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Somani YB, Boidin M, Peggen MAG, Wanders I, Proctor DN, Low DA, Jones H, Lip GYH, Thijssen DHJ. Single and 7-day handgrip and squat exercise prevents endothelial ischemia-reperfusion injury in individuals with cardiovascular disease risk factors. Am J Physiol Regul Integr Comp Physiol 2024; 326:R79-R87. [PMID: 37899755 DOI: 10.1152/ajpregu.00168.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/31/2023]
Abstract
Whole body exercise provides protection against endothelial ischemia-reperfusion (IR) injury. In this crossover study, we examined the effects of 1) single bout of local exercise (handgrip, squats) on endothelial responses to IR, and 2) if 7 days of daily local exercise bolsters these effects in individuals with cardiovascular disease (CVD) risk factors. Fifteen participants (9 women, 58 ± 5 yr, ≥2 CVD risk factors) attended the laboratory for six visits. Subsequent to familiarization (visit 1), during visit 2 (control) brachial artery flow-mediated dilation (FMD) was measured before and after IR (15-min upper-arm ischemia, 15-min reperfusion). One week later, participants were randomized to 4 × 5-min unilateral handgrip (50% maximal voluntary contraction, 25 rpm) or squat exercises (15 rpm), followed by IR plus FMD measurements. Subsequently, home-based exercise was performed (6 days), followed by another visit to the laboratory for the IR protocol plus FMD measurements (18-24 h after the last exercise bout). After a 2-wk washout period, procedures were repeated with the alternative exercise mode. For a single exercise bout, we found a significant IR injury × exercise mode interaction (P < 0.01) but no main effect of injury (P = 0.08) or condition (P = 0.61). A lower post-IR FMD was evident after control (pre-IR: 4.3 ± 2.1% to post-IR: 2.9 ± 1.9%, P < 0.01) but not after handgrip (pre-IR: 3.8 ± 1.6% to post-IR: 3.4 ± 1.5%, P = 0.31) or squats (pre-IR: 3.9 ± 1.8% to post-IR: 4.0 ± 1.9%, P = 0.74). After 7 days of daily exercise, we found no change in FMD post-IR following handgrip (pre-IR: 4.3 ± 1.9% to post-IR: 4.7 ± 3.2%) or squats (pre-IR: 3.7 ± 2.1% to post-IR: 4.7 ± 3.0%, P > 0.05). Single bouts of dynamic, local exercise (handgrip, squats) provide remote protection against endothelial IR-induced injury in individuals with CVD risk factors, with 1-wk daily, home-based exercise preserving these effects for up to 24 h following the last exercise bout.NEW & NOTEWORTHY We show that single bouts of dynamic handgrip and squat exercise provide remote protection against endothelial ischemia-reperfusion (IR)-induced injury in individuals with cardiovascular disease (CVD) risk factors, with 1-wk daily, home-based exercise preserving these effects for up to 24 h following the last exercise bout.
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Affiliation(s)
- Yasina B Somani
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Department of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Maxime Boidin
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Mandy A G Peggen
- Department of Medical Biosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Iris Wanders
- Department of Medical Biosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - David N Proctor
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - David A Low
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Danish Center for Clinical Health Services, Aalborg University, Aalborg, Denmark
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Department of Medical Biosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
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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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Yu Y, Anand G, Lowe A, Zhang H, Kalra A. Towards Estimating Arterial Diameter Using Bioimpedance Spectroscopy: A Computational Simulation and Tissue Phantom Analysis. SENSORS (BASEL, SWITZERLAND) 2022; 22:4736. [PMID: 35808233 PMCID: PMC9268936 DOI: 10.3390/s22134736] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
This paper improves the accuracy of quantification in the arterial diameter-dependent impedance variance by altering the electrode configuration. The finite element analysis was implemented with a 3D human wrist fragment using ANSYS Electronics Desktop, containing fat, muscle, and a blood-filled radial artery. Then, the skin layer and bones were stepwise added, helping to understand the dielectric response of multi-tissues and blood flow from 1 kHz to 1 MHz, the current distribution throughout the wrist, and the optimisation of electrode configurations for arterial pulse sensing. Moreover, a low-cost wrist phantom was fabricated, containing two components: the surrounding tissue simulant (20 wt % gelatine power and 0.017 M sodium chloride (NaCl) solution) and the blood simulant (0.08 M NaCl solution). The blood-filled artery was constricted using a desktop injection pump, and the impedance change was measured by the Multi-frequency Impedance Analyser (MFIA). The simulation revealed the promising capabilities of band electrodes to generate a more uniform current distribution than the traditional spot electrodes. Both simulation and phantom experimental results indicated that a longer spacing between current-carrying (CC) electrodes with shorter spacing between pick-up (PU) electrodes in the middle could sense a more uniform electric field, engendering a more accurate arterial diameter estimation. This work provided an improved electrode configuration for more accurate arterial diameter estimation from the numerical simulation and tissue phantom perspectives.
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Boice EN, Hernandez-Torres SI, Snider EJ. Comparison of Ultrasound Image Classifier Deep Learning Algorithms for Shrapnel Detection. J Imaging 2022; 8:jimaging8050140. [PMID: 35621904 PMCID: PMC9144026 DOI: 10.3390/jimaging8050140] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/06/2023] Open
Abstract
Ultrasound imaging is essential in emergency medicine and combat casualty care, oftentimes used as a critical triage tool. However, identifying injuries, such as shrapnel embedded in tissue or a pneumothorax, can be challenging without extensive ultrasonography training, which may not be available in prolonged field care or emergency medicine scenarios. Artificial intelligence can simplify this by automating image interpretation but only if it can be deployed for use in real time. We previously developed a deep learning neural network model specifically designed to identify shrapnel in ultrasound images, termed ShrapML. Here, we expand on that work to further optimize the model and compare its performance to that of conventional models trained on the ImageNet database, such as ResNet50. Through Bayesian optimization, the model’s parameters were further refined, resulting in an F1 score of 0.98. We compared the proposed model to four conventional models: DarkNet-19, GoogleNet, MobileNetv2, and SqueezeNet which were down-selected based on speed and testing accuracy. Although MobileNetv2 achieved a higher accuracy than ShrapML, there was a tradeoff between accuracy and speed, with ShrapML being 10× faster than MobileNetv2. In conclusion, real-time deployment of algorithms such as ShrapML can reduce the cognitive load for medical providers in high-stress emergency or miliary medicine scenarios.
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Snider EJ, Hernandez-Torres SI, Boice EN. An image classification deep-learning algorithm for shrapnel detection from ultrasound images. Sci Rep 2022; 12:8427. [PMID: 35589931 PMCID: PMC9117994 DOI: 10.1038/s41598-022-12367-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/06/2022] [Indexed: 01/01/2023] Open
Abstract
Ultrasound imaging is essential for non-invasively diagnosing injuries where advanced diagnostics may not be possible. However, image interpretation remains a challenge as proper expertise may not be available. In response, artificial intelligence algorithms are being investigated to automate image analysis and diagnosis. Here, we highlight an image classification convolutional neural network for detecting shrapnel in ultrasound images. As an initial application, different shrapnel types and sizes were embedded first in a tissue mimicking phantom and then in swine thigh tissue. The algorithm architecture was optimized stepwise by minimizing validation loss and maximizing F1 score. The final algorithm design trained on tissue phantom image sets had an F1 score of 0.95 and an area under the ROC curve of 0.95. It maintained higher than a 90% accuracy for each of 8 shrapnel types. When trained only on swine image sets, the optimized algorithm format had even higher metrics: F1 and area under the ROC curve of 0.99. Overall, the algorithm developed resulted in strong classification accuracy for both the tissue phantom and animal tissue. This framework can be applied to other trauma relevant imaging applications such as internal bleeding to further simplify trauma medicine when resources and image interpretation are scarce.
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Affiliation(s)
- Eric J Snider
- Engineering Technology and Automation Combat Casualty Care Research Team, United States Army Institute of Surgical Research, Ft. Sam Houston, TX, USA.
| | - Sofia I Hernandez-Torres
- Engineering Technology and Automation Combat Casualty Care Research Team, United States Army Institute of Surgical Research, Ft. Sam Houston, TX, USA
| | - Emily N Boice
- Engineering Technology and Automation Combat Casualty Care Research Team, United States Army Institute of Surgical Research, Ft. Sam Houston, TX, USA
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6
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Bailey DM, Culcasi M, Filipponi T, Brugniaux JV, Stacey BS, Marley CJ, Soria R, Rimoldi SF, Cerny D, Rexhaj E, Pratali L, Salmòn CS, Jáuregui CM, Villena M, Villafuerte F, Rockenbauer A, Pietri S, Scherrer U, Sartori C. EPR spectroscopic evidence of iron-catalysed free radical formation in chronic mountain sickness: Dietary causes and vascular consequences. Free Radic Biol Med 2022; 184:99-113. [PMID: 35398201 DOI: 10.1016/j.freeradbiomed.2022.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/12/2022]
Abstract
Chronic mountain sickness (CMS) is a high-altitude (HA) maladaptation syndrome characterised by elevated systemic oxidative-nitrosative stress (OXNOS) due to a free radical-mediated reduction in vascular nitric oxide (NO) bioavailability. To better define underlying mechanisms and vascular consequences, this study compared healthy male lowlanders (80 m, n = 10) against age/sex-matched highlanders born and bred in La Paz, Bolivia (3600 m) with (CMS+, n = 10) and without (CMS-, n = 10) CMS. Cephalic venous blood was assayed using electron paramagnetic resonance spectroscopy and reductive ozone-based chemiluminescence. Nutritional intake was assessed via dietary recall. Systemic vascular function and structure were assessed via flow-mediated dilatation, aortic pulse wave velocity and carotid intima-media thickness using duplex ultrasound and applanation tonometry. Basal systemic OXNOS was permanently elevated in highlanders (P = <0.001 vs. lowlanders) and further exaggerated in CMS+, reflected by increased hydroxyl radical spin adduct formation (P = <0.001 vs. CMS-) subsequent to liberation of free 'catalytic' iron consistent with a Fenton and/or nucleophilic addition mechanism(s). This was accompanied by elevated global protein carbonylation (P = 0.046 vs. CMS-) and corresponding reduction in plasma nitrite (P = <0.001 vs. lowlanders). Dietary intake of vitamins C and E, carotene, magnesium and retinol were lower in highlanders and especially deficient in CMS + due to reduced consumption of fruit and vegetables (P = <0.001 to 0.028 vs. lowlanders/CMS-). Systemic vascular function and structure were also impaired in highlanders (P = <0.001 to 0.040 vs. lowlanders) with more marked dysfunction observed in CMS+ (P = 0.035 to 0.043 vs. CMS-) in direct proportion to systemic OXNOS (r = -0.692 to 0.595, P = <0.001 to 0.045). Collectively, these findings suggest that lifelong exposure to iron-catalysed systemic OXNOS, compounded by a dietary deficiency of antioxidant micronutrients, likely contributes to the systemic vascular complications and increased morbidity/mortality in CMS+. TRIAL REGISTRY: ClinicalTrials.gov; No: NCT01182792; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, UK.
| | - Marcel Culcasi
- Aix Marseille Univ, CNRS, ICR, UMR, 7273, Marseille, France
| | - Teresa Filipponi
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, UK
| | - Julien V Brugniaux
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, UK; HP2 Laboratory, INSERM U1300, Grenoble Alpes University, Grenoble, France
| | - Benjamin S Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, UK
| | - Christopher J Marley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Wales, UK
| | - Rodrigo Soria
- Department of Cardiology and Biomedical Research, University Hospital, Bern, Switzerland
| | - Stefano F Rimoldi
- Department of Cardiology and Biomedical Research, University Hospital, Bern, Switzerland
| | - David Cerny
- Department of Cardiology and Biomedical Research, University Hospital, Bern, Switzerland
| | - Emrush Rexhaj
- Department of Cardiology and Biomedical Research, University Hospital, Bern, Switzerland
| | | | | | | | | | - Francisco Villafuerte
- Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antal Rockenbauer
- Institute of Materials and Environmental Chemistry, Research Center for Natural Sciences, 1117, Budapest, Hungary
| | - Sylvia Pietri
- Aix Marseille Univ, CNRS, ICR, UMR, 7273, Marseille, France
| | - Urs Scherrer
- Department of Cardiology and Biomedical Research, University Hospital, Bern, Switzerland; Facultad de Ciencias, Departamento de Biología, Universidad de Tarapacá, Arica, Chile
| | - Claudio Sartori
- Department of Internal Medicine, University Hospital, UNIL-Lausanne, Switzerland
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Fan JL, Sayegh ALC, Kaur M, Dawes M, Paton JFR, Fisher JP. Effects of hypoxia and hyperoxia on venous capacity and compliance in healthy men and women. Am J Physiol Regul Integr Comp Physiol 2022; 322:R445-R453. [PMID: 35319299 DOI: 10.1152/ajpregu.00319.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/03/2022] [Accepted: 03/18/2022] [Indexed: 11/22/2022]
Abstract
Blood oxygen is an important modulator of arterial function, but its impact on peripheral venous function is incompletely understood. Herein, we sought to determine the effect of hypoxia and hyperoxia on venous capacity and compliance in the lower limb. In 16 healthy individuals (7 women; age: 28.3 ± 7.6 yr, mean ± SD), we assessed peripheral oxygen saturation ([Formula: see text]), the cross-sectional area (CSA) of the great saphenous vein (GSV; Doppler ultrasound), and calf volume (strain-gauge plethysmography) during a standard 60 mmHg thigh cuff inflation-deflation protocol. Separate trials were undertaken during breathing of room air, hypoxia [fraction in inspired oxygen ([Formula: see text]): 0.10], and hyperoxia ([Formula: see text]: 0.50), according to a single-blinded, randomized design. Lower limb pressure-CSA and pressure-volume relationships were modeled using a quadratic regression equation and compliance derived. [Formula: see text] was decreased by hypoxia (83.6 ± 5.6%) and increased by hyperoxia (98.7 ± 0.5%) compared with room air (96.4 ± 1.0%, P < 0.001). Compared with room air (17.0 ± 7.9 mm2), hypoxia decreased GSV CSA (13.4 ± 5.7 mm2, P < 0.001), whereas no change was observed with hyperoxia (17.1 ± 8.7 mm2, P = 0.883). GSV compliance derived from the pressure-CSA relationships was elevated approximately twofold with hyperoxia (-0.0061 ± 0.0046 a.u.) when compared with room air (-0.0029 ± 0.002 a.u., P = 0.027) and hypoxia (-0.0030 ± 0.0032 a.u., P = 0.007). No differences were observed in calf pressure-volume parameters with either hypoxia or hyperoxia (P > 0.05). Our data indicate that GSV capacity is reduced by hypoxia, and that GSV compliance is increased by hyperoxia, thus highlighting the often overlooked role of oxygen in the regulation of venous circulation.
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Affiliation(s)
- Jui-Lin Fan
- Manaaki Manawa, The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ana Luiza C Sayegh
- Manaaki Manawa, The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Manpreet Kaur
- Manaaki Manawa, The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mathew Dawes
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Julian F R Paton
- Manaaki Manawa, The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - James P Fisher
- Manaaki Manawa, The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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Simulation of Ultrasound RF Signals Backscattered from a 3D Model of Pulsating Artery Surrounded by Tissue. Diagnostics (Basel) 2022; 12:diagnostics12020232. [PMID: 35204323 PMCID: PMC8871234 DOI: 10.3390/diagnostics12020232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 02/05/2023] Open
Abstract
Arterial stiffness is an independent predictor of cardiovascular events. The motion of arterial tissues during the cardiac cycle is important as a mechanical deformation representing vessel elasticity and is related to arterial stiffness. In addition, arterial pulsation is the main source of endogenous tissue micro-motions currently being studied for tissue elastography. Methods based on artery motion detection are not applied in clinical practice these days, because they must be carefully investigated in silico and in vitro before wide usage in vivo. The purpose of this paper is to propose a dynamic 3D artery model capable of reproducing the biomechanical behavior of human blood vessels surrounded by elastic tissue for endogenous deformation elastography developments and feasibility studies. The framework is based on a 3D model of a pulsating artery surrounded by tissue and simulation of linear scanning by Field II software to generate realistic dynamic RF signals and B-mode ultrasound image sequential data. The model is defined by a spatial distribution of motions, having patient-specific slopes of radial and longitudinal motion components of the artery wall and surrounding tissues. It allows for simulating the quantified mechanical micro-motions in the volume of the model. Acceptable simulation errors calculated between modeled motion patterns and those estimated from simulated RF signals and B-scan images show that this approach is suitable for the development and validation of elastography algorithms based on motion detection.
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9
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Meri̇c B, Solak S, Aydogdu N, Sut N, Vardar SA. The comparison of endothelial function of moderate intensity interval exercise with continuous exercise in healthy men. Curr Res Physiol 2022; 5:338-343. [PMID: 35880036 PMCID: PMC9307423 DOI: 10.1016/j.crphys.2022.07.003] [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: 02/08/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background/aim Materials and methods Results Conclusion
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Affiliation(s)
- Burcu Meri̇c
- Department of Physiology, Health Science Institute, Trakya University, Edirne, Turkey
| | - Serdar Solak
- Department of Radiology, Trakya University Medical Faculty, Edirne, Turkey
| | - Nurettin Aydogdu
- Department of Physiology, İnönü University Medical Faculty, Malatya, Turkey
| | - Necdet Sut
- Department of Biostatistics, Trakya University Medical Faculty, Edirne, Turkey
| | - Selma Arzu Vardar
- Department of Physiology, Health Science Institute, Trakya University, Edirne, Turkey
- Department of Physiology, Trakya University, Medical Faculty, Edirne, Turkey
- Corresponding author. Trakya University Medical Faculty Department of Physiology, 22030, Edirne, Turkey.
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10
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Al-harosh M, Yangirov M, Kolesnikov D, Shchukin S. Bio-Impedance Sensor for Real-Time Artery Diameter Waveform Assessment. SENSORS 2021; 21:s21248438. [PMID: 34960542 PMCID: PMC8709432 DOI: 10.3390/s21248438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 01/21/2023]
Abstract
The real-time artery diameter waveform assessment during cardio cycle can allow the measurement of beat-to-beat pressure change and the long-term blood pressure monitoring. The aim of this study is to develop a self-calibrated bio-impedance-based sensor, which can provide regular measurement of the blood-pressure-dependence time variable parameters such as the artery diameter waveform and the elasticity. This paper proposes an algorithm based on analytical models which need prior geometrical and physiological patient parameters for more appropriate electrode system selection and hence location to provide accurate blood pressure measurement. As a result of this study, the red cell orientation effect contribution was estimated and removed from the bio-impedance signal obtained from the artery to keep monitoring the diameter waveform correspondence to the change of blood pressure.
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11
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Bosso G, Valvano A, Apuzzi V, Mercurio V, Di Simone V, Cittadini A, Napoli R, Oliviero U. Peripheral Vascular Function in Dilated Cardiomyopathy of Different Etiology. Angiology 2020; 71:726-733. [DOI: 10.1177/0003319720932803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vascular function in dilated cardiomyopathy of different etiology has been poorly investigated. Moreover, reference values of flow-mediated dilation (FMD) in chronic heart failure (CHF) need to be updated according to the new standardized protocols. We characterized the vascular impairment in different stages of post-ischemic dilated cardiomyopathy (PI-DC) or idiopathic dilated cardiomyopathy (I-DC). Eighty consecutive outpatients with CHF in different New York Heart Association (NYHA) classes (45 PI-DC, 35 I-DC) and 50 control subjects underwent FMD and brachial distensibility coefficient measurement. Patients with CHF showed a marked impairment in FMD compared with controls that worsened from classes NYHA I-II to III-IV, independently of etiology ( P < .05). New York Heart Association I-II PI-DC patients showed a worse FMD compared with NYHA I-II I-DC patients ( P < .05). Brachial distensibility coefficient values were significantly lower in patients with CHF compared with controls ( P < .001) without differences between PI-DC and I-DC. In conclusion, advanced CHF is characterized by vascular impairment that is independent of etiology. In the early stages of CHF, endothelial dysfunction is more severe in patients with PI-DC compared with I-DC probably due to the high cardiovascular risk profile. In I-DC, vascular function impairment is independent of cardiovascular risk factors and could participate in the pathogenesis of I-DC.
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Affiliation(s)
- Giorgio Bosso
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Valvano
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valentina Apuzzi
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valeria Di Simone
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Raffaele Napoli
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Ugo Oliviero
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
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12
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Effect of direct renin inhibition on vascular function after long-term treatment with aliskiren in hypertensive and diabetic patients. J Hypertens 2020; 39:169-180. [PMID: 32740409 DOI: 10.1097/hjh.0000000000002595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We tested the hypothesis that chronic treatment with the direct renin inhibitor aliskiren improves vascular function in resistance and conduit arteries of type two diabetic and hypertensive patients. METHOD Sixteen patients with mild essential hypertension and with a previous diagnosis of noninsulin-dependent diabetes mellitus were included in the study. Patients were then randomized to aliskiren (150 mg once daily, n = 9), or ramipril (5 mg once daily, n = 7). Each patient underwent a biopsy of the subcutaneous tissue and small arteries were dissected and mounted on a pressurized micromyograph to evaluate endothelium dependent vasorelaxation in response to acetylcholine ± N omega-nitro-L-arginine methyl ester hydrochloride in vessels precontracted with norepinephrine. Endothelial function has been quantified also in large conduit arteries by flow-mediated dilation. RESULTS A similar office blood pressure-lowering effect was observed with the two drugs, although changes in DBP were not statistically significant in the ramipril group. Aliskiren significantly improved endothelium-dependent relaxation in subcutaneous resistance arteries, as well as increased flow-mediated dilation in conduit arteries, whereas the effects induced by ramipril did not reach statistical significance. Only aliskiren significantly increased the expression of p1177-endothelial nitric oxide synthase in the endothelium. Both aliskiren and ramipril had a negligible effect on markers of oxidative stress. CONCLUSION Aliskiren restored endothelial function and induced a more prompt peripheral vasodilation in hypertensive and diabetic patients possibly through the increased production of nitric oxide via the enhanced expression and function of the active phosphorylated form of endothelial nitric oxide synthase.
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13
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Junejo RT, May S, Alsalahi S, Alali M, Ogoh S, Fisher JP. Cerebrovascular carbon dioxide reactivity and flow-mediated dilation in young healthy South Asian and Caucasian European men. Am J Physiol Heart Circ Physiol 2020; 318:H756-H763. [PMID: 32083976 DOI: 10.1152/ajpheart.00641.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
South Asians living in the United Kingdom have a 1.5-fold greater risk of ischemic stroke than the general population. Impaired cerebrovascular carbon dioxide (CO2) reactivity is an independent predictor of ischemic stroke and cardiovascular mortality. We sought to test the hypothesis that cerebrovascular CO2 reactivity is reduced in South Asians. Middle cerebral artery blood velocity (MCA Vm) was measured at rest and during stepwise changes in end-tidal partial pressure of CO2 (PETCO2) in South Asian (n = 16) and Caucasian European (n = 18) men who were young (~20 yr), healthy, and living in the United Kingdom. Incremental hypercapnia was delivered via the open-circuit steady-state method, with stages of 4 and 7% CO2 (≈21% oxygen, nitrogen balanced). Cerebrovascular CO2 reactivity was calculated as the change in MCA Vm relative to the change in PETCO2. MCA Vm was not different in South Asians [59 (9) cm/s, mean (standard deviation)] and Caucasian Europeans [61 (12) cm/s; P > 0.05]. Similarly, cerebrovascular CO2 reactivity was not different between the groups [South Asian 2.53 (0.76) vs. Caucasian European 2.61 (0.81) cm·s-1·mmHg-1; P > 0.05]. Brachial artery flow-mediated dilation was lower in South Asians [5.48 (2.94)%] compared with Caucasian Europeans [7.41 (2.28)%; P < 0.05]; however, when corrected for shear rate no between-group differences in flow-mediated dilation were observed (P > 0.05). Flow-mediated dilation was not correlated with cerebrovascular CO2 reactivity measures. In summary, cerebrovascular CO2 reactivity and flow-mediated dilation corrected for shear rate are preserved in young healthy South Asian men living in the United Kingdom.NEW & NOTEWORTHY Previous reports have identified an increased risk of ischemic stroke and peripheral endothelial dysfunction in South Asians compared with Caucasian Europeans. The main finding of this study is that cerebrovascular carbon dioxide reactivity (an independent predictor of ischemic stroke) is not different in healthy young South Asian and Caucasian European men.
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Affiliation(s)
- Rehan T Junejo
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.,Liverpool Centre for Cardiovascular Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Sophie May
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sultan Alsalahi
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Mohammad Alali
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Saitama, Japan
| | - James P Fisher
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Joseph J, Chandran DS, Kiran RV, Abhidev VV, Sivaprakasam M. Image-Free Technique for Flow Mediated Dilation Using ARTSENS ® Pen. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:5051-5054. [PMID: 31946994 DOI: 10.1109/embc.2019.8856944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Flow mediated dilation (FMD) is a clinically accepted non-invasive tool for assessing endothelial dysfunction. FMD is conventionally performed with B-mode ultrasound systems that involve recording of the image sequences as DICOM files or video-graphic files and processing them offline. Sometimes the examinations may have to be rejected due to poor or unstable image sequences resulting non-reliable diameter estimates. We had earlier developed and extensively validated an image-free ultrasound technology, ARTSENS®, for the measurement of carotid artery wall dynamics and arterial stiffness metrics. In this work, we evaluate the feasibility of using the technology for continuous real-time diameter measurement of the brachial artery and thereby FMD. To investigate the performance of the ARTSENS® device an in-vivo study was conducted on 5 subjects as pilot. As a reference the measurements were also performed by a B-mode imaging system with a help of a commercially available clinically validated offline FMD analysis tool. The brachial artery diameter and FMD measurements performed by the ARTSENS® device were consistent with the earlier reported literature. The beat-to-beat repeatability of the baseline diameter measurements was acceptable with a CoV <; 4% for all the subjects. The diameter measurements performed by the two devices exhibited a significant correlation (r-square = 0.81, p <; 0.05). The RMSE for the diameter and FMD% measurements was 0.32 mm and 0.63% respectively, illustrating the measurement accuracy. The study demonstrated that the ARTSENS® can be reliably employed for performing FMD measurements and assessing endothelial dysfunction. This would help realize a field deployable solution for real-time automated FMD measurement and consequently for the acceleration of large population studies in this research area.
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Meister TA, Rimoldi SF, Soria R, von Arx R, Messerli FH, Sartori C, Scherrer U, Rexhaj E. Association of Assisted Reproductive Technologies With Arterial Hypertension During Adolescence. J Am Coll Cardiol 2019; 72:1267-1274. [PMID: 30190005 DOI: 10.1016/j.jacc.2018.06.060] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assisted reproductive technologies (ART) have been shown to induce premature vascular aging in apparently healthy children. In mice, ART-induced premature vascular aging evolves into arterial hypertension. Given the young age of the human ART group, long-term sequelae of ART-induced alterations of the cardiovascular phenotype are unknown. OBJECTIVES This study hypothesized that vascular alterations persist in adolescents and young adults conceived by ART and that arterial hypertension possibly represents the first detectable clinically relevant endpoint in this group. METHODS Five years after the initial assessment, the study investigators reassessed vascular function and performed 24-h ambulatory blood pressure (BP) monitoring (ABPM) in 54 young, apparently healthy participants conceived through ART and 43 age- and sex-matched controls. RESULTS Premature vascular aging persisted in ART-conceived subjects, as evidenced by a roughly 25% impairment of flow-mediated dilation of the brachial artery (p < 0.001) and increased pulse-wave velocity and carotid intima-media thickness. Most importantly, ABPM values (systolic BP, 119.8 ± 9.1 mm Hg vs. 115.7 ± 7.0 mm Hg, p = 0.03; diastolic BP, 71.4 ± 6.1 mm Hg vs. 69.1 ± 4.2 mm Hg, p = 0.02 ART vs. control) and BP variability were markedly higher in ART-conceived subjects than in control subjects. Eight of the 52 ART participants, but only 1 of the 43 control participants (p = 0.041 ART vs. controls) fulfilled ABPM criteria of arterial hypertension (>130/80 mm Hg and/or >95th percentile). CONCLUSIONS ART-induced premature vascular aging persists in apparently healthy adolescents and young adults without any other detectable classical cardiovascular risk factors and progresses to arterial hypertension. (Vascular Dysfunction in Offspring of Assisted Reproduction Technologies; NCT00837642.).
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Affiliation(s)
- Théo A Meister
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Stefano F Rimoldi
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Rodrigo Soria
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Robert von Arx
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Franz H Messerli
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Claudio Sartori
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | - Urs Scherrer
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland; Faculty of Sciences, Department of Biology, University of Tarapacá, Arica, Chile
| | - Emrush Rexhaj
- Department of Cardiology, University Hospital and Department for Biomedical Research, University of Bern, Bern, Switzerland.
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16
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Ghiadoni L, Francesconi M, Taddei S, Bruno RM. Hemodynamic and autonomic effects of low-dose glyceryl trinitrate used to test endothelium-independent vasodilation of the brachial artery. Vascul Pharmacol 2019; 120:106576. [PMID: 31279096 DOI: 10.1016/j.vph.2019.106576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 06/04/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
Abstract
Smooth muscle function is explored by sublingual glyceryl trinitrate (GTN) administration to compare with endothelium-dependent vasodilation of the brachial artery by flow-mediated-dilation (FMD). This study compared the hemodynamic and autonomic effects of the two most often used GTN dosages. In 80 essential hypertensive patients (HT) and 60 normotensive subjects (NT), FMD of the brachial artery and endothelium-independent response to sublingual GTN (25 μg and 400 μg) were evaluated by high-resolution ultrasound and automated image analysis. In 10 HT, muscle sympathetic nerve activity (MSNA) was also assessed by microneurography. HT showed significantly (p < .01) lower FMD (5.5 ± 3.3%) compared to NT (6.9 ± 2.2%). The response to GTN 25 μg tended to be lower (HT:7.2 ± 3.3%; NT:7.9 ± 2.9%; p = .06), whereas response to GTN 400 μg was similar (HT:14.3 ± 4.8%, NT:14.5 ± 4.7%, p = ns). Blood pressure (BP) reduction induced by GTN 400 μg (systolic-BP:-3.2 ± 7.7 mm Hg, diastolic-BP:-4.7 ± 5.0 mm Hg) was greater (p < .001) compared to GTN 25 μg (systolic-BP:-0.7 ± 5.8 mm Hg, diastolic-BP:-0.7 ± 4.4 mm Hg). Changes in heart rate were also greater (+5.6 ± 6.4 bpm versus -0.2 ± 5.4 bpm, p < .001). This behaviour was similar in either NT or HT. MSNA was significantly increased by GTN 400 μg (31 ± 7bursts/min to 41 ± 6bursts/min, p < .001) but not by 25 μg (33 ± 9bursts/min to 37 ± 11bursts/min, p = .19). In conclusion, the administration of low-dose GTN allows exploring endothelium-independent vasodilation in FMD protocols, inducing only modest hemodynamic and sympathetic responses.
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Affiliation(s)
- Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Martina Francesconi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy; Institute of Clinical Physiology, CNR, Pisa, Italy.
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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17
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Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, Zock PL, Taddei S, Deanfield JE, Luscher T, Green DJ, Ghiadoni L. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J 2019; 40:2534-2547. [DOI: 10.1093/eurheartj/ehz350] [Citation(s) in RCA: 338] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 06/13/2018] [Accepted: 05/24/2019] [Indexed: 12/18/2022] Open
Abstract
Abstract
Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations of cardiovascular disease (CVD). Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation represents an endothelium-dependent, largely nitric oxide (NO)-mediated dilatation of conduit arteries in response to an imposed increase in blood flow and shear stress. Flow-mediated dilation is affected by cardiovascular (CV) risk factors, relates to coronary artery endothelial function, and independently predicts CVD outcome. Accordingly, FMD is a tool for examining the pathophysiology of CVD and possibly identifying subjects at increased risk for future CV events. Moreover, it has merit in examining the acute and long-term impact of physiological and pharmacological interventions in humans. Despite concerns about its reproducibility, the available evidence shows that highly reliable FMD measurements can be achieved when specialized laboratories follow standardized protocols. For this purpose, updated expert consensus guidelines for the performance of FMD are presented, which are based on critical appraisal of novel technical approaches, development of analysis software, and studies exploring the physiological principles underlying the technique. Uniformity in FMD performance will (i) improve comparability between studies, (ii) contribute to construction of reference values, and (iii) offer an easy accessible and early marker of atherosclerosis that could complement clinical symptoms of structural arterial disease and facilitate early diagnosis and prediction of CVD outcomes.
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Affiliation(s)
- Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Anke C C M van Mil
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie M Holder
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Francesco Faita
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Arno Greyling
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Peter L Zock
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College of London, 1 St Martin le Grand, London, UK
| | - Thomas Luscher
- Royal Brompton and Harefield Hospitals, London University Heart Center, Sydney Street, London, UK
| | - Daniel J Green
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Perth, Australia
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Di Lascio N, Kusmic C, Rossi C, Solini A, Faita F. Alterations in Carotid Parameters in ApoE-/- Mice Treated with a High-Fat Diet: A Micro-ultrasound Analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:980-988. [PMID: 30712947 DOI: 10.1016/j.ultrasmedbio.2018.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Information on the common carotid artery and cerebral microcirculation can be obtained by micro-ultrasound (µUS). The aim of the study described here was to investigate high-fat diet-induced alterations in vascular parameters in ApoE-/- mice. Twenty-two ApoE-/- male mice were examined by µUS and divided into the standard diet (ApoE-/-SD) and high-fat diet (ApoE-/-HF) groups. The µUS examination was repeated after 4 mo (T1). Carotid stiffness, reflection magnitude and reflection index were measured; the amplitudes of the first (W1) and second (W2) local maxima, the local minimum (Wb) and the reflection index (RIWIA = Wb/W1) were assessed with wave intensity analysis. At T1, ApoE-/-HF mice had increased carotid stiffness (1.48 [0.36] vs. 1.88 [0.51]) and reflection magnitude (0.89 [0.07] vs. 0.94 [0.07]) values. Longitudinal comparisons highlighted increases in carotid stiffness for ApoE-/-HF mice (from 1.37 [0.25] to 1.88 [0.51] m/s) but not for ApoE-/-SD mice (from 1.40 [0.62] to 1.48 [0.36] m/s). ApoE-/-HF mice exhibited carotid artery stiffening and increased wave reflections.
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Affiliation(s)
- Nicole Di Lascio
- Institute of Clinical Physiology, CNR, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
| | | | - Chiara Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy
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Scicchitano P, Gesualdo M, Cortese F, Acquaviva T, de Cillis E, Bortone AS, Ciccone MM. Atrial septal defect and patent foramen ovale: early and long-term effects on endothelial function after percutaneous occlusion procedure. Heart Vessels 2019; 34:1499-1508. [PMID: 30895384 DOI: 10.1007/s00380-019-01385-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/15/2019] [Indexed: 12/16/2022]
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20
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Ramalli A, Aizawa K, Shore AC, Morizzo C, Palombo C, Lenge M, Tortoli P. Continuous Simultaneous Recording of Brachial Artery Distension and Wall Shear Rate: A New Boost for Flow-Mediated Vasodilation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:463-471. [PMID: 30582536 DOI: 10.1109/tuffc.2018.2889111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vascular ultrasound has been extensively applied in the clinical setting to noninvasively assess the endothelial function by means of the so-called brachial artery flow mediated dilation (FMD). Despite the usefulness in large-scale epidemiological studies, this approach has revealed some pitfalls for assessing vascular physiology and health in individual subjects. Mainly, a reliable FMD examination should be based on the simultaneous and reliable measurement of both the stimulus, i.e., the wall shear rate (WSR), and the response, i.e., the diameter change. However, multiple technical, practical, and methodological challenges must be faced to meet this goal. In this work, we present the technical developments needed to implement a system to enable the extensive and reliable clinical ultrasound FMD examination. It integrates both a hardware part, i.e., an upgraded version of the ultrasound advanced open platform (ULA-OP), and a software part, i.e., a signal processing and data analysis platform. The system was applied for a two-center pilot clinical study on 35 young and healthy volunteers. Therefore, we present here the results of a statistical analysis on magnitude, time-course, and kinetic parameters of WSR and diameter trends that allowed us to accurately explore the vasodilatory response to the dynamic WSR changes. Our observations demonstrate that a direct and accurate estimation of WSR stimulus by multigate spectral Doppler allows understanding brachial artery vasodilatory response to reactive hyperemia. Drawing inferences on WSR stimulus from the diameter response along with an inaccurate estimation of WSR may cause further uncertainties for the accurate interpretation of the FMD response.
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21
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Dalbeni A, Treggiari D, Tagetti A, Bevilaqua M, Bonafini S, Montagnana M, Scaturro G, Minuz P, Fava C. Positive Effects of Tomato Paste on Vascular Function After a Fat Meal in Male Healthy Subjects. Nutrients 2018; 10:E1310. [PMID: 30223563 PMCID: PMC6163719 DOI: 10.3390/nu10091310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 12/23/2022] Open
Abstract
Tomato consumption has been recently associated with a reduced incidence of cardiovascular disease (CVD). The aim of this study was to test whether a seven-day period of tomato paste purèe (tomato paste, TP) supplementation could improve some haemodynamic parameters in healthy volunteers before and after a standardized fat meal (FM). METHODS AND RESULTS Nineteen healthy male volunteers participated in a randomized, single-blind (operator) crossover study. Participants maintained low fiber diets (LFD) during the study periods. They were randomized either to a LFD and TP arm (80 g of TP/day) for seven-days, or to a control arm (LFD-only) with a two-week washout period. Flow Mediated Dilatation and other morpho-functional vascular indices were measured by ultrasound. Stiffness Index and Reflection Index were estimated by digital photo-plethysmography. All these parameters were measured one h before and two and 3.5 h after the FM. The difference in Stiffness Index was increased in the LFD and TP + FM-arm, as compared to the LFD-only + FM arm at both two and 3.5 h points. After the FM, in both arms, at two h, we observed a reduction in the Reflection Index and an increase in heart rate. Interestingly, only in the LFD and TP + FM-arm, some haemodynamic changes were detectable at two h; notably, there was an increase in brachial artery diameter and a reduction in diastolic blood pressure (BP). CONCLUSIONS TP has no effect on Flow Mediated Dilatation but acutely modifies some haemodynamic parameters triggered by FM, suggesting possible haemodynamic beneficial effects in people consuming tomatoes.
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Affiliation(s)
- Andrea Dalbeni
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Davide Treggiari
- Department of Biotechnology, University of Verona, 37134 Verona, Italy.
| | - Angela Tagetti
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Michele Bevilaqua
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Sara Bonafini
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Martina Montagnana
- Department of Neurological, Biomedical and Movement Sciences, Laboratory of Clinical Biochemistry, University of Verona, 37134 Verona, Italy.
| | - Giuliana Scaturro
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Pietro Minuz
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
| | - Cristiano Fava
- Department of Medicine, General Medicine & Hypertension Unit, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
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Soldani G, Murzi M, Faita F, Di Lascio N, Al Kayal T, Spanò R, Canciani B, Losi P. In vivo evaluation of an elastomeric small‐diameter vascular graft reinforced with a highly flexible Nitinol mesh. J Biomed Mater Res B Appl Biomater 2018; 107:951-964. [DOI: 10.1002/jbm.b.34189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 05/22/2018] [Accepted: 06/12/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Giorgio Soldani
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
| | - Michele Murzi
- Fondazione Toscana Gabriele Monasterio (FTGM) Massa 54100 Italy
| | - Francesco Faita
- Laboratory for Experimental UltrasoundIstituto di Fisiologia Clinica CNR Pisa 56127 Italy
| | - Nicole Di Lascio
- Laboratory for Experimental UltrasoundIstituto di Fisiologia Clinica CNR Pisa 56127 Italy
- Institute of Life SciencesScuola Superiore Sant'Anna Pisa 56127 Italy
| | - Tamer Al Kayal
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
| | - Raffaele Spanò
- Laboratory of Regenerative MedicineDIMES, University of Genoa Genoa 16132 Italy
| | - Barbara Canciani
- Laboratory of Regenerative MedicineDIMES, University of Genoa Genoa 16132 Italy
| | - Paola Losi
- Laboratory for Biomaterials & Graft TechnologyIstituto di Fisiologia Clinica CNR Massa 54100 Italy
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Anti-fibrotic effect of paramylon nanofibers from the WZSL mutant of Euglena gracilis on liver damage induced by CCl 4 in mice. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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24
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Elliott RO, Alsalahi S, Fisher JP. Impact of acute dynamic exercise on radial artery low-flow mediated constriction in humans. Eur J Appl Physiol 2018; 118:1463-1472. [PMID: 29748721 PMCID: PMC6028889 DOI: 10.1007/s00421-018-3876-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/26/2018] [Indexed: 01/22/2023]
Abstract
Purpose A “low-flow mediated constriction” (L-FMC) is evoked in the radial artery by the inflation of an ipsilateral wrist cuff to a supra-systolic pressure. We sought to test the hypothesis that the radial artery L-FMC response is augmented immediately following acute dynamic leg exercise in young healthy individuals. Methods Ten healthy and recreationally active men (23 ± 4 years) undertook a 30-min trial of incremental dynamic leg cycling exercise (10 min at 50, 100 and 150 W) and a 30-min time control trial (seated rest). Trials were randomly assigned and performed on separate days. Radial artery characteristics (diameter, blood flow and shear rate) were assessed throughout each trial, with L-FMC and flow-mediated vasodilatation (FMD) assessments conducted prior to and immediately following (10 min) trials. Results Dynamic leg cycling exercise increased radial artery blood flow, along with mean, retrograde and anterograde shear rate (P < 0.05). Blood flow profiles were unchanged during the time control trial (P > 0.05). Following exercise L-FMC was increased (mean [SD]; − 5.6 [3.3] vs. − 10.1 [3.8] %, P < 0.05), while it was not different in the time control condition (− 8.1 [3.2] vs. − 6.7 [3.4] %, P > 0.05). FMD was not different following either the exercise or time control trials (P > 0.05), but the composite end-point of L-FMC + FMD was enhanced post-exercise (P < 0.05). Conclusions Dynamic exercise with a large muscle mass acutely augments the vasoconstrictor response of the radial artery in response to a reduction in blood flow (L-FMC) in young healthy individuals. The time course of this post-exercise response and the underlying vasoregulatory mechanisms require elucidation.
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Affiliation(s)
- Robert O Elliott
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Sultan Alsalahi
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - James P Fisher
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
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25
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Faita F, Di Lascio N, Rossi C, Kusmic C, Solini A. Ultrasonographic Characterization of the db/db Mouse: An Animal Model of Metabolic Abnormalities. J Diabetes Res 2018; 2018:4561309. [PMID: 29707583 PMCID: PMC5863337 DOI: 10.1155/2018/4561309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/13/2017] [Accepted: 01/04/2018] [Indexed: 12/18/2022] Open
Abstract
The availability of an animal model able to reliably mirror organ damage occurring in metabolic diseases is an urgent need. These models, mostly rodents, have not been fully characterized in terms of cardiovascular, renal, and hepatic ultrasound parameters, and only sparse values can be found in literature. Aim of this paper is to provide a detailed, noninvasive description of the heart, vessels, liver, and kidneys of the db/db mouse by ultrasound imaging. Sixteen wild type and thirty-four db/db male mice (11-week-old) were studied. State-of-the-art ultrasound technology was used to acquire images of cardiovascular, renal, and hepatic districts. A set of parameters describing function of the selected organs was evaluated. db/db mice are characterized by systolic and diastolic dysfunction, confirmed by strain analysis. Abdominal aortic and carotid stiffness do not seem to be increased in diabetic rodents; furthermore, they are characterized by a smaller mean diameter for both vessels. Renal microcirculation is significantly compromised, while liver steatosis is only slightly higher in db/db mice than in controls. We offer here for the first time an in vivo detailed ultrasonographic characterization of the db/db mouse, providing a useful tool for a thoughtful choice of the right rodent model for any experimental design.
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MESH Headings
- Animals
- Aorta, Abdominal/diagnostic imaging
- Aorta, Abdominal/physiopathology
- Blood Glucose/metabolism
- Carotid Artery, Common/diagnostic imaging
- Carotid Artery, Common/physiopathology
- Diabetes Mellitus/blood
- Diabetes Mellitus/diagnostic imaging
- Diabetes Mellitus/genetics
- Diabetes Mellitus/physiopathology
- Disease Models, Animal
- Echocardiography, Doppler, Pulsed
- Genetic Predisposition to Disease
- Heart/diagnostic imaging
- Heart/physiopathology
- Lipids/blood
- Liver/diagnostic imaging
- Liver/physiopathology
- Male
- Mice, Inbred C57BL
- Microcirculation
- Perfusion Imaging/methods
- Phenotype
- Predictive Value of Tests
- Renal Artery/diagnostic imaging
- Renal Artery/physiopathology
- Renal Circulation
- Ultrasonography, Doppler, Pulsed
- Vascular Stiffness
- Ventricular Function, Left
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Affiliation(s)
- Francesco Faita
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Nicole Di Lascio
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Chiara Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Kusmic
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy
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26
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Ciccone MM, Loverro G, Scicchitano P, Loverro M, Ricci G, Scaramuzzi F, Gesualdo M, Zito A, Campagna M, Moncelli M, Nicolardi V, Manca F, Boninfante B, Carbonara S, Cortese F, Todarello O, Bettocchi C. Surgical and pharmacological reassignment: influence on transsexual cardiovascular risk profile. Intern Med J 2017; 47:1255-1262. [PMID: 28857448 DOI: 10.1111/imj.13597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 08/23/2017] [Accepted: 08/23/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Marco M. Ciccone
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Giuseppe Loverro
- Department of Obstetrics and Gynecology; University of Bari; Bari Italy
| | - Pietro Scicchitano
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Matteo Loverro
- Department of Obstetrics and Gynecology; University of Bari; Bari Italy
| | - Gabriella Ricci
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | | | - Michele Gesualdo
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Annapaola Zito
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Marcello Campagna
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit; University of Bari; Bari Italy
| | - Michele Moncelli
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Vittorio Nicolardi
- Department of Economics and Mathematical Methods; University of Bari; Italy
| | - Fabio Manca
- Department of Science of Educational Psychology, and Communication; University of Bari; Bari Italy
| | - Barbara Boninfante
- P.J.D. of Statistical Part-time Lecturer of Medical Statistics; University of Bari; Bari Italy
| | - Santa Carbonara
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | - Francesca Cortese
- Department of Cardiovascular Disease Section, Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | | | - Carlo Bettocchi
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit; University of Bari; Bari Italy
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Tagetti A, Bonafini S, Zaffanello M, Benetti MV, Vedove FD, Gasperi E, Cavarzere P, Gaudino R, Piacentini G, Minuz P, Maffeis C, Antoniazzi F, Fava C. Sleep-disordered breathing is associated with blood pressure and carotid arterial stiffness in obese children. J Hypertens 2017; 35:125-131. [PMID: 27648717 DOI: 10.1097/hjh.0000000000001123] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Both sleep-disordered breathing (SDB) and high blood pressure (BP) occur more frequently among obese children than among normal weight children, and this may be due to endothelial dysfunction and worsened arterial stiffness. The aim of this study was to evaluate the possible association between SDB and BP, and the possible role of endothelial function and local and systemic arterial stiffness in a sample of obese children asymptomatic for sleep disturbances. MATERIALS AND METHODS Thirty-nine obese children were included in the study. Children underwent overnight limited channel polysomnography, and the vascular measurements included the following: office and 24-h ambulatory BP; brachial flow-mediated dilatation, carotid intima-media thickness and carotid distensibility measured using ultrasound; and systemic arterial stiffness index measured using digital volume pulse analysis. RESULTS Significant correlations between different BP measurements (both office and ambulatory BP monitoring and estimated by Z score) and SDB were found, including correlations involving the respiratory disturbance index, the apnea-hypopnea index (AHI), the number of desaturations per hour and the mean peripheral saturation (r ranging between 0.330 and 0.474). Carotid distensibility was correlated with the AHI (r = -0.367; P = 0.030) and with the mean oxygen saturation (r = 0.401; P = 0.017). In contrast, there was no relationship among flow-mediated dilatation, stiffness index, carotid intima-media thickness and all the tested respiratory markers. In the multivariate analysis, the supine Z SBP remained independently associated with the number of desaturations per hour and the AHI, even after correction for carotid distensibility and BMI. CONCLUSION Our data suggest that in obese children asymptomatic for sleep respiratory problems, SDB might worsen BP, in part, through an increase in arterial stiffness.
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Affiliation(s)
- Angela Tagetti
- aDepartment of Medicine, Section of General Medicine and Hypertension bDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division cDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
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28
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Enseleit F, Michels S, Sudano I, Stahel M, Zweifel S, Schlager O, Becker M, Winnik S, Nägele M, Flammer AJ, Neidhart M, Graf N, Matter CM, Seifert B, Lüscher TF, Ruschitzka F. SAVE-AMD: Safety of VEGF Inhibitors in Age-Related Macular Degeneration. Ophthalmologica 2017; 238:205-216. [PMID: 28866675 DOI: 10.1159/000478665] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 06/12/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether intraocular treatment with vascular endothelial growth factor (VEGF) inhibitors change systemic endothelial function (EF) in patients with neovascular age-related macular degeneration (AMD). METHODS In this prospective, randomized, 2-center, double-masked controlled interventional trial, patients with neovascular and dry AMD were enrolled. Eligible neovascular AMD patients received 2 intravitreal loading doses of either ranibizumab 0.5 mg or bevacizumab 1.25 mg at 4-week intervals and were subsequently followed every 4 weeks and treated according to a pro re nata regime for up to 1 year. Patients with dry AMD served as controls. The primary endpoint was the change in EF assessed by flow-mediated dilatation (FMD) after 2 months of treatment with VEGF inhibitors in patients with AMD compared to patients with dry AMD. FMD was assessed with B-mode high-resolution ultrasonography of the left brachial artery. RESULTS 24 patients with neovascular AMD and 26 patients with dry ADM were included in the trial. Treatment with VEGF inhibitors did not significantly change FMD (from 4.7 ± 2.4 to 3.9 ± 1.9% after 8 weeks, p = 0.07, and to 5.1 ± 2.0% after 1 year; p = 0.93 vs. baseline, respectively). CONCLUSIONS EF did not significantly differ between patients with neovascular AMD treated with intravitreal VEGF inhibition and patients with dry AMD.
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Affiliation(s)
- Frank Enseleit
- Department of Ophthalmology, City Hospital Triemli Zurich, Zurich, Switzerland
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29
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Garcia MMO, Varela CG, Silva PF, Lima PRP, Góes PM, Rodrigues MG, Silva MDLLSE, Ladeia AMT, Guimarães AC, Correia LCL. Endothelial Effect of Statin Therapy at a High Dose Versus Low Dose Associated with Ezetimibe. Arq Bras Cardiol 2017; 106:279-88. [PMID: 27142792 PMCID: PMC4845700 DOI: 10.5935/abc.20160048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 11/24/2015] [Indexed: 01/22/2023] Open
Abstract
Background The effect of statins on the endothelial function in humans remains under
discussion. Particularly, it is still unclear if the improvement in
endothelial function is due to a reduction in LDL-cholesterol or to an
arterial pleiotropic effect. Objective To test the hypothesis that modulation of the endothelial function promoted
by statins is primarily mediated by the degree of reduction in
LDL-cholesterol, independent of the dose of statin administered. Methods Randomized clinical trial with two groups of lipid-lowering treatment (16
patients/each) and one placebo group (14 patients). The two active groups
were designed to promote a similar degree of reduction in LDL-cholesterol:
the first used statin at a high dose (80 mg, simvastatin 80 group) and the
second used statin at a low dose (10 mg) associated with ezetimibe (10 mg,
simvastatin 10/ezetimibe group) to optimize the hypolipidemic effect. The
endothelial function was assessed by flow-mediated vasodilation (FMV) before
and 8 weeks after treatment. Results The decrease in LDL-cholesterol was similar between the groups simvastatin 80
and simvastatin 10/ezetimibe (27% ± 31% and 30% ± 29%,
respectively, p = 0.75). The simvastatin 80 group presented an increase in
FMV from 8.4% ± 4.3% at baseline to 11% ± 4.2% after 8 weeks
(p = 0.02). Similarly, the group simvastatin 10/ezetimibe showed improvement
in FMV from 7.3% ± 3.9% to 12% ± 4.4% (p = 0.001). The placebo
group showed no variation in LDL-cholesterol level or endothelial
function. Conclusion The improvement in endothelial function with statin seems to depend more on a
reduction in LDL-cholesterol levels, independent of the dose of statin
administered, than on pleiotropic mechanisms.
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Affiliation(s)
| | | | | | | | - Paulo Meira Góes
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
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30
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Di Lascio N, Kusmic C, Stea F, Faita F. Ultrasound-based Pulse Wave Velocity Evaluation in Mice. J Vis Exp 2017:54362. [PMID: 28287528 PMCID: PMC5407600 DOI: 10.3791/54362] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Arterial stiffness can be evaluated by calculating pulse wave velocity (PWV), i.e., the speed with which the pulse wave travels in a conduit vessel. This parameter is being increasingly investigated in small rodent models in which it is used for assessing alterations in vascular function related to particular genotypes/treatments or for characterizing cardiovascular disease progression. This protocol describes an image processing algorithm which leads to non-invasive arterial PWV measurement in mice using ultrasound (US) images only. The proposed technique has been used to assess abdominal aorta PWV in mice and evaluate its age-associated changes. Abdominal aorta US scans are obtained from mice under gaseous anesthesia using a specific US device equipped with high-frequency US probes. B-mode and Pulse-Wave Doppler (PW-Doppler) images are analyzed in order to obtain diameter and mean velocity instantaneous values, respectively. For this purpose, edge detection and contour tracking techniques are employed. The single-beat mean diameter and velocity waveforms are time aligned and combined in order to achieve the diameter-velocity (lnD-V) loop. PWV values are obtained from the slope of the linear part of the loop, which corresponds to the early systolic phase. With the present approach, anatomical and functional information about the mouse abdominal aorta can be non-invasively achieved. Requiring the processing of US images only, it may represent a useful tool for the non-invasive characterization of different arterial sites in the mouse in terms of elastic properties. The application of the present technique can be easily extended to other vascular districts, such as the carotid artery, thus providing the possibility to obtain a multi-site arterial stiffness assessment.
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Affiliation(s)
- Nicole Di Lascio
- Institute of Life Science, Scuola Superiore Sant'Anna; Institute of Clinical Physiology, National Research Council;
| | - Claudia Kusmic
- Institute of Clinical Physiology, National Research Council
| | - Francesco Stea
- Institute of Clinical Physiology, National Research Council; Department of Clinical and Experimental Medicine, University of Pisa
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31
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Xu C, Xiong H, Gao Z, Liu X, Zhang H, Zhang Y, Du X, Wu W, Liu G, Li S. Beat-to-Beat Blood Pressure and Two-dimensional (axial and radial) Motion of the Carotid Artery Wall: Physiological Evaluation of Arterial Stiffness. Sci Rep 2017; 7:42254. [PMID: 28198819 PMCID: PMC5304179 DOI: 10.1038/srep42254] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/05/2017] [Indexed: 01/22/2023] Open
Abstract
The physiological relationship between local arterial displacement and blood pressure (BP) plays an integral role in assess- ment of the mechanical properties of arteries. In this study, we used more advanced methods to obtain reliable continuous BP and the displacement of the common carotid artery (CCA) simultaneously. We propose a novel evaluation method for arterial stiffness that relies on determining the physiological relationship between the axial and radial displacements of the CCA wall and beat-to-beat BP. Patients (total of 138) were divided into groups according to the following three criteria: essential hyper- tension (EH) and normotension, male and female, elderly and younger. The Pearson correlation test and canonical correlation analysis showed that the CCA indices were significantly correlated with BP indices (r = 0:787; p < 0:05). The slope of the CCA displacement/pressure curve showed a progressive reduction with increasing age and EH disease occurrence (EH: 0.496 vs. normotension: 0.822; age <= 60:0.585 vs. age > 60:0.783). Our method provides an explicit reference value and relationship for the manner in which the CCA wall responds to changes in BP. Short-term and continuous BP were significantly correlated with CCA displacement and exhibited a close inverse relationship with each subject's BP and EH, age, and systolic blood pressure.
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Affiliation(s)
- Chenchu Xu
- School of computer Science and Technology, Anhui University, Hefei, 230601, China
| | - Huahua Xiong
- Department of Ultrasound, Shenzhen Second People's Hospital, Shenzhen, 518000, China
| | - Zhifan Gao
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xin Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Heye Zhang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yanping Zhang
- School of computer Science and Technology, Anhui University, Hefei, 230601, China
| | - Xiuquan Du
- School of computer Science and Technology, Anhui University, Hefei, 230601, China
| | - Wanqing Wu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Guotao Liu
- School of computer Science and Technology, Anhui University, Hefei, 230601, China
| | - Shuo Li
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London ON, Canada
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32
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Endothelial dysfunction and cardiovascular risk factors in childhood acute lymphoblastic leukemia survivors. Int J Cardiol 2017; 228:621-627. [PMID: 27889551 DOI: 10.1016/j.ijcard.2016.11.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/27/2016] [Accepted: 11/04/2016] [Indexed: 12/18/2022]
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Bruno RM, Reesink KD, Ghiadoni L. Advances in the non-invasive assessment of vascular dysfunction in metabolic syndrome and diabetes: Focus on endothelium, carotid mechanics and renal vessels. Nutr Metab Cardiovasc Dis 2017; 27:121-128. [PMID: 27773467 DOI: 10.1016/j.numecd.2016.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/28/2016] [Accepted: 09/04/2016] [Indexed: 12/29/2022]
Abstract
AIM The present paper is a selective review on the methodology and clinical significance of techniques to assess specifically endothelial function, carotid mechanics and renal vascular function, particularly in the light of vascular dysfunction in metabolic syndrome and type 2 diabetes. DATA SYNTHESIS Endothelial dysfunction appears to be earlier detectable in the microcirculation of patients with altered glucose metabolism, while it attains significance in the macrocirculation at more advanced disease stages. Smooth muscle cell dysfunction is now increasingly recognized to play a role both in the development of endothelial dysfunction and abnormal arterial distensibility. Furthermore, impaired glucose metabolism affects carotid mechanics through medial calcification, structural changes in extracellular matrix due to advanced glycation and modification of the collagen/elastin material stiffness. The assessment of renal vascular function by dynamic ultrasound or magnetic resonance imaging has recently emerged as an appealing target for identifying subtle vascular alterations responsible for the development of diabetic nephropathy. CONCLUSIONS Vascular dysfunction represents a major mechanism for the development of cardiovascular disease in patients with abnormal glucose metabolism. Hence, the currently available non-invasive techniques to assess early structural and vascular abnormalities merit recommendation in this population, although their predictive value and sensitivity to monitor treatment-induced changes have not yet been established and are still under investigation.
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Affiliation(s)
- R M Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - K D Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Netherlands; Department of Biomedical Engineering, Cardiovascular Center, Maastricht University Medical Center, Netherlands
| | - L Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
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Tarzia P, Lanza GA, Sestito A, Villano A, Russo G, Figliozzi S, Lamendola P, De Vita A, Crea F. Long-term effects of bariatric surgery on peripheral endothelial function and coronary microvascular function. Obes Res Clin Pract 2017; 11:114-117. [PMID: 28057417 DOI: 10.1016/j.orcp.2016.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 12/06/2016] [Accepted: 12/10/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND We previously demonstrated that bariatric surgery (BS) leads to a short-term significant improvement of endothelial function and coronary microvascular function. In this study we assessed whether BS maintains its beneficial effect at long-term follow up. DESIGN We studied 19 morbidly obese patients (age 43±9years, 12 women) without any evidence of cardiovascular disease who underwent BS. Patients were studied before BS, at 3 months and at 4.0±1.5years follow up. METHODS Peripheral vascular function was assessed by flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), i.e., brachial artery diameter changes in response to post-ischemic forearm hyperhaemia and to nitroglycerin administration, respectively. Coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to intravenous adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery. RESULTS Together with improvement of anthropometric and metabolic profile, at long-term follow-up patients showed a significant improvement of FMD (6.43±2.88 vs. 8.21±1.73%, p=0.018), and CBF response to both adenosine (1.73±0.48 vs. 2.58±0.54; p<0.01) and CPT (1.43±0.30 vs. 2.23±0.48; p<0.01), compared to basal values. No differences in vascular end-points were shown at 3-month and 4-year follow-up after BS. CONCLUSIONS Our data show that, in morbidly obese patients, BS exerts beneficial and long lasting effects on peripheral endothelial function and on coronary microvascular dilator function.
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Affiliation(s)
- Pierpaolo Tarzia
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gaetano A Lanza
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Alfonso Sestito
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Angelo Villano
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giulio Russo
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefano Figliozzi
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Antonio De Vita
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Filippo Crea
- Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy
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35
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Ricci S, Swillens A, Ramalli A, Segers P, Tortoli P. Wall Shear Rate Measurement: Validation of a New Method Through Multiphysics Simulations. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:66-77. [PMID: 28092504 DOI: 10.1109/tuffc.2016.2608442] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Wall shear stress is known to affect the vessel endothelial function and to be related to important pathologies like the development of atherosclerosis. It is defined as the product of the blood viscosity by the blood velocity gradient at the wall position, i.e., the wall shear rate (WSR). The WSR measurement is particularly challenging in important cardiovascular sites, like the carotid bifurcation, because of the related complex flow configurations characterized by high spatial and temporal gradients, wall movement, and clutter noise. Moreover, accuracy of any method for WSR measurement can be effectively tested only if reliable gold standard WSR values, considering all the aforementioned disturbing effects, are available. Unfortunately, these requirements are difficult to achieve in a physical phantom, so that the accuracy test of the novel WSR measurement methods was so far limited to straight pipes and/or similar idealistic configurations. In this paper, we propose a new method for WSR measurement and its validation based on a mathematical model of the carotid bifurcation, which, exploiting fluid-structure simulations, is capable of reproducing realistic flow configuration, wall movement, and clutter noise. In particular, the profile near the wall, not directly measurable because affected by clutter, is estimated through a power-law fitting and compared with the gold standard provided by the model. In this condition, the WSR measurements featured an accuracy of ±20 %. A preliminary test on a volunteer confirmed the feasibility of the WSR method for in vivo application.
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Rathod KS, Jones DA, Van-Eijl TJA, Tsang H, Warren H, Hamshere SM, Kapil V, Jain AK, Deaner A, Poulter N, Caulfield MJ, Mathur A, Ahluwalia A. Randomised, double-blind, placebo-controlled study investigating the effects of inorganic nitrate on vascular function, platelet reactivity and restenosis in stable angina: protocol of the NITRATE-OCT study. BMJ Open 2016; 6:e012728. [PMID: 27998900 PMCID: PMC5223652 DOI: 10.1136/bmjopen-2016-012728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The mainstay treatment for reducing the symptoms of angina and long-term risk of heart attacks in patients with heart disease is stent implantation in the diseased coronary artery. While this procedure has revolutionised treatment, the incidence of secondary events remains a concern. These repeat events are thought to be due, in part, to continued enhanced platelet reactivity, endothelial dysfunction and ultimately restenosis of the stented artery. In this study, we will investigate whether a once a day inorganic nitrate administration might favourably modulate platelet reactivity and endothelial function leading to a decrease in restenosis. METHODS AND DESIGN NITRATE-OCT is a double-blind, randomised, single-centre, placebo-controlled phase II trial that will enrol 246 patients with stable angina due to have elective percutaneous coronary intervention procedure with stent implantation. Patients will be randomised to receive 6 months of a once a day dose of either nitrate-rich beetroot juice or nitrate-deplete beetroot juice (placebo) starting up to 1 week before their procedure. The primary outcome is reduction of in-stent late loss assessed by quantitative coronary angiography and optical coherence tomography at 6 months. The study is powered to detect a 0.22±0.55 mm reduction in late loss in the treatment group compared with the placebo group. Secondary end points include change from baseline assessment of endothelial function measured using flow-mediated dilation at 6 months, target vessel revascularisation (TVR), restenosis rate (diameter>50%) and in-segment late loss at 6 months, markers of inflammation and platelet reactivity and major adverse cardiac events (ie, myocardial infarction, death, cerebrovascular accident, TVR) at 12 and 24 months. ETHICS AND DISSEMINATION The study was approved by the Local Ethics Committee (15/LO/0555). Trial results will be published according to the CONSORT statement and will be presented at conferences and reported in peer-reviewed journals. TRIAL REGISTRATION NUMBERS NCT02529189 and ISRCTN17373946, Pre-results.
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Affiliation(s)
- Krishnaraj S Rathod
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Daniel A Jones
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - T J A Van-Eijl
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Hilda Tsang
- Imperial Clinical Trials Unit, Imperial College, London, UK
| | - Helen Warren
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
| | - Stephen M Hamshere
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Vikas Kapil
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
| | - Ajay K Jain
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
- King George Hospital, Barking and Havering NHS Trust, London, UK
| | - Andrew Deaner
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
- King George Hospital, Barking and Havering NHS Trust, London, UK
| | - Neil Poulter
- Imperial Clinical Trials Unit, Imperial College, London, UK
| | - Mark J Caulfield
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
| | - Anthony Mathur
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
- Department of Cardiology, Barts Heart Centre,2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Amrita Ahluwalia
- Barts NIHR Cardiovascular Biomedical Research Unit, Centre of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London, UK
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Greyling A, Bruno RM, Draijer R, Mulder T, Thijssen DH, Taddei S, Virdis A, Ghiadoni L. Effects of wine and grape polyphenols on blood pressure, endothelial function and sympathetic nervous system activity in treated hypertensive subjects. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Grassi D, Draijer R, Schalkwijk C, Desideri G, D'Angeli A, Francavilla S, Mulder T, Ferri C. Black Tea Increases Circulating Endothelial Progenitor Cells and Improves Flow Mediated Dilatation Counteracting Deleterious Effects from a Fat Load in Hypertensive Patients: A Randomized Controlled Study. Nutrients 2016; 8:nu8110727. [PMID: 27854314 PMCID: PMC5133112 DOI: 10.3390/nu8110727] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 01/17/2023] Open
Abstract
(1) Background: Endothelial dysfunction predicts cardiovascular events. Circulating angiogenic cells (CACs) maintain and repair the endothelium regulating its function. Tea flavonoids reduce cardiovascular risk. We investigated the effects of black tea on the number of CACs and on flow-mediated dilation (FMD) before and after an oral fat in hypertensives; (2) Methods: In a randomized, double-blind, controlled, cross-over study, 19 patients were assigned to black tea (150 mg polyphenols) or a placebo twice a day for eight days. Measurements were obtained in a fasted state and after consuming whipping cream, and FMD was measured at baseline and after consumption of the products; (3) Results: Compared with the placebo, black tea ingestion increased functionally active CACs (36 ± 22 vs. 56 ± 21 cells per high-power field; p = 0.006) and FMD (5.0% ± 0.3% vs. 6.6% ± 0.3%, p < 0.0001). Tea further increased FMD 1, 2, 3, and 4 h after consumption, with maximal response 2 h after intake (p < 0.0001). Fat challenge decreased FMD, while tea consumption counteracted FMD impairment (p < 0.0001); (4) Conclusions: We demonstrated the vascular protective properties of black tea by increasing the number of CACs and preventing endothelial dysfunction induced by acute oral fat load in hypertensive patients. Considering that tea is the most consumed beverage after water, our findings are of clinical relevance and interest.
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Affiliation(s)
- Davide Grassi
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 L'Aquila, Italy.
| | - Richard Draijer
- Unilever Research and Development, 3133 AT Vlaardingen, The Netherlands.
| | - Casper Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.
| | - Giovambattista Desideri
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 L'Aquila, Italy.
| | - Anatolia D'Angeli
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 L'Aquila, Italy.
| | - Sandro Francavilla
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 L'Aquila, Italy.
| | - Theo Mulder
- Unilever Research and Development, 3133 AT Vlaardingen, The Netherlands.
| | - Claudio Ferri
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, Viale S Salvatore, Delta 6 Medicina, 67100 L'Aquila, Italy.
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Fruzzetti F, Ghiadoni L, Virdis A, De Negri F, Perini D, Bucci F, Giannarelli C, Gadducci A, Taddei S. Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin. J Pediatr Adolesc Gynecol 2016; 29:489-495. [PMID: 27018756 PMCID: PMC5003746 DOI: 10.1016/j.jpag.2016.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 12/14/2015] [Accepted: 03/09/2016] [Indexed: 02/07/2023]
Abstract
STUDY OBJECTIVE To study whether adolescents with the classical form of polycystic ovary syndrome (PCOS) have alterations in metabolic and vascular structure and function. The effect of metformin was evaluated. DESIGN Controlled study. SETTING University outpatient clinic. PARTICIPANTS Eighteen nonobese adolescents with PCOS were enrolled. Seventeen healthy age-matched adolescents were recruited as control subjects. INTERVENTIONS The metabolic profile and the endothelial structure and function were evaluated. MAIN OUTCOME MEASURES Hormonal and lipid profile, blood pressure (BP) measurement, fasting glucose and insulin levels, C-reactive protein (CRP), homocysteine, tissue-type plasminogen activator, plasminogen activator inhibitor-1 (PAI-1), and plasmin-antiplasmin complexes (PAP) were measured. Flow mediated dilation (FMD), central pulse wave velocity (PWV), radial artery pulse wave, and common carotid intima-media thickness (IMT) were also assessed. Girls with PCOS were also studied 6 months after treatment with metformin (850 mg twice per day). RESULTS Adolescents with PCOS were insulin resistant and/or hyperinsulinemic and they had higher BP values and levels of CRP and PAI-1 than the control subjects. The levels of tissue-type plasminogen activator and PAP were similar in both groups. FMD, PWV, and IMT were also similar. Metformin significantly (P < .05) reduced insulin, BP, CRP, and PAI-1 levels. The PAP levels significantly (P < .05) increased. Radial artery pulse wave was significantly reduced after metformin treatment. No modifications in FMD, PWV, and IMT were observed. CONCLUSION Adolescents with classical PCOS have alterations in some surrogate markers of cardiovascular risk and they are ameliorated by metformin. No deterioration of vascular structure and function has been detected, probably because of the short duration of exposure to the disease.
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Affiliation(s)
- Franca Fruzzetti
- Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
| | - Lorenzo Ghiadoni
- Department of Internal Medicine, University of Pisa, Pisa, Italy
| | - Agostino Virdis
- Department of Internal Medicine, University of Pisa, Pisa, Italy
| | | | - Daria Perini
- Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
| | - Fiorella Bucci
- Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
| | | | - Angiolo Gadducci
- Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
| | - Stefano Taddei
- Department of Internal Medicine, University of Pisa, Pisa, Italy
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Impact of volunteer-related and methodology-related factors on the reproducibility of brachial artery flow-mediated vasodilation. J Hypertens 2016; 34:1738-45. [DOI: 10.1097/hjh.0000000000001012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Coolbaugh CL, Bush EC, Caskey CF, Damon BM, Towse TF. FloWave.US: validated, open-source, and flexible software for ultrasound blood flow analysis. J Appl Physiol (1985) 2016; 121:849-857. [PMID: 27516540 DOI: 10.1152/japplphysiol.00819.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 08/10/2016] [Indexed: 11/22/2022] Open
Abstract
Automated software improves the accuracy and reliability of blood velocity, vessel diameter, blood flow, and shear rate ultrasound measurements, but existing software offers limited flexibility to customize and validate analyses. We developed FloWave.US-open-source software to automate ultrasound blood flow analysis-and demonstrated the validity of its blood velocity (aggregate relative error, 4.32%) and vessel diameter (0.31%) measures with a skeletal muscle ultrasound flow phantom. Compared with a commercial, manual analysis software program, FloWave.US produced equivalent in vivo cardiac cycle time-averaged mean (TAMean) velocities at rest and following a 10-s muscle contraction (mean bias <1 pixel for both conditions). Automated analysis of ultrasound blood flow data was 9.8 times faster than the manual method. Finally, a case study of a lower extremity muscle contraction experiment highlighted the ability of FloWave.US to measure small fluctuations in TAMean velocity, vessel diameter, and mean blood flow at specific time points in the cardiac cycle. In summary, the collective features of our newly designed software-accuracy, reliability, reduced processing time, cost-effectiveness, and flexibility-offer advantages over existing proprietary options. Further, public distribution of FloWave.US allows researchers to easily access and customize code to adapt ultrasound blood flow analysis to a variety of vascular physiology applications.
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Affiliation(s)
- Crystal L Coolbaugh
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee;
| | - Emily C Bush
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee
| | - Charles F Caskey
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Bruce M Damon
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee; and
| | - Theodore F Towse
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee; Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee
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Zoccali C, Torino C, Curatola G, Panuccio V, Tripepi R, Pizzini P, Versace M, Bolignano D, Cutrupi S, Ghiadoni L, Thadhani R, Tripepi G, Mallamaci F. Serum phosphate modifies the vascular response to vitamin D receptor activation in chronic kidney disease (CKD) patients. Nutr Metab Cardiovasc Dis 2016; 26:581-589. [PMID: 27113290 DOI: 10.1016/j.numecd.2016.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/01/2016] [Accepted: 03/14/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Vitamin D receptor activation (VDRA) ameliorates endothelial dysfunction in CKD patients but also increases phosphate and FGF-23, which may attenuate the beneficial effect of VDRA on endothelial function. METHODS AND RESULTS This is a pre-specified secondary analysis of the PENNY trial (NCT01680198) testing the effect of phosphate and FGF-23 on the flow mediated vasodilatory (FMD) response to paricalcitol (PCT, 2 μg/day) and placebo over a 12-weeks treatment period. Eighty-eight stage G3-4 CKD patients were randomized to PCT (n = 44) and Placebo (n = 44). Endothelial function was assessed by measuring endothelium dependent forearm blood flow (FBF) response to ischemia. The FMD response was by the 61% higher in PCT treated patients than in those on placebo (P = 0.01). Phosphate (+11%, P = 0.039), calcium (+3%, P = 0.01) and, particularly so, FGF23 (+164%, P < 0.001) increased in PCT treated patients. Changes in FMD by PCT associated inversely with phosphate (r = -0.37, P = 0.01) but were independent of FGF-23, calcium and PTH changes. The response to PCT was maximal in patients with no changes in phosphate (1st tertile), attenuated in those with mild-to-moderate rise in phosphate (2nd tertile) and abolished in those with the most pronounced phosphate increase (3rd tertile) (effect modification P = 0.009). No effect modification by FGF-23 and other variables was observed. CONCLUSIONS The beneficial effect of PCT on endothelial function in CKD is maximal in patients with no or minimal changes in phosphate and it is abolished in patients with a pronounced phosphate rise. These findings generate the hypothesis that the endothelium protective effect by VDRA may be potentiated by phosphate lowering interventions.
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Affiliation(s)
- C Zoccali
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy.
| | - C Torino
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - G Curatola
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - V Panuccio
- Nephrology, Hypertension and Renal Transplantation Unit, Ospedali Riuniti, Reggio Calabria, Italy
| | - R Tripepi
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - P Pizzini
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - M Versace
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - D Bolignano
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - S Cutrupi
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - L Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Thadhani
- Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, MA, USA
| | - G Tripepi
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
| | - F Mallamaci
- CNR-IBIM/IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy; Nephrology, Hypertension and Renal Transplantation Unit, Ospedali Riuniti, Reggio Calabria, Italy
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Demi M. Contour Tracking with a Spatio-Temporal Intensity Moment. IEEE TRANSACTIONS ON PATTERN ANALYSIS AND MACHINE INTELLIGENCE 2016; 38:1141-1154. [PMID: 26390447 DOI: 10.1109/tpami.2015.2478438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Standard edge detection operators such as the Laplacian of Gaussian and the gradient of Gaussian can be used to track contours in image sequences. When using edge operators, a contour, which is determined on a frame of the sequence, is simply used as a starting contour to locate the nearest contour on the subsequent frame. However, the strategy used to look for the nearest edge points may not work when tracking contours of non isolated gray level discontinuities. In these cases, strategies derived from the optical flow equation, which look for similar gray level distributions, appear to be more appropriate since these can work with a lower frame rate than that needed for strategies based on pure edge detection operators. However, an optical flow strategy tends to propagate the localization errors through the sequence and an additional edge detection procedure is essential to compensate for such a drawback. In this paper a spatio-temporal intensity moment is proposed which integrates the two basic functions of edge detection and tracking.
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Greyling A, van Mil ACCM, Zock PL, Green DJ, Ghiadoni L, Thijssen DH. Assessing the perceived quality of brachial artery Flow Mediated Dilation studies for inclusion in meta-analyses and systematic reviews: Description of data employed in the development of a scoring ;tool based on currently accepted guidelines. Data Brief 2016; 8:73-7. [PMID: 27284565 PMCID: PMC4887556 DOI: 10.1016/j.dib.2016.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/28/2016] [Accepted: 05/09/2016] [Indexed: 12/02/2022] Open
Abstract
Brachial artery Flow Mediated Dilation (FMD) is widely used as a non-invasive measure of endothelial function. Adherence to expert consensus guidelines on FMD measurement has been found to be of vital importance to obtain reproducible data. This article lists the literature data which was considered in the development of a tool to aid in the objective judgement of the extent to which published studies adhered to expert guidelines for FMD measurement. Application of this tool in a systematic review of FMD studies (http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.011) (Greyling et al., 2016 [1]) indicated that adherence to expert consensus guidelines is strongly correlated to the reproducibility of FMD data.
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Affiliation(s)
- Arno Greyling
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Unilever R&D Vlaardingen, Vlaardingen, The Netherlands
| | - Anke C C M van Mil
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; TI Food and Nutrition, Wageningen, The Netherlands; Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter L Zock
- Unilever R&D Vlaardingen, Vlaardingen, The Netherlands; TI Food and Nutrition, Wageningen, The Netherlands
| | - Daniel J Green
- School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Australia
| | | | - Dick H Thijssen
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Research institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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Rodriguez-Miguelez P, Seigler N, Harris RA. Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test. J Vis Exp 2016:54011. [PMID: 27167596 PMCID: PMC4942014 DOI: 10.3791/54011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies. Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events. Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.
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Affiliation(s)
- Paula Rodriguez-Miguelez
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University
| | - Nichole Seigler
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University
| | - Ryan A Harris
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University; Sport and Exercise Science Research Institute, University of Ulster;
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Cocoa consumption dose-dependently improves flow-mediated dilation and arterial stiffness decreasing blood pressure in healthy individuals. J Hypertens 2016; 33:294-303. [PMID: 25380152 DOI: 10.1097/hjh.0000000000000412] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Cocoa flavonoids exert beneficial vascular effects and reduce the risk of cardiovascular morbidity and mortality. Nevertheless, the involved mechanisms have not been clarified and no study has yet focused on the dose-response effects. OBJECTIVES We aimed to investigate the effects of different doses of cocoa flavonoids on flow-mediated dilation (FMD), endothelin-1 (ET-1), pulse wave velocity (PWV), and SBP and DBP. DESIGN According to a randomized, double-blind, controlled, cross-over design, 20 healthy volunteers (1.5% improvement in FMD in 20 individuals: 0.99 at alpha = 0.05) were assigned to receive either five treatments with daily intake of 10 g cocoa (0, 80, 200, 500 and 800 mg cocoa flavonoids/day) in five periods lasting 1 week each. RESULTS Cocoa dose-dependently increased FMD from 6.2% (control) to 7.3, 7.6, 8.1 and 8.2% after the different flavonoid doses, respectively (P < 0.0001). Compared with the control, even 80 mg cocoa flavonoids per day increased FMD (P < 0.0001). Cocoa dose-dependently decreased PWV (P < 0.0001). Cocoa intake decreased office blood pressure (BP) (SBP: -4.8 ± 1.03 mmHg, P < 0.0001; DBP: -3.03 ± 1.07 mmHg, P = 0.0011). With respect to control, cocoa ingestion decreased 24-h (P = 0.05) and daytime (P = 0.038) SBP, and 24-h (P = 0.0064), daytime (P = 0.0088) and night-time (P = 0.0352) pulse pressure. Compared with the control, cocoa dose-dependently decreased ET-1 levels [from 17.1 (control) to 15.2, 14.5, 14.2 and 14.1 pg/ml, after the different flavonoid doses, respectively (P for treatment <0.05)]. Compared with the control, significant changes were observed for all doses of flavonoids (ET-1; P < 0.05). CONCLUSION Our study showed for the first time that cocoa dose-dependently improved FMD and decreased PWV and ET-1 also by ameliorating office and monitored BP. Our findings are clinically relevant, suggesting cocoa, with very low calorie intake, might be reasonably incorporated into a dietary approach, representing a consistent tool in cardiovascular prevention.
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Thomas KN, van Rij AM, Lucas SJE, Gray AR, Cotter JD. Substantive hemodynamic and thermal strain upon completing lower-limb hot-water immersion; comparisons with treadmill running. Temperature (Austin) 2016; 3:286-297. [PMID: 27857958 PMCID: PMC4964998 DOI: 10.1080/23328940.2016.1156215] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 12/13/2022] Open
Abstract
Exercise induces arterial flow patterns that promote functional and structural adaptations, improving functional capacity and reducing cardiovascular risk. While heat is produced by exercise, local and whole-body passive heating have recently been shown to generate favorable flow profiles and associated vascular adaptations in the upper limb. Flow responses to acute heating in the lower limbs have not yet been assessed, or directly compared to exercise, and other cardiovascular effects of lower-limb heating have not been fully characterized. Lower-limb heating by hot-water immersion (30 min at 42°C, to the waist) was compared to matched-duration treadmill running (65-75% age-predicted heart rate maximum) in 10 healthy, young adult volunteers. Superficial femoral artery shear rate assessed immediately upon completion was increased to a greater extent following immersion (mean ± SD: immersion +252 ± 137% vs. exercise +155 ± 69%, interaction: p = 0.032), while superficial femoral artery flow-mediated dilation was unchanged in either intervention. Immersion increased heart rate to a lower peak than during exercise (immersion +38 ± 3 beats·min-1 vs. exercise +87 ± 3 beats·min-1, interaction: p < 0.001), whereas only immersion reduced mean arterial pressure after exposure (−8 ± 3 mmHg, p = 0.012). Core temperature increased twice as much during immersion as exercise (+1.3 ± 0.4°C vs. +0.6 ± 0.4°C, p < 0.001). These data indicate that acute lower-limb hot-water immersion has potential to induce favorable shear stress patterns and cardiovascular responses within vessels prone to atherosclerosis. Whether repetition of lower-limb heating has long-term beneficial effects in such vasculature remains unexplored.
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Affiliation(s)
- Kate N Thomas
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - André M van Rij
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago , Dunedin, New Zealand
| | - Samuel J E Lucas
- Department of Physiology, University of Otago, Dunedin, New Zealand; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Andrew R Gray
- Department of Preventive and Social Medicine, University of Otago , Dunedin, New Zealand
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago , Dunedin, New Zealand
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Greyling A, van Mil ACCM, Zock PL, Green DJ, Ghiadoni L, Thijssen DH. Adherence to guidelines strongly improves reproducibility of brachial artery flow-mediated dilation. Atherosclerosis 2016; 248:196-202. [PMID: 27023841 DOI: 10.1016/j.atherosclerosis.2016.03.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/01/2016] [Accepted: 03/08/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Brachial artery FMD is widely used as a non-invasive measure of endothelial function. Adherence to expert guidelines is believed to be of vital importance to obtain reproducible measurements. We conducted a systematic review of studies reporting on the reproducibility of the FMD in order to determine the relation between adherence to current expert guidelines for FMD measurement and its reproducibility. METHODS Medline-database was searched through July 2015 and 458 records were screened for FMD reproducibility studies reporting the mean difference and variance of repeated FMD measurements. An adherence score was assigned to each of the included studies based on reported adherence to published guidelines on the assessment of brachial artery FMD. A Typical Error Estimate (TEE) of the FMD was calculated for each included study. The relation between the FMD TEE and the adherence score was investigated by means of Pearson correlation coefficients and multiple linear regression analysis. RESULTS Twenty-seven studies involving 48 study groups and 1537 subjects were included in the analyses. The adherence score ranged from 2.4 to 9.2 (out of a maximum of 10) and was strongly and inversely correlated with FMD TEE (adjusted R(2) = 0.36, P < 0.01). Use of automated edge-detection software, continuous diameter measurement, true peak diameter for %FMD calculation, a stereostatic probe holder, and higher age emerged as factors associated with a lower FMD TEE. CONCLUSIONS These data demonstrate that adherence to current expert consensus guidelines and applying contemporary techniques for measuring brachial artery FMD decreases its measurement error.
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Affiliation(s)
- Arno Greyling
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Unilever R&D Vlaardingen, Vlaardingen, The Netherlands
| | - Anke C C M van Mil
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; TI Food and Nutrition, Wageningen, The Netherlands; Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter L Zock
- Unilever R&D Vlaardingen, Vlaardingen, The Netherlands; TI Food and Nutrition, Wageningen, The Netherlands
| | - Daniel J Green
- School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Australia
| | | | - Dick H Thijssen
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
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Ciccone MM, Faienza MF, Altomare M, Nacci C, Montagnani M, Valente F, Cortese F, Gesualdo M, Zito A, Mancarella R, Leogrande D, Viola D, Scicchitano P, Giordano P. Endothelial and Metabolic Function Interactions in Overweight/Obese Children. J Atheroscler Thromb 2016; 23:950-9. [PMID: 26903398 PMCID: PMC7399297 DOI: 10.5551/jat.31740] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIM Although the underlined mechanisms are still unknown, metabolic/coagulation alterations related to childhood obesity can induce vascular impairments. The aim of this study was to investigate the relationship between metabolic/coagulation parameters and endothelial function/vascular morphology in overweight/obese children. METHODS Thirty-five obese/overweight children (22 pre-pubertal, mean age: 9.52±3.35 years) were enrolled. Body mass index (BMI), homeostasis model assessment index (HOMAIR), metabolic and coagulation parameters, [adiponectin, fibrinogen, high molecular weight adiponectin (HMW), endothelin-1, and vonWillebrand factor antigen] ultrasound early markers of atherosclerosis [flow-mediated dilatation (FMD), common carotid intima-media thickness (C-IMT), and anteroposterior diameter of infra-renal abdominal aorta (APAO)] were assessed. RESULTS APAO was related to anthropometric (age: r=0.520, p=0.001; height: r=0.679, p<0.001; weight: r=0.548, p=0.001; BMI: r=0.607, p<0.001; SBP: r=0.377, p=0.026) and metabolic (HOMAIR: r=0.357, p=0.035; HMW: r=-0.355, p=0.036) parameters. Age, height, and systolic blood pressure were positively related to increased C-IMT (r=0.352, p=0.038; r=0.356, p=0.036; r=0.346, p=0.042, respectively). FMD was not related to any clinical and biochemical characteristics of the pediatric population. Age, HOMAIR, fasting glucose levels, and HMW were independent predictors for APAO increase. Each unit decrease in HMW concentrations (1 μg/ml) induced a 0.065 mm increase in APAO. CONCLUSION High molecular weight adiponectin is related to cardiovascular risk in overweight/obese children.
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Affiliation(s)
- Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University
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50
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Rexhaj E, Rimoldi SF, Pratali L, Brenner R, Andries D, Soria R, Salinas C, Villena M, Romero C, Allemann Y, Lovis A, Heinzer R, Sartori C, Scherrer U. Sleep-Disordered Breathing and Vascular Function in Patients With Chronic Mountain Sickness and Healthy High-Altitude Dwellers. Chest 2016; 149:991-8. [PMID: 26540612 DOI: 10.1378/chest.15-1450] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/02/2015] [Accepted: 10/15/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Chronic mountain sickness (CMS) is often associated with vascular dysfunction, but the underlying mechanism is unknown. Sleep-disordered breathing (SDB) frequently occurs at high altitude. At low altitude, SDB causes vascular dysfunction. Moreover, in SDB, transient elevations of right-sided cardiac pressure may cause right-to-left shunting in the presence of a patent foramen ovale (PFO) and, in turn, further aggravate hypoxemia and pulmonary hypertension. We speculated that SDB and nocturnal hypoxemia are more pronounced in patients with CMS compared with healthy high-altitude dwellers, and are related to vascular dysfunction. METHODS We performed overnight sleep recordings, and measured systemic and pulmonary artery pressure in 23 patients with CMS (mean ± SD age, 52.8 ± 9.8 y) and 12 healthy control subjects (47.8 ± 7.8 y) at 3,600 m. In a subgroup of 15 subjects with SDB, we assessed the presence of a PFO with transesophageal echocardiography. RESULTS The major new findings were that in patients with CMS, (1) SDB and nocturnal hypoxemia was more severe (P < .01) than in control subjects (apnea-hypopnea index [AHI], 38.9 ± 25.5 vs 14.3 ± 7.8 number of events per hour [nb/h]; arterial oxygen saturation, 80.2% ± 3.6% vs 86.8% ± 1.7%, CMS vs control group), and (2) AHI was directly correlated with systemic blood pressure (r = 0.5216; P = .001) and pulmonary artery pressure (r = 0.4497; P = .024). PFO was associated with more severe SDB (AHI, 48.8 ± 24.7 vs 14.8 ± 7.3 nb/h; P = .013, PFO vs no PFO) and hypoxemia. CONCLUSIONS SDB and nocturnal hypoxemia are more severe in patients with CMS than in control subjects and are associated with systemic and pulmonary vascular dysfunction. The presence of a PFO appeared to further aggravate SDB. Closure of the PFO may improve SDB, hypoxemia, and vascular dysfunction in patients with CMS. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01182792; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Emrush Rexhaj
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland
| | - Stefano F Rimoldi
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland
| | | | - Roman Brenner
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland
| | - Daniela Andries
- Center for Investigation and Research in Sleep, Lausanne-CHUV, Switzerland
| | - Rodrigo Soria
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland
| | - Carlos Salinas
- Instituto Boliviano de Biologia de Altura, La Paz, Bolivia
| | | | | | - Yves Allemann
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland
| | - Alban Lovis
- Center for Investigation and Research in Sleep, Lausanne-CHUV, Switzerland
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep, Lausanne-CHUV, Switzerland
| | - Claudio Sartori
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland; Department of Internal Medicine, Lausanne-CHUV, Switzerland
| | - Urs Scherrer
- Department of Cardiology and Clinical Research, Inselspital, University of Bern, Bern, Switzerland; Facultad de Ciencias, Departamento de Biología, Universidad de Tarapacá, Arica, Chile.
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