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Scicali R, Bosco G, Scamporrino A, Di Mauro S, Filippello A, Di Giacomo Barbagallo F, Spampinato S, Pavanello C, Ossoli A, Di Pino A, Calabresi L, Purrello F, Piro S. Evaluation of high-density lipoprotein-bound long non-coding RNAs in subjects with familial hypercholesterolaemia. Eur J Clin Invest 2024; 54:e14083. [PMID: 37571980 DOI: 10.1111/eci.14083] [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: 02/24/2023] [Revised: 06/27/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Long non-coding RNAs (lncRNAs) could be attractive circulating biomarkers for cardiovascular risk stratification in subjects at high atherosclerotic cardiovascular disease risk such as familial hypercholesterolaemia (FH). Our aim was to investigate the presence of lncRNAs carried by high-density lipoprotein (HDL) in FH subjects and to evaluate the associations of HDL-lncRNAs with lipoproteins and mechanical vascular impairment assessed by pulse wave velocity (PWV). METHODS This was a retrospective observational study involving 94 FH subjects on statin treatment. Biochemical assays, HDL purification, lncRNA and PWV analyses were performed in all subjects. RESULTS LncRNA HIF1A-AS2, LASER and LEXIS were transported by HDL; moreover, HDL-lncRNA LEXIS was associated with Lp(a) plasma levels (p < .01). In a secondary analysis, the study population was stratified into two groups based on the Lp(a) median value. The high-Lp(a) group exhibited a significant increase of PWV compared to the low-Lp(a) group (9.23 ± .61 vs. 7.67 ± .56, p < .01). While HDL-lncRNA HIF1A-AS2 and LASER were similar in the two groups, the high-Lp(a) group exhibited a significant downregulation of HDL-lncRNA LEXIS compared to the low-Lp(a) group (fold change -4.4, p < .0001). Finally, Lp(a) and HDL-lncRNA LEXIS were associated with PWV (for Lp(a) p < .01; for HDL-lncRNA LEXIS p < .05). CONCLUSIONS LncRNA HIF1A-AS2, LASER and LEXIS were transported by HDL; moreover, significant relationships of HDL-lncRNA LEXIS with Lp(a) levels and PWV were found. Our study suggests that HDL-lncRNA LEXIS may be useful to better identify FH subjects with more pronounced vascular damage.
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Affiliation(s)
- Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giosiana Bosco
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Stefania Di Mauro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Salvatore Spampinato
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Chiara Pavanello
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Alice Ossoli
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura Calabresi
- Centro E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Hoffman RM, Chibwana F, Banda BA, Kahn D, Gama K, Boas ZP, Chimombo M, Kussen C, Currier JS, Namarika D, van Oosterhout J, Phiri S, Moses A, Currier JW, Sigauke H, Moucheraud C, Canan T. High rate of left ventricular hypertrophy on screening echocardiography among adults living with HIV in Malawi. Open Heart 2022; 9:openhrt-2022-002026. [PMID: 35649574 PMCID: PMC9161066 DOI: 10.1136/openhrt-2022-002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/12/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There are limited data on structural heart disease among people living with HIV in southern Africa, where the success of antiretroviral therapy (ART) has drastically improved life expectancy and where risk factors for cardiovascular disease are prevalent. METHODS We performed a cross-sectional study of screening echocardiography among adults (≥18 years) with HIV in Malawi presenting for routine ART care. We used univariable and multivariable logistic regression to evaluate correlates of abnormal echocardiogram. RESULTS A total of 202 individuals were enrolled with a median age of 45 years (IQR 39-52); 52% were female, and 27.7% were on antihypertensive medication. The most common clinically significant abnormality was left ventricular hypertrophy (LVH) (12.9%, n=26), and other serious structural heart lesions were rare (<2% with ejection fraction less than 40%, moderate-severe valve lesions or moderate-severe pericardial effusion). Characteristics associated with abnormal echocardiogram included older age (OR 1.04, 95% CI 1.01 to 1.08), higher body mass index (OR 1.09, 95% CI 1.02 to 1.17), higher mean systolic blood pressure (OR 1.03, 95% CI 1.02 to 1.05) and higher mean diastolic blood pressure (OR 1.03, 95% CI 1.01 to 1.05). In a multivariable model including age, duration on ART, body mass index, and systolic and diastolic blood pressure, only mean body mass index (adjusted OR 1.10, 95% CI 1.02 to 1.19), systolic blood pressure (aOR 1.05, 95% CI 1.03 to 1.08) and diastolic blood pressure (aOR 0.96, 95% CI 0.92 to 1.00) remained associated with abnormal echocardiogram. CONCLUSIONS LVH was common in this population of adults on ART presenting for routine care and was associated with elevated blood pressure. Further research is needed to characterise the relationship between chronic hypertension, LVH and downstream consequences, such as diastolic dysfunction and heart failure in people living with HIV.
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Affiliation(s)
- Risa M Hoffman
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | | | - Daniel Kahn
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | | | - Zachary P Boas
- Department of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA
| | | | | | - Judith S Currier
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | - Joep van Oosterhout
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, California, USA.,Partners in Hope, Lilongwe, Malawi
| | | | | | - Jesse W Currier
- VA West Los Angeles Medical Center, Los Angeles, California, USA
| | | | - Corrina Moucheraud
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Tim Canan
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
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Evaluation of Intima-Media Thickness and Arterial Stiffness as Early Ultrasound Biomarkers of Carotid Artery Atherosclerosis. Cardiol Ther 2022; 11:231-247. [PMID: 35362868 PMCID: PMC9135926 DOI: 10.1007/s40119-022-00261-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 02/07/2023] Open
Abstract
Carotid atherosclerosis is a major and potentially preventable cause of ischemic stroke. It begins early in life and progresses silently over the years. Identification of individuals with subclinical atherosclerosis is needed to initiate early aggressive vascular prevention. Although carotid plaque appears to be a powerful predictor of cardiovascular risk, carotid intima-media thickness (CIMT) and arterial stiffness can be detected at the initial phases and, therefore, they are considered important new biomarkers of carotid atherosclerosis. There is a well-documented association between CIMT and cerebrovascular events. CIMT provides a reliable marker in young people, in whom plaque formation or calcification is not established. However, the usefulness of CIMT measurement in the improvement of risk cardiovascular models is still controversial. Carotid stiffness is also significantly associated with ischemic stroke. Carotid stiffness adds value to the existing risk prediction based on Framingham risk factors, particularly individuals at intermediate cardiovascular risk. Carotid ultrasound is used to assess carotid atherosclerosis. During the last decade, automated techniques for sophisticated analysis of vascular mechanics have evolved, such as speckle tracking, and new methods based on deep learning have been proposed with promising outcomes. Additional research is needed to investigate the imaging-based cardiovascular risk prediction of CIMT and stiffness.
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Solmaz H, Cabuk AK, Altin Z, Albudak Ozcan E, Ozdogan O. Left ventricular systolic dyssynchrony index and endothelial dysfunction parameters as subclinical predictors of cardiovascular involvement in patients with beta-thalassemia major. Echocardiography 2021; 38:825-833. [PMID: 33945174 DOI: 10.1111/echo.15067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/05/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Cardiovascular iron load is the leading cause of morbidity and mortality in beta-thalassemia major (β-TM). However, many patients remain asymptomatic until the late stage. In this cross-sectional study, we investigated the role of three-dimensional (3D) echocardiography and endothelial dysfunction parameters in asymptomatic β-TM patients, and the relationship between these parameters and cardiac magnetic resonance imaging (MRI) T2* value. METHODS A total of 51 asymptomatic β-TM patients receiving regular blood transfusions were divided into two groups based on cardiac MRI-T2* values (MRI-T2*<20 ms and ≥20 ms), which MRI-T2*<20 ms determines myocardial iron load and evaluated by two-dimensional (2D) and 3D-echocardiography including endothelial dysfunction parameters. The relationships between ferritin levels, 2D and 3D-echocardiography measurements, endothelial dysfunction parameters, and cardiac MRI-T2* values were investigated. RESULTS All left ventricle ejection fraction (LVEF) obtained by 2D-echocardiography were normal (≥50%). LVEF-3D (53.25 ± 2.33 vs. 58.81 + 1.02), SDI12 (6.53 ± 0.56 vs. 2.85 + 0.48), and SDI16 (7.65 ± 0.75 vs. 3.26 + 0.49) were significantly different and negatively correlated between groups with MRI-T2*<20 ms and ≥20 ms, respectively. Flow-mediated dilatation (FMD) (6.08% ± 0.34% vs. 14.46% ± 1.12), aortic strain (7.79% ± 2.19% vs. 12.76% ± 4.19), ferritin levels were significantly different and negatively correlated between groups with MRI-T2*<20 ms and ≥20 ms, respectively. Higher ferritin, SDI12/16 were significant independent predictors of MR-T2* < 20 ms. SDI16 > 5.5, SDI12 > 4.3 predicted MRI-T2*<20ms with a sensitivity of 92%, specificity of 81% (AUC 0.85, P < .001), and sensitivity of 92%, specificity of 78% (AUC 0.83, P < .001), respectively. CONCLUSION SDI12/16 calculated by 3D-echocardiography may be a promising predictors of cardiovascular iron load and, decreased LVEF-3D, FMD, and aortic strain might be good indicators of subclinical cardiovascular involvement of β-TM.
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Affiliation(s)
- Hatice Solmaz
- Department of Cardiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Kemal Cabuk
- Department of Cardiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Zeynep Altin
- Department of Internal Medicine, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Esin Albudak Ozcan
- Department of Pediatrics, Division of Pediatric Hematology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Oner Ozdogan
- Department of Cardiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
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Jaspers Faijer-Westerink H, Stavnsbo M, Hutten BA, Chinapaw M, Vrijkotte TGM. Ideal cardiovascular health at age 5-6 years and cardiometabolic outcomes in preadolescence. Int J Behav Nutr Phys Act 2021; 18:33. [PMID: 33676545 PMCID: PMC7936465 DOI: 10.1186/s12966-021-01090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12. METHODS A total of 1666 children aged 5-6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring 'healthy' on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. RESULTS At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only. CONCLUSION Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.
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Affiliation(s)
- Hester Jaspers Faijer-Westerink
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands
| | - Mette Stavnsbo
- Department of Sports Science and Physical Education, University of Agder, PO BOX 422, 4604, Kristiansand, Norway
| | - Barbara A Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J1B-209-1, 1100 DE, Amsterdam, The Netherlands
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, PO Box 7057, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands.
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Gómez-Mendoza DP, Lara-Ribeiro AC, Verano-Braga T. Pathological cardiac remodeling seen by the eyes of proteomics. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2021; 1869:140622. [PMID: 33607275 DOI: 10.1016/j.bbapap.2021.140622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 12/26/2022]
Abstract
Cardiac remodeling involves cellular and structural changes that occur as consequence of multifactorial events to maintain the homeostasis. The progression of pathological cardiac remodeling involves a transition from adaptive to maladaptive changes that eventually leads to impairment of ventricular function and heart failure. In this scenario, proteins are key elements that orchestrate molecular events as increased expression of fetal genes, neurohormonal and second messengers' activation, contractile dysfunction, rearrangement of the extracellular matrix and alterations in heart geometry. Mass spectrometry based-proteomics has emerged as a sound method to study protein dysregulation and identification of cardiac diseases biomarkers in plasma. In this review, we summarize the main findings related to large-scale proteome modulation of cardiac cells and extracellular matrix occurred during pathological cardiac remodeling. We describe the recent proteomic progresses in the selection of protein targets and introduce the renin-angiotensin system as an interesting target for the treatment of pathological cardiac remodeling.
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Affiliation(s)
- Diana Paola Gómez-Mendoza
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte 31270-901, Brazil
| | - Ana Carolina Lara-Ribeiro
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte 31270-901, Brazil
| | - Thiago Verano-Braga
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte 31270-901, Brazil.
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Napoli R, Ruvolo A, Triggianese P, Prevete N, Schiattarella GG, Nigro C, Miele C, Magliulo F, Grassi S, Pecoraro A, Cittadini A, Esposito G, de Paulis A, Spadaro G. Immunoglobulins G modulate endothelial function and affect insulin sensitivity in humans. Nutr Metab Cardiovasc Dis 2020; 30:2085-2092. [PMID: 32807637 DOI: 10.1016/j.numecd.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/12/2020] [Accepted: 07/01/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Data from animals suggest that immunoglobulins G (IgG) play a mechanistic role in atherosclerosis and diabetes through endothelial dysfunction and insulin resistance. Patients with common variable immunodeficiency (CVID), who have low circulating levels of IgG and are treated with intravenous polyclonal IgG (IVIgG), may provide an ideal model to clarify whether circulating IgG modulate endothelial function and affect insulin sensitivity in humans. METHODS AND RESULTS We studied 24 patients with CVID and 17 matched healthy controls (HC). Endothelial function was evaluated as flow mediated dilation (FMD) of the brachial artery at baseline and 1, 7, 14, and 21 days after IVIgG infusion in the CVID patients. We measured also plasma glucose, insulin, and calculated the HOMA-IR index. We also investigated the role of human IgG on the production of Nitric Oxide (NO) in vitro in Human Coronary Artery Endothelial Cells (HCAEC). Compared to HC, FMD of CVID patients was significantly impaired at baseline (9.4 ± 0.9 and 7.6 ± 0.6% respectively, p < 0.05) but rose above normal levels 1 and 7 days after IVIgG infusion to return at baseline at 14 and 21 days. Serum insulin concentration and HOMA-IR index dropped by 50% in CVID patients after IVIgG (p < 0.002 vs. baseline). In vitro IgG stimulated NO production in HCAEC. CONCLUSIONS Reduced IgG levels are associated with endothelial dysfunction and IVIgG stimulates endothelial function directly while improving insulin sensitivity. The current findings may suggest an anti-atherogenic role of human IgG.
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Affiliation(s)
- Raffaele Napoli
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy.
| | - Antonio Ruvolo
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Paola Triggianese
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Nella Prevete
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Gabriele G Schiattarella
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Cecilia Nigro
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Claudia Miele
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Fabio Magliulo
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Simona Grassi
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Pecoraro
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Amato de Paulis
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
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Jamthikar A, Gupta D, Saba L, Khanna NN, Araki T, Viskovic K, Mavrogeni S, Laird JR, Pareek G, Miner M, Sfikakis PP, Protogerou A, Viswanathan V, Sharma A, Nicolaides A, Kitas GD, Suri JS. Cardiovascular/stroke risk predictive calculators: a comparison between statistical and machine learning models. Cardiovasc Diagn Ther 2020; 10:919-938. [PMID: 32968651 DOI: 10.21037/cdt.2020.01.07] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Statistically derived cardiovascular risk calculators (CVRC) that use conventional risk factors, generally underestimate or overestimate the risk of cardiovascular disease (CVD) or stroke events primarily due to lack of integration of plaque burden. This study investigates the role of machine learning (ML)-based CVD/stroke risk calculators (CVRCML) and compares against statistically derived CVRC (CVRCStat) based on (I) conventional factors or (II) combined conventional with plaque burden (integrated factors). Methods The proposed study is divided into 3 parts: (I) statistical calculator: initially, the 10-year CVD/stroke risk was computed using 13 types of CVRCStat (without and with plaque burden) and binary risk stratification of the patients was performed using the predefined thresholds and risk classes; (II) ML calculator: using the same risk factors (without and with plaque burden), as adopted in 13 different CVRCStat, the patients were again risk-stratified using CVRCML based on support vector machine (SVM) and finally; (III) both types of calculators were evaluated using AUC based on ROC analysis, which was computed using combination of predicted class and endpoint equivalent to CVD/stroke events. Results An Institutional Review Board approved 202 patients (156 males and 46 females) of Japanese ethnicity were recruited for this study with a mean age of 69±11 years. The AUC for 13 different types of CVRCStat calculators were: AECRS2.0 (AUC 0.83, P<0.001), QRISK3 (AUC 0.72, P<0.001), WHO (AUC 0.70, P<0.001), ASCVD (AUC 0.67, P<0.001), FRScardio (AUC 0.67, P<0.01), FRSstroke (AUC 0.64, P<0.001), MSRC (AUC 0.63, P=0.03), UKPDS56 (AUC 0.63, P<0.001), NIPPON (AUC 0.63, P<0.001), PROCAM (AUC 0.59, P<0.001), RRS (AUC 0.57, P<0.001), UKPDS60 (AUC 0.53, P<0.001), and SCORE (AUC 0.45, P<0.001), while the AUC for the CVRCML with integrated risk factors (AUC 0.88, P<0.001), a 42% increase in performance. The overall risk-stratification accuracy for the CVRCML with integrated risk factors was 92.52% which was higher compared all the other CVRCStat. Conclusions ML-based CVD/stroke risk calculator provided a higher predictive ability of 10-year CVD/stroke compared to the 13 different types of statistically derived risk calculators including integrated model AECRS 2.0.
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Affiliation(s)
- Ankush Jamthikar
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Deep Gupta
- Department of Electronics and Communication Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University, Tokyo, Japan
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, Rhode Island, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, Rhode Island, USA
| | - Petros P Sfikakis
- Rheumatology Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Protogerou
- Department of Cardiovascular Prevention & Research Unit Clinic & Laboratory of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, India
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and University of Nicosia Medical School, Nicosia, Cyprus
| | - George D Kitas
- R & D Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
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Wagner S, Lioret S, Girerd N, Duarte K, Lamiral Z, Bozec E, Van den Berghe L, Hoge A, Donneau AF, Boivin JM, Mercklé L, Zannad F, Laville M, Rossignol P, Nazare JA. Association of Dietary Patterns Derived Using Reduced-Rank Regression With Subclinical Cardiovascular Damage According to Generation and Sex in the STANISLAS Cohort. J Am Heart Assoc 2020; 9:e013836. [PMID: 32200718 PMCID: PMC7428593 DOI: 10.1161/jaha.119.013836] [Citation(s) in RCA: 9] [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: 12/20/2022]
Abstract
Background The diet impact on cardiovascular diseases has been investigated widely, but the association between dietary patterns (DPs) and subclinical cardiovascular damage remains unclear. More informative DPs could be provided by considering metabolic syndrome components as intermediate markers. This study aimed to identify DPs according to generation and sex using reduced‐rank regression (RRR) with metabolic syndrome components as intermediate markers and assess their associations with intima‐media thickness, left ventricular mass, and carotid‐femoral pulse‐wave velocity in an initially healthy population‐based family study. Methods and Results This study included 1527 participants from the STANISLAS (Suivi Temporaire Annuel Non‐Invasif de la Santé des Lorrains Assurés Sociaux) cohort fourth examination. DPs were derived using reduced‐rank regression according to generation (G1: age ≥50 years; G2: age <50 years) and sex. Associations between DPs and cardiovascular damage were analyzed using multivariable linear regression models. Although identified DPs were correlated between generations and sex, qualitative differences were observed: whereas only unhealthy DPs were found for both men generations, healthy DPs were identified in G2 (“fruity desserts”) and G1 (“fiber and w3 oil”) women. The “alcohol,” “fast food and alcohol,” “fried, processed, and dairy products,” and “meat, starch, sodas, and fat” DPs in G1 and G2 men and in G1 and G2 women, respectively, were associated with high left ventricular mass (β [95% CI], 0.23 [0.10–0.36], 0.76 [0.00–1.52], 1.71 [0.16–3.26], and 1.80 [0.45–3.14]). The “alcohol” DP in G1 men was positively associated with carotid‐femoral pulse‐wave velocity (0.22 [0.09–0.34]). Conclusions The DPs that explain the maximum variation in metabolic syndrome components had different associations with subclinical cardiovascular damage across generation and sex. Our results indicate that dietary recommendations should be tailored according to age and sex. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01391442.
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Affiliation(s)
- Sandra Wagner
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Sandrine Lioret
- Paris University Paris France.,UMR1153 Center for Research in Epidemiology and StatisticS (CRESS) Research Team on Early Life Origins of Health Inserm Paris France
| | - Nicolas Girerd
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Kevin Duarte
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Zohra Lamiral
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Erwan Bozec
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Laurie Van den Berghe
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Axelle Hoge
- Département des Sciences de la Santé Publique Université de Liège Belgium
| | | | - Jean-Marc Boivin
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Ludovic Mercklé
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Faiez Zannad
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Martine Laville
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Patrick Rossignol
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Julie-Anne Nazare
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
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10
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Niu P, Li L, Yin Z, Du J, Tan W, Huo Y. Speckle tracking echocardiography could detect the difference of pressure overload-induced myocardial remodelling between young and adult rats. J R Soc Interface 2020; 17:20190808. [PMID: 32093537 DOI: 10.1098/rsif.2019.0808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The assessment by speckle tracking echocardiography (STE) provides useful information on regional and global left ventricular (LV) functions. The aim of the study is to investigate if STE-based strain analysis could detect the difference of pressure overload-induced myocardial remodelling between young and adult rats. Physiological, haemodynamic, histological measurements were performed post-operatively in young and adult rats with transverse aortic constriction (TAC) as well as the age-matched shams. Two-way ANOVA was used to detect the statistical difference of various measured parameters. Pressure overload decreased the ejection fraction, fractional shortening, dp/dtmax and |dp/dtmin|, but increased the LV end-diastolic (ED) pressure in adult rat hearts for nine weeks after TAC operation than those in young rat hearts. Pressure overload also resulted in different changes of peak strain and strain rate in the free wall, but similar changes in the interventricular septum of young and adult rat hearts. The changes in myocardial remodelling were confirmed by the histological analysis including the increased apoptosis rate of myocytes and collagen area ratio in the free wall of adult rat hearts of LV hypertrophy when compared with the young. Pressure overload alters myocardial components in different degrees between young and adult animals. STE-based strain analysis could detect the subtle difference of pressure overload-induced myocardial remodelling between young and adult rats.
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Affiliation(s)
- Pei Niu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, People's Republic of China
| | - Li Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, People's Republic of China
| | - Zhongjie Yin
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, People's Republic of China
| | - Jie Du
- Beijing Anzhen Hospital Capital Medical University, Beijing, People's Republic of China
| | - Wenchang Tan
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, People's Republic of China.,PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, People's Republic of China.,Shenzhen Graduate School, Peking University, Shenzhen, Guangdong, People's Republic of China
| | - Yunlong Huo
- PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, People's Republic of China.,Institute of Mechanobiology and Medical Engineering, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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11
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GÖKASLAN S, ÖZER GÖKASLAN Ç, DEMİREL E, ÇELİK S. Role of aortic stiffness and inflammation in the etiology of young-onset hypertension. Turk J Med Sci 2019; 49:1748-1753. [PMID: 31655529 PMCID: PMC7518685 DOI: 10.3906/sag-1908-137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022] Open
Abstract
Background/aim Young-onset hypertension is a form of condition diagnosed in patients aged below 40. Cytokines such as interleukin (IL)-6 and also MCP-1 may play a role in the development of arterial hypertension. Aortic stiffness can be detected by measuring pulse wave velocity (PWV). We aimed to explore the relationship between inflammation and aortic stiffness and investigate their roles in the etiology of young-onset hypertension. Materials and methods We enrolled 16 patients diagnosed with young-onset hypertension and 16 volunteers without hypertension. The plasma levels of MCP-1 and IL-6 were determined using an enzyme-linked immunosorbent assay and quantitative enzyme-linked immunoassay, respectively. Carotid-femoral PWV was measured using an arteriograph device. Results Compared with those in normotensive controls, the plasma levels of IL-6 and MCP-1 and the PWV values were significantly higher in patients with young-onset hypertension (P < 0.001). PWV values were also positively correlated with the levels of MCP-1 and IL-6. However, no statistically significant difference was noted in intima-media thickness between the two groups (P = 0.224). Conclusion In this study, increased PWVs and the levels of inflammation markers were associated with aortic stiffness and inflammation in patients with young-onset hypertension, suggesting they have a role in the etiology of hypertension.
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Affiliation(s)
- Serkan GÖKASLAN
- Department of Cardiology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, AfyonkarahisarTurkey
| | - Çiğdem ÖZER GÖKASLAN
- Department of Radiology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, AfyonkarahisarTurkey
| | - Emin DEMİREL
- Department of Radiology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, AfyonkarahisarTurkey
| | - Sefa ÇELİK
- Department of Biochemistry, Faculty of Medicine, Afyonkarahisar University of Health Sciences, AfyonkarahisarTurkey
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12
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13
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Dattagupta A, Immaneni S. ST2: Current status. Indian Heart J 2018; 70 Suppl 1:S96-S101. [PMID: 30122246 PMCID: PMC6097168 DOI: 10.1016/j.ihj.2018.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 01/05/2018] [Accepted: 03/01/2018] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular diseases are leading cause of mortality and morbidity, and are responsible for 1 out of every 6 deaths in the United States.1 Cardiac remodeling is an important determinant of long term outcomes and occurrence of heart failure (HF). Many times one requires additional tools like biomarkers to identify high risk individuals, to diagnose disease conditions accurately and to effectively prognosticate the patients. ST2 is a member of the interleukin 1 receptor family and exists in two forms, a trans-membrane receptor (ST2L) as well as a soluble decoy receptor (sST2).2 The ligand of ST2 is Interleukin-33 (IL-33), which is involved in reducing fibrosis and hypertrophy in mechanically strained tissues.3
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Affiliation(s)
- Aditi Dattagupta
- Department of Cardiology, Sakra World Hospital, Bangalore, India; Cardiology, Apollo Main Hospital, Chennai, India.
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NADPH Oxidase Deficiency: A Multisystem Approach. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:4590127. [PMID: 29430280 PMCID: PMC5753020 DOI: 10.1155/2017/4590127] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/11/2017] [Accepted: 11/02/2017] [Indexed: 02/07/2023]
Abstract
The immune system is a complex system able to recognize a wide variety of host agents, through different biological processes. For example, controlled changes in the redox state are able to start different pathways in immune cells and are involved in the killing of microbes. The generation and release of ROS in the form of an “oxidative burst” represent the pivotal mechanism by which phagocytic cells are able to destroy pathogens. On the other hand, impaired oxidative balance is also implicated in the pathogenesis of inflammatory complications, which may affect the function of many body systems. NADPH oxidase (NOX) plays a pivotal role in the production of ROS, and the defect of its different subunits leads to the development of chronic granulomatous disease (CGD). The defect of the different NOX subunits in CGD affects different organs. In this context, this review will be focused on the description of the effect of NOX2 deficiency in different body systems. Moreover, we will also focus our attention on the novel insight in the pathogenesis of immunodeficiency and inflammation-related manifestations and on the protective role of NOX2 deficiency against the development of atherosclerosis.
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15
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Relationship between changes in blood pressure and left ventricular mass over 1 year in end-stage renal disease. J Hypertens 2017; 35:1709-1716. [DOI: 10.1097/hjh.0000000000001353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Anyfanti P, Triantafyllou A, Gkaliagkousi E, Triantafyllou G, Koletsos N, Chatzimichailidou S, Panagopoulos P, Botis I, Aslanidis S, Douma S. Subendocardial viability ratio in patients with rheumatoid arthritis: comparison with healthy controls and identification of prognostic factors. Clin Rheumatol 2017; 36:1229-1236. [PMID: 28455826 DOI: 10.1007/s10067-017-3659-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/16/2017] [Accepted: 04/21/2017] [Indexed: 12/16/2022]
Abstract
Cardiac involvement is common in rheumatoid arthritis. Subendocardial viability ratio (SEVR) is a non-invasive measure of microvascular coronary perfusion, yet it remains unclear whether it is affected in rheumatoid arthritis patients. We additionally sought predictors of SEVR in rheumatoid arthritis among a wide range of disease-related parameters, cardiac and hemodynamic factors, and markers of atherosclerosis, arteriosclerosis, and endothelial dysfunction. SEVR was estimated in rheumatoid arthritis patients and healthy controls by applanation tonometry, which was also used to evaluate arterial stiffness (pulse wave velocity and augmentation index). In the rheumatoid arthritis group, carotid intima-media thickness (cIMT) was additionally estimated by ultrasound, cardiac and hemodynamic parameters by impedance cardiography, and endothelial dysfunction by measurement of asymmetric dimethylarginine (ADMA). In a total of 122 participants, SEVR was lower among 91 patients with rheumatoid arthritis compared to 31 controls (141.4 ± 21.9 vs 153.1 ± 18.7%, p = 0.009) and remained so among 29 rheumatoid arthritis patients without hypertension, diabetes, or cardiovascular diseases, compared to the control group (139.7 ± 21.7 vs 153.1 ± 18.7%, p = 0.013). SEVR did not significantly correlate with arterial stiffness, cIMT, ADMA, or disease-related parameters. Multivariate analysis revealed gender (p = 0.007), blood pressure (p = 0.028), heart rate (p = 0.025), cholesterol levels (p = 0.008), cardiac index (p < 0.001) and left ventricular ejection time (p = 0.004) as independent predictors of SEVR among patients with rheumatoid arthritis. Patients with rheumatoid arthritis exhibit lower values of SEVR compared to healthy individuals. Cardiac and hemodynamic parameters, rather than functional indices of endothelial and macrovascular dysfunction, may be useful as predictors of myocardial perfusion in rheumatoid arthritis.
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Affiliation(s)
- Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece.
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Georgios Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Nikolaos Koletsos
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Sophia Chatzimichailidou
- Rheumatology Department-2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Panagopoulos
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Ioannis Botis
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
| | - Spyros Aslanidis
- Rheumatology Department-2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 564 29, Thessaloniki, Greece
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17
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Sarioglu N, Demirpolat G, Erel F, Kose M. Which Is the Ideal Marker for Early Atherosclerosis in Obstructive Sleep Apnea (OSA) - Carotid Intima-Media Thickness or Mean Platelet Volume? Med Sci Monit 2017; 23:1674-1681. [PMID: 28384127 PMCID: PMC5390721 DOI: 10.12659/msm.900959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/19/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is known to be closely associated with cardiovascular disease. Carotid intima-media thickness (IMT) is widely used for assessment of atherosclerosis. Mean platelet volume (MPV) is a new marker associated with atherothrombosis. In this study, we aimed to detect early atherosclerosis by measuring carotid intima-media thickness and to investigate the relationship between MPV and IMT and OSA severity. MATERIAL AND METHODS The study population consisted of 158 patients who underwent polysomnography and did not have any overt cardiac disease or risk factors. Carotid IMT was measured by ultrasonography. Blood samples were taken for MPV determination. Subjects were divided into 4 groups according to OSA severity: control, mild, moderate, and severe OSA. RESULTS CONCLUSIONS OSA patients appear to have increased carotid IMT suggestive of an atherosclerotic process. Carotid IMT could be a more useful indicator than MPV in these patients. Long-term prospective studies are needed to confirm these results.
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Affiliation(s)
- Nurhan Sarioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Gulen Demirpolat
- Department of Radiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Fuat Erel
- Department of Pulmonary Diseases, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Mehmet Kose
- Department of Pulmonary Diseases, Faculty of Medicine, Balikesir University, Balikesir, Turkey
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The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease. Blood Press Monit 2017; 22:18-26. [PMID: 27845956 PMCID: PMC5214226 DOI: 10.1097/mbp.0000000000000223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Supplemental Digital Content is available in the text. Introduction The aim of this study was to examine the association of night-time systolic blood pressure (BP) with subclinical cardiac dysfunction measured by global longitudinal strain (GLS) and subclinical vascular damage measured by carotid intima–media thickness (CIMT) and carotid plaques. Methods GLS was measured by speckle-tracking analysis of echocardiogram images. CIMT was measured at the distal 1 cm of the common carotid artery. The presence of carotid plaques was recorded. Philips QLAB cardiac and vascular ultrasound quantification software was used for analysis. The association of night-time systolic BP with GLS, CIMT and carotid plaques was assessed using linear and logistic regression. Results Fifty (response rate 63%) individuals took part in this study. In univariable models, night-time systolic BP was significantly associated with GLS [β coefficient 0.85 for every 10 mmHg increase, 95% confidence interval (CI): 0.3–1.4] and carotid plaques (odds ratio 1.9 for every 10 mmHg increase, 95% CI: 1.1–3.2). Univariable analysis of daytime systolic BP did not show any statistically significant associations. In age-adjusted and sex-adjusted models, the association for night-time systolic BP and GLS remained significant (β coefficient 0.68 for every 10 mmHg increase, 95% CI: 0.1–1.3). The association for carotid plaques was no longer statistically significant. In multivariable models, findings were diminished. Discussion Our results suggest a trend towards an association between night-time systolic BP and subclinical cardiac and vascular disease. When assessing ambulatory blood pressure monitoring results, the absolute night-time systolic BP seems to be a better prognostic parameter than daytime systolic BP, but ultimately a large randomised controlled trial involving chronotherapy is necessary to fully address this.
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Graham-Brown MPM, Rutherford E, Levelt E, March DS, Churchward DR, Stensel DJ, McComb C, Mangion K, Cockburn S, Berry C, Moon JC, Mark PB, Burton JO, McCann GP. Native T1 mapping: inter-study, inter-observer and inter-center reproducibility in hemodialysis patients. J Cardiovasc Magn Reson 2017; 19:21. [PMID: 28238284 PMCID: PMC5327541 DOI: 10.1186/s12968-017-0337-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Native T1 mapping is a cardiovascular magnetic resonance (CMR) technique that associates with markers of fibrosis and strain in hemodialysis patients. The reproducibility of T1 mapping in hemodialysis patients, prone to changes in fluid status, is unknown. Accurate quantification of myocardial fibrosis in this population has prognostic potential. METHODS Using 3 Tesla CMR, we report the results of 1) the inter-study, inter-observer and intra-observer reproducibility of native T1 mapping in 10 hemodialysis patients; 2) inter-study reproducibility of left ventricular (LV) structure and function in 10 hemodialysis patients; 3) the agreement of native T1 map and native T1 phantom analyses between two centres in 20 hemodialysis patients; 4) the effect of changes in markers of fluid status on native T1 values in 10 hemodialysis patients. RESULTS Inter-study, inter-observer and intra-observer variability of native T1 mapping were excellent with co-efficients of variation (CoV) of 0.7, 0.3 and 0.4% respectively. Inter-study CoV for LV structure and function were: LV mass = 1%; ejection fraction = 1.1%; LV end-diastolic volume = 5.2%; LV end-systolic volume = 5.6%. Inter-centre variability of analysis techniques were excellent with CoV for basal and mid-native T1 slices between 0.8-1.2%. Phantom analyses showed comparable native T1 times between centres, despite different scanners and acquisition sequences (centre 1: 1192.7 ± 7.5 ms, centre 2: 1205.5 ± 5 ms). For the 10 patients who underwent inter-study testing, change in body weight (Δweight) between scans correlated with change in LV end-diastolic volume (ΔLVEDV) (r = 0.682;P = 0.03) representing altered fluid status between scans. There were no correlations between change in native T1 between scans (ΔT1) and ΔLVEDV or Δweight (P > 0.6). Linear regression confirmed ΔT1 was unaffected by ΔLVEDV or Δweight (P > 0.59). CONCLUSIONS Myocardial native T1 is reproducible in HD patients and unaffected by changes in fluid status at the levels we observed. Native T1 mapping is a potential imaging biomarker for myocardial fibrosis in patients with end-stage renal disease.
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Affiliation(s)
- Matthew P M Graham-Brown
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK.
- Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, LE1 9HN, UK.
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Elaine Rutherford
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
- The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, UK
| | - E Levelt
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, UK
| | - Daniel S March
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
- Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, LE1 9HN, UK
| | - Darren R Churchward
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
- Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, LE1 9HN, UK
| | - David J Stensel
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Christie McComb
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
- Clinical Physics, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Kenneth Mangion
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
- West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
| | - Samantha Cockburn
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
| | - Colin Berry
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
- West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
| | - James C Moon
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Patrick B Mark
- BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, UK
- The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, UK
| | - James O Burton
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
- Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, LE1 9HN, UK
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, UK
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Violi F, Carnevale R, Loffredo L, Pignatelli P, Gallin JI. NADPH Oxidase-2 and Atherothrombosis: Insight From Chronic Granulomatous Disease. Arterioscler Thromb Vasc Biol 2016; 37:218-225. [PMID: 27932349 DOI: 10.1161/atvbaha.116.308351] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/28/2016] [Indexed: 01/08/2023]
Abstract
The phagocytic cell enzyme NADPH oxidase-2 (Nox2) is critical for killing micro-organisms via production of reactive oxygen species and thus is a key element of the innate immune system. Nox2 is also detectable in endothelial cells and platelets where it has vasoconstrictive and aggregating properties, respectively. Patients with X-linked chronic granulomatous disease with hereditary Nox2 deficiency not only have impaired bacterial killing but, in association with loss of Nox2 function, also have enhanced carotid artery dilation, impaired platelet-related thrombosis, and reduced carotid atherosclerotic burden. Experimental studies corroborated these reports in chronic granulomatous disease by demonstrating (1) Nox2 is upregulated in atherosclerotic plaque, and this upregulation significantly correlates with oxidative stress and (2) pharmacological inhibition of Nox2 is associated with a delayed atherosclerotic progression in animal models. Furthermore, the role of Nox2 in platelet-associated thrombosis was substantiated by experiments showing impaired platelet activation in animals treated with a Nox2 inhibitor or impaired platelet aggregation along with reduced platelet-related thrombosis in the mouse knockout model of Nox2. Interestingly, in chronic granulomatous disease patients and in the mouse knockout model of Nox2, no defects of primary hemostasis were detected. This review analyses experimental and clinical data suggesting Nox2 is a potential target for counteracting the atherothrombotic process.
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Affiliation(s)
- Francesco Violi
- From the Division of I Clinica Medica, Policlinico Umberto I, Sapienza University, Rome, Italy (F.V., L.L., P.P.); Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C.); and Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (J.I.G.).
| | - Roberto Carnevale
- From the Division of I Clinica Medica, Policlinico Umberto I, Sapienza University, Rome, Italy (F.V., L.L., P.P.); Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C.); and Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (J.I.G.)
| | - Lorenzo Loffredo
- From the Division of I Clinica Medica, Policlinico Umberto I, Sapienza University, Rome, Italy (F.V., L.L., P.P.); Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C.); and Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (J.I.G.)
| | - Pasquale Pignatelli
- From the Division of I Clinica Medica, Policlinico Umberto I, Sapienza University, Rome, Italy (F.V., L.L., P.P.); Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C.); and Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (J.I.G.)
| | - John I Gallin
- From the Division of I Clinica Medica, Policlinico Umberto I, Sapienza University, Rome, Italy (F.V., L.L., P.P.); Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C.); and Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (J.I.G.)
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Assessment of subclinical cardiac damage in chronic plaque psoriasis patients: a case control study. ARCHIVES OF MEDICAL SCIENCES. ATHEROSCLEROTIC DISEASES 2016; 1:e126-e132. [PMID: 28905034 PMCID: PMC5421544 DOI: 10.5114/amsad.2016.64165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/25/2016] [Indexed: 12/22/2022]
Abstract
Introduction Epidemiological studies have suggested that patients with psoriasis are at an increased risk of developing cardiovascular diseases. Chronic inflammation may play a role in the pathogenesis of atherosclerosis in psoriasis patients. Recent studies have evaluated the expression of plasma endocan and homocysteine levels. Endocan is a marker of vascular endothelial damage, and homocysteine plays a role in the development of atherosclerosis. Plasma endocan and homocysteine levels, as well as echocardiographic parameters, were evaluated in patients with psoriasis to assess cardiovascular disease risk. Material and methods This was a prospective cohort analysis of 40 patients who were diagnosed with psoriasis and 40 healthy controls matched to the patient group according to demographic and biochemical parameters. Results Serum endocan and homocysteine concentrations were significantly higher in the psoriasis group than the control group (p < 0.001). Serum endocan concentrations correlated positively with disease duration (p < 0.001; r = 0.725). The Tei index (myocardial performance) was elevated in psoriasis patients (p < 0.001). Additionally, the E/A (mitral valve early diastolic peak flow velocity/mitral valve late diastolic peak flow velocity) and E/Em (early diastolic myocardial velocity) ratios were reduced in psoriasis patients (p < 0.001). Parameters indicative of left ventricular asynchrony were elevated significantly in the psoriasis group versus the control group (p < 0.001). Conclusions We observed a substantial increase in serum endocan and homocysteine concentrations, and significant differences in key parameters of cardiac function, in psoriasis patients relative to controls. These results are consistent with the hypothesis that subclinical cardiac damage is increased in patients with psoriasis and that psoriasis itself may be a cardiovascular risk factor.
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Yoon JH, Cho IJ, Chang HJ, Sung JM, Lee J, Ryoo H, Shim CY, Hong GR, Chung N. The Value of Elastic Modulus Index as a Novel Surrogate Marker for Cardiovascular Risk Stratification by Dimensional Speckle-Tracking Carotid Ultrasonography. J Cardiovasc Ultrasound 2016; 24:215-222. [PMID: 27721952 PMCID: PMC5050310 DOI: 10.4250/jcu.2016.24.3.215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 11/25/2022] Open
Abstract
Background Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. Methods Four hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. Results Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. Conclusion The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.
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Affiliation(s)
- Ji Hyun Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - In-Jeong Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Min Sung
- Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jinyong Lee
- Infrastructure Technology Lab, Samsung Medison, Seoul, Korea
| | - Hojin Ryoo
- Infrastructure Technology Lab, Samsung Medison, Seoul, Korea
| | - Chi Young Shim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Geu-Ru Hong
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Namsik Chung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Wyman RA, Mays ME, McBride PE, Stein JH. Ultrasound-detected carotid plaque as a predictor of cardiovascular events. Vasc Med 2016; 11:123-30. [PMID: 16886843 DOI: 10.1191/1358863x06vm666ra] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Ultrasound detection of carotid plaque can be performed with equipment that is available in many clinical settings and can identify patients at increased risk of cardiovascular (CV) disease. We reviewed the literature to determine the CV risk factors associated with the presence of carotid plaque and whether its presence is associated with the presence and extent of coronary artery disease. A MEDLINE search subsequently was performed to determine whether carotid plaque burden predicts future CV events. Studies that had more than 300 subjects and reported hazard ratios or relative risk estimates for CV events, or data from which these values could be calculated, were included. References from identified studies also were examined for inclusion in the review. Nine studies met these criteria. Although there was not a uniform definition of carotid plaque, eight studies found that the presence of carotid plaque predicted incident CV death and/or myocardial infarction. In several studies, this relationship persisted after adjustments for risk factors. Ultrasound detection of carotid plaque is a straightforward, inexpensive, and safe tool that has the potential to be used in an office setting to help clarify a patient’s CV risk.
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Affiliation(s)
- Rachael A Wyman
- Cardiovascular Medicine Division, University of Wisconsin Medical School, Madison, Wisconsin, USA
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Wierzbowska-Drabik K, Cygulska K, Cieślik-Guerra U, Uznańska-Loch B, Rechciński T, Trzos E, Kurpesa M, Kasprzak JD. Circumferential strain of carotid arteries does not differ between patients with advanced coronary artery disease and group without coronary stenoses. Adv Med Sci 2016; 61:203-206. [PMID: 26890558 DOI: 10.1016/j.advms.2015.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/24/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Speckle tracking echocardiography is widely used for the analysis of myocardial function. Recently, circumferential strain (CS) of carotid arteries was postulated as novel indicator of vascular function. Our aim was to characterize and compare CS of carotid arteries in patients with advanced coronary artery disease and controls without significant coronary stenoses. PATIENTS/METHODS We compared CS of both common carotid arteries (CCA) in the 25 patients with three-vessel coronary artery disease (3VD) (mean age 69±9 years, 9 male) and in 16 age-matched subjects without significant coronary lesions (C) (69±8 years, 7 male). Additionally in 11 patients we estimated pulse wave velocity (PWV) and assessed the correlation between PWV and CS. Short-axis images of arteries were acquired for strain analysis with linear probe of echocardiograph. The assessment of CS was performed off-line by two observers. RESULTS The intraobserver variability for the CS (coefficient of variation) were 4.9 and 5.4% for left and right CCA and interobserver variability were 11.7% and 12.5%, respectively. The mean CS for left and right CCA did not differ between compared groups. We did not find correlation between CS strain and PWV. The only difference was related to the more prevalent plaque presence and thicker intima-media complex (IMT) in 3VD (p=0.0039 for IMT of left CCA and p=0.016 for IMT of right CCA). CONCLUSIONS The global CS of CCA, contrary to IMT, did not allow for differentiation between 3VD and C subjects. Despite good feasibility and concordance of CS measurements its clinical significance remains to be established.
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Kawase H, Bando YK, Nishimura K, Aoyama M, Monji A, Murohara T. A dipeptidyl peptidase-4 inhibitor ameliorates hypertensive cardiac remodeling via angiotensin-II/sodium-proton pump exchanger-1 axis. J Mol Cell Cardiol 2016; 98:37-47. [DOI: 10.1016/j.yjmcc.2016.06.066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
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The Prevalence of Left Ventricular Hypertrophy in Obese Children Varies Depending on the Method Utilized to Determine Left Ventricular Mass. Pediatr Cardiol 2016; 37:993-1002. [PMID: 27033247 DOI: 10.1007/s00246-016-1380-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/21/2016] [Indexed: 01/19/2023]
Abstract
Obesity and left ventricular hypertrophy (LVH) have been identified as independent risk factors for cardiovascular events. The definition of LVH depends on the geometric algorithm used to calculate LV mass (LVM) by echocardiography and the method used to normalize LVM for body size. This study evaluates the effect of these methods on the prevalence of LVH in obese children. LVM for 109 obese and 109 age-matched non-obese children was calculated using M-mode or two-dimensional echocardiography (2DE). LVM was then normalized to height 2.7 as indexed LVM (LVMI), to body surface area (BSA), height, and lean body mass (LBM) as LVM Z-scores. LVH was defined as LVMI >95th ‰ using age-specific normal reference values or LVM Z-scores ≥2. The prevalence of LVH by LVMI and LVM Z-scores was compared. There was a correlation between LVM determined by M-mode and by 2DE (R (2) = 0.91), although M-mode LVM was greater than 2DE LVM. However, the difference between these values was greater in obese children than in non-obese children. Based on the method of normalization, the prevalence of LVH among obese children was 64 % using LVMI, 15 % using LVM Z-scores for height, 8 % using LVM Z-scores for BSA and 1 % using LVM Z-scores for LBM. Height-based normalization correlates with obesity and hypertension. The methods used to measure and normalize LVM have a profound influence on the diagnosis of LVH in obese children. Further study is needed to determine which method identifies children at risk for cardiovascular morbidity and mortality.
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Endothelial function and carotid intima media thickness in obstructive sleep apnea without comorbidity. Sleep Breath 2016; 21:69-76. [PMID: 27344563 DOI: 10.1007/s11325-016-1371-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/18/2016] [Accepted: 06/14/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE The objective of this study was to evaluate endothelial function and carotid intima media thickness (CIMT) in moderate to severe obstructive sleep apnea (OSA) without comorbidities. METHODS It is an observational case control study in which endothelial function was assessed using flow-mediated dilatation (FMD) and peripheral arterial tonometry (PAT), and carotid artery ultrasound was used to measure CIMT in study group subjects that included 20 normotensive, non-diabetic, treatment naïve, and moderate to severe OSA patients, and 20 normotensive, non-diabetic, and non-OSA subjects served as a control group. Study was conducted in Polysomnography Laboratory, Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS) Hospital, New Delhi. RESULTS FMD was significantly lower in the moderate to severe OSA group compared to non-OSA group (mean ± SD, 8.3 ± 2.8 vs. 13.4 ± 4.1 %; p = 0.0001). Reactive hyperemia index (RHI) was also significantly lower in the OSA group (1.55 ± 0.27 vs. 2.01 ± 0.48, p = 0.0007). CIMT was observed to be significantly higher in the OSA group compared to the non-OSA group (0.54 ± 0.09 vs. 0.48 ± 0.08 mm; p = 0.049). In the OSA group, FMD, RHI, and CIMT did not show a significant correlation with OSA disease severity indices [apnea hypopnea index (AHI), oxygen desaturation index (ODI), and minimum O2 saturation]. CONCLUSION Endothelial function in macrovascular and microvascular circulation is significantly impaired in moderate to severe OSA patients without comorbidities. These patients also show evidence of subclinical atherosclerosis, in the form of increased CIMT.
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A Genetic Biomarker of Oxidative Stress, the Paraoxonase-1 Q192R Gene Variant, Associates with Cardiomyopathy in CKD: A Longitudinal Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1507270. [PMID: 27313824 PMCID: PMC4904111 DOI: 10.1155/2016/1507270] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/24/2016] [Accepted: 05/05/2016] [Indexed: 11/17/2022]
Abstract
Background. Oxidative stress is a hallmark of CKD and this alteration is strongly implicated in LV hypertrophy and in LV dysfunction. Methods and Patients. We resorted to the strongest genetic biomarker of paraoxonase-1 (PON1) activity, the Q192R variant in the PON1 gene, to unbiasedly assess (Mendelian randomization) the cross-sectional and longitudinal association of this gene-variant with LV mass and function in 206 CKD patients with a 3-year follow-up. Results. The R allele of Q192R polymorphism associated with oxidative stress as assessed by plasma 8-isoPGF2α (P = 0.03) and was dose-dependently related in a direct fashion to LVMI (QQ: 131.4 ± 42.6 g/m(2); RQ: 147.7 ± 51.1 g/m(2); RR: 167.3 ± 41.9 g/m(2); P = 0.001) and in an inverse fashion to systolic function (LV Ejection Fraction) (QQ: 79 ± 12%; RQ: 69 ± 9%; RR: 65 ± 10% P = 0.002). On longitudinal observation, this gene variant associated with the evolution of the same echocardiographic indicators [LVMI: 13.40 g/m(2) per risk allele, P = 0.005; LVEF: -2.96% per risk allele, P = 0.001]. Multivariate analyses did not modify these associations. Conclusion. In CKD patients, the R allele of the Q192R variant in the PON1 gene is dose-dependently related to the severity of LVH and LV dysfunction and associates with the longitudinal evolution of these cardiac alterations. These results are compatible with the hypothesis that oxidative stress is implicated in cardiomyopathy in CKD patients.
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Puato M, Boschetti G, Rattazzi M, Zanon M, Pesavento R, Faggin E, Fania C, Benetti E, Palatini P, Pauletto P. Intima-media thickness remodelling in hypertensive subjects with long-term well-controlled blood pressure levels. Blood Press 2016; 26:48-53. [PMID: 27216375 DOI: 10.1080/08037051.2016.1184964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aim of this study was to evaluate in a long follow-up the carotid artery remodelling in a cohort of young hypertensive subjects having good blood pressure (BP) control. We studied 20 grade I hypertensives (HT) by assessing the B-mode ultrasound of mean carotid intima-media thickness (mean-IMT) and maximum IMT (M-MAX) in each carotid artery segment (common, bulb, internal), bilaterally. We compared their ultrasound measurements with those recorded 5 and 10 years earlier. While the first 5-year follow-up was observational, in the second 5-year follow-up, lifestyle modifications and/or pharmacological therapy were started to obtain well-controlled BP levels. Office BP was measured at the time of the ultrasound studies and every 6 months during the follow-up. BP levels were: 10 years 144/91 mmHg, 5 years 143/90 mmHg and 129 ± 79 mmHg at the time of the study. In the first 5-year observational follow-up, both mean-IMT and M-MAX increased (Δ 0.116 and Δ 0.165 mm, respectively, p < 0.0005). In the 5-year intervention follow-up, characterized by well-controlled BP, mean-IMT slightly but significantly increased (Δ 0.084 mm, p = 0.004), whereas M-MAX remained stable (Δ 0.026 mm). In our HT, well-controlled BP levels were able to prevent pro-atherogenic remodelling (expressed by M-MAX). Conversely, good BP control slightly decreased but did not stop the progression in mean-IMT, which is likely to reflect some hypertrophy of the arterial media layer.
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Affiliation(s)
- Massimo Puato
- a Department of Medicine , University of Padova , Padova , Italy
| | | | - Marcello Rattazzi
- a Department of Medicine , University of Padova , Padova , Italy.,b Medicina I, Ospedale Ca' Foncello , Treviso , Italy
| | - Marta Zanon
- a Department of Medicine , University of Padova , Padova , Italy
| | | | | | - Claudio Fania
- a Department of Medicine , University of Padova , Padova , Italy
| | | | - Paolo Palatini
- a Department of Medicine , University of Padova , Padova , Italy
| | - Paolo Pauletto
- a Department of Medicine , University of Padova , Padova , Italy.,b Medicina I, Ospedale Ca' Foncello , Treviso , Italy
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Cho IJ, Chang HJ, Cho I, Heo R, Lee SE, Shim CY, Hong GR, Chung N. Association of Thoracic Aorta Calcium Score With Exercise Blood Pressure Response and Clinical Outcomes in Elderly Individuals: Differential Impact of Aorta Calcification Compared With Coronary Artery Calcification. J Am Heart Assoc 2016; 5:JAHA.115.003131. [PMID: 27107130 PMCID: PMC4859288 DOI: 10.1161/jaha.115.003131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The structure of the aorta is considered to influence exercise systolic blood pressure (SBP) response, which, in turn, might impact upon adverse outcomes. The current study sought to investigate the relationship of aortic calcification and exercise SBP with adverse outcomes among elderly individuals. METHODS AND RESULTS We retrospectively reviewed 702 elderly individuals (>65 years of age) without obstructive coronary artery disease (CAD; luminal stenosis <50%) who underwent coronary computed tomography (CT) and exercise treadmill testing. ΔSBPstage2 and ΔSBPpeak were defined as the difference in systolic blood pressure (SBP) between rest and stage 2 or peak exercise, respectively. Thoracic aortic calcium score (TACS) and coronary artery calcium score (CACS) were measured using CT scanning procedures. The primary endpoints were defined as all-cause death, admission for heart failure, obstructive CAD requiring coronary intervention, and stroke. In multivariable models, ΔSBPstage2 and ΔSBPpeak were positively related with log(TACS+1), even after adjusting for various clinical variables, baseline SBP, and CACS (P<0.001). During a median follow-up period of 65 months, there were 59 events (8.4%). In a multivariate Cox regression model, independent predictors for all events were age (hazard ratio [HR], 1.12; 95% CI, 1.05-1.19; P<0.001), dyslipidemia (HR, 1.96; 95% CI, 1.14-3.37; P=0.015), and the 4th quartile of TACS (HR, 1.24; 95% CI, 1.03-1.49; P=0.024). Among individual events, the 4th quartile of TACS was the only independent predictor for stroke (HR, 2.15; 95% CI, 1.09-5.13; P=0.044), whereas CACS ≥400 mm(3) was an independent predictor for obstructive CAD requiring intervention (HR, 7.04; 95% CI, 1.58-31.36; P=0.010). CONCLUSIONS Aortic calcification was related to SBP response during exercise and was an independent predictor for outcomes, especially stroke, regardless of resting SBP or CACS.
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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
| | - Iksung Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ran Heo
- Division of Cardiology, Severance Cardiovascular Hospital, 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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Long-term effect of specific treatment of primary aldosteronism on carotid intima-media thickness. J Hypertens 2016; 33:874-82; discussion 882. [PMID: 25490707 PMCID: PMC4354456 DOI: 10.1097/hjh.0000000000000464] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Aldosterone has been shown to substantially contribute to the accumulation of different types of collagen fibres and growth factors in the arterial wall, thus increasing wall thickness. A previous study showed reduction of increased common carotid intima–media thickness (IMT) in patients with primary aldosteronism 1 year after adrenalectomy. Our study in patients with primary aldosteronism was aimed at comparing the long-term effect of adrenalectomy vs. spironolactone therapy on common carotid IMT regression. Method: Forty-two patients with confirmed primary aldosteronism (21 with aldosterone-producing adenoma treated by unilateral laparoscopic adrenalectomy, 21 treated with spironolactone) were investigated by carotid ultrasound at baseline and 1 and 6 years after the specific treatment. Results: There was a decrease in common carotid IMT from 0.956 ± 0.140 to 0.900 ± 0.127 mm (−5.9%; P < 0.05) at 1 year and to 0.866 ± 0.130 mm (−9.4%; P < 0.01) at 6 years after adrenalectomy; in the spironolactone group, common carotid IMT decreased from 0.917 ± 0.151 to 0.900 ± 0.165 mm (−1.8%; NS) at 1 year and to 0.854 ± 0.176 mm (−6.8%; P < 0.01) at 6 years of treatment. The magnitude of improvement at 1 year was significantly higher (by 70%; P < 0.05) in the adrenalectomy group; however, the difference (by 27%) became nonsignificant at 6 years. Comparing the adrenalectomy and spironolactone groups, there was no significant difference in blood pressure decrease after treatment. Conclusion: In the long term, spironolactone therapy in patients with primary aldosteronism had significant effect on regression of IMT, which was comparable to surgical treatment in patients with unilateral forms of primary aldosteronism.
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Hermida-Ameijeiras Á, López-Paz JE, Riveiro-Cruz MA, Calvo-Gómez C. [Carotid intima-media thickness distribution according to the stratification of cardiovascular risk by means of Framingham-REGICOR and score function charts]. HIPERTENSION Y RIESGO VASCULAR 2016; 33:51-7. [PMID: 26796100 DOI: 10.1016/j.hipert.2015.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/29/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) has been suggested as a further tool for risk function charts. The aim of this study was to describethe relationship between cIMT and cardiovascular risk (CVR) estimation according to Framingham-REGICOR and SCORE equations. METHODS Observational, cross-sectional cohort study from 362 hypertensive subjects. Demographic and clinical information were collected as well as laboratory, ultrasonographic and CVR estimation by the Framingham-REGICOR and SCORE functions. Statistical analysis was performed using SPSS software (version 20,0). To analyze the data, statistical tests such as Chi-square, T-test, ANOVA, and Pearson correlation coefficient were used. RESULTS According to both functions, differences on mean cIMT were found between low CVR group and intermediate to high groups. No differences were found between intermediate and high risk groups (cIMT: 0,73mm low risk patients vs. 0,89 or 0,88mm respectively according to SCORE function and cIMT: 0,73 vs. 0,85 or 0,87mm respectively according to Framingham-REGICOR function). cIMT correlated positively with CVR estimation according to both SCORE (r=0,421; P<.01), and Framingham-REGICOR functions (r=0,363; P<.01). CONCLUSIONS cIMT correlates positively with CVR estimated by SCORE and Framingham-REGICOR functions. cIMT in those subjects at intermediate risk is similar to those at high risk. Our findings highlight the importance of carotid ultrasound in identifying silent target-organ damage in those patients at intermediate CVR.
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Affiliation(s)
- Á Hermida-Ameijeiras
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínico Universitario, Santiago de Compostela (La Coruña), España.
| | - J E López-Paz
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínico Universitario, Santiago de Compostela (La Coruña), España
| | - M A Riveiro-Cruz
- Departamento de Análisis Clínicos, Laboratorio Central, Hospital Clínico Universitario, Santiago de Compostela (La Coruña), España
| | - C Calvo-Gómez
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínico Universitario, Santiago de Compostela (La Coruña), España
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Zhao X, Modur V, Carayannopoulos LN, Laterza OF. Biomarkers in Pharmaceutical Research. Clin Chem 2015; 61:1343-53. [PMID: 26408531 DOI: 10.1373/clinchem.2014.231712] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/17/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND Biomarkers are important tools in drug development and are used throughout pharmaceutical research. CONTENT This review focuses on molecular biomarkers in drug development. It contains sections on how biomarkers are used to assess target engagement, pharmacodynamics, safety, and proof-of-concept. It also covers the use of biomarkers as surrogate end points and patient selection/companion diagnostics and provides insights into clinical biomarker discovery and biomarker development/validation with regulatory implications. To survey biomarkers used in drug development--acknowledging that many pharmaceutical development biomarkers are not published--we performed a focused PubMed search employing "biomarker" and the names of the largest pharmaceutical companies as keywords and filtering on clinical trials and publications in the last 10 years. This yielded almost 500 entries, the majority of which included disease-related (approximately 60%) or prognostic/predictive (approximately 20%) biomarkers. A notable portion (approximately 8%) included HER2 (human epidermal growth factor receptor 2) testing, highlighting the utility of biomarkers for patient selection. The remaining publications included target engagement, safety, and drug metabolism biomarkers. Oncology, cardiovascular disease, and osteoporosis were the areas with the most citations, followed by diabetes and Alzheimer disease. SUMMARY Judicious biomarker use can improve pharmaceutical development efficiency by helping to select patients most appropriate for treatment using a given mechanism, optimize dose selection, and provide earlier confidence in accelerating or discontinuing compounds in clinical development. Optimal application of biomarker technology requires understanding of candidate drug pharmacology, detailed modeling of biomarker readouts relative to pharmacokinetics, rigorous validation and qualification of biomarker assays, and creative application of these elements to drug development problems.
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Affiliation(s)
| | - Vijay Modur
- Translational Medicine, Genzyme Corporation, Cambridge, MA
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Wald R, Goldstein MB, Perl J, Kiaii M, Yuen D, Wald RM, Harel Z, Weinstein JJ, Jakubovic B, Leong-Poi H, Kirpalani A, Leipsic J, Dacouris N, Wolf M, Yan AT. The Association Between Conversion to In-centre Nocturnal Hemodialysis and Left Ventricular Mass Regression in Patients With End-Stage Renal Disease. Can J Cardiol 2015; 32:369-77. [PMID: 26386732 DOI: 10.1016/j.cjca.2015.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 06/26/2015] [Accepted: 07/05/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND In-centre nocturnal hemodialysis (INHD, 7-8 hours/session, 3 times/week) is an increasingly utilized form of dialysis intensification, though data on the cardiovascular benefits of this modality are limited. METHODS In this prospective cohort study, we enrolled 67 prevalent conventional hemodialysis (CHD, 4 hours/session, 3 times/week) recipients at 2 medical centres in Canada, of whom 37 converted to INHD and 30 remained on CHD. The primary outcome was the change in left ventricular mass (LVM) after 1 year as assessed by cardiac magnetic resonance imaging. Secondary outcomes included changes in serum phosphate concentration, phosphate binder burden, haemoglobin, erythropoiesis stimulating agent usage, and blood pressure. RESULTS Conversion to INHD was associated with a 14.2 (95% confidence interval [CI] 1.2-27.2) g reduction in LVM as compared with continuation on CHD. This result was maintained after adjustment for baseline imbalances between the groups and in ancillary analyses. There was a trend toward a larger drop in systolic blood pressure (9.8 [95% CI, -1.4-20.9] mm Hg) among INHD recipients with a significant reduction in the number of prescribed antihypertensive agents (0.7 [95% CI, 0.3-1.1] agents). Serum phosphate declined by 0.40 (95% CI, 0.16-0.63) mmol/L among INHD recipients without any difference in calcium-based phosphate binder requirements, as compared with those who remained on CHD. CONCLUSIONS Compared with continuation of CHD, conversion to INHD was associated with significant LVM regression and reduction in serum phosphate concentration at 1 year.
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Affiliation(s)
- Ron Wald
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
| | - Marc B Goldstein
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Jeffrey Perl
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Mercedeh Kiaii
- Division of Nephrology, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Darren Yuen
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Rachel M Wald
- Divisions of Cardiology and Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - Ziv Harel
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Jordan J Weinstein
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Baruch Jakubovic
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Howard Leong-Poi
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada; Division of Cardiology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Anish Kirpalani
- Department of Medical Imaging, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jonathon Leipsic
- Department of Radiology and Division of Cardiology, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Niki Dacouris
- Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Myles Wolf
- Division of Nephrology and Center for Translational Metabolism and Health - Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew T Yan
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada; Division of Cardiology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
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Clodfelter WH, Basu S, Bolden C, Dos Santos PC, King SB, Kim-Shapiro DB. The relationship between plasma and salivary NOx. Nitric Oxide 2015; 47:85-90. [PMID: 25910583 PMCID: PMC4439285 DOI: 10.1016/j.niox.2015.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/06/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
Several studies have shown that fasting plasma nitrite (NO2(-)) is an indicator of endothelial nitric oxide synthase (NOS) activity while plasma nitrate (NO3(-)) or the sum of NO2(-) and NO3(-) (NOx) does not reflect NOS function. Plasma NO2(-) can also be elevated through dietary NO3(-) where the NO3(-) is partially reduced to NO2(-) by oral bacteria and enters the plasma through the digestive system. NO3(-) is taken up from plasma by salivary glands and the cycle repeats itself. Thus, one may propose that salivary NO2(-) is an indicator of plasma NO2(-) and consequently of NO production. Many brands of nitric oxide (NO) saliva test strips have been developed that suggest that their product is indicative of circulatory NO availability. However, data supporting a relationship between salivary and plasma NO2(-) or NO bioavailability are lacking. Here we have measured basal salivary and plasma NO2(-) and NO3(-) to determine if any correlation exists between these in 13 adult volunteers. We found no significant correlation between basal salivary and plasma NO2(-). Also no correlation exists between salivary NO3(-) and plasma NO2(-). However, we did see a correlation between salivary NO3(-) and plasma NO3(-), and between salivary NO2(-) and plasma NO3(-). In a separate study, we compared the efficiency of salivary NO3(-) reduction with the efficacy of increasing plasma NO3(-) and NO2(-) after drinking beet juice, a high NO3(-)-containing beverage, in 10 adult volunteers. No significant correlation was observed between the ex vivo salivary reduction of NO3(-) to NO2(-) and plasma increases in NO3(-) or NO2(-). These results suggest that measures of salivary NO3(-), NO2(-) or NOx are not good indicators of endothelial function. In addition, the efficiency of saliva to reduce NO3(-) to NO2(-)ex-vivo does not demonstrate one's ability to increase plasma NO2(-) following consumption of dietary NO3(-).
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Affiliation(s)
- William H Clodfelter
- Department of Chemistry, Wake Forest University, Winston-Salem, NC 27109, USA; Translational Science Center, Wake Forest University, Reynolda Campus, Winston-Salem, NC 27109, USA
| | - Swati Basu
- Translational Science Center, Wake Forest University, Reynolda Campus, Winston-Salem, NC 27109, USA; Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA
| | - Crystal Bolden
- Department of Molecular Medicine and Translational Science, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
| | - Patricia C Dos Santos
- Department of Chemistry, Wake Forest University, Winston-Salem, NC 27109, USA; Translational Science Center, Wake Forest University, Reynolda Campus, Winston-Salem, NC 27109, USA
| | - S Bruce King
- Department of Chemistry, Wake Forest University, Winston-Salem, NC 27109, USA; Translational Science Center, Wake Forest University, Reynolda Campus, Winston-Salem, NC 27109, USA.
| | - Daniel B Kim-Shapiro
- Translational Science Center, Wake Forest University, Reynolda Campus, Winston-Salem, NC 27109, USA; Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA.
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Takahara M, Katakami N, Osonoi T, Saitou M, Sakamoto F, Matsuoka TA, Shimomura I. Different Impacts of Cardiovascular Risk Factors on Arterial Stiffness versus Arterial Wall Thickness in Japanese Patients with Type 2 Diabetes Mellitus. J Atheroscler Thromb 2015; 22:971-80. [PMID: 25864887 DOI: 10.5551/jat.29090] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM We statistically investigated whether the impact of cardiovascular risk factors on arterial stiffness would be different from that on arterial wall thickness. METHODS We analyzed 1648 Japanese type 2 diabetic patients. Arterial stiffness was evaluated by pulse wave verbosity (PWV) and wall thickness was assessed with carotid intima-media thickness (IMT) by ultrasonography. We developed a common regression model to PWV and IMT by extending the linear mixed model and statistically detected the difference in the impact of cardiovascular risk factors between the two indices. RESULTS There was a significant correlation between PWV and IMT (r=0.365, p < 0.001). Sex, diabetic duration, hemoglobin A1c levels, and the presence of retinopathy and cardiovascular disease were comparable independent risk factors for elevated PWV and IMT. On the other hand, the impact of age, systolic blood pressure, and low- and high-density lipoprotein cholesterol levels were significantly different between the two measurements (all p < 0.05). Cholesterol levels were significantly associated with IMT but not with PWV. Age and systolic blood pressure had a significant impact on both measurements, but the impact on PWV was significantly greater than that on IMT. Indeed, patients with low IMT but with advanced age and high systolic pressure had high PWV, whereas patients with low PWV but with impaired cholesterol levels had high IMT. CONCLUSION The extended linear mixed model statistically confirmed that the impact of cardiovascular risk factors on elevated PWV and IMT were not identical in Japanese patients with type 2 diabetes mellitus.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine
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O'Flynn AM, Madden JM, Russell AJ, Curtin RJ, Kearney PM. Isolated nocturnal hypertension and subclinical target organ damage: a systematic review of the literature. Hypertens Res 2015; 38:570-5. [PMID: 25832917 DOI: 10.1038/hr.2015.43] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/15/2014] [Accepted: 02/20/2015] [Indexed: 01/19/2023]
Abstract
Isolated nocturnal hypertension (INH) is associated with greater mortality and cardiovascular events. Subclinical target organ damage (TOD) is a prognostic marker for cardiovascular events. Our objective is to systematically summarize evidence on the association between INH and subclinical TOD. Observational population studies were considered. INH was defined as nighttime blood pressure (BP) ⩾120 and/or 70 mm Hg with daytime BP <135/85 mm Hg. We systematically searched Pubmed, EMBASE and the Cochrane Library. Abstracts were reviewed by two assessors. Potentially eligible articles were compared with inclusion criteria. The search yielded 954 titles, 13 abstracts were selected for review and four articles fulfilled inclusion criteria. INH was associated with higher ambulatory arterial stiffness index (0.4 unit vs. 0.35 unit, P<0.05), pulse wave velocity (16.2 m s(-1) vs. 14.7 m s(-1), P<0.05), central (140.4% vs. 134.0%, P<0.05) and peripheral (82.6% vs. 76.5%, P<0.01) augmentation index in a Chinese study. In the same population there was no association with left ventricular hypertrophy documented by electrocardiogram. INH was not associated with increased arterial stiffness or left venticular mass index in a Swedish study. An American study demonstrated higher left ventricular mass (152.46 g vs. 136.16 g, P=0.01) and greater odds of left ventricular hypertrophy (odds ratio 3.03, 95% confidence interval 1.02-9.05) in unadjusted analysis. There was no association with proteinuria. Evidence is inconclusive regarding the association between INH and subclinical TOD. Future research should focus on trying to elucidate the mechanisms that generate INH and contribute to the higher mortality associated with this BP pattern.
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Affiliation(s)
- Anne Marie O'Flynn
- 1] Department of Epidemiology and Public Health, University College Cork, Cork, Ireland [2] Department of Cardiology, Cork University Hospital, Cork, Ireland
| | - Jamie M Madden
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Audrey J Russell
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Ronan J Curtin
- Department of Cardiology, Cork University Hospital, Cork, Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Terzi S, Arslanoğlu S, Demiray U, Eren E, Cancuri O. Carotid Doppler ultrasound evaluation in patients with pulsatile tinnitus. Indian J Otolaryngol Head Neck Surg 2015; 67:43-7. [PMID: 25621231 DOI: 10.1007/s12070-014-0756-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022] Open
Abstract
A wide range of conditions, including atherosclerosis, may lead to pulsatile tinnitus. The objective of this study was to evaluate the patients with pulsatile tinnitus by means of carotid Doppler ultrasound parameters. Thirty-four patients with pulsatile tinnitus were enrolled in the study. Internal carotid artery intima-media thickness (IMT), blood flow velocities and arterial lumen diameters (LD) were measured and compared with the control group. Mean end diastolic velocity (EDV) (32.29 ± 17.22) and IMT (1.06 ± 0.36) values were significantly higher and mean LD (6.69 ± 1.20) was significantly lower compared to the control group. Peak systolic velocity and EDV values were significantly higher in patients whose IMT were greater than 1 mm. Pulsatile tinnitus may be the first symptom of a severe, life threatening disease. Doppler sonography is a noninvasive, safe and easily applicable diagnostic tool for the evaluation of the vascular structures, in patients with pulsatile tinnitus.
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Affiliation(s)
- S Terzi
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - S Arslanoğlu
- Department of Otolaryngology Head and Neck Surgery, Atatürk Research and Training Hospital, İzmir, Turkey
| | - U Demiray
- Department of Otolaryngology Head and Neck Surgery, State Hospital, Tatvan, Turkey
| | - E Eren
- Department of Otolaryngology Head and Neck Surgery, Atatürk Research and Training Hospital, İzmir, Turkey
| | - O Cancuri
- Department of Radiology, State Hospital, Gazimagusa, Famagusta, Turkish Republic of Northern Cyprus
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Erhayiem B, Pavitt S, Baxter P, Andrews J, Greenwood JP, Buch MH, Plein S. Coronary Artery Disease Evaluation in Rheumatoid Arthritis (CADERA): study protocol for a randomized controlled trial. Trials 2014; 15:436. [PMID: 25381560 PMCID: PMC4233100 DOI: 10.1186/1745-6215-15-436] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/24/2014] [Indexed: 02/06/2023] Open
Abstract
Background The incidence of cardiovascular disease (CVD) in rheumatoid arthritis (RA) is increased compared to the general population. Immune dysregulation and systemic inflammation are thought to be associated with this increased risk. Early diagnosis with immediate treatment and tight control of RA forms a central treatment paradigm. It remains unclear, however, whether using tumor necrosis factor inhibitors (TNFi) to achieve remission confer additional beneficial effects over standard therapy, especially on the development of CVD. Methods/Design Coronary Artery Disease Evaluation in Rheumatoid Arthritis (CADERA) is a prospective cardiovascular imaging study that bolts onto an existing single-centre, randomized controlled trial, VEDERA (Very Early versus Delayed Etanercept in Rheumatoid Arthritis). VEDERA will recruit 120 patients with early, treatment-naïve RA, randomized to TNFi therapy etanercept (ETN) combined with methotrexate (MTX), or therapy with MTX with or without additional synthetic disease modifying anti-rheumatic drugs with escalation to ETN following a ‘treat-to-target’ regimen. VEDERA patients will be recruited into CADERA and undergo cardiac magnetic resonance (CMR) assessment with; cine imaging, rest/stress adenosine perfusion, tissue-tagging, aortic distensibility, T1 mapping and late gadolinium imaging. Primary objectives are to detect the prevalence and change of cardiovascular abnormalities by CMR between TNFi and standard therapy over a 12-month period. All patients will enter an inflammatory arthritis registry for long-term follow-up. Discussion CADERA is a multi-parametric study describing cardiovascular abnormalities in early, treatment-naïve RA patients, with assessment of changes at one year between early biological therapy and conventional therapy. Trials registration This trial was registered with Current Controlled Trials (registration number: ISRCTN50167738) on 8 November 2013.
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Affiliation(s)
| | | | | | | | | | | | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre & Leeds Institute for Cardiovascular and Metabolic Medicine, Worsley Building, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK.
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Comparison of inflammation, arterial stiffness and traditional cardiovascular risk factors between rheumatoid arthritis and inflammatory bowel disease. JOURNAL OF INFLAMMATION-LONDON 2014; 11:29. [PMID: 25337037 PMCID: PMC4203921 DOI: 10.1186/s12950-014-0029-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/28/2014] [Indexed: 12/14/2022]
Abstract
Background Inflammation plays an important role in the pathogenesis of atherosclerosis. The link between rheumatoid arthritis (RA) and an increased risk of cardiovascular disease and mortality is well established; however, the association between inflammatory bowel disease (IBD) and cardiovascular risk is controversial. Arterial stiffness is both a marker and risk factor for atherosclerosis. Here we aimed to 1) compare circulating markers of inflammation and endothelial dysfunction, traditional cardiovascular risk factors, and arterial stiffness between RA and IBD to help to understand their different associations with cardiovascular disease; 2) assess the impacts of circulating markers of inflammation and endothelial dysfunction, and traditional risk factors on arterial stiffness. Methods Patients with RA (n = 43) and IBD (n = 42), and control subjects (n = 73) were recruited. Plasma inflammatory markers and von Willebrand factor (vWF) were measured by Multiplex assays or ELISA. Arterial stiffness was determined by brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) was measured. Framingham Risk Score (FRS) was calculated, and other traditional risk factors were also documented. Results Plasma levels of several inflammatory markers and vWF were significantly but comparably elevated in RA and IBD compared with controls, except for a higher level of C-reactive protein (CRP) in RA than IBD. Compared to controls, FRS, body mass index, waist circumference, and triglycerides were increased in RA, but not in IBD. baPWV did not significantly differ among 3 groups, while ABI was modestly but significantly lower in IBD than controls. Circulating markers (macrophage migration inhibitory factor, tumour necrosis factor-α, CRP, and vWF) were significantly associated with baPWV. However, traditional risk factors (age, systolic blood pressure, body mass index, diabetes and triglycerides) were the parameters associated with baPWV in multiple regression analyses (overall r = 0.866, p < 0.001). Conclusions RA has a higher level of CRP and more pronounced traditional cardiovascular risk factors than IBD, which may contribute to the difference in their associations with cardiovascular disease and mortality. Traditional risk factors, rather than inflammation markers, are major predictors of arterial stiffness even in subjects with inflammatory disorders. Our results point to the importance of modifying traditional risk factors in patients with inflammatory disorders.
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Mihai BM, Petriş AO, Ungureanu DA, Lăcătuşu CM. Insulin resistance and adipokine levels correlate with early atherosclerosis - a study in prediabetic patients. Open Med (Wars) 2014; 10:14-24. [PMID: 28352672 PMCID: PMC5152953 DOI: 10.1515/med-2015-0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 07/21/2014] [Indexed: 11/22/2022] Open
Abstract
Cardiovascular risk of prediabetes is still subject to controversies. We analyzed the associations between insulin resistance, adipokines and incipient atherosclerosis estimated by intima-media thickness (IMT) in a cross-sectional study on 122 prediabetic subjects without clinical signs of atherosclerotic disease. Homeostasis model assessment of insulin resistance (HOMA-IR, calculated as fasting insulin × fasting plasma glucose / 22.5), adiponectin, leptin, leptin-to-adiponectin ratio, carotid and femoral IMT were evaluated. We also assessed other parameters related to insulin resistance and adipokines (HbA1c, anthropometric and lipid parameters), as they may also influence atherosclerosis. Carotid IMT was correlated to adiponectin and leptin-to-adiponectin ratio (all p < 0.05), but not with HOMA-IR or leptin, while femoral IMT showed no relationship with these factors. After adjusting for leptin, leptin-to-adiponectin ratio, triglycerides, HDL-cholesterol, cholesterol-to-HDL ratio, triglycerides-to-HDL ratio and HbA1c, IMT values became correlated with HOMA-IR. Adjustment for HOMA-IR induced the appearance of new correlations between adipokines and both IMT values. In conclusion, insulin resistance and adipokines seem related to IMT in prediabetic subjects without clinical signs of arterial obstruction.
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Affiliation(s)
- Bogdan Mircea Mihai
- Discipline of Diabetes, Nutrition and Metabolic Diseases, First Medical Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania
| | - Antoniu Octavian Petriş
- Discipline of Internal Medicine and Cardiology, First Medical Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania
| | - Didona Anca Ungureanu
- Discipline of Biochemistry, Morpho-Functional Sciences Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania
| | - Cristina Mihaela Lăcătuşu
- Discipline of Diabetes, Nutrition and Metabolic Diseases, First Medical Department, University of Medicine and Pharmacy "Grigore T. Popa", 16th Universităţii Street, 700115, Iaşi, Romania
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Ayaz T, Durakoğlugil ME, Kocaman SA, Durakoğlugil T, Erdoğan T, Sahin OZ, Sahin SB, Ciçek Y, Satiroğlu O. Bilirubin Level is Associated with Left Ventricular Hypertrophy Independent of Blood Pressure in Previously Untreated Hypertensive Patients. Korean Circ J 2014; 44:336-43. [PMID: 25278987 PMCID: PMC4180611 DOI: 10.4070/kcj.2014.44.5.336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 07/05/2014] [Accepted: 08/19/2014] [Indexed: 02/07/2023] Open
Abstract
Background and Objectives Left ventricular hypertrophy (LVH), a sign of subclinical cardiovascular disease, is an important predictor of cardiovascular morbidity and mortality. The aim of our study was to determine the association of left ventricular mass (LVM) with possible causative anthropometric and biochemical parameters as well as carotid intima-media thickness (CIMT) and brachial flow-mediated dilation (FMD) as surrogates of atherosclerosis and endothelial dysfunction, respectively, in previously untreated hypertensive patients. Subjects and Methods Our study included 114 consecutive previously untreated hypertensive patients who underwent echocardiography and ultrasonography to evaluate their vascular status and function via brachial artery CIMT and FMD. Results Among all study parameters, age, systolic blood pressure (BP), diastolic BP, pulse pressure, plasma glucose, uric acid, total bilirubin, direct bilirubin, hemoglobin, and CIMT were positively correlated with the LVM index. Multiple logistic regression analysis revealed that office systolic BP, age, male gender, and total bilirubin were independent predictors of LVH. Conclusion Bilirubin seems to be related to LVM and LVH. The positive association of bilirubin with these parameters is novel and requires further research.
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Affiliation(s)
- Teslime Ayaz
- Department of Internal Medicine, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Murtaza Emre Durakoğlugil
- Department of Cardiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Sinan Altan Kocaman
- Department of Cardiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Tuğba Durakoğlugil
- Department of Radiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Turan Erdoğan
- Department of Cardiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Osman Zikrullah Sahin
- Department of Internal Medicine, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Serap Baydur Sahin
- Department of Internal Medicine, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Yüksel Ciçek
- Department of Cardiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
| | - Omer Satiroğlu
- Department of Cardiology, Recep Tayyip Erdoğan University, Education and Research Hospital, Rize, Turkey
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Abstract
OSA (obstructive sleep apnoea), the most common respiratory disorder of sleep, is caused by the loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. This results in recurrent nocturnal asphyxia. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxaemia, which leads to poor quality sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Furthermore, patients with untreated sleep apnoea are at an increased risk of hypertension, stroke, heart failure and atrial fibrillation. Although there are many predisposing risk factors for OSA, including male gender, endocrine disorders, use of muscle relaxants, smoking, fluid retention and increased age, the strongest risk factor is obesity. The aim of the present review is to focus on three cutting-edge topics with respect to OSA. The section on animal models covers various strategies used to simulate the physiology or the effects of OSA in animals, and how these have helped to understand some of the underlying mechanisms of OSA. The section on diabetes discusses current evidence in both humans and animal models demonstrating that intermittent hypoxia and sleep fragmentation has a negative impact on glucose tolerance. Finally, the section on cardiovascular biomarkers reviews the evidence supporting the use of these biomarkers to both measure some of the negative consequences of OSA, as well as the potential benefits of OSA therapies.
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Mahgerefteh J, Gidding S, Lopez L. Echocardiography as a Marker of Cardiac end Organ Injury at a Young age. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
More than one-half of young adults aged 18-24 y have at least 1 coronary heart disease (CHD) risk factor and nearly one-quarter have advanced atherosclerotic lesions. The extent of atherosclerosis is directly correlated with the number of risk factors. Unhealthy dietary choices made by this age group contribute to weight gain and dyslipidemia. Risk factor profiles in young adulthood strongly predict long-term CHD risk. Early detection is critical to identify individuals at risk and to promote lifestyle changes before disease progression occurs. Despite the presence of risk factors and pathological changes, risk assessment and disease prevention efforts are lacking in this age group. Most young adults are not screened and are unaware of their risk. This review provides pathological evidence along with current risk factor prevalence data to demonstrate the need for early detection. Eighty percent of heart disease is preventable through diet and lifestyle, and young adults are ideal targets for prevention efforts because they are in the process of establishing lifestyle habits, which track forward into adulthood. This review aims to establish the need for increased screening, risk assessment, education, and management in young adults. These essential screening efforts should include the assessment of all CHD risk factors and lifestyle habits (diet, exercise, and smoking), blood pressure, glucose, and body mass index in addition to the traditional lipid panel for effective long-term risk reduction.
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Affiliation(s)
- Jennifer Arts
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI; and
| | | | - Ingrid E. Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI; and
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Lee HY, Oh BH. Cardio–renal protection with aliskiren, a direct renin inhibitor, in the ASPIRE HIGHER program. Expert Rev Cardiovasc Ther 2014; 7:251-7. [DOI: 10.1586/14779072.7.3.251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Robles TF, Slatcher RB, Trombello JM, McGinn MM. Marital quality and health: a meta-analytic review. Psychol Bull 2014; 140:140-187. [PMID: 23527470 PMCID: PMC3872512 DOI: 10.1037/a0031859] [Citation(s) in RCA: 637] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in more than 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality (r = .11) and lower cardiovascular reactivity during marital conflict (r = -.13), but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health.
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Affiliation(s)
| | | | | | - Meghan M McGinn
- Mental Illness Research, Education, and Clinical Care, Veterans Affairs Puget Sound Healthcare System
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Nagai K, Shibata S, Akishita M, Sudoh N, Obara T, Toba K, Kozaki K. Efficacy of combined use of three non-invasive atherosclerosis tests to predict vascular events in the elderly; carotid intima-media thickness, flow-mediated dilation of brachial artery and pulse wave velocity. Atherosclerosis 2013; 231:365-70. [PMID: 24267253 DOI: 10.1016/j.atherosclerosis.2013.09.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 09/25/2013] [Accepted: 09/30/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intima-media thickness (IMT) of the carotid artery, flow-mediated dilation (FMD) of the brachial artery, and pulse wave velocity of the central artery (PWV) have been widely used to evaluate progression of atherosclerosis. Our previous work has revealed that IMT, FMD and PWV are related to each other, and the combination of these measurements was useful in identifying patients with atherosclerotic disease. The aim of the present study was to investigate whether combination of these measurements would predict future cardiovascular events better than each test alone. METHODS AND RESULTS From November 2000 to March 2008, 274 consecutive elderly subjects (men/women; 114/160, mean age; 71 ± 12 years) were enrolled in this study. We measured IMT, FMD, and PWV in all of these subjects and followed them for a mean of 41 ± 28 months. During the follow-up period, vascular events occurred in 42 patients (15.3%). IMT (hazard ratio = 1.28 [95%CI, 1.09-1.50], p = 0.002 per 0.1 mm increase in mean IMT) and brachial-ankle (ba) PWV (hazard ratio = 1.06 [95%CI, 1.01-1.10], p = 0.015 per 1 m/s increase in baPWV) were independent predictors of future vascular events by Cox proportional hazard analysis, although FMD did not reach statistical significance (hazard ratio = 0.85 [95%CI, 0.72-1.01], p = 0.062 per 1% increase in %FMD). Importantly, the number of tests showing results in the worst tertile was a more powerful predictor (hazard ratio = 2.21 [95%CI, 1.42-3.43], p = 0.0004 for number of tests showing worst tertile) of future vascular events than either IMT, baPWV, or FMD alone. When both IMT and baPWV (with respective cut-off values of 0.98 mm and 19.1 m/s) were taken into consideration, the efficacy increased as compared with each test alone (odds ratio 4.9). CONCLUSION These results indicate that IMT and baPWV, especially when combined, are useful in predicting future vascular events in elderly subjects.
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Affiliation(s)
- Kumiko Nagai
- Department of Geriatric Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
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García R, Villar AV, Cobo M, Llano M, Martín‐Durán R, Hurlé MA, Francisco Nistal J. Circulating levels of miR-133a predict the regression potential of left ventricular hypertrophy after valve replacement surgery in patients with aortic stenosis. J Am Heart Assoc 2013; 2:e000211. [PMID: 23948643 PMCID: PMC3828793 DOI: 10.1161/jaha.113.000211] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/16/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Myocardial microRNA-133a (miR-133a) is directly related to reverse remodeling after pressure overload release in aortic stenosis patients. Herein, we assessed the significance of plasma miR-133a as an accessible biomarker with prognostic value in predicting the reversibility potential of LV hypertrophy after aortic valve replacement (AVR) in these patients. METHODS AND RESULTS The expressions of miR-133a and its targets were measured in LV biopsies from 74 aortic stenosis patients. Circulating miR-133a was measured in peripheral and coronary sinus blood. LV mass reduction was determined echocardiographically. Myocardial and plasma levels of miR-133a correlated directly (r=0.46, P<0.001) supporting the myocardium as a relevant source of plasma miR-133a. Accordingly, a significant gradient of miR-133a was found between coronary and systemic venous blood. The preoperative plasma level of miR-133a was higher in the patients who normalized LV mass 1 year after AVR than in those exhibiting residual hypertrophy. Logistic regression analysis identified plasma miR-133a as a positive predictor of the hypertrophy reversibility after surgery. The discrimination of the model yielded an area under the receiver operator characteristic curve of 0.89 (P<0.001). Multiple linear regression analysis revealed plasma miR-133a and its myocardial target Wolf-Hirschhorn syndrome candidate 2/Negative elongation factor A as opposite predictors of the LV mass loss (g) after AVR. CONCLUSIONS Preoperative plasma levels of miR-133a reflect their myocardial expression and predict the regression potential of LV hypertrophy after AVR. The value of this bedside information for the surgical timing, particularly in asymptomatic aortic stenosis patients, deserves confirmation in further clinical studies.
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Affiliation(s)
- Raquel García
- Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Santander, Spain (R.G.)
| | - Ana V. Villar
- Department of Physiology and Pharmacology, School of Medicine, University of Cantabria, IFIMAV, Santander, Spain (A.V.V., M.H.)
| | - Manuel Cobo
- Department of Cardiology, University Hospital Marqués de Valdecilla, IFIMAV, Santander, Spain (M.C., M.L., R.M.D.)
| | - Miguel Llano
- Department of Cardiology, University Hospital Marqués de Valdecilla, IFIMAV, Santander, Spain (M.C., M.L., R.M.D.)
| | - Rafael Martín‐Durán
- Department of Cardiology, University Hospital Marqués de Valdecilla, IFIMAV, Santander, Spain (M.C., M.L., R.M.D.)
| | - María A. Hurlé
- Department of Physiology and Pharmacology, School of Medicine, University of Cantabria, IFIMAV, Santander, Spain (A.V.V., M.H.)
| | - J. Francisco Nistal
- Department of Cardiovascular Surgery, University Hospital Marqués de Valdecilla, IFIMAV, Santander, Spain (F.N.)
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Karatzi K, Rontoyanni VG, Protogerou AD, Georgoulia A, Xenos K, Chrysou J, Sfikakis PP, Sidossis LS. Acute effects of beer on endothelial function and hemodynamics: a single-blind, crossover study in healthy volunteers. Nutrition 2013; 29:1122-6. [PMID: 23810643 DOI: 10.1016/j.nut.2013.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Moderate consumption of beer is associated with lower cardiovascular (CV) risk. The goal of this study was to determine the effect of beer consumption on CV risk. To explore the underlying mechanisms, we studied the acute effects of the constituents of beer (alcohol and antioxidants), on established predictors of CV risk: endothelial function, aortic stiffness, pressure wave reflections and aortic pressure. METHODS In a randomized, single-blind, crossover study, 17 healthy, non-smoking, men (ages 28.5 ± 5.2 y with body mass index 24.4 ± 2.5 kg/m(2)) consumed on three separate occasions, at least 1 wk apart: 1. 400 mL of beer and 400 mL water, 2. 800 mL of dealcoholized beer (same amount of polyphenols as in the 400 mL of beer), and 3. 67 mL of vodka and 733 mL water (same amount of alcohol as in the 400 mL of beer). Each time aortic stiffness (pulse wave velocity), pressure wave reflections (AΙx), aortic and brachial pressure (Sphygmocor device), and endothelial function (brachial flow mediated dilatation) were assessed at fast and 1 and 2 h postprandial. RESULTS Aortic stiffness was significantly and similarly reduced by all three interventions. However, endothelial function was significantly improved only after beer consumption (average 1.33%, 95% confidence interval [CI] 0.15-2.53). Although wave reflections were significantly reduced by all three interventions (average of beer: 9.1%, dealcoholized beer: 2.8%, vodka 8.5%, all CI within limits of significance), the reduction was higher after beer consumption compared with dealcoholized beer (P = 0.018). Pulse pressure amplification (i.e., brachial/aortic) was increased by all three test drinks. CONCLUSIONS Beer acutely improves parameters of arterial function and structure, in healthy non-smokers. This benefit seems to be mediated by the additive or synergistic effects of alcohol and antioxidants and merits further investigation.
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Affiliation(s)
- Kalliopi Karatzi
- Laboratory of Nutrition and Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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