Change of carotid intima-media thickness is associated with age in elderly Japanese patients without a history of cardiovascular disease

[Association of AGT, ACE, NOS3, TNF, MMP9, CYBA polymorphism with subclinical arterial wall changes]

Aim    Activation of the renin-angiotensin-aldosterone system, decreased nitric oxide production, chronic inflammation, and oxidative stress result in subclinical changes in the arterial wall, which favor the development of cardiovascular diseases (CVD). The effect of allelic gene variants that encode the proteins participating in pathogenetic pathways of age-associated diseases with subclinical changes in the arterial wall [increased pulse wave velocity (PWV), increased intima-media thickness, endothelial dysfunction (ED), presence of atherosclerotic plaques (ASP)] are understudied. This study analyzed the relationship between AGT, ACE, NOS3 TNF, MMP9, and CYBA gene polymorphism and the presence of subclinical changes in the arterial wall, including the dependence on risk factors for CVD, in arbitrarily healthy people of various age.Material and methods    The relationship of polymorphisms с.521С>Т of AGT gene, Ins>Del of AСE gene, с.894G>T of NOS3 gene, - 238G>A of TNF gene, - 1562С>T of MMP9 gene, and c.214Т>С of CYBA gene with indexes of changes in the arterial wall and risk factors for CVD was studied in 160 arbitrarily healthy people by building models of multiple logistic regression and also by analyzing frequencies of co-emergence of two signs with the Pearson chi-squared test (χ2) and Fisher exact test.Results    The DD-genotype of Ins>Del ACE gene polymorphism was correlated with increased PWV (p=0.006; odds ratio (OR) =3.41, 95 % confidence interval (CI): 1.48-8.67) and ED (p=0.014; OR=2.60, 95 % CI: 1.22-5.68). The GG genotype of с.894G>T NOS3 gene polymorphism was correlated with ED (p=0.0087; OR=2.65, 95 % CI: 1.26-5.72); the ТТ-genotype of с.894G>T NOS3 gene polymorphism was correlated with ASP (p=0.033; OR=0.034, 95 % CI: 0.001-0.549).Conclusion    Polymorphic variants of AСE and NOS3 genes correlated with ED, increased arterial wall stiffness, and the presence of subclinical changes in the arterial wall.

Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials

In the present review, associations between traditional vascular risk factors (VRFs) and carotid intimamedial thickness progression (C-IMTp) as well as the effects of therapies for VRFs control on C-IMTp were appraised to infer causality between each VRF and C-IMTp. Cohort studies indicate that smoking, binge drinking, fatness, diabetes, hypertension and hypercholesterolemia are associated with accelerated C-IMTp. An exception is physical activity, with mixed data. Interventions for the control of obesity, diabetes, hypertension and hypercholesterolemia decelerate C-IMTp. Conversely, scarce information is available regarding the effect of smoking cessation, stop of excessive alcohol intake and management of the metabolic syndrome. Altogether, these data support a causative role of several traditional VRFs on C-IMTp. Shortcomings in study design and/or ultrasonographic protocols may account for most negative studies, which underlines the importance of careful consideration of methodological aspects in investigations using C-IMTp as the outcome.

Carotid Disease and Ageing: A Literature Review on the Pathogenesis of Vascular Senescence in Older Subjects

Aging is a natural process that affects all systems of the human organism, leading to its inability to adapt to environmental changes. Advancing age has been correlated with various pathological conditions, especially cardiovascular and cerebrovascular diseases. Carotid artery (CA) is mainly affected by age-induced functional and morphological alterations causing atheromatous disease. The evolvement of biomedical sciences has allowed the elucidation of many aspects of this condition. Symptomatic carotid disease (CD) derives from critical luminar stenosis or eruption of an atheromatous plaque due to structural modifications of the vessels, such as carotid intima-media thickening. At a histologic level, the aforementioned changes are mediated by elastin fragmentation, collagen deposition, immune cell infiltration, and accumulation of cytokines and vasoconstrictors. Underlying mechanisms include chronic inflammation and oxidative stress, dysregulation of cellular homeostatic systems, and senescence. Thus, there is an imbalance in components of the vessel wall, which fails to counteract exterior stress stimuli. Consequently, arterial relaxation is impaired and atherosclerotic lesions progress. This is a review of current evidence regarding the relationship of aging with vascular senescence and CD. A deeper understanding of these mechanisms can contribute to the production of efficient prevention methods and targeted therapeutic strategies.

ULTRASOUND B-MODE DESCRIPTORS AND THEIR ASSOCIATION TO AGE AND AUTOMATED IMT AND IMT VARIABILITY

The aim of this paper is to evaluate the association between four simple B-mode image descriptors and age, to further assess the association between the descriptors and automated intima-media thickness (IMT) and intima-media thickness variability (IMTV) measurements, and finally analyze the predictive value of the B-mode image descriptors. A database of 1774 images of the carotid artery is used to manually calculate the contrast and the signal-to-noise ratio (SNR) between the (i) intima-media complex and lumen, and (ii) adventitial wall layer and intima-media complex. A subset of 200 images is then used to automatically measure the IMT and IMTV parameters with a previously developed algorithm. Correlation studies and logistic regression analysis are then performed. The contrast and SNR between the intima-media complex and lumen (contrastIM and SNRIM) are 112.691[Formula: see text][Formula: see text][Formula: see text]247.427 and 19.542[Formula: see text][Formula: see text][Formula: see text]6.236, respectively; whereas between the adventitial wall layer and intima-media complex the parameters (contrastADV and SNRADV) are found to be 1.684[Formula: see text][Formula: see text][Formula: see text]1.182 and 32.859[Formula: see text][Formula: see text][Formula: see text]10.766, respectively. Pearson’s rho is significantly different from zero considering the contrastIM and the SNRADV descriptors when tested for the association with age. The automated IMT and IMTV measurements are 0.796[Formula: see text][Formula: see text][Formula: see text]0.152[Formula: see text]mm and 0.096[Formula: see text][Formula: see text][Formula: see text]0.044[Formula: see text]mm, respectively. Testing the association with the IMT and IMTV measurements yielded Pearson’s rho values which are significantly different from zero except in the case of contrastIM for the IMTV measurement. The logistic regression results showed the IMTV measurement and the SNR descriptor between the intima-media complex and the lumen has a significant predictive value. Considering the association between the IMT and IMTV, the B-mode image descriptors showed a strong and statistically significant association. Moreover, the SNR between the intima-media complex and lumen is found to be a predictive variable in demonstrating its effectiveness as an image descriptor.