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Jiang S, Liu Y, Liu J, Xie G, Zhao H, Zhao N, Wang H. The characteristics of arterial risk factors and ankle-brachial index in patients with lower extremity chronic venous diseases: results from the BEST study. INT ANGIOL 2024; 43:240-246. [PMID: 38619206 DOI: 10.23736/s0392-9590.24.05142-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND The aim of our study was to explore the characteristics of the arterial risk factors and ankle-brachial index (ABI) in patients with lower extremity chronic venous disease (LECVD). METHODS A total of 2642 subjects were employed in our study. The lifestyle and clinical data were collected. The history of vascular diseases contained coronary artery disease, stroke, hypertension, and diabetes. ABI low than 0.9 was considered as lower extremity artery disease (LEAD). A series of blood indicators were measured. RESULTS Patients with ABI low than 0.9 belonged to the group of LEAD. Age, smoking, drinking, hypertension, diabetes mellitus, lipid-lowering drug, antidiabetic, total protein, total protein, triglyceride, low-density lipoprotein cholesterol, glycosylated hemoglobin and homocysteine were the common risk factors shared by LEAD and LECVD (P<0.05). The prevalence of LEAD in patients with LECVD was higher than those without LECVD (P<0.05). In Pearson correlation analysis, LECVD was related to LEAD (P<0.05). Before and after adjusted shared factors, as the performance of the logistic regression models, LEAD was an independent risk factor for the prevalence of LECVD (OR=2.937, 95% CI: [1.956, 4.411], P<0.001). CONCLUSIONS Our study demonstrated that an ABI lower than 0.9 is an independent risk factor for LECVD.
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Affiliation(s)
- Shangtong Jiang
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Yue Liu
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
| | - Jinbo Liu
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- Heart and Vascular Health Research Center of Peking University Clinical Research Institute (HVHRC-PUCRI), Beijing, China
| | - Gaoqiang Xie
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- Heart and Vascular Health Research Center of Peking University Clinical Research Institute (HVHRC-PUCRI), Beijing, China
| | - Hongwei Zhao
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- Heart and Vascular Health Research Center of Peking University Clinical Research Institute (HVHRC-PUCRI), Beijing, China
| | - Na Zhao
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- Heart and Vascular Health Research Center of Peking University Clinical Research Institute (HVHRC-PUCRI), Beijing, China
| | - Hongyu Wang
- Vascular Medicine Center, Shougang Hospital, Peking University, Beijing, China -
- Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine, Beijing, China
- Vascular Health Research Center of Peking University Health Science Center (VHRC-PKUHSC), Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
- Heart and Vascular Health Research Center of Peking University Clinical Research Institute (HVHRC-PUCRI), Beijing, China
- Heart and Vascular Health Research Center of Chengdu Medical College (HVHRC-CMC), Chengdu, China
- Intelligent Heart and Vascular Health Digital Management Research Center, Health Big Data National Research Institute, Peking University, Beijing, China
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Pilt K, Reiu A. Effect of transmural pressure on the estimation of arterial stiffness index from the photoplethysmographic waveform. Med Biol Eng Comput 2024; 62:1049-1059. [PMID: 38123887 DOI: 10.1007/s11517-023-02992-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to find the effect of transmural pressure on the determination of the photoplethysmographic (PPG) waveform arterial stiffness index (PPGAI). The study was conducted on 51 subjects without diagnosis of cardiovascular disease, aged between 24 and 74 years. The relation between the transmural pressure, which is the difference between the arterial blood pressure and the PPG sensor contact pressure, and the PPGAI was determined. PPG, beat-to-beat blood pressure, and sensor contact pressure signals were recorded from the index, middle, and ring finger. The PPG sensor contact pressure of the index finger was increased from 20 to 120 mmHg. The aortic augmentation index (AIx@75) was estimated with a SphygmoCor device as a reference. High correlation coefficients r = 0.79 and r = 0.83 between PPGAI and AIx@75, and low PPGAI standard deviations were observed at the transmural pressures of 10 and 20 mmHg, respectively. Transmural pressure of 20 mmHg can be considered suitable for the PPG signal registration and PPGAI calculation for the assessment of arterial stiffness. In summary, the contact pressure of the sensor should be selected according to theblood pressure of the subject finger in order to achieve the transmural pressure suitable for the assessment of PPGAI and arterial stiffness.
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Affiliation(s)
- Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia.
| | - Andy Reiu
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia
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Nogueira JFL, Teixeira-Viana FC, Barboza-Silva BL, Mendes-Pinto D, Rodrigues-Machado MDG. Advanced Levels of Chronic Venous Insufficiency are Related to an Increased in Arterial Stiffness. Ann Vasc Surg 2023; 96:365-373. [PMID: 37003361 DOI: 10.1016/j.avsg.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Chronic venous insufficiency (CVI) is characterized by progressive inflammatory changes. Inflammatory damage occurs in the veins, adjacent tissues, and can lead to structural changes in the arteries. The aim of this study is to analyze whether the degree of CVI is associated with arterial stiffness. METHODS Cross-sectional study including patients with CVI classified by clinical, etiological, anatomical, and pathophysiological classification (CEAP) 1 to 6. We performed correlation between the degree of CVI, central and peripheral arterial pressure, and arterial stiffness measured by brachial artery oscillometry. RESULTS We evaluated 70 patients, 53 of whom were women with a mean age of 54.7 years. Patients with advanced degrees of venous insufficiency CEAP 4,5,6, had higher levels of systolic, diastolic, central, and peripheral arterial pressures compared to those with early stages (CEAP 1,2,3). The CEAP 4,5,6 group had higher arterial stiffness indices than the CEAP 1,2,3 group: pulse wave velocity (PWV) 9.3 m/s vs. 7.0 m/s, P < 0.001; augmentation pressure (AP) 8.0 mm Hg vs. 6.3 mm Hg; P = 0.04. There was a positive correlation between the degree of venous insufficiency measured by the venous clinical severity score, villalta score and CEAP classification, and the arterial stiffness indices (Spearman's coefficient = 0.62 for PWV and CEAP, P < 0.01). The factors influencing PWV were age, peripheral systolic arterial pressure (SAPp), and AP. CONCLUSIONS There is a correlation between the degree of venous disease and arterial structural changes characterized by arterial pressure and stiffness indices. Degenerative changes secondary to venous insufficiency are associated with impairment of the arterial system, which has implications for the development of cardiovascular disease.
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Affiliation(s)
- João Flávio Lima Nogueira
- Post-Graduate Program in Health Sciences, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; University Hospital of the Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flávia Costa Teixeira-Viana
- Post-Graduate Program in Health Sciences, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna Lorena Barboza-Silva
- Post-Graduate Program in Health Sciences, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Mendes-Pinto
- Department of Vascular Surgery, Hospital Felicio Rocho, Belo Horizonte, Minas Gerais, Brazil
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Pulse Wave Velocity for Risk Stratification of Patients with Aortic Aneurysm. J Clin Med 2022; 11:jcm11144026. [PMID: 35887789 PMCID: PMC9316234 DOI: 10.3390/jcm11144026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Patients with an aortic aneurysm are at high cardiovascular risk. Pulse wave velocity (PWV) is used as a parameter for risk stratification but may be affected by aortic disease (AoD). This study aimed to investigate the dependence of PWV on treated or untreated AoD and to identify modifiable factors of PWV. Methods: The measurement of PWV with the Mobil-O-Graph was performed fully automatically in a collective of 381 patients (75.6% male and 24.4% female). Of all patients, 53.8% had nonaortic atherosclerotic vascular disease (AVD), 28.9% had treated AoD, and 17.3% had untreated AoD. Results: There was a statistically significant effect of age (R2 = 0.838) and current systolic blood pressure (SBP) on PWV (page corrected < 0.05). After correction for age, no statistically significant difference was found between the PWV of men and women, patients with different body weights or degrees of chronic kidney disease, diabetics and nondiabetics, and smokers and nonsmokers. Comparison between patients with nonaortic AVD and treated or untreated AoD revealed no statistically significant differences (PWVnonaortic AVD 10.0 ± 1.8 m/s, PWVtreated AoD 10.0 ± 1.5 m/s, PWVuntreated AoD 9.8 ± 1.6 m/s; page corrected > 0.05). Conclusions: PWV determined with the Mobil-O-Graph correlated with age and current SBP. Neither aortic disease versus nonaortic AVD, its treatment, nor other cardiovascular risk factors had a significant effect on PWV. Successful blood pressure control is crucial to avoid high PWV and thus an increase in cardiovascular events.
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Silva APP, Pinto DM, Milagres VAMV, Bez LG, Maciel JCA, Lopes CDS. Results of venous reflux treatment with 1,470 nm endolaser and correlation with degree of venous insufficiency. J Vasc Bras 2021; 20:e20200172. [PMID: 34093690 PMCID: PMC8147881 DOI: 10.1590/1677-5449.200172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Patients with advanced chronic venous disease are more likely to need additional procedures for relapsed varicose veins. It has not yet been established whether severity of venous insufficiency is a factor that influences the occlusion rate of saphenous veins treated with endolasers. Objectives To analyze occlusion rate of venous segments treated with endolaser and correlate it with patients’ Venous Clinical Severity Score (VCSS) and Clinical-Etiological-Anatomical-Pathological (CEAP) classification. Methods Retrospective analysis of a cohort of patients operated using a 1,470 nm endolaser from November 2012 to March 2020. Descriptive statistics were calculated and Kaplan-Meier survival curves were plotted with Cox regression for groups stratified by VCSS and CEAP. Results A total of 180 venous segments were analyzed in 170 patients. Mean age was 44.3 ± 9.2 and the majority of patients were female (71%). Mean energy density used in the great saphenous vein was 49.2 ± 8.3 J/cm. The most common complications were pain along the course of the saphenous vein (12.2%) and paresthesias at 6 months (17.2%). There was no difference in venous occlusion rate between groups with VCSS ≤ 7 and VCSS > 7 (p = 0.067). A group of patients classified as CEAP classes C4, C5, or C6 had a lower occlusion rate than a group at classes C2 or C3 (hazard ratio [HR] = 3.22; confidence interval [CI] 1.85, 5.61; p = 0.001]. Conclusions The occlusion rates of venous segments treated with endolaser were lower in patients with higher CEAP classes. It is probably necessary to use more energy in these patients to achieve effective treatment of saphenous veins.
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Affiliation(s)
- Ana Paula Pires Silva
- Hospital Felício Rocho, equipe de Angiologia e Cirurgia Vascular, Belo Horizonte, MG, Brasil
| | - Daniel Mendes Pinto
- Hospital Felício Rocho, equipe de Angiologia e Cirurgia Vascular, Belo Horizonte, MG, Brasil.,Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Leonardo Ghizoni Bez
- Hospital Felício Rocho, equipe de Angiologia e Cirurgia Vascular, Belo Horizonte, MG, Brasil
| | | | - Caetano de Souza Lopes
- Hospital Felício Rocho, equipe de Angiologia e Cirurgia Vascular, Belo Horizonte, MG, Brasil
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