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Bianchini E, Guala A, Golemati S, Alastruey J, Climie RE, Dalakleidi K, Francesconi M, Fuchs D, Hartman Y, Malik AEF, Makūnaitė M, Nikita KS, Park C, Pugh CJA, Šatrauskienė A, Terentes-Printizios D, Teynor A, Thijssen D, Schmidt-Trucksäss A, Zupkauskienė J, Boutouyrie P, Bruno RM, Reesink KD. The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2183-2213. [PMID: 37148467 DOI: 10.1002/jum.16243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/24/2023] [Accepted: 04/14/2023] [Indexed: 05/08/2023]
Abstract
Non-invasive ultrasound (US) imaging enables the assessment of the properties of superficial blood vessels. Various modes can be used for vascular characteristics analysis, ranging from radiofrequency (RF) data, Doppler- and standard B/M-mode imaging, to more recent ultra-high frequency and ultrafast techniques. The aim of the present work was to provide an overview of the current state-of-the-art non-invasive US technologies and corresponding vascular ageing characteristics from a technological perspective. Following an introduction about the basic concepts of the US technique, the characteristics considered in this review are clustered into: 1) vessel wall structure; 2) dynamic elastic properties, and 3) reactive vessel properties. The overview shows that ultrasound is a versatile, non-invasive, and safe imaging technique that can be adopted for obtaining information about function, structure, and reactivity in superficial arteries. The most suitable setting for a specific application must be selected according to spatial and temporal resolution requirements. The usefulness of standardization in the validation process and performance metric adoption emerges. Computer-based techniques should always be preferred to manual measures, as long as the algorithms and learning procedures are transparent and well described, and the performance leads to better results. Identification of a minimal clinically important difference is a crucial point for drawing conclusions regarding robustness of the techniques and for the translation into practice of any biomarker.
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Affiliation(s)
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jordi Alastruey
- Department of Biomedical Engineering, King's College London, London, UK
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Kalliopi Dalakleidi
- Biomedical Simulations and Imaging (BIOSIM) Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Martina Francesconi
- Institute of Clinical Physiology, CNR, Pisa, Italy
- University of Pisa, Pisa, Italy
| | - Dieter Fuchs
- Fujifilm VisualSonics, Amsterdam, The Netherlands
| | - Yvonne Hartman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Afrah E F Malik
- CARIM School for Cardiovascular Diseases and Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Monika Makūnaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Konstantina S Nikita
- Biomedical Simulations and Imaging (BIOSIM) Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Christopher J A Pugh
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Agnė Šatrauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros klinikos, Vilnius, Lithuania
| | - Dimitrios Terentes-Printizios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Teynor
- Faculty of Computer Science, Augsburg University of Applied Sciences, Augsburg, Germany
| | - Dick Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Jūratė Zupkauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Pierre Boutouyrie
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Rosa Maria Bruno
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Hopital Europeen Georges Pompidou - APHP, Paris, France
| | - Koen D Reesink
- CARIM School for Cardiovascular Diseases and Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
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Willems L, Vermeulen J, Wiegerinck A, Fekkes S, Reijnen M, Warlé M, De Korte C, Thijssen D. Construct Validity and Reproducibility of Handheld Ultrasound Devices in Carotid Artery Diameter Measurement. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:866-874. [PMID: 36567191 DOI: 10.1016/j.ultrasmedbio.2022.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
The construct validity and reproducibility of three commonly used handheld ultrasound (US) devices in measuring carotid arterial diameter was evaluated: Telemed MicrUs EXT-1H (Telemed, Vilnius, Lithuania), Butterfly iQ (Butterfly Network, Inc., Guilford, CT, USA) and Philips Lumify (Philips Healthcare, Best, The Netherlands). An in vitro setup was built to evaluate construct validity, compared with high-end US, and intra-observer variability of handheld US devices. Handheld devices showed a mean difference of 0.023 ± 0.030 cm, 0.012 ± 0.037 cm and 0.009 ± 0.046 cm for, respectively, Telemed, Butterfly and Lumify in comparison with high-end US devices. Intraclass agreement with the high-end system as well as intra-observer variability for handheld US devices was classified as excellent, with all values greater than 0.95. Subsequently, inter-observer variability of handheld US devices was investigated in an in vivo setup with 20 healthy volunteers. Inter-observer variability was classified as excellent for Telemed (0.901), good for Lumify (0.827) and moderate for Butterfly (0.684) with a difference of, respectively, 0.005 ± 0.031 cm, 0.020 ± 0.050 cm and -0.003 ± 0.033 cm. In conclusion, handheld US devices demonstrated an excellent construct validity and intra-observer variability. Additionally, excellent-to-good inter-observer variability for Telemed and Lumify was observed, and Butterfly demonstrated a moderate inter-observer agreement. These results indicate that handheld US devices are effective for measuring carotid arterial diameter.
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Affiliation(s)
- Loes Willems
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Jenske Vermeulen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Anouk Wiegerinck
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Stein Fekkes
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Michel Reijnen
- Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands; Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Michiel Warlé
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Chris De Korte
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Dick Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study. J Clin Med 2023; 12:jcm12041413. [PMID: 36835948 PMCID: PMC9965558 DOI: 10.3390/jcm12041413] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown sustained microvascular dysfunction, systemic inflammation, and coagulation activation at 3 months after acute COVID-19. The long-term effects of COVID-19 on vascular function remain unknown. MATERIALS AND METHODS This cohort study involved 167 patients who participated in the COVAS trial. At 3 months and 18 months after acute COVID-19, macrovascular dysfunction was evaluated by measuring the carotid artery diameter in response to cold pressor testing. Additionally, plasma endothelin-1, von Willebrand factor, Interleukin(IL)-1ra, IL-6, IL-18, and coagulation factor complexes were measured using ELISA techniques. RESULTS The prevalence of macrovascular dysfunction did not differ between 3 months (14.5%) and 18 months (11.7%) after COVID-19 infection (p = 0.585). However, there was a significant decrease in absolute carotid artery diameter change, 3.5% ± 4.7 vs. 2.7% ± 2.5, p-0.001, respectively. Additionally, levels of vWF:Ag were persistently high in 80% of COVID-19 survivors, reflecting endothelial cell damage and possibly attenuated endothelial function. Furthermore, while levels of the inflammatory cytokines interleukin(IL)-1RA and IL-18 were normalized and evidence of contact pathway activation was no longer present, the concentrations of IL-6 and thrombin:antithrombin complexes were further increased at 18 months versus 3 months (2.5 pg/mL ± 2.6 vs. 4.0 pg/mL ± 4.6, p = 0.006 and 4.9 μg/L ± 4.4 vs. 18.2 μg/L ± 11.4, p < 0.001, respectively). DISCUSSION This study shows that 18 months after COVID-19 infection, the incidence of macrovascular dysfunction as defined by a constrictive response during carotid artery reactivity testing is not increased. Nonetheless, plasma biomarkers indicate sustained endothelial cell activation (vWF), systemic inflammation (IL-6), and extrinsic/common pathway coagulation activation (FVII:AT, TAT) 18 months after COVID-19 infection.
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Sarafis ZK, Squair JW, Barak OF, Coombs GB, Soriano JE, Larkin-Kaiser KA, Lee AHX, Hansen A, Vodopic M, Romac R, Grant C, Charbonneau R, Mijacika T, Krassioukov AV, Ainslie PN, Dujic Z, Phillips AA. Common carotid artery responses to the cold-pressor test are impaired in individuals with cervical spinal cord injury. Am J Physiol Heart Circ Physiol 2022; 323:H1311-H1322. [PMID: 36367686 DOI: 10.1152/ajpheart.00261.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cervical spinal cord injury (SCI) leads to autonomic cardiovascular dysfunction that underlies the three- to fourfold elevated risk of cardiovascular disease in this population. Reduced common carotid artery (CCA) dilatory responsiveness during the cold-pressor test (CPT) is associated with greater cardiovascular disease risk and progression. The cardiovascular and CCA responses to the CPT may provide insight into cardiovascular autonomic dysfunction and cardiovascular disease risk in individuals with cervical SCI. Here, we used CPT to perturb the autonomic nervous system in 14 individuals with cervical SCI and 12 uninjured controls, while measuring cardiovascular responses and CCA diameter. The CCA diameter responses were 55% impaired in those with SCI compared with uninjured controls (P = 0.019). The CCA flow, velocity, and shear response to CPT were reduced in SCI by 100% (P < 0.001), 113% (P = 0.001), and 125% (P = 0.002), respectively. The association between mean arterial pressure and CCA dilation observed in uninjured individuals (r = 0.54, P = 0.004) was absent in the SCI group (r = 0.22, P = 0.217). Steady-state systolic blood pressure (P = 0.020), heart rate (P = 0.003), and cardiac contractility (P < 0.001) were reduced in those with cervical SCI, whereas total peripheral resistance was increased compared with uninjured controls (P = 0.042). Relative cerebral blood velocity responses to CPT were increased in the SCI group and reduced in controls (middle cerebral artery, P = 0.010; posterior cerebral artery, P = 0.026). The CCA and cardiovascular responsiveness to CPT are impaired in those with cervical SCI.NEW & NOTEWORTHY This is the first study demonstrating that CCA responses during CPT are suppressed in SCI. Specifically, CCA diameter, flow, velocity, and shear rate were reduced. The relationship between changes in MAP and CCA dilatation in response to CPT was absent in individuals with SCI, despite similar cardiovascular activation between SCI and uninjured controls. These findings support the notion of elevated cardiovascular disease risk in SCI and that the cardiovascular responses to environmental stimuli are impaired.
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Affiliation(s)
- Zoe K Sarafis
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan W Squair
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,RESTORE.network, Departments of Physiology and Pharmacology, Cardiac Sciences and Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,MD/PhD Training Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Otto F Barak
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Geoff B Coombs
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jan Elaine Soriano
- RESTORE.network, Departments of Physiology and Pharmacology, Cardiac Sciences and Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kelly A Larkin-Kaiser
- RESTORE.network, Departments of Physiology and Pharmacology, Cardiac Sciences and Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Amanda H X Lee
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex Hansen
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Maro Vodopic
- Department of Neurology, General Hospital, Dubrovnik, Croatia
| | - Rinaldo Romac
- Department of Neurology, Clinical Hospital Center, Split, Croatia
| | - Christopher Grant
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca Charbonneau
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanja Mijacika
- Department of Integrative Physiology, University of Split School of Medicine, Split, Croatia
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada.,GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Zeljko Dujic
- Department of Integrative Physiology, University of Split School of Medicine, Split, Croatia
| | - Aaron A Phillips
- RESTORE.network, Departments of Physiology and Pharmacology, Cardiac Sciences and Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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5
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Willems LH, Thijssen DHJ, Groh LA, Kooijman NI, Ten Cate H, Spronk HMH, Donders ART, van der Vijver-Coppen RJ, van Hoek F, Nagy M, Reijnen MMPJ, Warlé MC. Dual pathway inhibition as compared to acetylsalicylic acid monotherapy in relation to endothelial function in peripheral artery disease, a phase IV clinical trial. Front Cardiovasc Med 2022; 9:979819. [PMID: 36277757 PMCID: PMC9583941 DOI: 10.3389/fcvm.2022.979819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Dual pathway inhibition (DPI) by combining acetylsalicylic acid (ASA) with low-dose rivaroxaban has been shown to reduce cardiovascular events in patients with peripheral arterial disease (PAD) when compared to ASA monotherapy. A potential explanation is that inhibition of factor Xa improves endothelial function through crosstalk between coagulation and inflammatory pathways, subsequently attenuating the occurrence of cardiovascular events. We hypothesize that the addition of rivaroxaban to ASA in PAD patients leads to improved endothelial function. Design An investigator-initiated, multicentre trial investigating the effect of DPI on endothelial function. Methods Patients, diagnosed with PAD, were enrolled in two cohorts: cohort A (Rutherford I-III) and cohort B (Rutherford IV-VI). Participants received ASA monotherapy for a 4-weeks run-in period, followed by 12 weeks of DPI. Macro- and microvascular endothelial dysfunction were studied by measuring carotid artery reactivity upon sympathetic stimulus and by measuring plasma endothelin-1 concentrations, respectively. All measurements were performed during the use of ASA (baseline) and after 12 weeks of DPI. Results 159 PAD patients (111 cohort A, 48 cohort B) were enrolled. Twenty patients discontinued study drugs early. Carotid artery constriction upon sympathetic stimulation at baseline (ASA) and after 12 weeks of DPI was similar in the total group, 22.0 vs. 22.7% (p = 1.000), and in the subgroups (Cohort A 22.6 vs. 23.7%, p = 1.000; cohort B 20.5 vs. 20.5%, p = 1.000), respectively. The mean concentration of plasma endothelin-1 at baseline and after 12 weeks of DPI did not differ, 1.70 ± 0.5 vs. 1.66 ± 0.64 pmol/L (p = 0.440) in the total group, 1.69 ± 0.59 vs. 1.62 ± 0.55 pmol/L in cohort A (p = 0.202), and 1.73 ± 0.53 vs. 1.77 ± 0.82 pmol/L in cohort B (p = 0.682), respectively. Conclusion Macro- and microvascular endothelial dysfunction, as reflected by carotid artery reactivity and plasma endothelin-1 concentrations, are not influenced in PAD patients by addition of low-dose rivaroxaban to ASA monotherapy for 12 weeks. Trial registration https://clinicaltrials.gov/ct2/show/NCT04218656.
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Affiliation(s)
- Loes H. Willems
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands,*Correspondence: Loes H. Willems
| | - Dick H. J. Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Laszlo A. Groh
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nina I. Kooijman
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Hugo Ten Cate
- Departments of Internal Medicine and Biochemistry, Maastricht University Medical Center (MUMC) and Cardiovascular Research Institute Maastricht (CARIM) School for Cardiovascular Diseases, Maastricht, Netherlands,Center for Thrombosis and Haemostasis, Gutenberg University Medical Center, Mainz, Germany
| | - Henri M. H. Spronk
- Departments of Internal Medicine and Biochemistry, Maastricht University Medical Center (MUMC) and Cardiovascular Research Institute Maastricht (CARIM) School for Cardiovascular Diseases, Maastricht, Netherlands
| | - A. Rogier T. Donders
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Frank van Hoek
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Magdolna Nagy
- Departments of Internal Medicine and Biochemistry, Maastricht University Medical Center (MUMC) and Cardiovascular Research Institute Maastricht (CARIM) School for Cardiovascular Diseases, Maastricht, Netherlands
| | - Michel M. P. J. Reijnen
- Department of Surgery, Rijnstate Hospital, Arnhem, Netherlands,Multi-Modality Medical Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, Netherlands
| | - Michiel C. Warlé
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
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Acute Effects of Inorganic Nitrate Intake on Brachial and Femoral Flow-Mediated Vasodilation, and on Carotid Artery Reactivity Responses: Results of a Randomized, Double-Blinded, Placebo-Controlled Cross-Over Study in Abdominally Obese Men. Nutrients 2022; 14:nu14173560. [PMID: 36079817 PMCID: PMC9460748 DOI: 10.3390/nu14173560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 12/26/2022] Open
Abstract
Most trials on the effects of inorganic nitrate intake have focused on only one specific aspect of the endothelial cell response to a stimulus, thereby possibly missing other important effects. The aim of the present randomized, double-blinded, placebo-controlled cross-over study was therefore to investigate in eighteen healthy abdominally obese men (18–60 years, waist circumference ≥ 102 cm) acute effects of potassium nitrate on brachial and femoral flow-mediated vasodilation (FMD), and on carotid artery reactivity (CAR) to a cold pressure test. Participants received in random order a drink providing 10 mmol potassium nitrate (i.e., 625 mg of nitrate) or an iso-molar placebo drink with potassium chloride. Fasted and 4 h post-drink FMD and blood pressure measurements were performed. CAR responses were assessed at 4 h. Circulating nitrate plus nitrite concentration increased following nitrate intake (p = 0.003). Compared with placebo, potassium nitrate did not affect brachial (mean [95% confidence interval]: −0.2% [−2.5, 2.1], p = 0.86) and femoral FMD responses (−0.6% [−3.0; 1.7], p = 0.54). CAR responses were also not different (−0.8% [−2.5, 0.9], p = 0.32). Finally, changes in blood pressure and heart rate did not differ. No adverse events were observed. In conclusion, this trial did not provide evidence for effects of a single dose of inorganic nitrate on 4 h vascular endothelial function in abdominally obese men.
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Kleinloog JPD, Mensink RP, Roodt JO, Thijssen DHJ, Hesselink MKC, Joris PJ. Aerobic exercise training improves not only brachial artery flow-mediated vasodilatation but also carotid artery reactivity: A randomized controlled, cross-over trial in older men. Physiol Rep 2022; 10:e15395. [PMID: 36030401 PMCID: PMC9419153 DOI: 10.14814/phy2.15395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023] Open
Abstract
It is well-known that aerobic exercise training beneficially affects endothelial function as measured by brachial artery flow-mediated vasodilation (FMD). This trial with older sedentary overweight and obese men, therefore, examined the effects of aerobic training on other non-invasive markers of the vasculature, which have been studied in less detail. Seventeen men (67 ± 2 years, BMI: 30.3 ± 2.8 kg/m2 ) participated in this controlled cross-over study. Study participants followed in random order a fully supervised, progressive, aerobic exercise training (three 50-min sessions each week at 70% maximal power) and a no-exercise control period for 8 weeks, separated by a 12-week wash-out period. At the end of each period, endothelial function was assessed by the carotid artery reactivity (CAR) response to a cold pressor test and FMD, and local carotid and regional aortic stiffness by the carotid-to-femoral pulse wave velocity (PWVc-f ). The retinal microvasculature, the serum lipid profile, 24-h ambulatory blood pressure, and 96-h continuous glucose concentrations were also determined. Aerobic training increased CAR from 1.78% to 4.01% (Δ2.23 percentage point [pp]; 95% CI: 0.58, 3.89 pp; p = 0.012) and FMD from 3.88% to 6.87% (Δ2.99 pp; 95% CI: 0.58, 5.41 pp; p = 0.019). The stiffness index β0 increased by 1.1 (95% CI: 0.3, 1.9; p = 0.012), while PWVc-f did not change. Retinal arteriolar width increased by 4 μm (95% CI: 0, 7 μm; p = 0.041). Office blood pressure decreased, but ambulatory blood pressure, and serum lipid and continuous glucose concentrations did not change. Aerobic exercise training improved endothelial function and retinal arteriolar width in older sedentary overweight and obese men, which may reduce cardiovascular risk.
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Affiliation(s)
- Jordi P. D. Kleinloog
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
| | - Ronald P. Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
| | - Jos op’t. Roodt
- Department of Internal MedicineMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Dick H. J. Thijssen
- Department of PhysiologyRadboud University Medical CentreNijmegenThe Netherlands
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Matthijs K. C. Hesselink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
| | - Peter J. Joris
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
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Vermeulen JJ, Jansen AJS, van de Sande S, Hartman YA, Holewijn S, Reijnen MM, Thijssen DH. Carotid artery vasoreactivity correlates with abdominal aortic vasoreactivity in young healthy individuals but not in patients with abdominal aortic aneurysm. Curr Res Physiol 2022; 5:224-231. [PMID: 35677214 PMCID: PMC9168379 DOI: 10.1016/j.crphys.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Sympathetic stimulation of central arteries, such as coronary and carotid arteries, cause vasodilation in healthy subjects, but vasoconstriction in those with increased cardiovascular risk. This study compared vasoreactivity to sympathetic stimulation between abdominal aorta and carotid artery in healthy young individuals (young group, n = 20), in patients with abdominal aortic aneurysm (AAA group, n = 20) and in a healthy older group, age- and gender matched with AAA group (matched group, n = 18). Method All subjects underwent cold pressor test, while performing concomitantly duplex ultrasound of abdominal aorta and carotid artery vasoreactivity. Observer-independent software was used to analyze and calculate magnitude and timing of maximum vasodilation or vasoconstriction. Pearson's correlation coefficient was calculated to investigate vasoreactivity between arteries. Results Carotid artery reactivity [Interquartile range 25%, Interquartile range 75%] did not significantly differ between the young, matched and AAA group (3.5% [1.4, 4.7], 2.6% [2.0, 4.1] and 2.2% [-1.9, 3.7], respectively, p = 0.301). Abdominal aortic responsiveness demonstrated larger differences between young (4.9% [-0.2, 8.4]), matched (3.3% [-2.5, 4.4]) and individuals with AAA (0.5% [-3.9, 4.1], p = 0.059). Pooled analysis showed a significant correlation between carotid and abdominal aortic vasoreactivity (r = 0.444, p = 0.001). Subgroup analyses demonstrated significant correlation between both arteries in young (r = 0.636, p = 0.003), but not matched (r = −0.040, p = 0.866) or AAA group (r = 0.410, p = 0.129). Conclusions Sympathetic stimulation induces powerful vasodilation of the carotid artery and abdominal aorta, which is significantly correlated in healthy individuals. No such correlation is present in abdominal aortic aneurysm patients. This suggests the aneurysm alters local abdominal aorta vasoreactivity, but not the carotid artery. Vasoreactivity is significantly correlated between carotid and abdominal aorta. Presence of abdominal aneurysm was associated with local impaired vasoreactivity. Abdominal aorta demonstrates a stronger vasoreactivity than the carotid artery. Vasoreactivity of the carotid artery did not differ between groups.
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Vascular Function in Norwegian Female Elite Runners: A Cross-Sectional, Controlled Study. Sports (Basel) 2022; 10:sports10030037. [PMID: 35324646 PMCID: PMC8955513 DOI: 10.3390/sports10030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
In general, aerobic exercise has a positive impact on the vascular system, but the syndrome of relative energy-deficiency in sports (RED-S) makes this impact less clear for the athlete. The present cross-sectional controlled study aimed to investigate the vascular function in female elite long-distance runners, compared to inactive women. Sixteen female elite long-distance runners and seventeen healthy controls were recruited. Assessments of vascular function and morphology included endothelial function, evaluated by flow-mediated dilatation (FMD), vascular stiffness, evaluated with pulse wave velocity (PWV), carotid artery reactivity (CAR %), and carotid intima-media thickness (cIMT). Blood samples included hormone analyses, metabolic parameters, lipids, and biomarkers reflecting endothelial activation. RED-S risk was assessed through the low energy availability in female questionnaire (LEAF-Q), and body composition was measured by dual-energy X-ray absorptiometry (DXA). We found no significant differences in brachial FMD, PWV, CAR %, cIMT, or biomarkers reflecting endothelial activation between the two groups. Forty-four percent of the runners had a LEAF-Q score consistent with being at risk of RED-S. Runners showed significantly higher HDL-cholesterol and insulin sensitivity compared to controls. In conclusion, Norwegian female elite runners had an as good vascular function and morphology as inactive women of the same age.
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10
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Longer-term soy nut consumption improves vascular function and cardiometabolic risk markers in older adults: Results of a randomized, controlled cross-over trial. Clin Nutr 2022; 41:1052-1058. [DOI: 10.1016/j.clnu.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/21/2022] [Accepted: 03/04/2022] [Indexed: 11/22/2022]
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Aarts E, Akkerman A, Altgassen M, Bartels R, Beckers D, Bevelander K, Bijleveld E, Blaney Davidson E, Boleij A, Bralten J, Cillessen T, Claassen J, Cools R, Cornelissen I, Dresler M, Eijsvogels T, Faber M, Fernández G, Figner B, Fritsche M, Füllbrunn S, Gayet S, van Gelder MMHJ, van Gerven M, Geurts S, Greven CU, Groefsema M, Haak K, Hagoort P, Hartman Y, van der Heijden B, Hermans E, Heuvelmans V, Hintz F, den Hollander J, Hulsman AM, Idesis S, Jaeger M, Janse E, Janzing J, Kessels RPC, Karremans JC, de Kleijn W, Klein M, Klumpers F, Kohn N, Korzilius H, Krahmer B, de Lange F, van Leeuwen J, Liu H, Luijten M, Manders P, Manevska K, Marques JP, Matthews J, McQueen JM, Medendorp P, Melis R, Meyer A, Oosterman J, Overbeek L, Peelen M, Popma J, Postma G, Roelofs K, van Rossenberg YGT, Schaap G, Scheepers P, Selen L, Starren M, Swinkels DW, Tendolkar I, Thijssen D, Timmerman H, Tutunji R, Tuladhar A, Veling H, Verhagen M, Verkroost J, Vink J, Vriezekolk V, Vrijsen J, Vyrastekova J, van der Wal S, Willems R, Willemsen A. Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context. PLoS One 2021; 16:e0260952. [PMID: 34965252 PMCID: PMC8716054 DOI: 10.1371/journal.pone.0260952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022] Open
Abstract
The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30–39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access. Trail registration:https://www.trialregister.nl/trial/7955.
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Affiliation(s)
- Healthy Brain Study consortium
- Radboud University, Nijmegen, The Netherlands
- Radboud University Medical Center, Nijmegen, The Netherlands
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Esther Aarts
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Agnes Akkerman
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Ronald Bartels
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Debby Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Erik Bijleveld
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | | | - Janita Bralten
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toon Cillessen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Jurgen Claassen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roshan Cools
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Martin Dresler
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Myrthe Faber
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guillén Fernández
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
| | - Bernd Figner
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Matthias Fritsche
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sascha Füllbrunn
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Surya Gayet
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | | | - Marcel van Gerven
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sabine Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Corina U. Greven
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martine Groefsema
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Koen Haak
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Hagoort
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Yvonne Hartman
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erno Hermans
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Florian Hintz
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | | | - Anneloes M. Hulsman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Sebastian Idesis
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain
| | - Martin Jaeger
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esther Janse
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Joost Janzing
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johan C. Karremans
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Willemien de Kleijn
- School of Psychology and Artificial Intelligence, Radboud University, Nijmegen, The Netherlands
| | - Marieke Klein
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris Klumpers
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Nils Kohn
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hubert Korzilius
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Bas Krahmer
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris de Lange
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Judith van Leeuwen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Huaiyu Liu
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Peggy Manders
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katerina Manevska
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - José P. Marques
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jon Matthews
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - James M. McQueen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Pieter Medendorp
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - René Melis
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antje Meyer
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Joukje Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Lucy Overbeek
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marius Peelen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jean Popma
- Interdisciplinary Hub for Security, Privacy and Data Governance, Radboud University, Nijmegen, The Netherlands
| | - Geert Postma
- Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Gabi Schaap
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Paul Scheepers
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc Selen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Marianne Starren
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick Thijssen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Timmerman
- University Medical Center Groningen, Groningen, The Netherlands
| | - Rayyan Tutunji
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil Tuladhar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harm Veling
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maaike Verhagen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Jacqueline Vink
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Janna Vrijsen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jana Vyrastekova
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Roel Willems
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
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Wanders L, Aengevaeren VL, Kersten BTP, Klok JM, van Mil ACCM, Carter HH, Dawson EA, Eijsvogels TMH, Hopman MTE, Thijssen DHJ. Traditional and Nontraditional Cardiovascular Risk Factors in Active Octogenarians Who Develop Cardiovascular Events. J Am Med Dir Assoc 2021; 23:1427-1429. [PMID: 34953782 DOI: 10.1016/j.jamda.2021.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Lisa Wanders
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands; TiFN, Wageningen, the Netherlands
| | - Vincent L Aengevaeren
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Bregina T P Kersten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Johanna M Klok
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Anke C C M van Mil
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Howard H Carter
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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13
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Willems LH, Nagy M, Ten Cate H, Spronk HMH, Groh LA, Leentjens J, Janssen NAF, Netea MG, Thijssen DHJ, Hannink G, van Petersen AS, Warlé MC. Sustained inflammation, coagulation activation and elevated endothelin-1 levels without macrovascular dysfunction at 3 months after COVID-19. Thromb Res 2021; 209:106-114. [PMID: 34922160 PMCID: PMC8642246 DOI: 10.1016/j.thromres.2021.11.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/14/2021] [Accepted: 11/24/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Endothelial damage and thrombosis caused by COVID-19 may imperil cardiovascular health. More than a year since the WHO declared COVID-19 pandemic, information on its effects beyond the acute phase is lacking. We investigate endothelial dysfunction, coagulation and inflammation, 3 months post-COVID-19. MATERIALS AND METHODS A cohort study was conducted including 203 patients with prior COVID-19. Macrovascular dysfunction was assessed by measuring the carotid artery diameter in response to hand immersion in ice-water. A historic cohort of 312 subjects served as controls. Propensity score matching corrected for baseline differences. Plasma concentrations of endothelin-1 were measured in patients post-COVID-19, during the acute phase, and in matched controls. Coagulation enzyme:inhibitor complexes and inflammatory cytokines were studied. RESULTS AND CONCLUSIONS The prevalence of macrovascular dysfunction did not differ between the COVID-19 (18.6%) and the historic cohort (22.5%, RD -4%, 95%CI: -15-7, p = 0.49). Endothelin-1 levels were significantly higher in acute COVID-19 (1.67 ± 0.64 pg/mL) as compared to controls (1.24 ± 0.37, p < 0.001), and further elevated 3 months post-COVID-19 (2.74 ± 1.81, p < 0.001). Thrombin:antithrombin(AT) was high in 48.3%. Markers of contact activation were increased in 16-30%. FVIIa:AT (35%) and Von Willebrand Factor:antigen (80.8%) were elevated. Inflammatory cytokine levels were high in a majority: interleukin(IL)-18 (73.9%), IL-6 (47.7%), and IL-1ra (48.9%). At 3 months after acute COVID-19 there was no indication of macrovascular dysfunction; there was evidence, however, of sustained endothelial cell involvement, coagulation activity and inflammation. Our data highlight the importance of further studies on SARS-CoV-2 related vascular inflammation and thrombosis, as well as longer follow-up in recovered patients.
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Affiliation(s)
- L H Willems
- Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M Nagy
- Departments of Internal medicine and Biochemistry, MUMC and CARIM School for Cardiovascular diseases, Maastricht, the Netherlands
| | - H Ten Cate
- Departments of Internal medicine and Biochemistry, MUMC and CARIM School for Cardiovascular diseases, Maastricht, the Netherlands; Center for Thrombosis and Haemostasis, Gutenberg University Medical Center, Mainz, Germany
| | - H M H Spronk
- Departments of Internal medicine and Biochemistry, MUMC and CARIM School for Cardiovascular diseases, Maastricht, the Netherlands
| | - L A Groh
- Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - J Leentjens
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - N A F Janssen
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M G Netea
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - D H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands/Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - G Hannink
- Department of Operating Rooms, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A S van Petersen
- Department of Surgery, Bernhoven Hospital, Uden, the Netherlands
| | - M C Warlé
- Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands.
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Speretta GF, Fornasiero A, Johns JA, Hopkins N, Thijssen DH, Low DA. Effects of Breaking up Deskwork with Physical Activity Combined with Tea Consumption on Cerebrovascular Function, Mood, and Affect. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Gijbels A, Trouwborst I, Jardon KM, Hul GB, Siebelink E, Bowser SM, Yildiz D, Wanders L, Erdos B, Thijssen DHJ, Feskens EJM, Goossens GH, Afman LA, Blaak EE. The PERSonalized Glucose Optimization Through Nutritional Intervention (PERSON) Study: Rationale, Design and Preliminary Screening Results. Front Nutr 2021; 8:694568. [PMID: 34277687 PMCID: PMC8278004 DOI: 10.3389/fnut.2021.694568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022] Open
Abstract
Background: It is well-established that the etiology of type 2 diabetes differs between individuals. Insulin resistance (IR) may develop in different tissues, but the severity of IR may differ in key metabolic organs such as the liver and skeletal muscle. Recent evidence suggests that these distinct tissue-specific IR phenotypes may also respond differentially to dietary macronutrient composition with respect to improvements in glucose metabolism. Objective: The main objective of the PERSON study is to investigate the effects of an optimal vs. suboptimal dietary macronutrient intervention according to tissue-specific IR phenotype on glucose metabolism and other health outcomes. Methods: In total, 240 overweight/obese (BMI 25 – 40 kg/m2) men and women (age 40 – 75 years) with either skeletal muscle insulin resistance (MIR) or liver insulin resistance (LIR) will participate in a two-center, randomized, double-blind, parallel, 12-week dietary intervention study. At screening, participants undergo a 7-point oral glucose tolerance test (OGTT) to determine the hepatic insulin resistance index (HIRI) and muscle insulin sensitivity index (MISI), classifying each participant as either “No MIR/LIR,” “MIR,” “LIR,” or “combined MIR/LIR.” Individuals with MIR or LIR are randomized to follow one of two isocaloric diets varying in macronutrient content and quality, that is hypothesized to be either an optimal or suboptimal diet, depending on their tissue-specific IR phenotype (MIR/LIR). Extensive measurements in a controlled laboratory setting as well as phenotyping in daily life are performed before and after the intervention. The primary study outcome is the difference in change in disposition index, which is the product of insulin sensitivity and first-phase insulin secretion, between participants who received their hypothesized optimal or suboptimal diet. Discussion: The PERSON study is one of the first randomized clinical trials in the field of precision nutrition to test effects of a more personalized dietary intervention based on IR phenotype. The results of the PERSON study will contribute knowledge on the effectiveness of targeted nutritional strategies to the emerging field of precision nutrition, and improve our understanding of the complex pathophysiology of whole body and tissue-specific IR. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03708419, clinicaltrials.gov as NCT03708419.
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Affiliation(s)
- Anouk Gijbels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands.,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Inez Trouwborst
- Top Institute Food and Nutrition, Wageningen, Netherlands.,Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Kelly M Jardon
- Top Institute Food and Nutrition, Wageningen, Netherlands.,Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Gabby B Hul
- Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Els Siebelink
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Suzanne M Bowser
- Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Dilemin Yildiz
- Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Lisa Wanders
- Top Institute Food and Nutrition, Wageningen, Netherlands.,Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Balázs Erdos
- Top Institute Food and Nutrition, Wageningen, Netherlands.,Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Gijs H Goossens
- Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Ellen E Blaak
- Top Institute Food and Nutrition, Wageningen, Netherlands.,Department of Human Biology, Maastricht University Medical Center+, Maastricht, Netherlands
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Lefferts WK, Lefferts EC, Hibner BA, Smith KJ, Fernhall B. Impact of acute changes in blood pressure and arterial stiffness on cerebral pulsatile haemodynamics in young and middle-aged adults. Exp Physiol 2021; 106:1643-1653. [PMID: 33938052 DOI: 10.1113/ep089319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/28/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does cerebrovascular pulsatility respond differently to acute increases in arterial stiffness in middle-aged compared with young adults? What is the main finding and its importance? Compared with young adults, middle-aged adults exhibited similar changes in cerebral pulsatile damping despite attenuated changes in carotid diameter and cerebrovascular pulsatility during blood pressure-dependent, but not blood pressure-independent, increases in large artery stiffness. ABSTRACT Acute manipulation of arterial stiffness through interventions that increase sympathetic activity might provoke cerebral pulsatility and damping and reveal whether cerebrovascular haemodynamics respond differently to transient elevations in arterial stiffness in middle-aged compared with young adults. We compared cerebral pulsatility and damping in middle-aged versus young adults during two different sympathetic interventions [cold pressor test (CP) and lower-body negative pressure (LBNP)] that increase arterial stiffness acutely. Cerebrovascular haemodynamics were assessed in 15 middle-aged (54 ± 7 years old; 11 female) and 15 sex-matched young adults (25 ± 4 years old) at rest and during the CP test (4 min, 6.4 ± 0.8°C) and LBNP (6 min, -20 mmHg). Mean blood pressure was measured continuously via finger photoplethysmography. Carotid-femoral pulse wave velocity (cfPWV) and carotid stiffness were measured via tonometry and ultrasound. Blood velocity pulsatility index (PI) was measured at the middle cerebral (MCA) and common carotid artery (CCA) using Doppler, with pulsatile damping calculated as CCA PI divided by MCA PI. Increases in cfPWV were driven by changes in mean pressure during CP but not during LBNP in both groups (P < 0.05). Pulsatile damping decreased in both groups (P < 0.05) despite reductions in MCA PI and greater carotid dilatation during CP in young compared with middle-aged adults (P < 0.05). Pressure-independent increases in cfPWV during LBNP did not alter pulsatile damping but decreased MCA PI in both young and middle-aged adults (P < 0.05). These data suggest that changes in carotid diameter and cerebrovascular pulsatility differ between young and middle-aged adults despite similar changes in cerebral pulsatile damping during blood pressure-dependent, but not blood pressure-independent, increases in large artery stiffness.
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Affiliation(s)
- Wesley K Lefferts
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA.,Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Elizabeth C Lefferts
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Brooks A Hibner
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kurt J Smith
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bo Fernhall
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
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Roberts KA, Draijer R, Hopkins ND, de Graaf Y, Holder SM, Carter SE, Thijssen DHJ, Low DA. Impact of green tea on the deleterious cardiometabolic effects of 7-days unhealthy lifestyle in young healthy males. Physiol Rep 2021; 9:e14720. [PMID: 33682367 PMCID: PMC7937942 DOI: 10.14814/phy2.14720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The aim of this study was to examine if catechin-rich green tea abrogates the negative effects of 7-days of physical inactivity and excessive calorie-intake on insulin homeostasis and peripheral vascular function. METHODS Using a randomized, double-blind, crossover design, twelve healthy men (29 ± 6 yrs) underwent 7-days unhealthy lifestyle (UL), including physical inactivity (-50% steps/day) and overfeeding (+50% kcal/day). This was combined with green tea consumption (UL-tea; 3 doses/day) or placebo (UL-placebo). Before and after each intervention, we examined postprandial blood glucose and insulin (3-h after a 1,202 kcal meal) and upper and lower limb vascular function (flow-mediated dilation (FMD%)) and carotid artery reactivity (CAR%). RESULTS UL-placebo increased postprandial glucose and insulin, while UL-tea decreased postprandial glucose and insulin (Time*Intervention interaction effects: both p < 0.05). UL-placebo decreased CAR% and femoral FMD%, while UL-tea prevented these effects (Time*Intervention interaction effects of p < 0.04 and p < 0.001, respectively). There was no main effect of Time or Time*Intervention interaction (both p > 0.05) for brachial FMD%. CONCLUSION Seven days of physical inactivity and overfeeding impair insulin homeostasis and vascular function. These effects were mitigated by a daily intake of catechin-rich green tea.
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Affiliation(s)
- Kirsty A Roberts
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Richard Draijer
- Unilever Foods Innovation Centre, Wageningen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Young de Graaf
- Unilever Foods Innovation Centre, Wageningen, The Netherlands
| | - Sophie M Holder
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Sophie E Carter
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.,Department of Physiology, Research Institute for Health Science, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - David A Low
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Wanders L, Cuijpers I, Kessels RPC, van de Rest O, Hopman MTE, Thijssen DHJ. Impact of prolonged sitting and physical activity breaks on cognitive performance, perceivable benefits, and cardiometabolic health in overweight/obese adults: The role of meal composition. Clin Nutr 2020; 40:2259-2269. [PMID: 33873267 DOI: 10.1016/j.clnu.2020.10.006] [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: 06/25/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS Physical activity (PA) breaks may effectively attenuate the detrimental impact of prolonged sitting on acute cognitive performance, perceivable benefits (e.g. mood), vascular function, and metabolic health. To date, the impact of meal composition on the effects of sedentary behavior and/or PA breaks on health has been scarcely studied. Therefore, our aim was to investigate whether meal composition alters how sedentary behavior and PA breaks affect these acute health outcomes. METHODS A total of 24 overweight and obese, sedentary adults completed four conditions in randomized order in a cross-over design: [a] high-protein, low-fat breakfast (HPLF) + 4hrs uninterrupted sitting (SIT), [b] HPLF + 4hrs interrupted sitting (ACT; 5-min cycling every 30 min), [c] Western breakfast (WEST; higher in fats/simple sugars, lower in protein/fiber) + SIT, [d] WEST + ACT. WEST and HPLF were isocaloric. Linear mixed models were used to examine changes in cognitive performance (Test of Attentional Performance), perceivable benefits (Likert-scales, Profile of Mood States questionnaire), vascular health (carotid artery reactivity, blood pressure), and metabolic health (post-breakfast glucose, insulin, lipids). RESULTS Independent of meal composition, we did not observe any effect of PA breaks on cognitive performance, vascular health and post-breakfast lipid responses. PA breaks delayed post-breakfast mood and vigor decrements, as well as increases in fatigue and sleepiness (all p < 0.05), but effects were independent of meal composition (p > 0.05). WEST resulted in higher post-breakfast glucose levels compared to HPLF (p < 0.05), while PA breaks did not impact this response (p > 0.05). PA breaks reduced post-breakfast insulin (p < 0.05), which did not differ between meals (p > 0.05). CONCLUSIONS The acute impact of PA breaks and/or prolonged sitting on cognitive performance, perceivable benefits, and vascular and metabolic health was not altered by the composition of a single meal in overweight/obese, sedentary adults. Possibly, breaking up prolonged sitting, rather than meal composition, is a more potent strategy to impact acute health outcomes, such as perceivable benefits and insulin levels.
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Affiliation(s)
- Lisa Wanders
- TiFN, P.O. Box 557, 6700 AN, Wageningen, the Netherlands; Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Radboudumc, Department of Physiology (392), P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Iris Cuijpers
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Radboudumc, Department of Physiology (392), P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology, Radboud university medical center, Radboudumc, Department of Medical Psychology (925), P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
| | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University & Research, Division of Human Nutrition and Health (Bode 62), P.O. Box 17, 6700 AA, Wageningen, the Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Radboudumc, Department of Physiology (392), P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Radboudumc, Department of Physiology (392), P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, L3 3AF, Liverpool, United Kingdom
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19
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Carr JMJR, Hoiland RL, Caldwell HG, Coombs GB, Howe CA, Tremblay JC, Green DJ, Ainslie PN. Internal carotid and brachial artery shear‐dependent vasodilator function in young healthy humans. J Physiol 2020; 598:5333-5350. [DOI: 10.1113/jp280369] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Jay M. J. R. Carr
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
| | - Ryan L. Hoiland
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
- Department of Anesthesiology Pharmacology and Therapeutics Vancouver General Hospital University of British Columbia Vancouver British Columbia Canada
| | - Hannah G. Caldwell
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
| | - Geoff B. Coombs
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
| | - Connor A. Howe
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
| | - Joshua C. Tremblay
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
| | - Daniel J. Green
- School of Human Sciences (Sport and Exercise Sciences) The University of Western Australia Crawley Western Australia Australia
| | - Philip N. Ainslie
- Centre for Heart Lung and Vascular Health School of Health and Exercise Sciences University of British Columbia – Okanagan Campus Kelowna British Columbia Canada
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Yang D, Ji Y, Wang D, Watase H, Hippe DS, Zhao X, Yuan C. Comparison of carotid atherosclerotic plaques between subjects in Northern and Southern China: a Chinese atherosclerosis risk evaluation study. Stroke Vasc Neurol 2020; 5:138-145. [PMID: 32404502 PMCID: PMC7337372 DOI: 10.1136/svn-2019-000288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/05/2019] [Accepted: 12/30/2019] [Indexed: 01/27/2023] Open
Abstract
Background and purpose To investigate differences in the characteristics of carotid atherosclerotic plaques of symptomatic subjects in northern and southern China using MRI. Methods Sixty-three subjects in northern China (mean age: 59.1±8.6 years, 45 men) and 56 subjects in southern China (mean age: 60.4±8.6 years, 38 men) were included. All subjects underwent carotid artery multicontrast vessel wall MRI. Plaque morphology, calcification, lipid-rich necrotic core, intraplaque haemorrhage, luminal surface disruption and high-risk plaque were measured and identified. All plaque characteristics were compared between subjects in northern and southern China using Mann-Whitney U test or χ2 test. Results Compared with subjects in southern China, those in northern China had significantly greater areas for lumen (57.7±14.9 mm2 vs 50.4±18.3 mm2, p=0.009), wall (38.4±13.1 mm2 vs 31.9±11.7 mm2, p<0.001) and total vessel (96.1±20.2 mm2 vs 82.4±22.7 mm2, p=0.001) and mean wall thickness (1.25±0.43 mm vs 1.13±0.40 mm, p=0.019). χ2 analysis showed that subjects in northern China tended to have a higher prevalence of intraplaque haemorrhage (14.3% vs 5.4%, p=0.106) and high-risk plaque (20.6% vs 10.7%, p=0.140) than those in southern China, although these differences were not statistically significant (all p>0.05). Conclusion Subjects in northern China have significantly larger vessel size and may have a higher prevalence of vulnerable plaques than those in southern China. Our findings provide additional perspective to optimise the management of cerebrovascular disease in individuals in different regions in China. Trial registration number NCT02017756
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Affiliation(s)
- Dandan Yang
- Center for Brain Disorders Research, Capital Medical University and Beijing Institute of Brain Disorders, Beijing, China
| | - Yang Ji
- Department of Radiology, Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dan Wang
- Department of Radiology, Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Hiroko Watase
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Daniel S Hippe
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Tsinghua University, Beijing, China
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, Washington, USA
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21
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Peace A, Pinna V, Timmen F, Speretta G, Jones H, Lotto R, Jones I, Thijssen D. Role of Blood Pressure in Mediating Carotid Artery Dilation in Response to Sympathetic Stimulation in Healthy, Middle-Aged Individuals. Am J Hypertens 2020; 33:146-153. [PMID: 31560753 DOI: 10.1093/ajh/hpz159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/07/2019] [Accepted: 09/20/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Carotid artery diameter responses to sympathetic stimulation, i.e., carotid artery reactivity (CAR), represent a novel test of vascular health and relates to cardiovascular disease (CVD)/risk. This study aims to understand the relationship between the increase in blood pressure and carotid artery diameter response during the CAR-test in healthy, middle-aged men. METHODS Sample consisted of 40 normotensive men (aged 31-59 years) with no history of CVD of currently taking medication. Noninvasive ultrasound was used to measure carotid artery diameter during the cold pressor test (CPT), with CAR% being calculated as the relative change from baseline (%). Mean arterial pressure (MAP) was measured with beat-to-beat blood pressure recording. RESULTS CAR% was 4.4 ± 5.4%, peaking at 92 ± 43 seconds. MAP increased from 88 ± 9 mmHg to 110 ± 15 mmHg, peaked at 112 ± 38 seconds, which was significantly later than the diameter peak (P = 0.04). The correlation between resting MAP and CAR% was weak (r = 0.209 P = 0.197). Tertiles based on resting MAP or MAP-increase revealed no significant differences between groups in subject characteristics including age, body mass index, or CAR% (all P > 0.05). Subgroup analysis of individuals with carotid constriction (n = 6) vs. dilation (n = 34), revealed no significant difference in resting MAP or increase in MAP (P = 0.209 and 0.272, respectively). CONCLUSION Our data suggest that the characteristic increase in MAP during the CPT does not mediate carotid artery vasomotion.
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Affiliation(s)
- Arron Peace
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Virginia Pinna
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboudumc, Nijmegen, The Netherlands
- Department of Medical Sciences and Public Health, Sports Physiology Lab, University of Cagliari, Cagliari, Italy
| | - Friso Timmen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboudumc, Nijmegen, The Netherlands
| | - Guillherme Speretta
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Department of Physiological Sciences, Biological Sciences Centre, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Robyn Lotto
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Ian Jones
- Faculty of Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Dick Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboudumc, Nijmegen, The Netherlands
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22
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Cerebral and peripheral vascular differences between pre- and postmenopausal women. ACTA ACUST UNITED AC 2020; 27:170-182. [DOI: 10.1097/gme.0000000000001442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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23
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Pouwels S, Van Genderen ME, Kreeftenberg HG, Ribeiro R, Parmar C, Topal B, Celik A, Ugale S. Utility of the cold pressor test to predict future cardiovascular events. Expert Rev Cardiovasc Ther 2019; 17:305-318. [PMID: 30916592 DOI: 10.1080/14779072.2019.1598262] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The cold pressor test (CPT) is a common and extensively validated test, which induces systemic stress involving immersion of an individual's hand in ice water (normally temperature between 0 and 5 degrees Celsius) for a period of time. CPT has been used in various fields, like examining effects of stress on memory, decision-making, pain and cardiovascular health. Areas covered: In terms of cardiovascular health, current research is mainly interested in predicting the occurrence of cardiovascular (CV) events. The objective of this review is to give an overview of the history and methodology of the CPT, and clinical utility in possibly predicting CV events in CAD and other atherosclerotic diseases. Secondly, we will discuss possible future applications of the CPT in clinical care. Expert opinion: An important issue to address is the fact that the physiology of the CPT is not fully understood at this moment. As pointed out multiple mechanisms might be responsible for contributing to either coronary vasodilatation or coronary vasoconstriction. Regarding the physiological mechanism of the CPT and its effect on the measurements of the carotid artery reactivity even less is known.
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Affiliation(s)
- Sjaak Pouwels
- a Department of Surgery , Franciscus Gasthuis & Vlietland , Rotterdam/Schiedam , The Netherlands
| | - Michel E Van Genderen
- b Department of Internal Medicine , Franciscus Gasthuis & Vlietland , Rotterdam/Schiedam , The Netherlands
| | - Herman G Kreeftenberg
- c Department of Internal Medicine , Catharina Hospital , Eindhoven , The Netherlands.,d Department of Intensive Care Medicine , Catharina Hospital , Eindhoven , The Netherlands
| | - Rui Ribeiro
- e Metabolic Patient Multidisciplinary Centre , Clínica de Santo António , Lisbon , Portugal
| | - Chetan Parmar
- f Department of Surgery , Whittington Hospital , London , UK
| | - Besir Topal
- g Department of Cardiothoracic Surgery , OLVG , Amsterdam , The Netherlands
| | - Alper Celik
- h Department of metabolic surgery , Metabolic Surgery Clinic , Istanbul , Turkey
| | - Surendra Ugale
- i Department of Surgery , Virinchi Hospitals , Hyderbad , India
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25
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Carotid Artery Function Is Restored in Subjects With Elevated Cardiovascular Disease Risk After a 12-Week Physical Activity Intervention. Can J Cardiol 2019; 35:23-26. [DOI: 10.1016/j.cjca.2018.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 12/24/2022] Open
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van Mil ACCM, Tymko MM, Kerstens TP, Stembridge M, Green DJ, Ainslie PN, Thijssen DHJ. Similarity between carotid and coronary artery responses to sympathetic stimulation and the role of α 1-receptors in humans. J Appl Physiol (1985) 2018; 125:409-418. [PMID: 29565771 DOI: 10.1152/japplphysiol.00386.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Carotid artery (CCA) dilation occurs in healthy subjects during cold pressor test (CPT), while the magnitude of dilation relates to cardiovascular risk. To further explore this phenomenon and mechanism, we examined carotid artery responses to different sympathetic tests, with and without α1-receptor blockade and assessed similarity to these responses between carotid and coronary arteries. In randomized order, 10 healthy participants (25 ± 3 yr) underwent sympathetic stimulation using the CPT (3-min left-hand immersion in ice-slush) and lower-body negative pressure (LBNP). Before and during sympathetic tests, CCA diameter and velocity (Doppler ultrasound) and left anterior descending (LAD) coronary artery velocity (echocardiography) were recorded across 3 min. Measures were repeated 90 min following selective α1-receptor blockade via oral prazosin (0.05 mg/kg body wt). CPT significantly increased CCA diameter, LAD maximal velocity, and velocity-time integral area-under-the-curve (all P < 0.05). In contrast, LBNP resulted in a decrease in CCA diameter, LAD maximal velocity, and velocity time integral (VTI; all P < 0.05). Following α1-receptor blockade, CCA and LAD velocity responses to CPT were diminished. In contrast, during LBNP (-30 mmHg), α1-receptor blockade did not alter CCA or LAD responses. Finally, changes in CCA diameter and LAD VTI responses to sympathetic stimulation were positively correlated ( r = 0.66, P < 0.01). We found distinct carotid artery responses to different tests of sympathetic stimulation, where α1 receptors partly contribute to CPT-induced responses. Finally, we found agreement between carotid and coronary artery responses. These data indicate similarity between carotid and coronary responses to sympathetic tests and the role of α1 receptors that is dependent on the nature of the sympathetic challenge. NEW & NOTEWORTHY We showed distinct carotid artery responses to cold pressor test (CPT; i.e., dilation) and lower-body negative pressure (LBNP; i.e., constriction). Blockade of α1-receptors significantly attenuated dilator responses in carotid and coronary arteries during CPT, while no changes were found during LBNP. Our findings indicate strong similarity between carotid and coronary artery responses to distinct sympathetic stimuli, and for the role of α-receptors.
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Affiliation(s)
- Anke C C M van Mil
- Department of Physiology, Radboudumc, Nijmegen , The Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Liverpool , United Kingdom
| | - Michael M Tymko
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Thijs P Kerstens
- Department of Physiology, Radboudumc, Nijmegen , The Netherlands
| | - Mike Stembridge
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada.,Cardiff School of Sport, Cardiff Metropolitan University , Cardiff , United Kingdom
| | - Daniel J Green
- School of Sports Science, Exercise and Health, the University of Western Australia , Nedlands , Australia
| | - Philip N Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Dick H J Thijssen
- Department of Physiology, Radboudumc, Nijmegen , The Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Liverpool , United Kingdom
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Peace A, van Mil A, Jones H, Thijssen DH. Similarities and Differences Between Carotid Artery and Coronary Artery Function. Curr Cardiol Rev 2018; 14:254-263. [PMID: 30198437 PMCID: PMC6300794 DOI: 10.2174/1573403x14666180910125638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cardiovascular Disease (CVD) remains one of the leading causes of morbidity and mortality. Strategies to predict development of CVD are therefore key in preventing and managing CVD. One stratergy in predicting CVD is by examining the role of traditional risk factors for CVD (e.g. age, sex, weight, blood pressure, blood lipids, blood glucose, smoking and physical activity). Although these measures are non-invasive and simple to perform, they provide limited information of CVD prediction. Directly examining functional characteristics of arteries that are involved in the pathophysiological changes that contribute to the development of CVD improve prediction of future CVD. Nevertheless, examining the function of arteries susceptible to atherosclortic changes, such as the coronary arteries, is invasive, expensive, and associated with high risk for complications. More accessible arteries can be used as a surrogate measure of coronary artery function. For example, the carotid artery may be a superior surrogate measure of coronary artery function given that, the carotid artery represents a central vessel that shows similarities in vasomotor function and anatomical structure with coronary arteries. CONCLUSION This review summarises the similarities between the carotid and coronary arteries, describes how both arteries respond to specific vasoactive stimuli, and discusses if the easily assessible carotid artery can provide information about vascular function (e.g. vasomotor reactivity to sympathetic stimulation) which is prognostic for future cardiovascular events. Finally, the impact of older age and lifestyle interventions (e.g. exercise training) on carotid artery function will be discussed.
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Affiliation(s)
| | | | | | - Dick H.J. Thijssen
- Address correspondence to this author at the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street L3 3AF, Liverpool, United Kingdom;
Tel: +441519046264; E-mail:
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Heffernan KS, Lefferts WK, Yoon ES, Park SH, Lee YH, Jae SY. Carotid artery reactivity during sympathetic activation following acute resistance exercise. Clin Auton Res 2017; 27:417-421. [DOI: 10.1007/s10286-017-0469-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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