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Rao S, Weng M, Lian R, Zhuo Y, Lin J, You D, Cui J, Chen Y, Wan J. Correlation between coronary calcification and cardiac structure in non-dialysis patients with chronic kidney disease. ESC Heart Fail 2024. [PMID: 39239806 DOI: 10.1002/ehf2.15057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/04/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024] Open
Abstract
AIMS We aim to explore the correlation between coronary artery calcification (CAC) score (CACS) and cardiac structure and function in chronic kidney disease (CKD) patients, create a clinical prediction model for severe CAC associated with cardiac ultrasound indexes. METHODS AND RESULTS The study included 178 non-dialysis CKD patients who underwent CACS testing and collected general information, serological indices, cardiac ultrasound findings and follow-up on renal function, heart failure (HF) manifestations and re-hospitalization. The mean age of participants in the study cohort was 67.4 years; 59% were male, and 66.9% of patients had varying degrees of comorbid CAC. CKD patients with CACS > 100 were older, predominantly male and had a higher proportion of smoking, diabetes and hypertension (P < 0.05) compared with those with CACS = 0 and 0 < CACS ≤ 100, and had higher brain natriuretic peptide, serum magnesium and fibrinogen levels were also higher (P < 0.05). CACS was positively correlated with left atrial inner diameter (LAD), left ventricular end-diastolic inner diameter (LVDd), left ventricular volume at diastole (LVVd), output per beat (SV) and mitral orifice early diastolic blood flow velocity/early mitral annular diastolic myocardial motion velocity (E/e) (P < 0.05). We tested the associations between varying degrees of CAC and HF and heart valve calcification using multivariable-adjusted regression models. The risk of HF in patients with severe CAC was about 1.95 times higher than that in patients without coronary calcification, and the risk of heart valve calcification was 2.46 times higher than that in patients without coronary calcification. Heart valve calcification and HF diagnosis, LAD and LVDd are essential in predicting severe CAC. During a mean follow-up time of 18.26 ± 10.17 months, 65 (36.52%) patients had a composite renal endpoint event, of which 36 (20.22%) were admitted to renal replacement therapy. Patients with severe CAC had a higher risk of progression of renal function, re-admission due to cardiovascular and renal events and more pronounced symptoms of HF (P < 0.05). CONCLUSIONS There is a correlation between CACS and cardiac structure and function in non-dialysis CKD patients, which may mainly involve abnormalities in left ventricular structure and cardiac diastolic function. CAC may affect renal prognosis and quality of survival in CKD patients. Based on clinical information, HF, valvular calcification status and indicators related to left ventricular hypertrophy can identify people at risk for severe CAC.
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Affiliation(s)
- Siyi Rao
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Mengjie Weng
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ruoshan Lian
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yongjie Zhuo
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jiaqun Lin
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Danyu You
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jiong Cui
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yi Chen
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jianxin Wan
- Department of Nephrology, Blood Purification Research Center, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Maffeis C, Rossi A, Bonapace S, Cannata L, Tafciu E, Cicoira M, Temporelli PL. Aortic stiffness plays a role in the discrepancy between mitral valve lesion severity and hemodynamic burden of secondary mitral regurgitation. Eur J Intern Med 2023; 117:85-90. [PMID: 37393182 DOI: 10.1016/j.ejim.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND By the framework of proportionate/disproportionate secondary mitral regurgitation (sMR), disproportionate sMR is characterized by a low left ventricular stroke volume (SV) and an out of proportion regurgitant fraction (RF) for the same effective regurgitant orifice area (EROA). The degree of aortic stiffness is a determinant of the ventricular forward SV. We aim to analyze the importance of aortic stiffness in influencing the discrepancy between measures of mitral valve lesion severity (EROA) and sMR hemodynamic burden (regurgitant volume [RV] and RF). METHODS We enrolled stable patients with heart failure with reduced ejection fraction (HFrEF) and at least mild sMR. Mitral EROA, RV, RF and aortic pulse wave velocity (PWV) were measured by echocardiography. We defined three groups based on the degree of actual RF deviation from RF estimated by the linear regression equation of RF on EROA (concordant, low-discordant [residuals lower-than -5%] and high-discordant RF [residuals higher-than 5%]). RESULTS 117 patients were analyzed (68±13 years; female 30%; LVEF 33±8%; EROA 16±12mm2; RV 24±15 ml; RF 27±13%; PWV 6.6 ± 3.2 m/s). LVEF, end-diastolic-volume and EROA didn't differ among groups. PWV and RV were higher in patients with high-discordant RF (p ≤ 0.01), whereas total left ventricular-SV and left ventricular outflow tract-SV (LVOT-SV) were lower (p ≤ 0.0004). PWV was associated with LVOT-SV (r=-0.3;p = 0.0008) and RV (r = 0.3;p = 0.0009). High-discordant RF was predicted by PWV (p = 0.001) independently of LVOT-SV and RV. CONCLUSION In this HFrEF cohort with sMR, higher PWV was associated with higher-than-expected RF for a given EROA. Aortic stiffness might play a role in the discrepancy between mitral valve lesion severity and sMR hemodynamic burden.
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Affiliation(s)
- Caterina Maffeis
- Division of Cardiology, Department of Medicine, University of Verona, P.le Stefani 1, Verona 37126, Italy.
| | - Andrea Rossi
- Division of Cardiology, Department of Medicine, University of Verona, P.le Stefani 1, Verona 37126, Italy
| | - Stefano Bonapace
- Division of Cardiology, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar, Italy
| | - Lorenzo Cannata
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno, Italy
| | - Elvin Tafciu
- Division of Cardiology, Department of Medicine, University of Verona, P.le Stefani 1, Verona 37126, Italy
| | | | - Pier Luigi Temporelli
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno, Italy
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Tunedal K, Viola F, Garcia BC, Bolger A, Nyström FH, Östgren CJ, Engvall J, Lundberg P, Dyverfeldt P, Carlhäll CJ, Cedersund G, Ebbers T. Haemodynamic effects of hypertension and type 2 diabetes: Insights from a 4D flow MRI-based personalized cardiovascular mathematical model. J Physiol 2023; 601:3765-3787. [PMID: 37485733 DOI: 10.1113/jp284652] [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: 04/14/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Type 2 diabetes (T2D) and hypertension increase the risk of cardiovascular diseases mediated by whole-body changes to metabolism, cardiovascular structure and haemodynamics. The haemodynamic changes related to hypertension and T2D are complex and subject-specific, however, and not fully understood. We aimed to investigate the haemodynamic mechanisms in T2D and hypertension by comparing the haemodynamics between healthy controls and subjects with T2D, hypertension, or both. For all subjects, we combined 4D flow magnetic resonance imaging data, brachial blood pressure and a cardiovascular mathematical model to create a comprehensive subject-specific analysis of central haemodynamics. When comparing the subject-specific haemodynamic parameters between the four groups, the predominant haemodynamic difference is impaired left ventricular relaxation in subjects with both T2D and hypertension compared to subjects with only T2D, only hypertension and controls. The impaired relaxation indicates that, in this cohort, the long-term changes in haemodynamic load of co-existing T2D and hypertension cause diastolic dysfunction demonstrable at rest, whereas either disease on its own does not. However, through subject-specific predictions of impaired relaxation, we show that altered relaxation alone is not enough to explain the subject-specific and group-related differences; instead, a combination of parameters is affected in T2D and hypertension. These results confirm previous studies that reported more adverse effects from the combination of T2D and hypertension compared to either disease on its own. Furthermore, this shows the potential of personalized cardiovascular models in providing haemodynamic mechanistic insights and subject-specific predictions that could aid in the understanding and treatment planning of patients with T2D and hypertension. KEY POINTS: The combination of 4D flow magnetic resonance imaging data and a cardiovascular mathematical model allows for a comprehensive analysis of subject-specific haemodynamic parameters that otherwise cannot be derived non-invasively. Using this combination, we show that diastolic dysfunction in subjects with both type 2 diabetes (T2D) and hypertension is the main group-level difference between controls, subjects with T2D, subjects with hypertension, and subjects with both T2D and hypertension. These results suggest that, in this relatively healthy population, the additional load of both hypertension and T2D affects the haemodynamic function of the left ventricle, whereas each disease on its own is not enough to cause significant effects under resting conditions. Finally, using the subject-specific model, we show that the haemodynamic effects of diastolic dysfunction alone are not sufficient to explain all the observed haemodynamic differences. Instead, additional subject-specific variations in cardiac and vascular function combine to explain the complex haemodynamics of subjects affected by hypertension and/or T2D.
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Affiliation(s)
- Kajsa Tunedal
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Federica Viola
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Belén Casas Garcia
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Ann Bolger
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Fredrik H Nyström
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl Johan Östgren
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jan Engvall
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Peter Lundberg
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl-Johan Carlhäll
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Gunnar Cedersund
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Androulakis E, Kourek C, Vrettos A, Kontopodis N, Lioudaki E, Prasinou M, Xanthopoulos A, Antonopoulos A, Briasoulis A, Mohiaddin R. Assessment of extra-coronary peripheral arteriopathy in spontaneous coronary dissection: state of the art in non-invasive imaging techniques and future perspectives. EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE 2023; 1:qyad044. [PMID: 39045059 PMCID: PMC11195703 DOI: 10.1093/ehjimp/qyad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/19/2023] [Indexed: 07/25/2024]
Abstract
Spontaneous coronary artery dissection (SCAD) has been recognized as an important cause of acute coronary syndrome in women ≤ 50 years old, and up to 43% of pregnancy-associated myocardial infarction. SCAD has a strong association with extra-coronary arteriopathies, including either more common entities such as dissections, intracranial or other aneurysms, and extra-coronary and coronary arterial tortuosity or less common inherited vascular disorders such as Ehlers-Danlos syndrome, Marfan syndrome, and Loeys-Dietz syndrome, leading to the conclusion that systemic arterial disorders may underlie SCAD. Fibromuscular dysplasia is the most common extra-coronary vascular abnormality identified among these patients, also sharing a common genetic variant with SCAD. The American Heart Association, in a scientific statement regarding the management of SCAD, recommends that patients with SCAD should undergo additional evaluation with imaging techniques including either computed tomography angiography (CTA) or magnetic resonance angiography (MRA). MRA has been shown to have sufficient diagnostic accuracy in identifying extra-coronary arterial abnormalities, almost equal to CTA and conventional angiography. The aim of this review is to appraise the most recent important evidence of extra-coronary arteriopathy in the setting of SCAD and to discuss the strengths and weaknesses of various non-invasive imaging methods for screening of extra-coronary arteriopathies in patients with SCAD.
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Affiliation(s)
- Emmanuel Androulakis
- Inherited Cardiac Conditions Department, St George's University Hospital, Blackshaw Rd, London SW17 0QT, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, National and Heart Lung Institute, Imperial College London, Sydney St, London SW3 6NP, UK
| | - Christos Kourek
- Department of Cardiology, 417 Army Share Fund Hospital (NIMTS), Athens, Greece
- Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nikolaos Kontopodis
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Eirini Lioudaki
- Renal Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Maria Prasinou
- Department of Immunology, Royal Free London NHS Trust, London, UK
| | | | - Alexios Antonopoulos
- Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Briasoulis
- Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Raad Mohiaddin
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, National and Heart Lung Institute, Imperial College London, Sydney St, London SW3 6NP, UK
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Arici M, Ferrandi M, Barassi P, Hsu SC, Torre E, Luraghi A, Ronchi C, Chang GJ, Peri F, Ferrari P, Bianchi G, Rocchetti M, Zaza A. Istaroxime Metabolite PST3093 Selectively Stimulates SERCA2a and Reverses Disease-Induced Changes in Cardiac Function. J Pharmacol Exp Ther 2023; 384:231-244. [PMID: 36153005 DOI: 10.1124/jpet.122.001335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 01/03/2023] Open
Abstract
Heart failure (HF) therapeutic toolkit would strongly benefit from the availability of ino-lusitropic agents with a favorable pharmacodynamics and safety profile. Istaroxime is a promising agent, which combines Na+/K+ pump inhibition with sarcoplasmic reticulum Ca2+ ATPase (SERCA2a) stimulation; however, it has a very short half-life and extensive metabolism to a molecule named PST3093. The present work aims to investigate whether PST3093 still retains the pharmacodynamic and pharmacokinetic properties of its parent compound. We studied PST3093 for its effects on SERCA2a and Na+/K+ ATPase activities, Ca2+ dynamics in isolated myocytes, and hemodynamic effects in an in vivo rat model of diabetic [streptozotocin (STZ)-induced] cardiomyopathy. Istaroxime infusion in HF patients led to accumulation of PST3093 in the plasma; clearance was substantially slower for PST3093 than for istaroxime. In cardiac rat preparations, PST3093 did not inhibit the Na+/K+ ATPase activity but retained SERCA2a stimulatory activity. In in vivo echocardiographic assessment, PST3093 improved overall cardiac performance and reversed most STZ-induced abnormalities. PST3093 intravenous toxicity was considerably lower than that of istaroxime, and it failed to significantly interact with 50 off-targets. Overall, PST3093 is a "selective" SERCA2a activator, the prototype of a novel pharmacodynamic category with a potential in the ino-lusitropic approach to HF with prevailing diastolic dysfunction. Its pharmacodynamics are peculiar, and its pharmacokinetics are suitable to prolong the cardiac beneficial effect of istaroxime infusion. SIGNIFICANCE STATEMENT: Heart failure (HF) treatment would benefit from the availability of ino-lusitropic agents with favourable profiles. PST3093 is the main metabolite of istaroxime, a promising agent combining Na+/K+ pump inhibition and sarcoplasmic reticulum Ca2+ ATPase2a (SERCA2a) stimulation. PST3093 shows a longer half-life in human circulation compared to istaroxime, selectively activates SERCA2a, and improves cardiac performance in a model of diabetic cardiomyopathy. Overall, PST3093 as a selective SERCA2a activator can be considered the prototype of a novel pharmacodynamic category for HF treatment.
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Affiliation(s)
- Martina Arici
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Mara Ferrandi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Paolo Barassi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Shih-Che Hsu
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Eleonora Torre
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Andrea Luraghi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Carlotta Ronchi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Gwo-Jyh Chang
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Francesco Peri
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Patrizia Ferrari
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Giuseppe Bianchi
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, Università degli Studi di Milano-Bicocca, Milan, Italy (M.A., E.T., A.L., C.R., F.P., M.R., A.Z.); Windtree Therapeutics Inc., Warrington, Pennsylvania (M.F., P.B., P.F., G.B.); CVie Therapeutics Limited, Taipei, Taiwan (S.-C.H.); Graduate Institute of Clinical Medicinal Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan (G.-J.C.); and Università Vita-Salute San Raffaele, Milan, Italy (G.B.)
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Abstract
The aorta contributes to cardiovascular physiology and function. Understanding biomechanics in health, disease, and after aortic interventions will facilitate optimization of perioperative patient care.
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Maffeis C, Rossi A, Faggiano P. Non-significant aortic valve stenosis and poor outcome: the dark side of the moon. Eur Heart J Cardiovasc Imaging 2022; 23:613-615. [PMID: 35175351 DOI: 10.1093/ehjci/jeac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Caterina Maffeis
- Division of Cardiology, Department of Medicine, University of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - Andrea Rossi
- Division of Cardiology, Department of Medicine, University of Verona, Piazzale Stefani, 1, 37126 Verona, Italy
| | - Pompilio Faggiano
- Cardiothoracic Department, Fondazione Poliambulanza, via Bissolati, 57, 25124 Brescia, Italy
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Nabati M, Namazi S, Yazdani J. Aortic wall elasticity and left ventricular function in hypertensive patients with nonsignificant coronary artery disease. ULTRASOUND (LEEDS, ENGLAND) 2021; 29:162-171. [PMID: 34567228 PMCID: PMC8366218 DOI: 10.1177/1742271x20963346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Hypertension is an important cause of nonischemic heart failure. It is important to identify subclinical left ventricular dysfunction in patients with hypertension in an early stage to lower the risk of progression to more severe illness. The aim of our study was to assess the correlation between indices of left ventricular function and aortic stiffness in patients with hypertension. METHODS Our study was a case control study of 42 hypertensive and 40 normotensive patients with nonsignificant coronary artery disease. All the patients underwent echocardiography and left ventricular ejection fraction, global longitudinal strain, post systolic index, pulsed Doppler early transmitral peak flow velocity, early diastolic mitral annular velocity (e'), and aortic elasticity measurements were calculated. RESULTS The hypertensive patients were older (58.47 ± 9.57 vs. 52.94 ± 10.38 years, p = 0.018) and had a higher body mass index (30.09 ± 5.08 vs. 27.48 ± 4.17 kg/m2, p = 0.013) and E/e' ratio (8.16 ± 1.81 vs. 6.56 ± 1.71, p < 0.001) and a lower e' velocity (8.25 ± 2.28 vs. 9.52 ± 2.34 cm/s, p = 0.015) than normotensives. They also had a lower aortic distensibility (p = 0.008) and a higher aortic stiffness index (p = 0.039) compared with the normotensive group. The hypertensive patients did not show any association between aortic elasticity and stiffness with age or e' velocity despite significant association in normotensives. CONCLUSION Hypertension is associated with a high prevalence of diastolic dysfunction, elevated left ventricular filling pressure, and increased arterial stiffness, all of which have significant association with adverse outcomes. The measurements found in the hypertensive patients compared with the normotensive group may be due to several age-independent mechanisms.
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Affiliation(s)
- Maryam Nabati
- Department of cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shojaoddin Namazi
- Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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9
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Corda A, Corda F, Caivano D, Saderi L, Sotgiu G, Mollica A, Birettoni F, Porciello F, Pinna Parpaglia ML. Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs. J Vet Intern Med 2020; 34:2337-2344. [PMID: 32949191 PMCID: PMC7694867 DOI: 10.1111/jvim.15891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
Background Systemic hypertension (SH) is a persistent and pathological increase in arterial blood pressure (BP). Chronic SH leads to an increase in aortic (Ao) stiffness, and measuring Ao elasticity is useful for estimating Ao stiffness in humans. Currently, no literature in veterinary medicine describes noninvasive assessment of abdominal Ao elasticity in dogs with SH. Objective Compare ultrasonographic‐derived abdominal Ao strain (AoSt) between hypertensive (HT) and normotensive (NT) dogs. Animals Fifty privately‐owned dogs with clinical signs, conditions, or both potentially associated with SH. Methods Prospective observational case‐control study. Aortic stiffness was estimated by calculating AoSt as follows: AoSt = ([AoDs − AoDd]/AoDd) × 100, where AoDs and AoDd are the Ao diameter in systole and in diastole, respectively. Aortic stiffness was calculated from 2 different Ao transverse sections, the first caudal to the left renal artery (K_AoSt), and the second cranial to the external iliac arteries (I_AoSt). Results Thirty‐two dogs were included in the HT group and 18 in the NT group. Both K_AoSt and I_AoSt in HT dogs were significantly lower (P < .05) than in NT dogs (7.4 ± SD 3.6) vs 10.3 (±3.8) and 5.7 (interquartile range [IQR], 3.9‐7.5) vs 8.1 (IQR, 7‐10.3), respectively. Only K_AoSt was significantly influenced by age. Conclusions and Clinical Importance Ultrasonographic Ao elasticity assessment was feasible to compare HT and NT dogs. Results indicated that K_AoSt and I_AoSt indices can be used to assess SH‐related Ao stiffness, especially when indirect BP measurements are inconsistent or inaccurate. Additional studies to assess the AoSt in healthy dogs of various ages are needed.
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Affiliation(s)
- Andrea Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesca Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Domenico Caivano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Laura Saderi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Mollica
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesco Birettoni
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Francesco Porciello
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
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Mansiroglu AK, Isa S, Yilmaz G. Effect of radiation on endothelial functions in workers exposed to radiation. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2020; 66:992-997. [PMID: 32844919 DOI: 10.1590/1806-9282.66.7.992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/19/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Our aim is to determine whether radiation affects the endothelial function of hospital staff working in the radiation unit for diagnostic and therapeutic purposes. We have evaluated endothelial function with vascular imaging parameters such as flow-mediated dilatation (FMD) and aortic stiffness index (ASI). METHODS A total of 75 employees, 35 of whom are exposed to radiation due to their profession and 40 as the control group, were included in our single-centered study. Demographic data, FMD, aortic stiffness, and echocardiographic findings of the two groups were compared. RESULTS There were no significant differences in demographic data. Median FMD values tended to be lower in the radiation exposure group [7.89 (2.17-21.88) vs. 11.69 (5.13-27.27) p=0.09]. The FMD value was significantly lower in the catheter laboratory group than in the radiation-exposed (p=0.034) and control (p=0.012) groups. However, there was no statistically significant difference between the non-catheter lab radiation exposed group and the control group (p=0.804). In addition, there was no statistically significant difference in the ASI value between the groups (p=0.201). CONCLUSION We have found that FMD is decreased among hospital staff working in radiation-associated areas. This may be an early marker for radiation-induced endothelial dysfunction.
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Affiliation(s)
- Asli Kurtar Mansiroglu
- Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Sincer Isa
- Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Gunes Yilmaz
- Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
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11
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Nabati M, Namazi SS, Yazdani J, Sharif Nia H. Relation Between Aortic Stiffness Index and Distensibility with Age in Hypertensive Patients. Int J Gen Med 2020; 13:297-303. [PMID: 32606894 PMCID: PMC7296550 DOI: 10.2147/ijgm.s253357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Systolic and diastolic blood pressure is associated with physiologic changes of aortic wall and left ventricular structure. We aimed to evaluate aortic stiffness index and distensibility, global longitudinal strain (GLS), post systolic index (PSI) in hypertensive patients and compare these parameters with normotensive subjects. Patients and Methods Eighty-two patients (42 hypertensive compared with 40 normotensive subjects) with preserved left ventricular ejection fraction and without significant coronary artery disease were enrolled in the study. Systolic and diastolic blood pressure was measured by automated BP measurement system. Aortic stiffness index and distensibility, GLS and PSI were measured by transthoracic echocardiography and compared in both study groups. Results Aortic stiffness index (0.097 vs 0.069) and E/e´ (8.16 vs 6.56) were significantly higher in hypertensive patients, respectively (p<0.05). Aortic distensibility (cm2/dyn) (0.28 vs 0.42) and e´ (cm/s) (8.25 vs 9.52) were significantly lower in hypertensive patients than normotensive subjects (p<0.05). PSI and GLS were not significantly different between both study groups. Aortic stiffness index and distensibility had significant correlation with age in normotensive subjects while this correlation was not statistically significant in hypertensive patients. Conclusion Hypertension is associated with diastolic dysfunction and abnormal aortic wall compliance. Age-related aortic wall changes can present early in hypertensive patients.
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Affiliation(s)
- Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Shojaeddin Namazi
- Student Research Committee, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamid Sharif Nia
- Department of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
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12
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Egbe AC, Miranda WR, Connolly HM. Increased prevalence of left ventricular diastolic dysfunction in adults with repaired coarctation of aorta. INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VASCULATURE 2020; 28:100530. [PMID: 32462075 PMCID: PMC7240224 DOI: 10.1016/j.ijcha.2020.100530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 01/28/2023]
Abstract
Background Left ventricular (LV) pressure overload and coronary artery disease are common in patients with coarctation of aorta (COA), and they are risk factors for LV diastolic dysfunction. Patients with COA may have aortic vasculopathy that can result in LV pressure overload even in the absence of hemodynamically significant COA. We therefore hypothesized that patients with mild COA (without hemodynamically significant COA) will have more LV diastolic dysfunction compared to controls. Methods Adult patients with mild COA (Doppler peak velocity < 2.5 m/s) were matched 1:1 to patients without structural heart disease using propensity score method based on age, sex, body mass index, hypertension and blood pressure. The objective was to compare LV diastolic dysfunction (defined as E/e′ > 2 standard deviations above age-specific normative values) between adults with repaired COA and controls. Results Of 204 COA and 204 control patients (age 35 ± 12 years), patients with COA had higher septal and lateral E/e′ ratio (12 ± 4 vs 9 ± 4, p = 0.009) and (10 ± 3 vs 7 ± 3, p < 0.001), respectively. Compared to controls, the prevalence of LV diastolic dysfunction was higher in patients with COA for every age group: <40 years (63% vs 13%, p < 0.001); 41–60 years (87% vs 33%, p < 0.001); age > 60 years (82% vs 56%, p = 0.076). Left ventricular mass index (LVMI) was the strongest determinant of E/e′ (β = 2.71 per 10 g/m2, standard error = 1.25, p < 0.001). Conclusion LV diastolic dysfunction was common in patients with COA, and the association with LVMI suggests that patients with COA may have ongoing LV pressure overload in the absence of hemodynamically significant re-coarctation.
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Affiliation(s)
- Alexander C Egbe
- The Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - William R Miranda
- The Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Heidi M Connolly
- The Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, United States
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Ghorbani N, Muthurangu V, Khushnood A, Goubergrits L, Nordmeyer S, Fernandes JF, Lee CB, Runte K, Roth S, Schubert S, Kelle S, Berger F, Kuehne T, Kelm M. Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study. BMJ Open 2020; 10:e034853. [PMID: 32213521 PMCID: PMC7170596 DOI: 10.1136/bmjopen-2019-034853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation. DESIGN Cross-sectional study. SETTING The study was conducted at two university medical centres, located in Berlin and London. PARTICIPANTS A total of 121 patients with aortic coarctation (ages 1-71 years) underwent cardiac MRI, echocardiography and blood pressure measurements. OUTCOME MEASURES Cross-sectional diameters of the ascending and descending aortas were assessed to compute aortic area distensibility. Findings were compared with age-specific reference values. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology statement and reporting guidelines. RESULTS Impaired distensibility (below fifth percentile) was seen in 37% of all patients with coarctation in the ascending aorta and in 43% in the descending aorta. BAVD (43%) and arterial hypertension (72%) were present across all ages. In patients >10 years distensibility impairment of the ascending aorta was predominantly associated with BAVD (OR 3.1, 95% CI 1.33 to 7.22, p=0.009). Distensibility impairment of the descending aorta was predominantly associated with arterial hypertension (OR 2.8, 95% CI 1.08 to 7.2, p=0.033) and was most pronounced in patients with uncontrolled hypertension despite antihypertensive treatment. CONCLUSION From early adolescence on, both arterial hypertension and BAVD have a major impact on aortic distensibility. Their specific effects differ in strength and localisation (descending vs ascending aorta). Moreover, adequate blood pressure control is associated with improved distensibility. These findings could contribute to the understanding of cardiovascular complications and the management of patients with aortic coarctation.
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Affiliation(s)
- Niky Ghorbani
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Vivek Muthurangu
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK
| | - Abbas Khushnood
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK
| | - Leonid Goubergrits
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Sarah Nordmeyer
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Joao Filipe Fernandes
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Chong-Bin Lee
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum, Berlin, Germany
| | - Kilian Runte
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Sophie Roth
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Stephan Schubert
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Sebastian Kelle
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Felix Berger
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Titus Kuehne
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Marcus Kelm
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- BIH (Berlin Institute of Health), Berlin, Germany
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Ceyhun G, Erbay G. A rare cause of erectile dysfunction: left ventricular diastolic dysfunction. Minerva Cardioangiol 2020; 68:295-301. [PMID: 32163242 DOI: 10.23736/s0026-4725.20.05149-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The aim of this study was to investigate the association between left ventricular diastolic dysfunction (LVDD) and erectile dysfunction (ED) without overt cardiovascular disease. METHODS A total of 80 patients with LVDD and without a history of coronary artery disease were compared with 80 age- and gender-matched healthy controls. The International Index of Erectile Function Questionnaire (IIEF-5) was used to diagnose and grade ED. LVDD and its relation with ED severity were assessed. RESULTS The mean age, Body Mass Index, total testosterone, low- and high-density lipoprotein cholesterol, and triglyceride levels did not significantly differ between the LVDD and control groups (P>0.05). There was a negative correlation between the stage of LVDD and IIEF-5 score (r=-0.635, P<0.05). Additionally, the left atrial volume index, peak TR velocity and E/e' ratio were independent risk factors for lowering the IIEF-5 score. CONCLUSIONS This study indicates that LVDD is significantly associated with ED. There were significant associations between the increased severity of ED and the presence of LVDD in middle-aged men.
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Affiliation(s)
- Gökhan Ceyhun
- Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey -
| | - Güven Erbay
- Department of Urology, Faculty of Medicine, Omer Halisdemir University, Nigde, Turkey
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Impairment of myocardial functions and arterial stiffness in patients with lichen planus. An Bras Dermatol 2020; 95:180-186. [PMID: 32146010 PMCID: PMC7175034 DOI: 10.1016/j.abd.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/30/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lichen planus is a chronic inflammatory mucocutaneous disease. Recent studies have suggested that it is associated with an increased risk of cardiovascular comorbidities. OBJECTIVE The purpose of this study was to assess and compare arterial stiffness and cardiovascular hemodynamics in patients with lichen planus and a healthy control group. METHODS Fifty-five patients with lichen planus and 42 healthy controls were enrolled. All patients underwent echocardiographic examination, and arterial stiffness was measured using applanation tonometry. RESULTS No statistically significant difference was determined between the patient and control groups in terms of arterial stiffness, but stiffness was markedly higher in patients with erosive lichen planus compared to the control group and other patients (p=0.006, and p=0.023, respectively). Moderate positive correlation was determined between duration of disease and arterial stiffness. Impairment of systolic and diastolic functions was also determined in patients with lichen planus compared to the control group (p<0.001, and p=0.005, respectively). STUDY LIMITATIONS Relatively low number of patients. CONCLUSION The positive correlation observed between duration of disease and arterial stiffness in patients with lichen planus suggests that these patients should be followed-up in terms of cardiovascular risk in the presence of resistant and long-term disease, particularly in case of erosive lichen planus.
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Oner T, Akgun G, Ergin SO, Karadag H, Yucel İK, Celebi A. Risk Factors Associated with Ascending Aortic Aneurysms and Aortic Elasticity Parameters in Children with a Bicuspid Aortic Valve. Pediatr Cardiol 2019; 40:980-986. [PMID: 31016325 DOI: 10.1007/s00246-019-02102-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/05/2019] [Indexed: 11/28/2022]
Abstract
Aneurysms of the ascending aorta are frequently found in patients with a bicuspid aortic valve (BAV). This study assessed the risk factors of ascending aortic aneurysms and aortic elasticity in children with BAV. The study included 66 patients with no history of transcatheter intervention or surgical procedure who had been diagnosed with isolated BAV. Echocardiographic, blood pressure, and pulse measurements were obtained for all patients. The BAVs were classified as described by Sievers et al. (J Thorac Cardiovasc Surg 133:1226-1233, 2007), and aortic elasticity parameters were calculated using various formulas. The patients were divided into groups with and without cusp fusion, aortic stenosis (AS), aortic regurgitation (AR), or mixed lesions; the groups were then compared. The mean patient age was 10.43 ± 3.91 years; 15%he patients had no AS or AR, 33% had both AS and AR, 17% had AS alone, and 35% had AR alone. The most common type of BAV was type 5, and the ascending aorta z-scores were higher in children with mixed lesions and without a cusp fusion. Aortic distensibility (AD) was significantly higher, and the stiffness index was significantly lower, in patients with an ascending aorta z-score > 4. The ascending aortic z-scores were higher in the no-fusion and mixed lesion (AS + AR) groups, especially those originating from post-stenotic dilation due to AS. The AD was increased in patients with an ascending aorta z-score > 4. Patients should thus be monitored closely for dissection risk, and preventive medical treatment should be started early in those with AS without cusp fusion.
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Affiliation(s)
- Taliha Oner
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey.
| | - Gokmen Akgun
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - Selma Oktay Ergin
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - Huseyin Karadag
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - İlker Kemal Yucel
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - Ahmet Celebi
- Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, Turkey
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Vizzardi E, Sciatti E, Bonadei I, Menotti E, Prati F, Scodro M, Dallapellegrina L, Berlendis M, Poli P, Padoan R, Metra M. Elastic aortic properties in cystic fibrosis adults without cardiovascular risk factors: A case‐control study. Echocardiography 2019; 36:1118-1122. [DOI: 10.1111/echo.14375] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Enrico Vizzardi
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Edoardo Sciatti
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Ivano Bonadei
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Elisa Menotti
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Francesco Prati
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Marta Scodro
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Lucia Dallapellegrina
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | | | - Piercarlo Poli
- Cystic Fibrosis Center, Pediatric Department ASST Spedali Civili and University of Brescia Brescia Italy
| | - Rita Padoan
- Cystic Fibrosis Center, Pediatric Department ASST Spedali Civili and University of Brescia Brescia Italy
| | - Marco Metra
- Section of Cardiovascular Diseases Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
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Gulsin GS, Athithan L, McCann GP. Diabetic cardiomyopathy: prevalence, determinants and potential treatments. Ther Adv Endocrinol Metab 2019; 10:2042018819834869. [PMID: 30944723 PMCID: PMC6437329 DOI: 10.1177/2042018819834869] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/08/2019] [Indexed: 12/18/2022] Open
Abstract
The prevalence of type 2 diabetes (T2D) has reached a pandemic scale. These patients are at a substantially elevated risk of developing cardiovascular disease, with heart failure (HF) being a leading cause of morbidity and mortality. Even in the absence of traditional risk factors, diabetes still confers up to a twofold increased risk of developing HF. This has led to identifying diabetes as an independent risk factor for HF and recognition of the distinct clinical entity, diabetic cardiomyopathy. Despite a wealth of research interest, the prevalence and determinants of diabetic cardiomyopathy remain uncertain. This limited understanding of the pathophysiology of diabetic heart disease has also hindered development of effective treatments. Tight blood-glucose and blood-pressure control have not convincingly been shown to reduce macrovascular outcomes in T2D. There is, however, emerging evidence that T2D is reversible and that the metabolic abnormalities can be reversed with weight loss. Increased aerobic exercise capacity is associated with significantly lower cardiovascular and overall mortality in diabetes. Whether such lifestyle modifications as weight loss and exercise may ameliorate the structural and functional derangements of the diabetic heart has yet to be established. In this review, the link between T2D and myocardial dysfunction is explored. Insights into the structural and functional perturbations that typify the diabetic heart are first described. This is followed by an examination of the pathophysiological mechanisms that contribute to the development of cardiovascular disease in T2D. Lastly, the current and emerging therapeutic strategies to prevent or ameliorate cardiac dysfunction in T2D are evaluated.
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Affiliation(s)
- Gaurav S. Gulsin
- Department of Cardiovascular Sciences, University of Leicester and the Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Lavanya Athithan
- Department of Cardiovascular Sciences, University of Leicester and the Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Gerry P. McCann
- Department of Cardiovascular Sciences, University of Leicester and the Leicester NIHR Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
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Wang S, Cui H, Zhu C, Wu R, Meng L, Yu Q, Huang X, Xiao M, Wang S. Obstructive sleep apnea causes impairment of the carotid artery in patients with hypertrophic obstructive cardiomyopathy. Respir Med 2019; 150:107-112. [PMID: 30961935 DOI: 10.1016/j.rmed.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) prevalence is high among patients with hypertrophic cardiomyopathy (HCM). OSA can cause increase in carotid intima-media thickness (CIMT) in the general population. However, whether this phenomenon is applicable to patients with HCM is unclear. METHODS A total of 130 consecutive patients with a confirmed diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) at Fuwai Hospital between September 2017 and May 2018 were analyzed. RESULTS 72 patients (55.4%) were diagnosed with OSA. Patients with OSA were older. Compared to those in patients without OSA, the left, right, and mean CIMTs were significantly increased in patients with OSA. In the multiple linear regression model, age (β = 0.341, p < 0.001), apnea-hypopnea index (AHI) (β = 0.421, p < 0.001), and fasting glucose level (β = 0.167, p < 0.03) were independently associated with mean CIMT increase (adjusted R2 = 0.458, p < 0.001). In the receiver operating characteristic curve analysis, the area under the curve for CIMT was 0.813 (95% CI, 0.717-0.909, p < 0.001) with a sensitivity and specificity of 0.84 and 0.70 for unexplained syncope, respectively. In the multivariate logistic regression model, we found that the mean CIMT (OR = 10.4, 95% CI = 3.16-34.11, p < 0.001), left ventricular ejection fraction (LVEF) (OR = 0.90, 95% CI = 0.83-0.99, p = 0.03), and amaurosis (OR = 5.07, 95% CI = 1.47-17.49, p = 0.01) were independently associated with unexplained syncope occurrence. CONCLUSIONS In patients with HOCM, CIMT increased with OSA severity. Age, AHI, and fasting plasma glucose level were independently associated with mean CIMT increase. Moreover, amaurosis, LVEF, and higher mean CIMT were independently associated with unexplained syncope in patients with HOCM.
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Affiliation(s)
- Shengwei Wang
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Cui
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Changsheng Zhu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Wu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liukun Meng
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinjun Yu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Huang
- Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minghu Xiao
- Department of Echocardiography State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuiyun Wang
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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20
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Ahmed MK, Adam KF, El-Shafey WE. Assessment of Aortic Root Mechanics in Hypertensive Patients by Speckle Tracking Echocardiography. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/wjcd.2019.93019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Deng L, Zhang Y, Zhao Z, Zhang K, Hu X, Gao L, Liang H, Zhang J. Ultrasound simulation model incorporating incident and reflected wave propagations along a common carotid artery. Comput Biol Med 2018; 104:267-277. [PMID: 30551000 DOI: 10.1016/j.compbiomed.2018.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 11/28/2022]
Abstract
An ultrasound simulation model incorporating incident and reflected wave propagations is proposed to provide a realistic data source for validation of transit time (TT)-based local pulse wave velocity (PWV) estimation algorithms. First, the incident wave (IW) and reflected wave (RW) at a certain position over a common carotid artery (CCA) are estimated. Then, the propagating pulse waves (PWs) along the CCA are modelled with the synthesizations of the estimated IWs and RWs, whose occurrences are delayed in opposite sequences according to a preset PWV. In ultrasound simulation, a geometric model of a CCA is built, and the dynamic scatterer models are constructed by moving the scatterer positions according to the synthesized PWs. The RF signals are generated using Field II. To characterize the PW propagations of different arterial stiffnesses consistent with clinical ones in the model, 30 healthy subjects from young, middle-aged, and elderly groups are recruited for extractions of IWs and RWs. To quantitatively verify the effectiveness of the simulation model, the normalized root-mean-squared errors (NRMSEs) are used to compare the estimated and preset PWs, time delays (TDs), and PWVs. Results show that for the three age groups, the estimated PWs, TDs, and PWVs conform to the preset ones with the mean NRMSEs of 0.92%, 18.47%, and 8.55%, respectively. Moreover, the model can characterize the effect of the wave reflection on the local PW propagation as its clinical manifestation. Therefore, the proposed model can be effective as a data source for the validation of TT-based local PWV estimation algorithms, particularly the effects of RWs on the estimation performance.
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Affiliation(s)
- Li Deng
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China.
| | - Zhengpeng Zhao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Kexin Zhang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650031, China
| | - Xiao Hu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Lian Gao
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Hong Liang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
| | - Junhua Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, Yunnan, 650091, China
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22
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Priksz D, Bombicz M, Varga B, Kurucz A, Gesztelyi R, Balla J, Toth A, Papp Z, Szilvassy Z, Juhasz B. Upregulation of Myocardial and Vascular Phosphodiesterase 9A in A Model of Atherosclerotic Cardiovascular Disease. Int J Mol Sci 2018; 19:ijms19102882. [PMID: 30249014 PMCID: PMC6213954 DOI: 10.3390/ijms19102882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/10/2018] [Accepted: 09/20/2018] [Indexed: 01/09/2023] Open
Abstract
Atherosclerosis is strongly associated with cardiac dysfunction and heart failure. Besides microvascular dysfunction and diminishment of the cardiac nitric oxide-Protein Kinase G (NO-PKG) pathway, recent evidence suggests that phosphodiesterase 9A (PDE9A) enzyme has an unfavorable role in pathological changes. Here, we characterized a rabbit model that shows cardiac dysfunction as a result of an atherogenic diet, and examined the myocardial PDE9A signaling. Rabbits were divided into Control (normal diet) and HC (atherogenic diet) groups. Cardiac function was evaluated by echocardiography. Vascular function was assessed, along with serum biomarkers. Histological stains were conducted, expression of selected proteins and cyclic guanosine monophosphate (cGMP) levels were determined. Signs of diastolic dysfunction were shown in HC animals, along with concentric hypertrophy and interstitial fibrosis. Endothelial function was diminished in HC rabbits, along with marked reduction in the aortic lumen, and increased left ventricle outflow tract (LVOT) pressures. A significant increase was shown in myocardial PDE9A levels in HC animals with unchanged vasodilator-stimulated phosphoprotein (VASP) phosphorylation and cGMP levels. Upregulation of PDE9A may be associated with early stage of cardiac dysfunction in atherosclerotic conditions. Since PDE9A is involved in cGMP degradation and in deactivation of the cardioprotective PKG signaling pathway, it may become an encouraging target for future investigations in atherosclerotic diseases.
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Affiliation(s)
- Daniel Priksz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Mariann Bombicz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Balazs Varga
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Andrea Kurucz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Jozsef Balla
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Attila Toth
- Division of Clinical Physiology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Zoltan Papp
- Division of Clinical Physiology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Zoltan Szilvassy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
| | - Bela Juhasz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
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23
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Heier M, Stensæth KH, Brunborg C, Seljeflot I, Margeirsdottir HD, Hanssen KF, Dahl-Jørgensen K. Increased arterial stiffness in childhood onset diabetes: a cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging 2018; 19:694-700. [PMID: 28950341 DOI: 10.1093/ehjci/jex178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/19/2017] [Indexed: 11/13/2022] Open
Abstract
Aims Arterial stiffness is a strong predictor of cardiovascular events. We aimed to assess the impact of type 1 diabetes (T1D) on arterial stiffness and cardiac function in young adults. Methods and results Aortic pulse wave velocity (PWV), distensibility, left ventricular (LV) function and LV mass were measured by cardiovascular magnetic resonance imaging (CMR) in 47 T1D patients and 33 healthy controls. All were participants in the Atherosclerosis and Childhood Diabetes study, with baseline values registered 5 years previously. The patients had a mean age of 20.8 years and a median duration of diabetes of 10.0 years. PWV was significantly higher in the diabetes group compared with controls, mean 4.10 (SD = 4.58) vs. 3.90 (SD = 4.04) m/s, P = 0.045. In the diabetes group, insulin pump users at baseline had lower PWV than multiple injection users, mean 3.94 (SD = 0.38) vs. 4.23 (SD = 0.48) m/s, P = 0.028. Also in the diabetes group, multiple regression analysis identified C-reactive protein (CRP), female gender and insulin pump use as independent baseline risk factors for PWV 5 years later. There was no difference in cardiac function or LV mass between the diabetes and control groups. Conclusion In this prospective study, we found increased PWV assessed by CMR in young adults with T1D compared with controls. Also, CRP, female gender and insulin pump use emerged as independent baseline risk factors for PWV 5 years later.
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Affiliation(s)
- Martin Heier
- Pediatric Department, Oslo University Hospital, Ullevål, Postboks 4950 Nydalen, 0424 Oslo, Norway.,Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway
| | - Knut Haakon Stensæth
- Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Postboks 3250 Sluppen, Trondheim 7006, Norway.,Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Postboks 8905, Trondheim 7491, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Postboks 1122 Blindern, Oslo 0317, Norway
| | - Ingebjørg Seljeflot
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Center for Clinical Heart Research and Department of Cardiology, Oslo University Hospital, Kirkeveien 166, Oslo 0407, Norway
| | - Hanna Dis Margeirsdottir
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway.,Pediatric Department, Akershus University Hospital, Sykehusveien 25, Lørenskog 1478, Norway
| | - Kristian F Hanssen
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway.,Department of Endocrinology, Oslo University Hospital, Aker, Trondheimsveien 235, Oslo 0586, Norway
| | - Knut Dahl-Jørgensen
- Pediatric Department, Oslo University Hospital, Ullevål, Postboks 4950 Nydalen, 0424 Oslo, Norway.,Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway
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24
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Yang F, Wang D, Liu H, Zhu X, Zou D, Wang X, Hu Z, Ji M, Cui S, Zhu YX, Wen J. Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT. Medicine (Baltimore) 2018; 97:e11125. [PMID: 29952955 PMCID: PMC6039643 DOI: 10.1097/md.0000000000011125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
As the prevalence of coronary computed tomographic angiography (CCTA), it is meaningful that CCTA can provide not only the structural details of artery, but also functional information of vessel elasticity. Our aim was to explore the elasticity characteristics of ascending aorta (AA), descending aorta (DA), main pulmonary artery (MPA), left pulmonary artery (LPA), right pulmonary artery (RPA), and their relationship between each other using 640 slice-volume computed tomography (CT). Furthermore, this study will also observe their relations with age.A total of 42 subjects that were free of cardiovascular disease, high blood pressure, diabetes, and hyperlipidemia underwent CCTA on 640 slice-volume CT and were enrolled in this study. The subjects were divided into 2 groups: Group 1, age <46; Group 2, age ≥46. The aortic distensibility (AD) and aortic compliance (AC) of aorta and pulmonary artery (PA) of each group were compared.The AD and AC of PA decreased in the following order: MPA, RPA, and LPA. The correlation coefficients of different elastic parameters between different vessels were found to be different. The correlation coefficient of AD between AA and DA, AA and MPA, DA and MPA, RPA and MPA, LPA and MPA, and RPA and LPA were 0.689 (P = .000), 0.520 (P = .000), 0.393 (P = .010), 0.329 (P = .033), 0.579 (P = .000), and 0.534 (P = .000), respectively. The correlation coefficients of AC for the 6 groups mentioned above were 0.351 (P = .023), 0.470 (P = .002), 0.249 (P = .112), 0.190 (P = .228), 0.441 (P = .005), and 0.409 (P = .010), respectively. There was an age-dependent decrease of AD and AC in AA, DA, MPA, LPA (P < .05), but no difference in RPA (P > .05).The elasticity characteristics of AA, DA, MPA, LPA, and RPA could be well shown by 640 slice-volume CT. The elasticity relativity was observed and was different between AA and DA, AA and MPA, LPA and MPA, LPA and RPA. An obvious age-related decrease in vascular elasticity was found in AA, DA, MPA, and LPA, which should be taken into consideration in clinical trials and treatments for the elasticity-related cardiovascular diseases.
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Affiliation(s)
- Fei Yang
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang
| | - Dawei Wang
- Department of Cardiac Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou
| | - Huaijun Liu
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang
| | | | | | | | | | | | | | | | - Jing Wen
- Department of CT, Toshiba Medical Systems (China) Co. Ltd., Beijing, China
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25
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Sciatti E, Vizzardi E, Castiello A, Valentini F, Bonadei I, Gelsomino S, Lorusso R, Metra M. The role of type 2 diabetes mellitus on hypertensive-related aortic stiffness. Echocardiography 2018; 35:798-803. [PMID: 29457265 DOI: 10.1111/echo.13841] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Hypertension is strongly related to arterial stiffness in a cause-effect fashion. Diabetes mellitus is also thought to determine vascular damage, mostly by means of advanced glycosylation end-products (AGEs). Aim of our study was to study the role of type 2 diabetes mellitus (T2DM) as regard ascending aortic elastic properties in hypertensive patients. METHODS We prospectively enrolled outpatients with hypertension (n = 99) and type 2 diabetes mellitus plus hypertension (n = 42) without cardiovascular events. They underwent a transthoracic echocardiography to measure aortic diameters, aortic elastic properties (ie, compliance, distensibility, stiffness index, Peterson's elastic modulus, pulse wave velocity, M-mode strain), tissue Doppler imaging (TDI) to calculate diastolic (E' and A') and systolic (S') velocities, and tissue strain. Multivariable analysis was run to assess the association between T2DM and these variables after correcting for possible confounders (age, sex, body mass index [BMI], dyslipidemia). RESULTS The two groups did not differ as regards age, sex, BMI, and blood pressure. However, T2DM patients were more likely to be dyslipidemic (43% vs 71%, P = .003). Aortic diameters were similar in the two groups, but the aortic elastic properties significantly more impaired in T2DM group. At multivariable analysis, stiffness index, Peterson's elastic modulus, the TDI waves, and the tissue strain remained associated with the co-presence of T2DM and hypertension. CONCLUSION Our data suggest that people suffering from both T2DM and hypertension have more impaired aortic elastic properties than those hypertensive alone. Considering the prognostic role of aortic stiffness, these patients may benefit from a closer follow-up.
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Affiliation(s)
- Edoardo Sciatti
- Cardiology Unit, University and ASST Spedali Civili, Brescia, Italy
| | - Enrico Vizzardi
- Cardiology Unit, University and ASST Spedali Civili, Brescia, Italy
| | | | | | - Ivano Bonadei
- Cardiology Unit, University and ASST Spedali Civili, Brescia, Italy
| | - Sandro Gelsomino
- Department of Cardio-Thoracic Surgery, Cardiovascular Research Institute Maastricht-CARIM, Heart & Vascular Center, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Cardiovascular Research Institute Maastricht-CARIM, Heart & Vascular Center, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Marco Metra
- Cardiology Unit, University and ASST Spedali Civili, Brescia, Italy
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26
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Li M, Wang S, Lin W, Li J, Wang C, Chen H, Lu W, Yang K, Wang J, Zeng Q. Cardiovascular parameters of chest CT scan in estimating pulmonary arterial pressure in patients with pulmonary hypertension. THE CLINICAL RESPIRATORY JOURNAL 2018; 12:572-579. [PMID: 27696745 DOI: 10.1111/crj.12564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/03/2016] [Accepted: 09/17/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To develop a formula to compute mean pulmonary arterial pressure (MPAP) by chest computerized tomography (CT), and to verify its accuracy and reliability. METHODS Eighty-five patients who had taken chest CT and right heart catheterization (RHC) were recruited. The pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), and MPAP of each subject were measured and recorded by RHC. The diameters of the ascending aorta (dAA), descending aorta (dDA) and main pulmonary artery (dMPA), Cobb angle, diameters of right ventricle (dRV), diameters of left ventricle (dLV) were measured by means of chest CT scans. Systolic blood pressure (SBP) was measured by using electronic sphygmomanometer. A linear regression equation was generated in 56 patients to estimate PAP based on chest CT values, 29 patients were used to test the accuracy of the formula. RESULTS The computed equation for analyzing MPAP is: MPAP = 9.011 + 34.195 × dMPA/dAA - 0.319 × SBP + 0.402 × Cobb angle. AUC of equation with three variables (dMPA/dAA, SBP, and Cobb angle) was 0.923 with 95% CI (0.863-0.982). The mean ± SD of predicted values and RHC values had no statistical difference. CONCLUSIONS Ratio of dMAP/dAA, Cobb angle, and SBP can be reliably used to estimate MPAP and predict severity of PH.
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Affiliation(s)
- Mengxi Li
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Ningbo Yinzhou Peoples' Hospital (The Affiliated Yinzhou Hospital of School of Medicine of Ningbo University), Ningbo, Zhejiang, China
| | - Shouyang Wang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- The first affiliated hospital of Shantou University Medical College, Shantou, China
| | - Weiquan Lin
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Jinhui Li
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- The Affiliated Hospital of School of Medicine of Ningbo University, Ningbo, Zhejiang, China
| | - Chunyang Wang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- The first affiliated hospital of Shantou University Medical College, Shantou, China
| | - Huai Chen
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wenju Lu
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kai Yang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- State Key Laboratory of Protein and Plant Gene Research, School of Life Sciences, Peking University, Beijing, China
| | - Jian Wang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Medicine/Pulmonary, Johns Hopkins University, Baltimore, Maryland, USA
| | - Qingsi Zeng
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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27
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Longitudinal Changes in LV Structure and Diastolic Function in Relation to Arterial Properties in General Population. JACC Cardiovasc Imaging 2017; 10:1307-1316. [DOI: 10.1016/j.jcmg.2016.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/12/2016] [Accepted: 10/20/2016] [Indexed: 01/09/2023]
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28
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Cho IJ, Chang HJ, Lee SE, Shim CY, Hong GR, Chung N. Prognostic Application of Thoracic Aortic Calcium Scoring for Adverse Clinical Outcome Risk in Elderly Patients with Left Ventricular Hypertrophy. Korean Circ J 2017; 47:918-928. [PMID: 29035431 PMCID: PMC5711684 DOI: 10.4070/kcj.2016.0443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/03/2017] [Accepted: 07/19/2017] [Indexed: 01/09/2023] Open
Abstract
Background and Objectives Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aorta calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17–89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71–11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
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Affiliation(s)
- In Jeong Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Sang Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chi Young Shim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Geu Ru Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Namsik Chung
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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29
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Ichikawa K, Sakuragi S, Nishihara T, Tsuji M, Mori A, Yokohama F, Wada T, Hasegawa D, Kawamoto K, Tanakaya M, Katayama Y, Ito H. Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure. Heart 2017; 104:318-323. [DOI: 10.1136/heartjnl-2017-311751] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/28/2022] Open
Abstract
ObjectiveAlthough blood pressure (BP) is a major determinant of arterial stiffness, whether high pulse wave velocity (PWV) adversely influences cardiac parameters and cardiovascular (CV) outcome in patients without high BP remains unclear.MethodsOutpatients without high BP (n=320), defined as systolic BP ≥140 mm Hg, were enrolled in this retrospective study. At baseline, all patients underwent echocardiography and multidetector CT to determine the coronary artery calcification (CAC) score. Arterial stiffness was assessed based on brachial-ankle PWV (baPWV), from which patients were classified into two groups: those with high (≥18 m/s, n=89) and low baPWV (<18 m/s, n=231). Cardiac parameters and CV event incidence during the follow-up period were compared between these groups.ResultsIn multivariable linear regression analysis, baPWV was significantly associated with CAC score and serum N-terminal pro-brain natriuretic peptide hormone level, after adjustment for confounding factors. In multivariable logistic regression analysis, baPWV ≥18 m/s was significantly associated with CAC score ≥400 (OR 2.466, 95% CI 1.012 to 6.009, p=0.0471). Kaplan-Meier analysis showed that the high-baPWV group experienced more CV events during the 575 days of follow-up (20% vs 6%, p=0.0003).ConclusionsHigh baPWV was associated with greater CAC and a high risk of a future CV event, especially coronary artery disease, even in patients without high BP.
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Di Salvo G, Bulbul Z, Pergola V, Issa Z, Siblini G, Muhanna N, Galzerano D, Fadel B, Al Joufan M, Al Fayyadh M, Al Halees Z. Gothic aortic arch and cardiac mechanics in young patients after arterial switch operation for d-transposition of the great arteries. Int J Cardiol 2017; 241:163-167. [DOI: 10.1016/j.ijcard.2017.03.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/09/2017] [Indexed: 12/18/2022]
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Fan X, Zhu M, Chi C, Yu S, Xiong J, Lu Y, Bai B, Xu Y, Zhang Y. Association of arteriosclerosis and/or atherosclerosis with hypertensive target organ damage in the community-dwelling elderly Chinese: the Northern Shanghai Study. Clin Interv Aging 2017; 12:929-936. [PMID: 28652715 PMCID: PMC5472426 DOI: 10.2147/cia.s133691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective Vascular abnormality includes two forms, arteriosclerosis (ARS) and atherosclerosis (ATS), which coexist in patients with cardiovascular (CV) diseases. However, whether their combination may lead to a worsening status in those patients remains unclear. We therefore aimed to investigate the association of ARS and/or ATS with hypertensive target organ damage (TOD). Methods From June 2014 to August 2015, a total of 1,599 community-dwelling elderly subjects (aged >65 years) from northern Shanghai were recruited. Vascular measurements, such as carotid–femoral pulse wave velocity (cf-PWV), ankle–brachial index (ABI) and carotid plaque, were conducted on each participant, and ARS was defined as cf-PWV >12 m/s, while ATS was defined as participants who have carotid plaque or ABI <0.9. Within the framework of comprehensive CV examinations, CV risk factors were assessed, and asymptomatic TOD was evaluated by measuring participants’ left ventricular mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), urinary albumin–creatinine rate (UACR) and estimated glomerular filtration rate (eGFR). Results Although LVMI, E/Ea and eGFR were significantly different among subjects with or without ARS and/or ATS (P<0.02), in full adjustment model, only E/Ea showed the independent and significant difference (P=0.023). Moreover, E/Ea was significantly different between participants with ARS or ATS and those without ARS or ATS (P=0.045), while there was no significant difference between participants with ARS and ATS and those without ARS or ATS (P=0.28). Similar results were obtained in the multivariate logistic regression of left ventricular diastolic dysfunction (LVDD). With similar adjustment, LVDD was significantly associated with ATS (P=0.01) but not with ARS (P=0.99). Conclusion In the community-dwelling elderly Chinese, among hypertensive TOD, LVDD was significantly associated with ATS but not with ARS. The proportion of patients with LVDD was not significantly different despite the presence of both ATS and ARS, when compared to patients with ATS alone.
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Affiliation(s)
- Ximin Fan
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Mengyun Zhu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jing Xiong
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yuyan Lu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Bin Bai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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Chester RC, Gornbein JA, Hundley WG, Srikanthan P, Watson KE, Horwich T. Reflection Magnitude, a Measure of Arterial Stiffness, Predicts Incident Heart Failure in Men But Not Women: Multi-Ethnic Study of Atherosclerosis (MESA). J Card Fail 2017; 23:353-362. [DOI: 10.1016/j.cardfail.2017.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 09/16/2016] [Accepted: 01/13/2017] [Indexed: 12/19/2022]
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Karagodin I, Aba-Omer O, Sparapani R, Strande JL. Aortic stiffening precedes onset of heart failure with preserved ejection fraction in patients with asymptomatic diastolic dysfunction. BMC Cardiovasc Disord 2017; 17:62. [PMID: 28196483 PMCID: PMC5310057 DOI: 10.1186/s12872-017-0490-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/03/2017] [Indexed: 01/14/2023] Open
Abstract
Background Identifying which patients with diastolic dysfunction will progress to heart failure with preserved ejection fraction (HFpEF) remains challenging. The goal of this study is to determine whether increased vascular stiffness as identified on 2D transthoracic echocardiography (TTE) serves as a biomarker for the development of HFpEF in patients with diastolic dysfunction. Methods The study design is a matched retrospective case–control study. Subjects with diastolic dysfunction were divided into two groups based on whether they had a clinical diagnosis of HFpEF. The two groups were matched based on age, gender, race and body surface area, resulting in 77 matched pairs (n = 154). Data from the first TTE that documented diastolic dysfunction prior to the development of HFpEF was extracted along with baseline demographic and clinical data. Indices of vascular stiffness were measured and compared. A sub-group analysis was performed to compare diabetic subjects in Group 1 (n = 43) to those in Group 2 (n = 21). Results Group 1 had significantly decreased aortic distensibility as measured on the initial TTE when compared to Group 2 (1.9 ± 1.0 vs. 2.8 ± 1.8 cm2dyne−110−3, p = 0.01). In the diabetic subset, Group 1 had significantly less aortic strain (6.9 ± 3.3 vs. 9.7 ± 5.6%, p = 0.02) and aortic distensibility (1.8 ± 1.0 vs. 3.5 ± 2.6 cm2dyne−110−3, p = 0.02) compared to Group 2. Other indices of vascular stiffness did not differ significantly between groups. Conclusions This study demonstrates that increased proximal aortic stiffness is associated with the development of HFpEF in patients with asymptomatic diastolic dysfunction. Larger prospective studies are needed to further investigate this relationship.
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Affiliation(s)
- Ilya Karagodin
- Department of Medicine, Medical College of Wisconsin, 9200 Wisconsin Ave, Milwaukee, WI, 53226, USA.
| | - Omer Aba-Omer
- Department of Medicine, Medical College of Wisconsin, 9200 Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Rodney Sparapani
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer L Strande
- Department of Medicine, Medical College of Wisconsin, 9200 Wisconsin Ave, Milwaukee, WI, 53226, USA.,Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Park KT, Kim HL, Oh S, Lim WH, Seo JB, Chung WY, Kim SH, Kim MA, Zo JH. Association between reduced arterial stiffness and preserved diastolic function of the left ventricle in middle-aged and elderly patients. J Clin Hypertens (Greenwich) 2017; 19:620-626. [DOI: 10.1111/jch.12968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/23/2016] [Accepted: 12/03/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kyung-Taek Park
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Hack-Lyoung Kim
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Sohee Oh
- Department of Biostatistics; Boramae Medical Center; Seoul Korea
| | - Woo-Hyun Lim
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Jae-Bin Seo
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Woo-Young Chung
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Sang-Hyun Kim
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Myung-A Kim
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
| | - Joo-Hee Zo
- Department of Internal Medicine; Boramae Medical Center; Seoul National University College of Medicine; Seoul Korea
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Vriz O, Magne J, Driussi C, Brosolo G, Ferrara F, Palatini P, Aboyans V, Bossone E. Comparison of arterial stiffness/compliance in the ascending aorta and common carotid artery in healthy subjects and its impact on left ventricular structure and function. Int J Cardiovasc Imaging 2016; 33:521-531. [PMID: 27885494 DOI: 10.1007/s10554-016-1032-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/21/2016] [Indexed: 12/21/2022]
Abstract
Arterial stiffness and compliance parameters from two adjacent elastic arteries [aorta and common carotid artery (CCA)] were compared and their relationship with left ventricular (LV) structure and function and clinical parameters was assessed. 584 healthy subjects were prospectively enrolled [mean age 47.8 ± 18.4 years, range 16-94; 318 (54.4%) men]. They underwent comprehensive transthoracic echocardiography; M-mode diameters were measured at the level of the ascending aorta in systole and diastole and by echo-tracking at the level of the left CCA. The β-stiffness, pressure-strain elastic modulus, arterial compliance and one-point pulse wave velocity were derived. A significant correlation was observed between aortic and CCA stiffness and compliance parameters (p < 0.0001 for all). At multiple regression analysis, CCA stiffness parameters were constantly correlated with age and systolic blood pressure, and accounted for up to 56% of the variability (vs. only 29% in aortic stiffness and compliance). CCA stiffness parameters were found to better predict LV structure, diastolic function than aortic stiffness parameters. Aortic and CCA stiffness and compliance were found to correlate with each other and with age, with the correlation being higher for CCA stiffness. At multiple regression analysis, CCA stiffness parameters were better predictors of LV structure and function than aortic stiffness.
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Affiliation(s)
- Olga Vriz
- Cardiology and Emergency Department, San Antonio Hospital, Via Trento-Trieste, 33038, Udine, San Daniele Del Friuli, Italy.
| | - Julien Magne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Caterina Driussi
- Cardiology and Emergency Department, San Antonio Hospital, Via Trento-Trieste, 33038, Udine, San Daniele Del Friuli, Italy
| | | | - Francesco Ferrara
- Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital Heart Department, University of Salerno, Salerno, Italy
| | - Paolo Palatini
- Department of Medicine, University of Padova, Padova, Italy
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Eduardo Bossone
- Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital Heart Department, University of Salerno, Salerno, Italy
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Namba T, Masaki N, Matsuo Y, Sato A, Kimura T, Horii S, Yasuda R, Yada H, Kawamura A, Takase B, Adachi T. Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease. Int Heart J 2016; 57:729-735. [PMID: 27829641 DOI: 10.1536/ihj.16-112] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Left ventricular (LV) diastolic dysfunction is considered the main cause of heart failure with preserved ejection fraction (HFpEF). There have been few reports on the correlation between LV diastolic dysfunction and arterial stiffness in patients with clinical cardiovascular disease.This cross-sectional study enrolled 100 patients (67 men, 33 women; mean age, 70 years). All participants were diagnosed with cardiovascular disease. A total of 89 (89%) patients had coronary artery disease or HF. Patients with reduced EF and valvular disease were excluded. Arterial stiffness was assessed by the cardio-ankle vascular index (CAVI), and LV diastolic dysfunction was estimated using echocardiography. The patients were divided into two groups based on the median value of CAVI. In all patients the ratio of early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e') was significantly higher in the high CAVI group than in the low CAVI group (15.5 ± 6.4 versus 12.5 ± 2.9, P = 0.003). In the HF subgroup, E/e' was also significantly higher in the high CAVI group than in the low CAVI group (17.2 ± 5.9 versus 13.0 ± 3.1, P = 0.026). In univariate regression analysis, CAVI was significantly associated with E/e' in all patients (β = 0.28, P = 0.004) and in HF patients (β = 0.4, P = 0.028). Also in multivariate analysis, CAVI remained as an independent predictive factor of E/e' (β = 0.252, P = 0.037).A high CAVI was independently associated with LV diastolic dysfunction in patients with clinical cardiovascular disease. These results suggested that arterial stiffness contributed to the development of LV diastolic dysfunction.
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Affiliation(s)
- Takayuki Namba
- Department of Cardiology, National Defense Medical College
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Harada M, Tabako S. Carotid atherosclerosis is associated with left ventricular diastolic function. J Echocardiogr 2016; 14:120-9. [PMID: 27364492 DOI: 10.1007/s12574-016-0296-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/06/2016] [Accepted: 05/13/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND It has been reported that carotid intima-media thickness (IMT) correlates with the risk of stroke or cardiovascular disease. The purpose of this study was to analyze the relationships between echocardiographic findings and carotid atherosclerosis. METHODS A total of 234 patients (62 ± 15 years) were referred for echocardiography to evaluate the left ventricular (LV) function. The LV ejection fraction, the ratio of the peak velocity of early rapid filling and the peak velocity of atrial filling (E/A), and the peak early diastolic mitral annular velocity (e') were obtained by echocardiography. The maximum IMT (Max-IMT) and plaque score (PS) were measured by carotid ultrasonography within 1 month of the echocardiographic examination. RESULTS The mean values of Max-IMT and carotid PS were 2.41 ± 1.23 mm and 8.5 ± 6.3, respectively. The decreased mean E/A (0.94 ± 0.39) and mitral e' (5.5 ± 1.9 cm/s) indicated LV diastolic dysfunction. A good correlation was observed between Max-IMT and PS (r = 0.83, p < 0.0001). It was shown that 2.8 mm of Max-IMT was equivalent to 10.1 of carotid PS, which indicated severe carotid atherosclerosis. In multiple logistic stepwise regression analysis, among the echocardiographic parameters, only e' was independently associated with severe carotid atherosclerosis (Max-IMT ≥ 2.8 mm or PS ≥ 10.1). CONCLUSIONS The present study demonstrated that decreased early diastolic mitral annular velocity relates to the parameter reflecting carotid atherosclerosis. Therefore, the presence of severe carotid atherosclerosis may affect LV diastolic dysfunction.
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Affiliation(s)
- Masahiko Harada
- Department of Clinical Functional Physiology, Toho University Medical Center Omori Hospital, 6-11-1 Omori-nishi, Oota-ku, Tokyo, 143-8541, Japan.
| | - Satoshi Tabako
- Department of Clinical Functional Physiology, Toho University Medical Center Omori Hospital, 6-11-1 Omori-nishi, Oota-ku, Tokyo, 143-8541, Japan
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Ben-Zvi D, Savion N, Kolodgie F, Simon A, Fisch S, Schäfer K, Bachner-Hinenzon N, Cao X, Gertler A, Solomon G, Kachel E, Raanani E, Lavee J, Kotev Emeth S, Virmani R, Schoen FJ, Schneiderman J. Local Application of Leptin Antagonist Attenuates Angiotensin II-Induced Ascending Aortic Aneurysm and Cardiac Remodeling. J Am Heart Assoc 2016; 5:JAHA.116.003474. [PMID: 27143353 PMCID: PMC4889208 DOI: 10.1161/jaha.116.003474] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Ascending thoracic aortic aneurysm (ATAA) is driven by angiotensin II (AngII) and contributes to the development of left ventricular (LV) remodeling through aortoventricular coupling. We previously showed that locally available leptin augments AngII‐induced abdominal aortic aneurysms in apolipoprotein E–deficient mice. We hypothesized that locally synthesized leptin mediates AngII‐induced ATAA. Methods and Results Following demonstration of leptin synthesis in samples of human ATAA associated with different etiologies, we modeled in situ leptin expression in apolipoprotein E–deficient mice by applying exogenous leptin on the surface of the ascending aorta. This treatment resulted in local aortic stiffening and dilation, LV hypertrophy, and thickening of aortic/mitral valve leaflets. Similar results were obtained in an AngII‐infusion ATAA mouse model. To test the dependence of AngII‐induced aortic and LV remodeling on leptin activity, a leptin antagonist was applied to the ascending aorta in AngII‐infused mice. Locally applied single low‐dose leptin antagonist moderated AngII‐induced ascending aortic dilation and protected mice from ATAA rupture. Furthermore, LV hypertrophy was attenuated and thickening of aortic valve leaflets was moderated. Last, analysis of human aortic valve stenosis leaflets revealed de novo leptin synthesis, whereas exogenous leptin stimulated proliferation and promoted mineralization of human valve interstitial cells in culture. Conclusions AngII‐induced ATAA is mediated by locally synthesized leptin. Aortoventricular hemodynamic coupling drives LV hypertrophy and promotes early aortic valve lesions, possibly mediated by valvular in situ leptin synthesis. Clinical implementation of local leptin antagonist therapy may attenuate AngII‐induced ATAA and moderate related LV hypertrophy and pre–aortic valve stenosis lesions. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00449306.
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Affiliation(s)
- Danny Ben-Zvi
- Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA
| | - Naphtali Savion
- Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Amos Simon
- Cancer Research Laboratory, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sudeshna Fisch
- Cardiovascular Physiology Core, Brigham and Women's Hospital, Boston, MA
| | - Katrin Schäfer
- Medical Clinic 2, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | - Xin Cao
- Cardiovascular Physiology Core, Brigham and Women's Hospital, Boston, MA
| | - Arieh Gertler
- Faculty of Agriculture, Food and Environment, Hebrew University, Rehovot, Israel
| | - Gili Solomon
- Faculty of Agriculture, Food and Environment, Hebrew University, Rehovot, Israel
| | - Erez Kachel
- Department of Cardiac Surgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Raanani
- Department of Cardiac Surgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Lavee
- Department of Cardiac Surgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Kotev Emeth
- Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Frederick J Schoen
- Department of Pathology, Brigham and Women's Hospital, Harvard-MIT Division of Health Sciences and Technology, and Harvard Medical School, Boston, MA
| | - Jacob Schneiderman
- The Gottesdiener Vascular Biology Laboratory, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Vascular Surgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Vascular Surgery Research Laboratory, Department of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Relationship Between Echocardiographically Evaluated Aortic Stiffness and Prolidase Activity in Aortic Tissue of Patients with Critical Coronary Artery Disease. Arch Med Res 2016; 47:200-6. [DOI: 10.1016/j.arcmed.2016.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/28/2016] [Indexed: 11/18/2022]
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Karamanli H, Kiyici A, Arik B, Efe D, Akgedik R. Influence of obstructive sleep apnea on ischemia-modified albumin levels and carotid intima-media thickness. J Investig Med 2016; 64:1035-41. [PMID: 27029471 DOI: 10.1136/jim-2016-000063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 12/22/2022]
Abstract
Obstructive sleep apnea (OSA) is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (CIMT) is strongly associated with the presence of significant risk factors for cardiovascular disturbances. A disturbance in the oxidative/antioxidative balance is involved in the pathogenesis of OSA and cardiovascular diseases. Ischemia-modified albumin (IMA) is suggested as a novel marker of oxidative stress; IMA can be defined as decreased binding of transitional metal ions to serum albumin in oxidative status. The purpose of this research was to evaluate the influence of OSA on IMA levels and CIMT. In total, 61 individuals with OSA with no comorbidities and 24 healthy controls with a similar body mass index and age were enrolled in this study. Serum levels of IMA, CIMT (estimated radiologically), and polysomnographic parameters, were determined and interpreted. Serum IMA levels were significantly higher in individuals with OSA compared with the control group (p=0.0003). CIMT was significantly higher in the OSA group compared with the control group (0.88± 0.26 mm vs 0.75±0.17 mm, p=0.005). The CIMT and serum IMA levels were positively correlated with the apnea-hypopnea index (r=0.35 and r=0.32, respectively), and with the oxygen desaturation index (r=0.34 and r=0.29, respectively) at baseline. Increased IMA levels and CIMT may be related to increased oxidative stress and risk of atherosclerosis in individuals with OSA.
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Affiliation(s)
- Harun Karamanli
- Department of Pulmonology, Ataturk Chest and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Aysel Kiyici
- Department of Biochemistry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Bilal Arik
- Department of Radiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Duran Efe
- Department of Radiology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Recep Akgedik
- Department of Pulmonology, Faculty of Medicine, Ordu University, Ordu, Turkey
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Bassareo PP, Saba L, Marras AR, Mercuro G. Altered Aortic Upper Wall TDI Velocity Is Inversely Related with Left Ventricular Diastolic Function in Operated Tetralogy of Fallot. CONGENIT HEART DIS 2016; 11:598-605. [DOI: 10.1111/chd.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Pier Paolo Bassareo
- Department of Medical Sciences “M.Aresu”; University of Cagliari; Cagliari Italy
| | - Luca Saba
- Department of Radiology; University of Cagliari; Cagliari Italy
| | - Andrea R. Marras
- Department of Medical Sciences “M.Aresu”; University of Cagliari; Cagliari Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences “M.Aresu”; University of Cagliari; Cagliari Italy
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Koseoglu C, Erdogan M, Ertem A, Koseoglu G, Akoglu G, Aktas A, Ozdemir E, Kurmus O, Durmaz T, Keles T, Bozkurt E. Aortic Elastic Properties and Myocardial Performance Index Are Impaired in Patients with Lichen Planus. Med Princ Pract 2016; 25:247-53. [PMID: 26683851 PMCID: PMC5588385 DOI: 10.1159/000443478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 12/17/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the elastic properties of the aorta and the myocardial performance index of the left ventricle (LV) in patients with lichen planus (LP). SUBJECTS AND METHODS A total of 54 patients with LP and 50 controls were enrolled in the study. The 2 groups were well-matched regarding age, gender, body mass index, any smoking history, diabetes mellitus and systolic and diastolic blood pressure (SBP and DBP). The echocardiographic examination was performed on the study subjects and the controls. Aortic elasticity parameters and the myocardial performance index of the LV were calculated. The Student t test, the x03C7;2 test and multiple linear regression were used for the statistical analysis. RESULTS Aortic strain (AS, 4.77 ± 1.81 vs. 8.95 ± 2.22; p < 0.001) and aortic distensibility (AD, 0.25 ± 0.009 vs. 0.42 ± 0.120; p < 0.001) were significantly lower, and aortic stiffness index β (ASIβ, 3.65 ± 1.03 vs. 2.70 ± 0.91; p < 0.001) was significantly higher in the LP group than in the controls. The myocardial performance index (Tei index) was significantly higher in the LP group than in the control group (p = 0.001). The duration of the LP was negatively correlated with AS (r = -0.364, p < 0.001) and AD (r = -0.279, p = 0.006), and positively correlated with the Tei index (r = 0.324, p = 0.001) and ASIβ (r = 0.364, p < 0.001). After adjustment for relevant confounders (age, male gender, smoking, SBP, DBP, diabetes mellitus and low- and high-density lipoprotein cholesterol), LP and its duration were still associated with AS, AD and ASIβ. CONCLUSION In this study, AS and AD were lower and ASIβ and myocardial performance index higher in LP patients than in controls.
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Affiliation(s)
- C. Koseoglu
- Department of Cardiology, Ankara Training and Research Hospital, Departments of, Mersin, Turkey
- *Cemal Koseoglu, MD, Ankara Training and Research Hospital, Sukriye District, Ulucanlar Street, TR-06340 Altýndag, Ankara (Turkey), E-Mail
| | - M. Erdogan
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - A.G. Ertem
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - G. Koseoglu
- Department of Dermatology, Ankara University Faculty of Medicine, Ankara, Mersin, Turkey
| | - G. Akoglu
- Dermatology of Ataturk Training and Research Hospital, Mersin, Turkey
| | - A. Aktas
- Dermatology of Ataturk Training and Research Hospital, Mersin, Turkey
| | - E. Ozdemir
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - O. Kurmus
- Department of Cardiology, Tarsus State Hospital, Mersin, Turkey
| | - T. Durmaz
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - T. Keles
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
| | - E. Bozkurt
- Department of Cardiology, Tarsus State Hospital, Cardiology, Mersin, Turkey
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Kalyva A, Marketou ME, Parthenakis FI, Pontikoglou C, Kontaraki JE, Maragkoudakis S, Petousis S, Chlouverakis G, Papadaki HA, Vardas PE. Endothelial progenitor cells as markers of severity in hypertrophic cardiomyopathy. Eur J Heart Fail 2015; 18:179-84. [PMID: 26696595 DOI: 10.1002/ejhf.436] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/05/2015] [Accepted: 10/06/2015] [Indexed: 01/05/2023] Open
Abstract
AIMS Endothelial progenitor cells (EPCs) are bone marrow-derived cells that are mobilized into the circulation to migrate and differentiate into mature endothelial cells contributing to post-natal physiological and pathological neovascularization. In this study, we evaluated circulating EPCs in patients with hypertrophic cardiomyopathy (HCM) and examined a potential association with clinical parameters of the disease. METHODS AND RESULTS We included 40 HCM patients and 23 healthy individuals. Using flow cytometry we measured EPCs in peripheral blood as two subpopulations of CD45-/CD34+/VEGFR2+ and CD45-/CD34+/CD133+ cells. Circulating CD45-/CD34+/VEGFR2+ cells were significantly increased in HCM patients in comparison with the controls (0.000238 ± 0.0003136 vs. 0.000057 ± 0.0001316, respectively, P = 0.002). However, there was no significant difference in the number of circulating CD45-/CD34+/CD133+ cells (0.003079 ± 0.0033288 vs. 0.002065 ± 0.0022173, respectively, P = 0.153). The CD45-/CD34+/VEGFR2+ subpopulation revealed a moderate correlation with LV mass index (r = 0.35, P = 0.026), while both EPC subpopulation levels showed strong positive correlations with th E/e' ratio (r = 0.423, P = 0.007 for CD45-/CD34+/VEGFR2+ and r = 0.572, P < 0.001 for CD45-/CD34+/CD133+). CONCLUSION HCM patients showed an increased mobilization of EPCs compared with healthy individuals that correlated with diastolic dysfunction. Our findings may open up new dimensions in the pathophysiology, prognostication, and treatment of HCM.
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Affiliation(s)
- Athanasia Kalyva
- Molecular Cardiology Laboratory, School of Medicine, University of Crete, Greece
| | - Maria E Marketou
- Department of Cardiology, Heraklion University Hospital, Crete, Greece
| | | | | | - Joanna E Kontaraki
- Molecular Cardiology Laboratory, School of Medicine, University of Crete, Greece
| | | | | | | | - Helen A Papadaki
- Department of Haematology, Heraklion University Hospital, Crete, Greece
| | - Panos E Vardas
- Department of Cardiology, Heraklion University Hospital, Crete, Greece
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Solovjova S, Ryliškytė L, Čelutkienė J, Badarienė J, Navickas R, Puronaitė R, Bieliauskaitė G, Skiauterytė E, Lisaitė G, Laucevičius A. Aortic stiffness is an independent determinant of left ventricular diastolic dysfunction in metabolic syndrome patients. Blood Press 2015; 25:11-20. [DOI: 10.3109/08037051.2016.1093334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Janwanishstaporn S, Boonyasirinant T. Correlation between aortic stiffness and left atrial volume index in hypertensive patients. Clin Exp Hypertens 2015; 38:160-5. [PMID: 26452403 DOI: 10.3109/10641963.2015.1081211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Both arterial stiffness and left atrial volume index are crucial predictors of cardiovascular outcomes in hypertensive patients. The correlation between these two factors has not been previously well established in hypertensive population. OBJECTIVES To determine the correlation between arterial stiffness and left atrial volume index in hypertensive patients. METHODS AND RESULTS The study was performed in 111 consecutive hypertensive patients (49.5% male, mean age 70.8 ± 10.3 years) undergoing cardiac magnetic resonance imaging (CMR). Arterial stiffness was determined by pulse wave velocity in the thoracic aorta by velocity-encoded imaging. Left atrial volume was assessed by biplane area-length method. Pulse wave velocity was significantly correlated with left atrial volume index in univariate analysis (r = 0.20, p = 0.032). In multivariate analysis, pulse wave velocity, coronary artery disease and left ventricular mass remain independent predictors (β = 1.01, p = 0.02). CONCLUSION Increased arterial stiffness correlates with left atrial enlargement in hypertensive patients. The prevention of left atrial enlargement and subsequent complications by specific antihypertensive drugs with positive effect on aortic stiffness warrants further studies.
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Affiliation(s)
- Satit Janwanishstaporn
- a Division of Cardiology , Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Thananya Boonyasirinant
- a Division of Cardiology , Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
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Kim HL, Seo JB, Chung WY, Kim SH, Kim MA, Zo JH. Independent association between brachial-ankle pulse wave velocity and global longitudinal strain of left ventricle. Int J Cardiovasc Imaging 2015; 31:1563-70. [DOI: 10.1007/s10554-015-0744-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/13/2015] [Indexed: 12/01/2022]
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Sakuragi S, Ichikawa K, Yamada K, Tanimoto M, Miki T, Otsuka H, Yamamoto K, Kawamoto K, Katayama Y, Tanakaya M, Ito H. An increase in the coronary calcification score is associated with an increased risk of heart failure in patients without a history of coronary artery disease. J Cardiol 2015; 67:358-64. [PMID: 26254962 DOI: 10.1016/j.jjcc.2015.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/21/2015] [Accepted: 06/26/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The presence of coronary artery calcification (CAC) and its severity predict future cardiovascular events and is used for risk stratification. However, the association of CAC with heart failure (HF) in patients without a history of coronary artery disease (CAD) remains unclear. This study aimed to determine the correlations of CAC with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and HF events in patients without a history of CAD or HF. METHODS From June 2010 to June 2013, a total of 487 patients without a history of CAD and HF were enrolled. All of the patients underwent plane multi-detector computed tomography. They were divided into four categories according to CAC scores: ≤10, 11-100, 101-400, and ≥401. RESULTS The proportion of patients with high NT-proBNP levels increased with CAC categories (p<0.0001). The CAC score was associated with NT-proBNP levels ≥400pg/ml, with an odds ratio of 2.901 (95% confidence interval: 1.368-6.151, p=0.0055) for CAC scores ≥401 compared with CAC scores of 0-10 after adjustment for confounding factors. During the follow-up period of 497±315 days, nine patients were admitted for HF. Kaplan-Meier analysis showed that patients with CAC scores ≥401 had a lower rate of freedom from admission for HF with cumulative incidences of 0.4%, 1%, 2%, and 8% for CAC scores of 0-10, 11-100, 101-400, and ≥401, respectively (p<0.0001). Increasing CAC scores were associated with an increase in incidence of admission for HF, with a hazard ratio of 10.371 for CAC scores ≥401 (95% CI: 1.062-101.309, p=0.0443) compared with CAC scores of 0-10 after adjustment for risk factors. CONCLUSION Severe CAC is an independent determinant of high NT-proBNP levels and a predictor of admission for HF in a population without a history of CAD or HF.
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Affiliation(s)
- Satoru Sakuragi
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan.
| | - Keishi Ichikawa
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Keiji Yamada
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Masafumi Tanimoto
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Takashi Miki
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Hiroaki Otsuka
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Kazuhiko Yamamoto
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Kenji Kawamoto
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Yusuke Katayama
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Machiko Tanakaya
- Department of Cardiovascular Medicine, Iwakuni Clinical Center, Iwakuni, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medical and Dentistry, Okayama, Japan
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A multicenter, randomized, trial comparing urapidil and nitroglycerin in multifactor heart failure in the elderly. Am J Med Sci 2015; 350:109-15. [PMID: 26164864 DOI: 10.1097/maj.0000000000000522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients. METHODS Seventy-two elderly consecutive patients were randomized into 2 groups that received treatment with urapidil or NG. All patients were monitored for blood pressure (BP) and heart rate and received tests for metabolic activity and cardiovascular function. RESULTS Patients receiving urapidil had significantly lower systolic BP than their counterparts in NG group (P < 0.05). Moreover, patients in urapidil group showed lower N-terminal pro-B-type natriuretic peptide levels but higher ejection fraction (t = 2.206, P < 0.05), cardiac index (t = 3.13, P < 0.05) and left end-diastolic volume (t = -3.104, P < 0.05) compared to NG group. Although both urapidil and NG decreased fasting plasma glucose (FPG) levels, there was no significant difference of FPG levels between these 2 groups. CONCLUSIONS Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.
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Kim HL, Seo JB, Chung WY, Kim SH, Kim MA, Zo JH. Association between invasively measured central aortic pressure and left ventricular diastolic function in patients undergoing coronary angiography. Am J Hypertens 2015; 28:393-400. [PMID: 25125636 DOI: 10.1093/ajh/hpu146] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Because of the invasive nature of catheterization, limited information is available on hemodynamic interaction between the left ventricle and aorta using invasive aortic pressure monitoring. Our aim was to investigate whether parameters of invasively measured central aortic pressure waveform were related with those of left ventricular (LV) diastolic function. METHODS A total of 153 consecutive stable patients (mean age = 64±11 years; 62% men) undergoing invasive coronary angiography (ICA) and transthoracic echocardiography (TTE) were prospectively evaluated. Central aortic pressure waveform was obtained at the ascending aorta using a pigtail catheter before ICA. We calculated pulse pressure (PP), fractional PP (FPP; the ratio of PP to mean pressure), pulsatility index (PI; the ratio of PP to diastolic pressure), augmentation index, wave reflection time, and ejection duration and analyzed their associations with parameters of LV diastolic function in TTE. RESULTS Most patients (n = 135/153; 88.2%) had significant stenosis (≥50%) of ≥1 epicardial coronary arteries. In multiple linear regression analyses, e' and E/e' were significantly correlated with PP, FPP, and PI even after adjustment for potential confounders. There were no significant correlations between other parameters of LV diastolic function, including E/A, deceleration time, and left atrial volume index and parameters of central aortic pressure wave. CONCLUSIONS Invasively measured central aortic PP, FPP, and PI were independently associated with e' and E/e' in patients undergoing ICA. This result adds to the evidence of a close interaction between LV diastolic function and aortic stiffness in this population.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Bin Seo
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo-Young Chung
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo-Hee Zo
- Division of Cardiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Osawa K, Miyoshi T, Oe H, Sato S, Nakamura K, Kohno K, Morita H, Kanazawa S, Ito H. Association between coronary artery calcification and left ventricular diastolic dysfunction in elderly people. Heart Vessels 2015; 31:499-507. [PMID: 25673497 DOI: 10.1007/s00380-015-0645-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/30/2015] [Indexed: 01/08/2023]
Abstract
Coronary artery calcification (CAC) is associated with the incidence of congestive heart failure. We evaluated the association between CAC and left ventricular diastolic dysfunction (LVDD) in elderly patients without coronary artery disease. Coronary computed tomography was performed in 1,021 consecutive patients >55 years of age who were suspected of having coronary artery disease. A total of 530 patients (age, 70 ± 8 years; 56 % men) with a LV ejection fraction >50 % and without obstructive coronary artery disease and a history of coronary artery disease were included in the analysis. LVDD was defined according to a standard algorithm by echocardiography (septal e' <8, lateral e' <10, and left atrial volume index ≥34 mL/m(2)). A total of 224 of 530 patients had LVDD. CAC scores in patients with LVDD were higher than those in patients without LVDD (p < 0.01). The prevalence of LVDD in patients with CAC scores ≥400 was greater than that in patients with CAC scores of 0-9 (58 vs. 34 %, p < 0.01). After adjustment for confounding factors, the CAC score was associated with LVDD, with an odds ratio of 1.96 (95 % confidence interval: 1.11-3.43, p = 0.02) for a CAC score ≥400 compared with a CAC score of 0-9. A CAC score ≥400 was associated with LVDD in elderly patients without CAD in this population. Further prospective studies are needed to evaluate the clinical relevance of CAC as a risk of heart failure with preserved ejection fraction.
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Affiliation(s)
- Kazuhiro Osawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Hiroki Oe
- Center of Ultrasound, Okayama University Hospital, Okayama, Japan
| | - Shuhei Sato
- Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Kunihisa Kohno
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan
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