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Delialis D, Georgiopoulos G, Tual-Chalot S, Angelidakis L, Aivalioti E, Mavraganis G, Sopova K, Argyris A, Kostakou P, Konstantaki C, Papaioannou M, Tsilimigras D, Chatoupis K, Zacharoulis AA, Galyfos G, Sigala F, Stellos K, Stamatelopoulos K. Amyloid beta is associated with carotid wall echolucency and atherosclerotic plaque composition. Sci Rep 2024; 14:14944. [PMID: 38942831 PMCID: PMC11213915 DOI: 10.1038/s41598-024-64906-8] [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: 11/17/2023] [Accepted: 06/14/2024] [Indexed: 06/30/2024] Open
Abstract
Circulating amyloid-beta 1-40 (Αb40) has pro-atherogenic properties and could serve as a biomarker in atherosclerotic cardiovascular disease (ASCVD). However, the association of Ab40 levels with morphological characteristics reflecting atherosclerotic plaque echolucency and composition is not available. Carotid atherosclerosis was assessed in consecutively recruited individuals without ASCVD (n = 342) by ultrasonography. The primary endpoint was grey scale median (GSM) of intima-media complex (IMC) and plaques, analysed using dedicated software. Vascular markers were assessed at two time-points (median follow-up 35.5 months). In n = 56 patients undergoing carotid endarterectomy, histological plaque features were analysed. Plasma Αb40 levels were measured at baseline. Ab40 was associated with lower IMC GSM and plaque GSM and higher plaque area at baseline after multivariable adjustment. Increased Ab40 levels were also longitudinally associated with decreasing or persistently low IMC and plaque GSM after multivariable adjustment (p < 0.05). In the histological analysis, Ab40 levels were associated with lower incidence of calcified plaques and plaques without high-risk features. Ab40 levels are associated with ultrasonographic and histological markers of carotid wall composition both in the non-stenotic arterial wall and in severely stenotic plaques. These findings support experimental evidence linking Ab40 with plaque vulnerability, possibly mediating its established association with major adverse cardiovascular events.
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Affiliation(s)
- Dimitrios Delialis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Simon Tual-Chalot
- Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lasthenis Angelidakis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Evmorfia Aivalioti
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Georgios Mavraganis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Kateryna Sopova
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Heidelberg University, Ludolf-Krehl-Straße 13-17, D-68167, Mannheim, Germany
- Department of Cardiology, University Hospital Mannheim, Mannheim, Germany
| | - Antonios Argyris
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Peggy Kostakou
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Christina Konstantaki
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Maria Papaioannou
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | - Diamantis Tsilimigras
- First Department of Propaedeutic Surgery, Hippocrateion Hospital, Medical School, University of Athens, Athens, Greece
| | - Konstantinos Chatoupis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece
| | | | - George Galyfos
- First Department of Propaedeutic Surgery, Hippocrateion Hospital, Medical School, University of Athens, Athens, Greece
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, Hippocrateion Hospital, Medical School, University of Athens, Athens, Greece
| | - Konstantinos Stellos
- Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
- Department of Cardiovascular Research, European Center for Angioscience (ECAS), Heidelberg University, Ludolf-Krehl-Straße 13-17, D-68167, Mannheim, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany.
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, PO Box 11528, 80 Vas. Sofias Str., Athens, Greece.
- Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
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Yang M, Lu T, Weng B, He Y, Yang H. Association Between Blood Pressure Variability and Short-Term Outcome After Intra-arterial Thrombectomy in Acute Stroke Patients With Large-Vessel Occlusion. Front Neurol 2021; 11:604437. [PMID: 33505348 PMCID: PMC7829217 DOI: 10.3389/fneur.2020.604437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/20/2020] [Indexed: 01/01/2023] Open
Abstract
The optimal range of blood pressure variability (BPV) for acute stroke patients with large-vessel occlusion (LVO) remains unclear. This study investigated the association between BPV from admission through the first 24 h after intra-arterial thrombectomy (IAT) and short-term outcome in LVO patients. We retrospectively analyzed 257 consecutive patients with LVO stroke who were treated with IAT. BP values were recorded at 2-h intervals from admission through the first 24 h after IAT. BPV, as reflected by pulse pressure variability (PPV), was determined based on standard deviation (SD), coefficient of variation (CV), successive variation (SV), and the difference between maximum and minimum blood pressure (ΔBP; systolic BP minus diastolic BP). The association between BPV and clinical outcome (Modified Rankin Scale score at 90 days) was analyzed by multivariate logistic regression analysis. Of the 257 included patients, 70 had a good outcome at 3 months. PPV from admission through the first 24 h after IAT was independently associated in a graded manner with poor outcome [multivariable-adjusted odds ratios (95% confidence interval) for the highest of PPV were 43.0 (8.7–212.8) for SD, 40.3 (9.8–165.0) for CV, 55.0 (11.2–271.2) for SV, and 40.1 (8.0–201.9) for ΔBP]. The area under the receiver operating characteristic curve (95% confidence interval) of the PPV parameters were 0.924 (0.882–0.965) for SD, 0.886 (0.835–0.938) for CV, 0.932 (0.891–0.973) for SV, and 0.892 (0.845–0.939) for ΔBP, and the Youden index values were 0.740, 0.633, 0.759, and 0.756, respectively. In summary, BPV from admission through the first 24 h after IAT was independently associated with poor outcome at 3 months in patients with LVO, with greater variability corresponding to a stronger association. Thus, PPV may be a clinically useful predictor of functional prognosis in LVO patients treated with IAT.
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Affiliation(s)
- Mengqi Yang
- Neurology and Stroke Center, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Tao Lu
- Neurology and Stroke Center, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Baohui Weng
- Neurology and Stroke Center, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yi He
- Medical Records Room, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Hong Yang
- Neurology and Stroke Center, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
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Zhang T, Wang X, Wen C, Zhou F, Gao S, Zhang X, Lin S, Shi J, Li W. Effect of short-term blood pressure variability on functional outcome after intra-arterial treatment in acute stroke patients with large-vessel occlusion. BMC Neurol 2019; 19:228. [PMID: 31558167 PMCID: PMC6764143 DOI: 10.1186/s12883-019-1457-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/04/2019] [Indexed: 01/01/2023] Open
Abstract
Background Endovascular treatment (EVT) is advocated for acute ischaemic stroke with large-vessel occlusion (LVO), but perioperative periods are challenging. This study investigated the relationship between post-EVT short-term blood pressure variability (BPV) and early outcomes in LVO patients. Methods We retrospectively reviewed 72 LVO patients undergoing EVT between June 2015 and June 2018. Hourly systolic and diastolic blood pressures (SBP and DBP, respectively) were recorded in the first 24 h post-EVT. BPV were evaluated as standard deviation (SD), coefficient of variation (CV), and successive variation (SV) separately for SBP and DBP. Functional independence at 3 months was defined as a modified Rankin Scale (mRS) score of 0–2. Results For 58.3% patients with favorable outcomes, the median National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT scores on admission were 14 and 8, respectively. The maximum SBP ([154.3 ± 16.8] vs. [163.5 ± 15.6], P = 0.02), systolic CV ([8. 8% ± 2.0%] vs. [11.0% ± 1.8], P < 0.001), SV ([11.4 ± 2.3] vs. [14.6 ± 2.0], P < 0.001), and SD ([10.5 ± 2.4] vs. [13.8 ± 3.9], P < 0.001) were lower in patients with favorable outcomes. On multivariable logistic regression analysis, systolic SV (OR: 4.273, 95% CI: 1.030 to 17.727, P = 0.045) independently predicted unfavorable prognosis. The area under the curve was 0.868 (95% CI: 0.781 to 0.955, P < 0.001), and sensitivity and specificity were 93.3% and 73.8%, respectively, showing excellent predictive value for 3-month poor-outcomes. Conclusions Decreased systolic SV following intra-arterial therapies result in favorable outcomes at 3 months. Systolic SV may be a novel predictor of functional prognosis in LVO patients. Supplementary information Supplementary information accompanies this paper at 10.1186/s12883-019-1457-5.
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Affiliation(s)
- Tianli Zhang
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Xiaolong Wang
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Chao Wen
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Feng Zhou
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Shengwei Gao
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Xiaodong Zhang
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Shiqin Lin
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Jing Shi
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China
| | - Weirong Li
- Department of Neurology, Taiyuan Central Hospital, Taiyuan city, 030009, Shanxi Province, China.
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Georgiopoulos G, Kontogiannis C, Stakos D, Bakogiannis C, Koliviras A, Kyrkou A, Karapanou L, Benekos K, Augoulea A, Armeni E, Laina A, Stellos K, Lambrinoudaki I, Stamatelopoulos K. Abdominal Fat Tissue Echogenicity: A Marker of Morbid Obesity. J Clin Endocrinol Metab 2019; 104:301-311. [PMID: 30358874 DOI: 10.1210/jc.2018-01301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/19/2018] [Indexed: 02/09/2023]
Abstract
PURPOSE Menopause-related changes may affect regional but also morphological characteristics of adipose tissue. We sought to assess the clinical value of echogenicity of subcutaneous adipose tissue (SAT) and preperitoneal adipose tissue (pPAT) in postmenopausal women without cardiovascular disease. METHODS In 244 consecutively recruited postmenopausal women, subclinical atherosclerosis was assessed in the femoral and carotid arteries by intima-media thickness (IMT) and atheromatous plaques using high-resolution ultrasonography. In 41 women with a second visit (median follow-up 41.5 months), carotid atherosclerosis was re-evaluated. Images of SAT and pPAT were ultrasonographically acquired, and their echogenicity was evaluated by grayscale mean (GSMn) using a dedicated software. A control group of 20 healthy premenopausal women was used for comparisons in fat echogenicity. RESULTS SAT GSMn but not pPAT was higher in postmenopausal as compared with healthy premenopausal women and was independently associated with metabolic markers of adiposity including body mass index (BMI) and waist circumference (WC). SAT GSMn was associated with carotid IMT and the presence and number of atheromatous plaques [adjusted OR 2.44 and 2.32 per 1-SD increase in GSMn (95% CIs 1.55 to 3.93 and 1.55 to 3.45), respectively]. SAT GSMn conferred incremental value over traditional risk factors, insulin resistance, BMI, and WC for the detection of subclinical atherosclerosis. Increased baseline SAT GSMn was associated with increased rate of progression in carotid IMT. CONCLUSIONS SAT echogenicity may serve as a qualitative marker of adiposity, conferring incremental clinical value over BMI and WC in postmenopausal women. Further investigation is warranted to assess the utility of ultrasonography-derived fat echogenicity as a screening method for morbid obesity.
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Affiliation(s)
- Georgios Georgiopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Kontogiannis
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Stakos
- Cardiology Department, Democritus University of Thrace, Alexandroupolis, Greece
| | - Constantinos Bakogiannis
- 3rd Department of Cardiology, Ippokrateio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Koliviras
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Kyrkou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Labrini Karapanou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kosmas Benekos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ageliki Laina
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Stellos
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kimon Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Kargiotis O, Safouris A, Magoufis G, Georgala M, Roussopoulou A, Stamboulis E, Moulakakis KG, Lazaris A, Geroulakos G, Vasdekis S, Tsivgoulis G. The Role of Neurosonology in the Diagnosis and Management of Patients with Carotid Artery Disease: A Review. J Neuroimaging 2018; 28:239-251. [DOI: 10.1111/jon.12495] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
| | | | | | - Maria Georgala
- Department of Clinical NeurophysiologyMetropolitan Hospital Piraeus Greece
| | - Andromachi Roussopoulou
- Second Department of NeurologyMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
| | | | - Konstantinos G. Moulakakis
- Department of Vascular SurgeryMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
| | - Andreas Lazaris
- Department of Vascular SurgeryMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
| | - George Geroulakos
- Department of Vascular SurgeryMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
| | - Spyros Vasdekis
- Department of Vascular SurgeryMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
| | - Georgios Tsivgoulis
- Second Department of NeurologyMedical SchoolNational and Kapodistrian University of Athens“Attikon” University Hospital Athens Greece
- Department of NeurologyThe University of Tennessee Health Science Center Memphis TN
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Yano Y. "Time rate" of 24-hour blood pressure variability. J Clin Hypertens (Greenwich) 2017; 19:1078-1080. [PMID: 28960772 DOI: 10.1111/jch.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yuichiro Yano
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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