mean artery pressure (MAP)(ABImap) and diastolic blood pressure (DBP)(ABIdbp) for mortality prediction in AMI patients. Therefore, our study was aimed to investigate the issue. 199 AMI patients were enrolled. Different ABIs were measured by an ABI-form device. The median follow-up to mortality was 64 months. There were 40 cardiovascular and 137 all-cause mortality. The best cutoff values of ABImbp and ABIdbp for mortality prediction were 0.91 and 0.78, respectively. After multivariate analysis, only ABIdbp and ABIdbp < 0.78 could predict cardiovascular mortality (P ≤ .047). However, all of six ABI parameters, including ABIsbp, ABImap, ABIdbp, ABIsbp < 0.90, ABImap < 0.91, and ABIdbp < 0.78, could predict all-cause mortality (P ≤ .048). In a direct comparison of six ABI models for prediction of all-cause mortality, basic model + ABIdbp <0.78 had the highest predictive value (P ≤ .025). In conclusion, only ABIdbp and ABIdbp < 0.78 could predict cardiovascular and all-cause mortality after multivariate analysis in our study. Furthermore, when adding into a basic model, ABIdbp < 0.78 had the highest additively predictive value for all-cause mortality in the six ABI parameters. Hence, calculation of ABI using DBP except SBP might provide an extra benefit in prediction of cardiovascular and all-cause mortality in AMI patients.
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Affiliation(s)
- Po-Chao Hsu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsien Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Cheng-An Chiu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ying-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Ching-Tang Chang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yuan Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chol Voon
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Ter Lai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hsiung Sheu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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32
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Triantafyllou C, Nikolaou M, Ikonomidis I, Bamias G, Papaconstantinou I. Endothelial and Cardiac Dysfunction in Inflammatory Bowel Diseases: Does Treatment Modify the Inflammatory Load on Arterial and Cardiac Structure and Function? Curr Vasc Pharmacol 2020; 18:27-37. [PMID: 30488796 DOI: 10.2174/1570161117666181129095941] [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] [Received: 09/09/2018] [Revised: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 02/06/2023]
Abstract
Inflammatory bowel diseases (IBD), largely represented by Crohn's disease (CD) and ulcerative colitis (UC), alter gastrointestinal physiology and mucosal immunity through a complex inflammatory process. These diseases can lead to significant arterial endothelial dysfunction. There is also evidence linking IBD with a modification of cardiac structure and function. A growing body of research has associated IBD with an acceleration of arterial stiffness and atherosclerosis and an increased risk of cardiovascular (CV) morbidity and mortality. The focus of this review is two-fold. Firstly, the literature on IBD in relation to CV dysfunction was evaluated (mainly based on 25 relevant surveys carried out between 2005 and 2018). The vast majority of these studies support a significant association of IBD with a deterioration in CV function. Secondly, the literature available regarding the effect of IBD treatment on CV dysfunction was considered based on studies published between 2007 and 2018. This literature search suggests that IBD treatment may have the potential to ameliorate CV dysfunction resulting in CV benefits. This review will analyse the literature as well as consider emerging research perspectives regarding how IBD treatment could improve CV dysfunction.
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Affiliation(s)
| | - Maria Nikolaou
- Department of Cardiology, Amalia Fleming General Hospital of Athens, Athens, Greece
| | - Ignatios Ikonomidis
- 2nd Academic Department of Cardiology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Giorgos Bamias
- GI-Unit, 3rd Academic Department of Internal Medicine, Sotiria Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Papaconstantinou
- 2nd Academic Department of Surgery, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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New Ultrasound Technologies for Ischemic Heart Disease Assessment and Monitoring in Cardiac Rehabilitation. J Clin Med 2020; 9:jcm9103131. [PMID: 32998251 PMCID: PMC7599992 DOI: 10.3390/jcm9103131] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/17/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022] Open
Abstract
Owing to its ease of application, noninvasive nature, and safety, echocardiography is an essential imaging modality to assess cardiac function in patients affected by ischemic heart disease (IHD). Over the past few decades, we have witnessed a continuous series of evolutions in the ultrasound field that have led to the introduction of innovative echocardiographic modalities which allowed to better understand the morphofunctional abnormalities occurring in cardiovascular diseases. This article offers an overview of some of the newest echocardiographic modalities and their promising application in IHD diagnosis, risk stratification, management, and monitoring after cardiac rehabilitation.
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ABCA1 Polymorphism Is Associated With the Warfarin-Induced Aortic Stiffness After Coronary Artery Bypass Surgery in the Chinese Population. J Cardiovasc Pharmacol 2020; 76:360-366. [PMID: 32902944 DOI: 10.1097/fjc.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Warfarin is the most widely prescribed oral anticoagulant and is recommended for patients recovering from coronary artery bypass graft (CABG) with atrial fibrillation. Increasing evidence suggested that warfarin increased arterial stiffness in those patients. We aimed to examine the effect of warfarin therapy on aortic stiffness in patients who underwent CABG with or without postoperative warfarin treatment and explored the potential relationships of warfarin therapy with ABCA1 polymorphisms. This was a retrospect observational study of 24 patients who were continuously treated with warfarin were selected as the warfarin group and matched them by age (±3 years) and gender to 48 patients with nonuse of warfarin as the control group. The aortic stiffness, cholesterol efflux capacity, and plasma level of PIVKA-II were measured. Two ABCA1 polymorphisms were genotyped. Compared with baseline, treatment with warfarin for 1 year significantly increased the plasma level of PIVKA-II and aortic stiffness in pulse pressure and pulse wave velocity in patients after CABG. The increase of pulse wave velocity and plasma PIVKA-II level in the TT genotype was significantly greater than the CC genotype when comparing the -565C/T genotypes. The capacity of cholesterol efflux was significantly lower in the TT genotype at baseline and 1-year follow-up than the CC genotype. Postoperative treatment of warfarin for 1 year significantly increased aortic stiffness in patients who underwent CABG. ABCA1 -565C/T polymorphisms affected the cholesterol efflux capacity and were associated with the vitamin K status and the increased aortic stiffness after warfarin treatment in those patients.
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Establishing normal reference value of carotid ultrafast pulse wave velocity and evaluating changes on coronary slow flow. Int J Cardiovasc Imaging 2020; 36:1931-1939. [PMID: 32506285 DOI: 10.1007/s10554-020-01908-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
Pulse wave velocity (PWV) measured by ultrafast ultrasound imaging can early evaluate arteriosclerosis. The study aimed to establish normal reference range for ufPWV in healthy adults and explore its influencing factors, and evaluate the ufPWV changes on coronary slow flow (CSF). ufPWV at the beginning and end of systole (ufPWV-BS and ufPWV-ES, respectively) was measured in healthy adults (201 cases). CSF was diagnosed based on thrombolysis in myocardial infarction (TIMI) frame count during coronary angiography. ufPWV-BS and ufPWV-ES were compared between CSF (50 cases) and control groups (50 healthy age-, body mass index-, and blood pressure-matched adults). In healthy adults, average ufPWV-BS and ufPWV-ES was 5.36 ± 1.27 m/s and 6.99 ± 1.93 m/s, respectively. ufPWV-BS and ufPWV-ES positively correlated with age, body mass index, and blood pressure. ufPWV-BS and ufPWV-ES in the CSF group were higher than in the control group (ufPWV-BS, 6.05 ± 1.07 vs. 5.26 ± 0.89 m/s, P < 0.001; ufPWV-ES, 9.07 ± 1.84 vs. 6.84 ± 1.08 m/s, P < 0.001). Receiver operating characteristic curves showed that ufPWV-ES was more sensitive than ufPWV-BS. The normal reference range of ufPWV for healthy adults was established. Age, body mass index, and blood pressure were the main influencing factors. ufPWV was increased in the patients with CSF. The findings indicated that, in addition to reflecting atherosclerosis, ufPWV might also provide a basis for the noninvasive evaluation of microvascular impairment in the patients with CSF.
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Yang M, Zhang X, Ding Z, Wang F, Wang Y, Jiao C, Chen JH. Low skeletal muscle mass is associated with arterial stiffness in community-dwelling Chinese aged 45 years and older. BMC Public Health 2020; 20:226. [PMID: 32054503 PMCID: PMC7020604 DOI: 10.1186/s12889-020-8323-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/05/2020] [Indexed: 11/19/2022] Open
Abstract
Background Evidence suggests that body composition has impact on arterial stiffness. However, evidence in Chinese are limited, and results remain controversial. The aim of our study is to investigate whether skeletal muscle mass is associated with arterial stiffness in Chinese community-dwelling men and women aged 45 years and older. Methods In this cross-sectional study, 20,477 participants (age range: 45–80 years, 68.8% women) were included in the analysis. Brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness was measured using a waveform device. Total muscle mass and muscle mass of arm, leg and trunk were measured by bioelectrical impedance analysis. Height and weight were measured and appendicular skeletal muscle mass index (ASMI) was calculated as appendicular skeletal muscle mass (sum of arm and leg muscle mass) divided by height square. Results After adjustment for age, body fat percentage, systolic blood pressure and diastolic blood pressure, ASMI was negatively associated with baPWV [β (SE) for men: − 0.208 (0.016), p < 0.0001; for women: − 0.245 (0.012), p < 0.0001]. High ASMI was a protective factor for the presence of arterial stiffness (defined as baPWV) [OR (95%CI) for men: 0.730 (0.682, 0.782), p < 0.0001; women: 0.634 (0.593, 0.677), p < 0.0001]. Similar associations were found between quantity of muscle mass (total and appendicular muscle mass, muscle mass of arm, leg and trunk) and arterial stiffness in men and women after further adjustment for height (all p < 0.0001). Conclusion Low skeletal muscle mass is associated with increased risk of arterial stiffness in Chinese community-dwelling adults aged 45 years and older.
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Affiliation(s)
- Mingzhe Yang
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Xuguang Zhang
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Zhenkai Ding
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Feijie Wang
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Yufang Wang
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Changya Jiao
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China
| | - Jie-Hua Chen
- Nutrition and Health Research Centre, By-Health Co. Ltd, No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Science City, Huangpu District, Guangzhou, 510633, China. .,Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou North Avenue 1838, Guangzhou, 510515, People's Republic of China.
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Rafouli-Stergiou P, Ikonomidis I, Katsiki N, Kadoglou NPE, Vlachos S, Thymis J, Parissis J, Moulakakis KG, Kakisis JD. Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms. J Clin Hypertens (Greenwich) 2020; 22:187-193. [PMID: 32049424 DOI: 10.1111/jch.13825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/31/2019] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
Abstract
Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19-4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.
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Affiliation(s)
- Pinelopi Rafouli-Stergiou
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ignatios Ikonomidis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Katsiki
- First Department of Internal Medicine, Division of Endocrinology and Metabolism, Diabetes Center, Medical School, AHEPA University Hospital, Thessaloniki, Greece
| | - Nikolaos P E Kadoglou
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefanos Vlachos
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John Thymis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John Parissis
- Second Department of Cardiology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos G Moulakakis
- Department of Vascular Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John D Kakisis
- Department of Vascular Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Mandraffino G, Scicali R, Rodríguez-Carrio J, Savarino F, Mamone F, Scuruchi M, Cinquegrani M, Imbalzano E, Di Pino A, Piro S, Rabuazzo AM, Squadrito G, Purrello F, Saitta A. Arterial stiffness improvement after adding on PCSK9 inhibitors or ezetimibe to high-intensity statins in patients with familial hypercholesterolemia: A Two-Lipid Center Real-World Experience. J Clin Lipidol 2020; 14:231-240. [PMID: 32111581 DOI: 10.1016/j.jacl.2020.01.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/29/2019] [Accepted: 01/28/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is characterized by increased cardiovascular risk; despite-high intensity statins, only few patients with FH achieve the recommended low-density lipoprotein cholesterol (LDL-C) targets. OBJECTIVE We aimed to evaluate the effectiveness of six-month add-on therapy with proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9-i) or ezetimibe on lipid profile and pulse wave velocity (PWV) in patients with FH. METHODS In this observational study, we evaluated 98 genetically confirmed patients with FH with an LDL-C off-target despite high-intensity statins with or without ezetimibe; of these, 53 patients (statin plus ezetimibe) added PCSK9-i (PCSK9-i group) and 45 (statin only) added ezetimibe (EZE group) per applicable guidelines and reimbursement rules. All patients obtained biochemical analysis and PWV evaluation at baseline and after six months of optimized treatment. RESULTS After 6 months of add-on therapy, most patients achieving LDL-C targets were in the PCSK9-i group (77.3% PCSK9-i group vs 37.8% EZE group, P < .001). The PCSK9-i group achieved both a greater LDL-C and PWV reduction than the EZE group [-51% vs -22.8%, P < .001 and -15% vs -8.5%, P < .01, respectively]. In a linear regression analysis, we showed a coefficient (r) of 0.334 for the relationship between ΔPWV and ΔLDL (P < .05); moreover, in an exploratory analysis, the relationship appeared to be stronger in patients with FH without cardiovascular events (r = 0.422, P < .01). CONCLUSIONS Lipid and PWV profiles in patients with FH significantly improved after addition of PCSK9-i or ezetimibe to high-intensity statin therapy; moreover, ΔPWV was associated with ΔLDL. Our results are consistent with a beneficial role of these novel therapies in FH subjects.
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Affiliation(s)
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Javier Rodríguez-Carrio
- Department of Functional Biology, Area of Immunology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Area of Metabolism, Instituto de Investigación Sanitaria Del Principado de Asturias (ISPA), Oviedo, Spain; Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, RED in REN Del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Francesca Savarino
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Federica Mamone
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Michele Scuruchi
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Maria Cinquegrani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | | | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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Zekavat SM, Aragam K, Emdin C, Khera AV, Klarin D, Zhao H, Natarajan P. Genetic Association of Finger Photoplethysmography-Derived Arterial Stiffness Index With Blood Pressure and Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2020; 39:1253-1261. [PMID: 31070453 DOI: 10.1161/atvbaha.119.312626] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective- Arterial stiffness index (ASI) is independently associated with blood pressure (BP) and coronary artery disease (CAD) epidemiologically. However, it is unknown whether these associations represent causal relationships. Here, we assess whether genetic predisposition to increased ASI is associated with elevated BP and CAD risk. Approach and Results- We first performed a large-scale epidemiological association of finger photoplethysmography-derived ASI in the UK Biobank, finding significant associations with systolic BP (β=0.55 mm Hg; [95% CI, 0.45-0.65]; P=5.77×10-24; N=137 858), diastolic BP (β=1.05 mm Hg; [95% CI, 0.99-1.11]; P=7.27×10-272; N=137 862), and incident CAD (hazard ratio, 1.08; [95% CI, 1.04-1.11]; P=1.5×10-6; N=3692 cases, 126 615 controls) in multivariable models. We then performed an ASI genome-wide association study analysis in 131 686 participants from the UK Biobank. Across participants not in the ASI genome-wide association study, a 6-variant ASI polygenic risk score was calculated. Each SD increase in genetic ASI was associated with systolic BP (β=4.63 mm Hg; [95% CI, 2.1-7.2]; P=3.37×10-4; N=208 897), and diastolic BP (β=2.61 mm Hg; [95% CI, 1.2-4.0]; P=2.85×10-4; N=208 897); however, no association was observed with incident CAD (hazard ratio, 1.12; [95% CI, 0.55-2.3]; P=0.75; N=223 061; 7534 cases). The lack of CAD association observed was replicated among 184 305 participants (60 810 cases) from the CARDIOGRAMplusC4D (Coronary Artery Disease Genetics Consortium; odds ratio, 0.56; [95% CI, 0.26-1.24]; P=0.15). Conclusions- Our data support the conclusion that finger photoplethysmography-derived ASI is an independent, genetically causal risk factor for BP, but do not support the notion that ASI is a suitable surrogate for CAD risk.
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Affiliation(s)
- Seyedeh M Zekavat
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Yale School of Medicine, New Haven, CT (S.M.Z.).,Computational Biology and Bioinformatics Program, Yale University, New Haven, CT (S.M.Z., H.Z.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston
| | - Krishna Aragam
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Connor Emdin
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Amit V Khera
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Derek Klarin
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Hongyu Zhao
- Computational Biology and Bioinformatics Program, Yale University, New Haven, CT (S.M.Z., H.Z.).,Department of Biostatistics, Yale School of Public Health, New Haven, CT (H.Z.)
| | - Pradeep Natarajan
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
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Zeng J, Zheng G, Li Y, Yang Y. Preoperative Pulse Pressure and Adverse Postoperative Outcomes: A Meta-Analysis. J Cardiothorac Vasc Anesth 2019; 34:624-631. [PMID: 31986286 DOI: 10.1053/j.jvca.2019.09.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/29/2019] [Accepted: 09/25/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate the association between preoperative pulse pressure (PP) and the incidences of renal, neurologic, cardiac, and mortality outcomes after surgery. DESIGN Systematic review and meta-analysis of cohort studies. SETTING Hospitals. PARTICIPANTS Patients who underwent cardiac or noncardiac surgeries. INTERVENTION The preoperative PP was measured. MEASUREMENT AND MAIN RESULTS Relevant cohort studies were obtained by systematic search of PubMed and Embase databases. A randomized effect model was used to pool the results. The multivariate adjusted risk ratio (RR) and its 95% confidence intervals (CI) were calculated to reflect the association between preoperative PP and adverse postoperative outcomes. Twelve cohort studies that included 40,143 patients who had undergone cardiac, vascular, or noncardiac surgery were included in the meta-analysis. The results showed that above a threshold of 40 mmHg, an increase in preoperative PP of 10 mmHg was independently associated with increased risk for renal events (adjusted RR: 1.13, 95% CI 1.08-1.19, p < 0.001; I2 = 0%), neurologic events (adjusted RR: 1.75, 95% CI 1.01-3.02, p = 0.04; I2 = 70%), cardiac events (adjusted RR: 1.19, 95% CI 1.03-1.37, p = 0.01; I2 = 0%), major cardiovascular adverse events (adjusted RR: 1.62, 95% CI 1.10-2.41, p = 0.02; I2 = 0%), and overall mortality (adjusted RR: 1.13, 95% CI 1.07-1.20, p < 0.001; I2 = 0%) after surgery. CONCLUSIONS Patients with higher-than-normal preoperative PP are at increased risk for adverse postoperative outcomes.
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Affiliation(s)
- Jin Zeng
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Anesthesiology, Liuzhou People's Hospital, Liuzhou, China
| | - Guoquan Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yalan Li
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Yuanyuan Yang
- Out-patient Department, Liuzhou People's Hospital, Liuzhou, China
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41
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Scicali R, Di Pino A, Urbano F, Ferrara V, Marchisello S, Di Mauro S, Scamporrino A, Filippello A, Piro S, Rabuazzo AM, Purrello F. Analysis of S100A12 plasma levels in hyperlipidemic subjects with or without familial hypercholesterolemia. Acta Diabetol 2019; 56:899-906. [PMID: 30963307 DOI: 10.1007/s00592-019-01338-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/30/2019] [Indexed: 12/13/2022]
Abstract
AIMS Inflammation is a key regulatory process that links hypercholesterolemia and immune mechanisms promoting atherosclerosis. Inflammatory biomarkers may be helpful to better define the atherosclerotic burden in patients with high cholesterol levels such as familial hypercholesterolemia (FH). Our aim was to evaluate the concentration of S100A12 protein in FH patients and its association with pulse wave velocity (PWV). METHODS We measured glucose and lipid profile, S100A12, sRAGE, esRAGE and PWV in 39 patients with a genetically confirmed diagnosis of FH and 39 hypercholesterolemic subjects without a clinical diagnosis of FH (Dutch score ≤ 3). All subjects were on statin treatment at the time of the enrollment. RESULTS No difference of glucose and lipid profile was found in the two groups. FH patients had higher S100A12 plasma levels than non-FH subjects (12.87 ± 4.82 vs. 8.57 ± 4.87 ng/mL, p < 0.01). No difference of hs-CRP, sRAGE and esRAGE was found between the two groups. Also, PWV was higher in FH patients than non-FH subjects (8.63 ± 0.92 vs. 6.68 ± 0.73 m/s, p < 0.05). Finally, S100A12 was independently correlated with age (p < 0.01), genetic mutation (p < 0.01) and PWV (p < 0.001). CONCLUSIONS FH patients exhibited higher S100A12 levels than non-FH subjects. A novel vascular inflammation pathway, other than hs-CRP, might be useful to better characterize cardiovascular risk profile.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Francesca Urbano
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Simona Marchisello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Stefania Di Mauro
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Alessandra Scamporrino
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Agata Maria Rabuazzo
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636 95122, Catania, Italy.
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Way KL, Sultana RN, Sabag A, Baker MK, Johnson NA. The effect of high Intensity interval training versus moderate intensity continuous training on arterial stiffness and 24 h blood pressure responses: A systematic review and meta-analysis. J Sci Med Sport 2019; 22:385-391. [DOI: 10.1016/j.jsams.2018.09.228] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/10/2018] [Accepted: 09/15/2018] [Indexed: 12/17/2022]
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43
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Ikonomidis I, Aboyans V, Blacher J, Brodmann M, Brutsaert DL, Chirinos JA, De Carlo M, Delgado V, Lancellotti P, Lekakis J, Mohty D, Nihoyannopoulos P, Parissis J, Rizzoni D, Ruschitzka F, Seferovic P, Stabile E, Tousoulis D, Vinereanu D, Vlachopoulos C, Vlastos D, Xaplanteris P, Zimlichman R, Metra M. The role of ventricular-arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association. Eur J Heart Fail 2019; 21:402-424. [PMID: 30859669 DOI: 10.1002/ejhf.1436] [Citation(s) in RCA: 191] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
Ventricular-arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic interventions. Traditionally, VAC is assessed by the non-invasive measurement of the ratio of arterial (Ea) to ventricular end-systolic elastance (Ees). With disease progression, both Ea and Ees may become abnormal and the Ea/Ees ratio may approximate its normal values. Therefore, the measurement of each component of this ratio or of novel more sensitive markers of myocardial (e.g. global longitudinal strain) and arterial function (e.g. pulse wave velocity) may better characterize VAC. In valvular heart disease, systemic arterial compliance and valvulo-arterial impedance have an established diagnostic and prognostic value and may monitor the effects of valve replacement on vascular and cardiac function. Treatment guided to improve VAC through improvement of both or each one of its components may delay incidence of heart failure and possibly improve prognosis in heart failure. In this consensus document, we describe the pathophysiology, the methods of assessment as well as the clinical implications of VAC in cardiac diseases and heart failure. Finally, we focus on interventions that may improve VAC and thus modify prognosis.
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Affiliation(s)
- Ignatios Ikonomidis
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,Inserm 1094, Limoges School of Medicine, Limoges, France
| | - Jacque Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Paris-Descartes University, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Marianne Brodmann
- Division of Angiology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | - Dirk L Brutsaert
- Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
| | - Julio A Chirinos
- Perelman School of Medicine and Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, USA
| | - Marco De Carlo
- Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU SantTilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - John Lekakis
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,Inserm 1094, Limoges School of Medicine, Limoges, France
| | - Petros Nihoyannopoulos
- NHLI - National Heart and Lung Institute, Imperial College London, London, UK.,1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - John Parissis
- Heart Failure Unit, School of Medicine and Department of Cardiology, National and Kapodistrian University of Athens, Athens University Hospital Attikon, Athens, Greece
| | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital, Zurich, University Heart Center, Zurich, Switzerland
| | - Petar Seferovic
- Cardiology Department, Clinical Centre Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Eugenio Stabile
- Department of Advanced Biomedical Sciences, 'Federico II' University, Naples, Italy
| | - Dimitrios Tousoulis
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dragos Vinereanu
- University of Medicine and Pharmacy 'Carol Davila', and Department of Cardiology, University and Emergency Hospital, Bucharest, Romania
| | - Charalambos Vlachopoulos
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitrios Vlastos
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Xaplanteris
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Reuven Zimlichman
- Department of Medicine and Hypertension Institute, Brunner Institute for Cardiovascular Research, Sackler Faculty of Medicine, The E. Wolfson Medical Center, Institute for Quality in Medicine, Israeli Medical Association, Tel Aviv University, Tel Aviv, Israel
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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Sang GY, Chen ZY, Meng CR, Tian T, Zhang ZX. Serum Tumor Marker Carbohydrate Antigen 125 Levels and Carotid Atherosclerosis in Patients with Coronary Artery Disease. Open Med (Wars) 2018; 13:534-538. [PMID: 30613787 PMCID: PMC6310918 DOI: 10.1515/med-2018-0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/23/2018] [Indexed: 12/29/2022] Open
Abstract
Objective We assessed the correlation between serum carbohydrate antigen 125 (CA125) and carotid intima-media thickness (cIMT) in patients with coronary artery disease (CAD). Methods We collected 518 CAD patients from the cardiovascular disease center in our hospital, and all cIMT values were measured in patients with CAD. Results The serum CA125 concentrations were found to be increased in CAD patients with early carotid atherosclerosis compared with patients without early carotid atherosclerosis (20.1±7.72 vs. 17.7±6.41 U/mL, p<0.001). The cIMT values were increased in patients with higher serum CA-125 levels than those with lower serum CA-125 concentrations (1.16±0.32 vs. 0.98±0.29 mm, p<0.001). There was a positive correlation between serum CA125 and cIMT in CAD patients (r=0.262, p<0.001). Moreover, the serum CA125 concentrations also were positively correlated with cIMT in subjects with early carotid atherosclerosis and without early carotid atherosclerosis (r=0.255, p<0.001; r=0.189, p=0.002). We found that serum CA-125 concentrations were independently correlated with cIMT (beta = 0.293, p<0.001) in multiple linear regression analysis. Conclusions We found that serum CA125 concentrations were positively correlated with cIMT in CAD patients, serum CA125 might be a potential biochemical marker for the estimation of atherosclerosis in patients with CAD.
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Affiliation(s)
- Guo-Yao Sang
- Laboratory Medicine Diagnostic Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
| | - Zhao-Yun Chen
- Laboratory Medicine Diagnostic Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
| | - Cun-Ren Meng
- Laboratory Medicine Diagnostic Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
| | - Tian Tian
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zhao-Xia Zhang
- Laboratory Medicine Diagnostic Center, The First Affiliated Hospital, Xinjiang Medical University, No. 137, Liyushan Road, Xin'shi Region, Urumqi, Xinjiang 830011, China
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Alves AJ, Oliveira NL, Lopes S, Ruescas-Nicolau MA, Teixeira M, Oliveira J, Ribeiro F. Arterial Stiffness is Related to Impaired Exercise Capacity in Patients With Coronary Artery Disease and History of Myocardial Infarction. Heart Lung Circ 2018; 28:1614-1621. [PMID: 30318391 DOI: 10.1016/j.hlc.2018.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/04/2018] [Accepted: 08/31/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Augmented arterial stiffness and reduced cardiorespiratory fitness are associated with increased morbidity and mortality from coronary artery disease (CAD). The relationship between exercise capacity and arterial stiffness is independent of known influencing variables in CAD. This study aimed to analyse the interaction between exercise capacity, arterial stiffness and early vascular ageing in patients with CAD. METHODS This cross-sectional study included 96 CAD patients with myocardial infarction (55.9±10.9years, 81 men) referred to cardiac rehabilitation. Arterial stiffness was assessed using carotid-femoral pulse wave velocity (cf-PWV). Cardiopulmonary exercise test was performed to measure VO2peak. Comparisons of VO2peak across cf-PWV risk threshold values (high-risk cf-PWV≥10m/s) and tertile groups, and across cf-PWV threshold values and age groups (younger group<60 years) were performed. Correlation tests were used to study the association between pair of variables. RESULTS Patients with high-risk cf-PWV had lower VO2peak than those with low-risk cf-PWV (p<0.001). VO2peak decreased across tertiles of cf-PWV, showing significantly lower values in the third tertile (p<0.001). There were no differences in the VO2peak between younger patients with high-risk cf-PWV and older patients irrespective of their cf-PWV values. VO2peak showed an upward trend in younger patients with low-risk cf-PWV compared to their age-mates with high-risk cf-PWV (p=0.09). VO2peak was strongly and inversely correlated with cf-PWV (r=-0.502, p<0.001). CONCLUSIONS Arterial stiffening is associated with lower cardiorespiratory fitness in CAD patients with myocardial infarction. When its values are above risk threshold, exercise capacity is impaired regardless of the relationship between age and arterial stiffness.
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Affiliation(s)
- Alberto Jorge Alves
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, Maia, Portugal.
| | - Norton Luís Oliveira
- Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal; Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - Susana Lopes
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | | | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - José Oliveira
- Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
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Abstract
PURPOSE OF REVIEW Recent US guidelines have changed the definition of hypertension to ≥ 130/80 mmHg and recommended more intense blood pressure (BP) targets. We summarize the evidence for intense BP treatment and discuss risks that must be considered when choosing treatment goals for individual patients. RECENT FINDINGS The SPRINT study reported that treating to a systolic BP target of 120 mmHg reduces cardiovascular outcomes in high-risk individuals, supporting more intensive BP reduction than previously recommended. However, recent observational studies have placed emphasis on the BP J-curve phenomenon, where low BPs are associated with adverse cardiovascular outcomes, suggesting that overly aggressive BP targets may sometimes be harmful. We attempt to reconcile these apparent contradictions for the clinician. We also review other potential dangers of aggressive BP targets, including syncope, renal impairment, polypharmacy, drug interactions, subjective drug side-effects, and non-adherence. We suggest a personalized approach to BP drug management considering individual risks, benefits, and preferences when choosing therapeutic targets, recognizing that a goal of 130/80 mmHg should always be considered. Additionally, we recommend an intense focus on lifestyle changes and medication adherence.
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Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040659. [PMID: 29614802 PMCID: PMC5923701 DOI: 10.3390/ijerph15040659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/25/2018] [Accepted: 03/27/2018] [Indexed: 12/12/2022]
Abstract
As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population have been reported. Therefore, we conducted an epidemiological study among 2141 Thai enterprise employees (858 men and 1283 women) who were free from any diagnosed cardiovascular disease. Work stress was measured using Karasek’s Job Demand–Control model for job strain (a combination of high demand and low control). Arterial stiffness was evaluated by a non-invasive approach using pulse-wave analysis based on a finger photoplethysmogram. Multivariable linear regression was applied to examine associations between job strain and arterial stiffness. In men, job strain was significantly associated with arterial stiffness (β = 0.078, 95% confidence interval = 0.026 to 0.130), after accounting for sociodemographic, behavioral, dietary and biomedical factors. However, the association in women was not significant. As the first study in Thailand on work stress and cardiovascular risk, we found that job strain might be an important risk factor for cardiovascular disease among Thai working men. Further studies with longitudinal design are warranted.
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Ikonomidis I, Voumvourakis A, Makavos G, Triantafyllidi H, Pavlidis G, Katogiannis K, Benas D, Vlastos D, Trivilou P, Varoudi M, Parissis J, Iliodromitis E, Lekakis J. Association of impaired endothelial glycocalyx with arterial stiffness, coronary microcirculatory dysfunction, and abnormal myocardial deformation in untreated hypertensives. J Clin Hypertens (Greenwich) 2018; 20:672-679. [DOI: 10.1111/jch.13236] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 01/04/2018] [Accepted: 01/12/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Ignatios Ikonomidis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Astrinos Voumvourakis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - George Makavos
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Helen Triantafyllidi
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - George Pavlidis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Konstantinos Katogiannis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Dimitris Benas
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Dimitris Vlastos
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Paraskevi Trivilou
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Maria Varoudi
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - John Parissis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - Efstathios Iliodromitis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - John Lekakis
- Second Cardiology Department; Attikon Hospital; Medical School National and Kapodistrian University of Athens; Athens Greece
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Scandale G, Dimitrov G, Recchia M, Carzaniga G, Minola M, Perilli E, Carotta M, Catalano M. Arterial stiffness and subendocardial viability ratio in patients with peripheral arterial disease. J Clin Hypertens (Greenwich) 2018; 20:478-484. [PMID: 29447429 DOI: 10.1111/jch.13213] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/16/2017] [Accepted: 12/08/2017] [Indexed: 11/29/2022]
Abstract
Arterial stiffening is a hallmark of the aging process and atherosclerosis, including peripheral arterial disease (PAD). We investigated the associations between carotid-femoral pulse wave velocity (c-fPWV), augmentation index corrected for heart rate (Aix@HR75), ankle brachial index (ABI), and subendocardial viability ratio (SEVR), an indicator of cardiac perfusion. The c-fPWV, Aix@HR75, and SEVR was estimated using applanation tonometry. The ankle systolic pressure measurements for the calculation of the ABI were obtained using an 8-mHz Doppler probe. The study group included 555 subjects, mean age 63 ± 11 years (248 PAD (ABI < 1.0), and 307 non-PAD (ABI ≥ 1.0 ≤ 1.3). After the stepwise selection process in both PAD and non-PAD patients SEVR was not related to c-fPWV and ABI (P = .154; P = .156) and (P = .101; P = .402), respectively. In PAD patients, SEVR was negatively related to Aix@HR75 (P < .0001) and aortic PP (P = .0005). In conclusion, arterial stiffness is associated with non-invasive indices of myocardial perfusion in PAD patients, suggesting a potential pathophysiological link for increased cardiovascular events.
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Affiliation(s)
- Giovanni Scandale
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | - Gabriel Dimitrov
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | | | - Gianni Carzaniga
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | - Marzio Minola
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | - Edoardo Perilli
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | - Maria Carotta
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
| | - Mariella Catalano
- Research Center on Vascular Diseases and Angiology Unit, University of Milan, Milan, Italy
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Rahman F, McEvoy JW. The J-shaped Curve for Blood Pressure and Cardiovascular Disease Risk: Historical Context and Recent Updates. Curr Atheroscler Rep 2018; 19:34. [PMID: 28612327 DOI: 10.1007/s11883-017-0670-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The definition and treatment of hypertension have both changed dramatically over the last century, with recent trials suggesting benefit for lower blood pressure (BP) targets than ever before considered. However, tempering the enthusiasm for more intensive BP targets are long-held concerns that BP reduction below a certain threshold may pose dangers, the so-called "J-curve." In this review, we summarize the evidence for a J-curve in the treatment of hypertension. RECENT FINDINGS The Systolic Blood Pressure Intervention Trial (SPRINT) reported that achieving a systolic BP target of 120 mmHg reduces cardiovascular disease in high-risk individuals, supporting more intensive BP reduction. However, contemporary observational studies consistently demonstrate a BP J-curve, the threshold of which is often close to the SPRINT target. Studies also suggest that the BP level of this J-curve may vary based on patient characteristics, including age and comorbidities. There is also more compelling evidence for the specific presence of a J-curve between diastolic BP and coronary events, in contrast to conflicting evidence of a J-curve with systolic BP and cardiovascular disease more generally. There is increased risk of coronary events below a diastolic BP of 60-70 mmHg. In comparison, the presence of a systolic J-curve is less clear and some persons at high risk may actually benefit from systolic levels down to 120 mmHg. Therefore, we suggest a personalized approach to BP management considering individual risks, benefits, and preferences when choosing therapeutic targets. Further, well-designed studies are required to support our suggestions and to define J-curve thresholds more clearly.
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Affiliation(s)
- Faisal Rahman
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John W McEvoy
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524C, Baltimore, MD, 21287, USA.
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