1
|
Sasaki N, Ueno Y, Ozono R, Nakano Y, Higashi Y. Insulin resistance in the adipose tissue predicts future vascular resistance: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases. Atherosclerosis 2024; 393:117547. [PMID: 38703418 DOI: 10.1016/j.atherosclerosis.2024.117547] [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: 11/10/2023] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND AND AIMS Diameter, plaque score, and resistance index (RI) in the common carotid artery (CCA) are indicators of arterial remodeling, atherosclerosis, and vascular resistance, respectively. This study investigated the longitudinal association between adipose tissue insulin resistance or serum free fatty acid (FFA) levels and the CCA parameters. METHODS This retrospective cohort analysis included 1089 participants (mean age 57.6 years; 40.0 % women) with data on health checkups from January 1982 to March 2003 and carotid artery ultrasonography from January 2015 to June 2019. Baseline serum FFA and immunoreactive insulin levels were assessed before and 30, 60, and 120 min after glucose ingestion. Adipose insulin resistance index (Adipo-IR) was calculated as the product of fasting serum insulin and FFA levels. An RI value >0.75 was defined as high RI. RESULTS A significant association was found between Adipo-IR and RI; however, Adipo-IR showed no association with CCA diameter or plaque score. The incidence of high RI increased with Adipo-IR quartile (Q) groups (47.3 % in Q1, 52.8 % in Q2, 53.3 % in Q3, 62.4 % in Q4; Cochrane-Armitage test for trend, p < 0.001). In multivariate analysis, Adipo-IR levels (Q4 vs. Q1 odds ratio: 1.67, 95 % confidence interval: 1.12-2.51) were positively associated with high RI incidence. Moreover, a significant association was found between RI and serum FFA levels after glucose intake, but not fasting FFA levels. CONCLUSIONS Future vascular resistance was predicted by insulin resistance in the adipose tissue. After glucose intake, serum FFA levels may significantly impact vascular resistance development.
Collapse
Affiliation(s)
- Nobuo Sasaki
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan; Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
| | - Yoshitaka Ueno
- Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan
| | - Ryoji Ozono
- Department of General Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukihito Higashi
- Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
2
|
Yin Z, Guo J, Li R, Zhou H, Zhang X, Guan S, Tian Y, Jing L, Sun Q, Li G, Xing L, Liu S. Common carotid artery diameter and the risk of cardiovascular disease mortality: a prospective cohort study in northeast China. BMC Public Health 2024; 24:251. [PMID: 38254061 PMCID: PMC10801967 DOI: 10.1186/s12889-024-17749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The association between the common carotid artery (CCA) diameter and cardiovascular disease (CVD) is recognized, but the precise nature of this link remains elusive. This study aimed to investigate the potential relationship between CCA diameter and the risk of CVD mortality in a large population in northeast China. METHODS The current study included 5668 participants (mean age 58.9 ± 10.1 years) from a population-based study conducted in rural areas of northeast China between September 2017 and May 2018. Information on death was collected from baseline until July 31, 2022. The CCA inter-adventitial diameter was measured using ultrasound. Cox proportional-hazard models were employed to explore the relationship between the common carotid artery diameter and cardiovascular mortality. RESULTS At baseline, the mean CCA diameter (mm) of subjects was 7.30 ± 0.99 and increased significantly with age, ranging from 6.65 ± 0.71 among people 40-49 years to 7.99 ± 1.04 among people ≥ 80 years. CCA diameter was significantly larger in males compared to females (7.51 ± 1.03 versus vs. 7.16 ± 0.94; P < 0.001). A total of 185 participants died of CVD during a median follow-up of 4.48 years. CCA diameters were divided into quartiles, and the highest quartile of carotid diameter (≥ 8.06 mm) had a 2.29 (95% confidence interval [CI]: 1.24, 4.22) times higher risk of CVD mortality than the lowest quartile (≤ 6.65 mm) (P < 0.01) in the fully adjusted model. Each increase in the diameter of the common carotid artery (per SD) raised the risk of cardiovascular death by 36% (hazard ratio [HR]: 1.36; 95% CI: 1.18, 1.57). The subgroup analysis results demonstrated that a per SD increase was associated with a 42% increased risk of CVD mortality in participants aged ≥ 64 years in the fully adjusted model (HR: 1.42; 95%CI: 1.21, 1.66). CONCLUSIONS Our study indicates the possible incremental value of CCA diameter in optimizing the risk stratification of cardiovascular disease and provides essential insights into reducing the burden of cardiovascular disease.
Collapse
Affiliation(s)
- Ziyi Yin
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110000, People's Republic of China
| | - Jiajing Guo
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110000, People's Republic of China
| | - Ru Li
- Department of Ultrasound, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, 710000, People's Republic of China
| | - Hong Zhou
- Department of Cardiovascular Ultrasound, Central Hospital of Chaoyang City, Chaoyang, 122000, People's Republic of China
| | - Xue Zhang
- Department of Cardiovascular Ultrasound, Central Hospital of Chaoyang City, Chaoyang, 122000, People's Republic of China
| | - Shanshan Guan
- Department of Cardiovascular Ultrasound, Central Hospital of Chaoyang City, Chaoyang, 122000, People's Republic of China
| | - Yuanmeng Tian
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, People's Republic of China
| | - Li Jing
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, People's Republic of China
| | - Qun Sun
- Department of Chronic Disease, Disease Control and Prevention of Chao Yang City, Chaoyang, 122000, People's Republic of China
| | - Guangxiao Li
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Liying Xing
- Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, People's Republic of China.
| | - Shuang Liu
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110000, People's Republic of China.
| |
Collapse
|
3
|
González LDM, Romero-Orjuela SP, Rabeya FJ, del Castillo V, Echeverri D. Age and vascular aging: an unexplored frontier. Front Cardiovasc Med 2023; 10:1278795. [PMID: 38028481 PMCID: PMC10665864 DOI: 10.3389/fcvm.2023.1278795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Vascular age is an emerging field in cardiovascular risk assessment. This concept includes multifactorial changes in the arterial wall, with arterial stiffness as its most relevant manifestation, leading to increased arterial pressure and pulsatile flow in the organs. Today, the approved test for measuring vascular age is pulse wave velocity, which has been proven to predict cardiovascular events. Furthermore, vascular phenotypes, such as early vascular aging and "SUPERNOVA," representing phenotypic extremes of vascular aging, have been found. The identification of these phenotypes opens a new field of study in cardiovascular physiology. Lifestyle interventions and pharmacological therapy have positively affected vascular health, reducing arterial stiffness. This review aims to define the concepts related to vascular age, pathophysiology, measurement methods, clinical signs and symptoms, and treatment.
Collapse
Affiliation(s)
- Laura del Mar González
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| | | | - Fernando J. Rabeya
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Valeria del Castillo
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| | - Darío Echeverri
- Department of Cardiology, Fundación Cardioinfantil–Instituto de Cardiología, Bogotá, Colombia
| |
Collapse
|
4
|
Nève G, Komulainen P, Savonen K, Hassinen M, Männikkö R, Infanger D, Schmidt-Trucksäss A, Rauramaa R. Adherence to Life's simple 7 is associated with better carotid properties. Atherosclerosis 2022; 360:21-26. [DOI: 10.1016/j.atherosclerosis.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/02/2022]
|
5
|
Liu XJ, Che P, Xing M, Tian XB, Gao C, Li X, Zhang N. Cerebral Hemodynamics and Carotid Atherosclerosis in Patients With Subcortical Ischemic Vascular Dementia. Front Aging Neurosci 2021; 13:741881. [PMID: 34880744 PMCID: PMC8645960 DOI: 10.3389/fnagi.2021.741881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
A growing body of evidence indicates that atherosclerosis is correlated with cerebral small vessel disease and contributes to cognitive decline. This study aimed to explore the characteristics and contributions of intracranial hemodynamics and carotid atherosclerosis to cognitive dysfunction in subjects with subcortical ischemic vascular dementia (SIVD). Notably, 44 patients with SIVD, 30 patients with Alzheimer's disease (AD), and 30 healthy controls (HCs) were recruited from our longitudinal MRI study for AD and SIVD (ChiCTR1900027943). The cerebral mean flow velocity (MFV) and pulsatility index (PI) of both anterior and posterior circulations, artery plaque, and lumen diameter in carotid arteries were investigated using transcranial Doppler and carotid ultrasound, respectively. Their correlations with cognitive function were analyzed in patients with dementia. Decreased MFV and increased PI were found in patients with SIVD and AD. Patients with SIVD showed lower MFV and higher PI in the bilateral posterior cerebral arteries compared to patients with AD. Increases in lumen diameter, number of arteries with plaque, and total carotid plaque score were found in patients with SIVD. The Mini-Mental State Examination score was positively correlated with the MFV and negatively correlated with the PI of most major cerebral arteries, while it was negatively correlated with the lumen diameter of the common carotid artery, number of arteries with plaque, and total carotid plaque score in patients with dementia. There were also correlations between these parameters of some arteries and memory and executive function. Our results provide additional evidence suggesting that the pathological changes in macrovascular structure and function are correlated with cognitive impairment in dementia patients with SIVD and to a lesser extent AD.
Collapse
Affiliation(s)
- Xiao-Jiao Liu
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Ping Che
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengya Xing
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao-Bing Tian
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunli Gao
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiuyan Li
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.,Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
6
|
Li H, Xu X, Luo B, Zhang Y. The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors-A "SPIDER" Promoting Atherosclerosis. Front Cardiovasc Med 2021; 8:706490. [PMID: 34447790 PMCID: PMC8382941 DOI: 10.3389/fcvm.2021.706490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Insufficient recommendations do not support the clinical use of carotid ultrasonography for further risk stratification in moderate-to-high risk patients with cardiovascular disease (CVD). A literature review was performed to assess six aspects of the research progress and limitations of carotid ultrasonography and carotid atherosclerosis-related risk factors: (1) structures of the carotid intima and media; (2) plaques; (3) inflammation; (4) dynamics of carotid blood flow; (5) early detection and intervention; and (6) risk factors for CVD. Although carotid intima-media thickness and carotid plaques are well-acknowledged independent predictors of CVD risk, normative and cut-off values are difficult to define due to the heterogeneous measurements reported in previous studies. Plaque properties, including location, number, density, and size, become more important risk predictors for cardiovascular disease, but a better approach for clinical use needs to be further established. Three-dimensional ultrasound and contrast-enhanced ultrasound are promising for promoting risk stratification with more details on plaque morphology. Moreover, inflammatory diseases and biomarkers should be evaluated for a full assessment of the inflammatory burden for atherosclerosis. Carotid flow velocity is not only an indicator for stenosis but also a potential risk predictor. Carotid atherosclerosis should be detected and treated early, and additional clinical trials are needed to determine the efficacy of these measures in reducing CVD risk. Cardiovascular risk factors tend to affect carotid plaques, and early treat-to-target therapy might yield clinical benefits. Based on the aforementioned six aspects, we consider that these six important factors act like a “SPIDER” spinning the web of atherosclerosis; a timely comprehensive assessment and intervention may halt the progression to CVD. Carotid ultrasound results should be combined with other atherosclerotic factors, and a comprehensive risk assessment may help to guide cardiovascular prevention decisions.
Collapse
Affiliation(s)
- Hongwei Li
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| | - Xiaolin Xu
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China
| |
Collapse
|
7
|
Zhao C, Li D, Feng C, Li S. OF-UMRN: Uncertainty-guided multitask regression network aided by optical flow for fully automated comprehensive analysis of carotid artery. Med Image Anal 2021; 70:101982. [PMID: 33609919 DOI: 10.1016/j.media.2021.101982] [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: 05/07/2020] [Revised: 12/14/2020] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
Fully automated comprehensive analysis of carotid artery (localization of range of interest (ROI), direct quantitative measurement and segmentation of lumen diameter (CALD) and intima-media thickness (CIMT), and motion estimation of the carotid wall) is a reliable auxiliary diagnosis of cardiovascular diseases, which relieves physicians from laborious workloads. No work has achieved fully automated comprehensive analysis of carotid artery due to five intractable challenges: (1) The heavy reliance on experienced carotid physicians for the selection of ROI limits fully automated studies. (2) The weak structural information of intima-media thickness increases the difficulty of feature encoding. (3) The radial motion of the carotid wall results in the lack of discriminant features of boundaries. (4) Diseased carotid arteries lose many expression features. (5) Optimal weights of multitask regression are hard to tune manually. In this paper, we propose a novel uncertainty-guided multitask regression network aided by optical flow named OF-UMRN to solve the intractable challenges. The four modules and three innovations of the OF-UMRN take their responsibility. OF-UMRN takes localization and mapping of ROI as a pre-processing. It achieves direct quantitative measurement and segmentation by a multitask regression network. And we creatively model homoscedastic uncertainty to automated tune the weights of the two tasks optimally. The OF-UMRN adopts a bidirectional mechanism to encode the optical flow used to predict the carotid wall's motion fields. More importantly, we creatively propose a dual optimization module based on the co-promotion between segmentation and motion estimation to improve the performance of radially moving and diseased carotid arteries. Therefore, the OF-UMRN makes the most of the pathological relationship between multiple objects and co-promotion between various tasks. Extensive experiments on US sequences of 101 patients have demonstrated the superior performance of OF-UMRN on the fully automated comprehensive analysis of the carotid artery. Therefore the OF-UMRN has excellent potential in clinical disease diagnoses and assessments of the carotid artery.
Collapse
Affiliation(s)
- Chengqian Zhao
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, Shandong, China; Department of Medical Imaging, Western University, London, ON, Canada; Digital Imaging Group, London, ON, Canada
| | - Dengwang Li
- Shandong Key Laboratory of Medical Physics and Image Processing, Shandong Institute of Industrial Technology for Health Sciences and Precision Medicine, School of Physics and Electronics, Shandong Normal University, Jinan, Shandong, China.
| | - Cheng Feng
- Department of Ultrasound, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen Third Peoples Hospital, Shenzhen, Guangdong, China
| | - Shuo Li
- Department of Medical Imaging, Western University, London, ON, Canada; Digital Imaging Group, London, ON, Canada.
| |
Collapse
|
8
|
Costa TJ, Barros PR, Arce C, Santos JD, da Silva-Neto J, Egea G, Dantas AP, Tostes RC, Jiménez-Altayó F. The homeostatic role of hydrogen peroxide, superoxide anion and nitric oxide in the vasculature. Free Radic Biol Med 2021; 162:615-635. [PMID: 33248264 DOI: 10.1016/j.freeradbiomed.2020.11.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/08/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023]
Abstract
Reactive oxygen and nitrogen species are produced in a wide range of physiological reactions that, at low concentrations, play essential roles in living organisms. There is a delicate equilibrium between formation and degradation of these mediators in a healthy vascular system, which contributes to maintaining these species under non-pathological levels to preserve normal vascular functions. Antioxidants scavenge reactive oxygen and nitrogen species to prevent or reduce damage caused by excessive oxidation. However, an excessive reductive environment induced by exogenous antioxidants may disrupt redox balance and lead to vascular pathology. This review summarizes the main aspects of free radical biochemistry (formation, sources and elimination) and the crucial actions of some of the most biologically relevant and well-characterized reactive oxygen and nitrogen species (hydrogen peroxide, superoxide anion and nitric oxide) in the physiological regulation of vascular function, structure and angiogenesis. Furthermore, current preclinical and clinical evidence is discussed on how excessive removal of these crucial responses by exogenous antioxidants (vitamins and related compounds, polyphenols) may perturb vascular homeostasis. The aim of this review is to provide information of the crucial physiological roles of oxidation in the endothelium, vascular smooth muscle cells and perivascular adipose tissue for developing safer and more effective vascular interventions with antioxidants.
Collapse
Affiliation(s)
- Tiago J Costa
- Pharmacology Department, Ribeirao Preto Medical School, University of São Paulo, Brazil.
| | | | - Cristina Arce
- Department of Biomedical Sciences, University of Barcelona School of Medicine and Health Sciences, Barcelona, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS)-University of Barcelona, Barcelona, Spain; Institut de Nanociencies i Nanotecnologia (IN2UB), University of Barcelona, Barcelona, Spain
| | | | - Júlio da Silva-Neto
- Pharmacology Department, Ribeirao Preto Medical School, University of São Paulo, Brazil
| | - Gustavo Egea
- Department of Biomedical Sciences, University of Barcelona School of Medicine and Health Sciences, Barcelona, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS)-University of Barcelona, Barcelona, Spain; Institut de Nanociencies i Nanotecnologia (IN2UB), University of Barcelona, Barcelona, Spain
| | - Ana Paula Dantas
- Institut Clínic del Tòrax, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Rita C Tostes
- Pharmacology Department, Ribeirao Preto Medical School, University of São Paulo, Brazil
| | - Francesc Jiménez-Altayó
- Department of Pharmacology, Therapeutics and Toxicology, Neuroscience Institute, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| |
Collapse
|
9
|
Fritze F, Groß S, Ittermann T, Völzke H, Felix SB, Schminke U, Dörr M, Bahls M. Carotid Lumen Diameter Is Associated With All-Cause Mortality in the General Population. J Am Heart Assoc 2020; 9:e015630. [PMID: 32805196 PMCID: PMC7660798 DOI: 10.1161/jaha.119.015630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Common carotid intima–media thickness (cIMT) is a biomarker for subclinical atherosclerosis and is associated with all‐cause as well as cardiovascular mortality. Higher cIMT is accompanied by a compensatory increase in lumen diameter (LD) of the common carotid arteries. Whether cIMT or LD carry more information with regard to mortality is unclear. Methods and Results A total of 2751 subjects (median age 53 years; 52% female) were included. During a median follow‐up of 14.9 years (range: 12.8–16.5) a total of 506 subjects died. At baseline, cIMT and LD were assessed by carotid ultrasound scans. Multivariable Cox regression models were used to relate cIMT, LD, LD adjusted for cIMT (LD+cIMT), and LD/cIMT ratio with all‐cause, cardiovascular, and noncardiovascular mortality. All models were ranked using Akaike's information criterion. Harrel's c statistic was used to compare the models' predictive power for mortality. A 1‐mm increase in LD was related to a higher risk for all‐cause mortality (hazard ratio [HR], 1.29; 95% CI, 1.14–1.45, P<0.01). This association remained significant when cIMT was added to the model (HR, 1.26; 95% CI, 1.11–1.42; P<0.01). A 1‐mm higher cIMT was also related with greater mortality risk (HR, 1.73; 95% CI, 1.09–2.75). The LD/cIMT ratio was not associated with all‐cause mortality. LD had the lowest Akaike's information criterion regarding all‐cause mortality and improved all‐cause mortality prediction compared with the null model (P=0.01). CIMT weakened all‐cause mortality prediction compared with the LD model. Conclusions LD provided more information for all‐cause mortality compared with cIMT in a large population‐based sample.
Collapse
Affiliation(s)
- Felix Fritze
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany
| | - Stefan Groß
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany
| | - Till Ittermann
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany.,Institute for Community Medicine University Medicine Greifswald Greifswald Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany.,Institute for Community Medicine University Medicine Greifswald Greifswald Germany
| | - Stephan B Felix
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany
| | - Ulf Schminke
- Department of Neurology University Medicine Greifswald Greifswald Germany
| | - Marcus Dörr
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald Greifswald Germany
| |
Collapse
|
10
|
Assessment of carotid cross-sectional area in hypertensive patients: phenotyping and prognostic validation in The Campania Salute Network. J Hum Hypertens 2020; 35:524-529. [PMID: 32541664 DOI: 10.1038/s41371-020-0365-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/16/2020] [Accepted: 06/01/2020] [Indexed: 11/08/2022]
Abstract
Increased intima-media thickness (IMT) of common carotid artery (CA) is considered the hallmark of vascular hypertension-mediated target organ damage, even if vessel remodeling due to mechanical stress may also induce changes in diameter. We developed a method computing both diameter and IMT of CA, to assess correlates and prognostic impact of carotid cross-sectional area (CCSA) in a large registry of treated hypertensive patients. We selected 6300 hypertensive patients of the Campania Salute Network registry free of overt cardiovascular (CV) disease and with available CA ultrasound (54 ± 11 years; 57% male). CCSA was computed as:[Formula: see text]CCSA was considered high if >90th percentile of the sex-specific distribution (>48 mm2 in men and >41 mm2 in women). Patients with high CCSA were male, with older age, higher pulse pressure (PP), more prevalent obese and diabetic, with higher total and LDL cholesterol (p < 0.01 for all). During a median follow-up of 60 months (IQR 19-87), 206 incident composite major and minor CV events occurred. In Cox regression analysis high CCSA was associated with more than 100% increased risk of incident CV events ((HR 2.11, 95%CI 1.46-3.1, p < 0.0001), independently of the effect of older age, male sex, PP > 60 mmHg, presence of left ventricular hypertrophy (LVH), carotid plaque (CP), and less anti-RAS therapy (p < 0.05 for all). In treated hypertensive patients, increased CCSA is associated with worse metabolic and lipid profile and predict incident CV events, independently of high PP, presence of LVH and CP.
Collapse
|
11
|
Wang KT, Liu YY, Sung KT, Liu CC, Su CH, Hung TC, Hung CL, Chien CY, Yeh HI. Circulating Monocyte Count as a Surrogate Marker for Ventricular-Arterial Remodeling and Incident Heart Failure with Preserved Ejection Fraction. Diagnostics (Basel) 2020; 10:diagnostics10050287. [PMID: 32397256 PMCID: PMC7277943 DOI: 10.3390/diagnostics10050287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 12/23/2022] Open
Abstract
Among 2085 asymptomatic subjects (age: 51.0 ± 10.7 years, 41.3% female) with data available on common carotid artery diameter (CCAD) and circulating total white blood cell (WBC) counts, higher circulating leukocytes positively correlated with higher high sensitivity C-reactive protein (hs-CRP). Higher WBC/segmented cells and monocyte counts were independently associated with greater relative wall thicknesses and larger CCADs, which in general were more pronounced in men and obese subjects (body mass index ≥ 25 kg/m2) (all P interaction: < 0.05). Using multivariate adjusting models, only the monocyte count independently predicted the left ventricular mass index (LVMi) (ß-Coef: 0.06, p = 0.01). Higher circulating WBC, segmented, and monocyte counts and a greater CCAD were all independently associated with a higher risk of heart failure (HF)/all-cause death during a median of 12.1 years of follow-up in fully adjusted models, with individuals manifesting both higher CCADs and monocyte counts incurring the highest risk of HF/death (adjusted hazard ratio: 2.81, 95% CI: 1.57. −5.03, p < 0.001; P interaction, 0.035; lower CCAD/lower monocyte as reference). We conclude that a higher monocyte count is associated with cardiac remodeling and carotid artery dilation. Both an elevated monocyte count and a larger CCAD may indicate a specific phenotype that confers the highest risk of HF, which likely signifies the role of circulating monocytes in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
Collapse
Affiliation(s)
- Kuang-Te Wang
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan;
| | - Yen-Yu Liu
- Critical Care Medicine, Department of Internal Medicine, MacKay Memorial Hospital, Tamsui Branch, Tamsui 25160, Taiwan;
| | - Kuo-Tzu Sung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Branch, Taipei 10449, Taiwan; (K.-T.S.); (C.-H.S.); (T.-C.H.); (H.-I.Y.)
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Chuan-Chuan Liu
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan;
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Cheng-Huang Su
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Branch, Taipei 10449, Taiwan; (K.-T.S.); (C.-H.S.); (T.-C.H.); (H.-I.Y.)
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Ta-Chuan Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Branch, Taipei 10449, Taiwan; (K.-T.S.); (C.-H.S.); (T.-C.H.); (H.-I.Y.)
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 11260, Taiwan
| | - Chung-Lieh Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Branch, Taipei 10449, Taiwan; (K.-T.S.); (C.-H.S.); (T.-C.H.); (H.-I.Y.)
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
- Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
- Correspondence: (C.-L.H.); (C.-Y.C.); Tel.: +886-2-2543-3535 (C.-L.H. & C.-Y.C.); Fax: +886-2-2543-3642 (ext. 3121) (C.-L.H. & C.-Y.C.)
| | - Chen-Yen Chien
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 11260, Taiwan
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Correspondence: (C.-L.H.); (C.-Y.C.); Tel.: +886-2-2543-3535 (C.-L.H. & C.-Y.C.); Fax: +886-2-2543-3642 (ext. 3121) (C.-L.H. & C.-Y.C.)
| | - Hung-I Yeh
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei Branch, Taipei 10449, Taiwan; (K.-T.S.); (C.-H.S.); (T.-C.H.); (H.-I.Y.)
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan
- Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
| |
Collapse
|
12
|
Watase H, Canton G, Sun J, Zhao X, Hatsukami TS, Yuan C. Four Different Carotid Atherosclerotic Behaviors Based on Luminal Stenosis and Plaque Characteristics in Symptomatic Patients: An in Vivo Study. Diagnostics (Basel) 2019; 9:diagnostics9040137. [PMID: 31581663 PMCID: PMC6963409 DOI: 10.3390/diagnostics9040137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 09/29/2019] [Accepted: 09/30/2019] [Indexed: 01/19/2023] Open
Abstract
Correct stratification of ischemic stroke risk allows for the proper treatment of carotid atherosclerotic disease. We seek to differentiate plaque types based on stenosis level and plaque morphology. The Chinese Atherosclerosis Risk Evaluation (CARE-II) study is a cross-sectional, observational, multicenter study to assess carotid atherosclerotic plaques in symptomatic subjects using vessel wall magnetic resonance imaging. Plaque morphology and presence of plaque components were reviewed using multi-contrast magnetic resonance imaging. The carotid arteries were divided into four groups based on stenosis level and plaque components. Out of 1072 ischemic stroke subjects, 452 ipsilateral side carotid arteries were included. Significant stenosis (SS) (≥50% stenosis) with high-risk plaque (HRP) features was present in 37 arteries (8.2%), SS(+)/HRP(-) in 29 arteries (6.4%), SS(-)/HRP(+) in 57 arteries (12.6%), and SS(-)/HRP(-) in 329 arteries (72.8%). The prevalence of SS(-)/HRP(+) arteries in this cohort was substantial and had greater wall thickness than the SS(+)/HRP(-) group. These arteries may be misclassified for carotid revascularization by current guidelines based on the degree of luminal stenosis only. These findings have implications for further studies to assess stroke risk using vessel wall imaging.
Collapse
Affiliation(s)
- Hiroko Watase
- Department of Surgery, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA.
| | - Gador Canton
- Department of Radiology, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA.
| | - Jie Sun
- Department of Radiology, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA.
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, China Haidian District, Beijing 100084, China.
| | - Thomas S Hatsukami
- Department of Surgery, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA.
| | - Chun Yuan
- Department of Radiology, University of Washington, United States 850 Republican Street, Seattle, WA 98109, USA.
| |
Collapse
|
13
|
Holwerda SW, Luehrs RE, DuBose LE, Majee R, Pierce GL. Sex and age differences in the association between sympathetic outflow and central elastic artery wall thickness in humans. Am J Physiol Heart Circ Physiol 2019; 317:H552-H560. [PMID: 31274352 DOI: 10.1152/ajpheart.00275.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Aging is characterized by increased wall thickness of the central elastic arteries (i.e., aorta and carotid arteries), although the mechanisms involved are unclear. Evidence suggests that age-related increases in muscle sympathetic nerve activity (MSNA) may be a contributing factor. However, studies in humans have been lacking. Therefore, we tested the hypothesis that age-related increases in MSNA would be independently associated with carotid artery intima-media thickness (IMT) but not in young women given the reduced influence of MSNA on the vasculature in this group. In 93 young and middle-age/older (MA/O) adults (19-73 yr, 41 women), we performed assessments of MSNA (microneurography) and common carotid IMT and lumen diameter (ultrasonography). Multiple regression that included MSNA and other cardiovascular disease risk factors indicated that MSNA (P = 0.002) and 24-h systolic blood pressure (BP) (P = 0.024) were independent determinants of carotid IMT-to-lumen ratio (model R2 = 0.38, P < 0.001). However, when examining only young women (<45 yr), no correlation was observed between MSNA and carotid IMT-to-lumen ratio (R = -0.01, P = 0.963). MSNA was significantly correlated with IMT-to-lumen ratio while controlling for 24-h systolic BP among young men (R = 0.49, P < 0.001) and MA/O women (R = 0.59, P = 0.022). However, among MA/O men, controlling for 24-h systolic BP attenuated the association between MSNA and carotid IMT-to-lumen ratio (R = 0.50, P = 0.115). Significant age differences in IMT-to-lumen ratio between young and MA/O men (P = 0.047) and young and MA/O women (P = 0.023) were removed when adjusting for MSNA (men: P = 0.970; women: P = 0.152). These findings demonstrate an association between higher sympathetic outflow and carotid artery wall thickness with a particular exception to young women.NEW & NOTEWORTHY Increased wall thickness of the large elastic arteries serves as a graded marker for cardiovascular disease risk and progression of atherosclerosis. Findings from the present study establish an independent association between higher sympathetic outflow and carotid artery wall thickness in adults with an exception to young women and extend findings from animal models that demonstrate hypertrophy of vascular smooth muscle following chronic sympathetic-adrenergic stimulation.
Collapse
Affiliation(s)
- Seth W Holwerda
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
| | - Rachel E Luehrs
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Lyndsey E DuBose
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Rumbidzai Majee
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa
| |
Collapse
|
14
|
Lim ST, Park JK, Park SH, Lee EJ, Kim WN, Min SK. The effects of the elastin polymorphisms on carotid intima-media thickness in women aged 30 - 70. J Exerc Nutrition Biochem 2018; 22:18-22. [PMID: 30149422 PMCID: PMC6058069 DOI: 10.20463/jenb.2018.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/30/2018] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Elastin is one of the major determinants of arterial distensibility of large blood vessels that forms the principal component of elastic fibers from the media of arteries. However, the association between elastin(ELN) genotype and vascular function is still unclear. [Methods] 120women were recruited from the Saha-gu (Busan, Korea) Community Center. Measurements of body composition and vascular function included carotid intima-media thickness (CIMT), carotid artery luminal diameter (CLD), minimum (diastolic) artery luminal diameter (CLDmin) and maximum (systolic) artery luminal diameter (CLDmax). Genotyping for the ELN (rs 2071307) polymorphism was performed using the TaqMan approach. ELN gene distribution of subjects were in the Hardy-Weinberg equilibrium (p=0.402). [Results] The relative CIMT differed significantly among the ELN genotypes. And not significant differences in CLD and CIMT/CLD ratio, but AA genotype was tended higher than other genotypes (AG and GG). The relative CIMT and CLD min differed significantly between the ELN alleles. And not significant differences in CLD max and CIMT/CLD ratio, but A allele was tended higher than G allele. [Conclusion] These results suggest that ELN gene polymorphism might be used a one of the genetic determinants of vascular disease in both pre- and postmenopausal women.
Collapse
|
15
|
Niemczyk NA, Bertolet M, Catov JM, Desai M, McClure CK, Roberts JM, Sekikawa A, Tepper PG, Barinas-Mitchell EJ. Common carotid artery intima-media thickness increases throughout the pregnancy cycle: a prospective cohort study. BMC Pregnancy Childbirth 2018; 18:195. [PMID: 29855290 PMCID: PMC5984334 DOI: 10.1186/s12884-018-1841-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/22/2018] [Indexed: 12/04/2022] Open
Abstract
Background High parity is associated with greater cardiovascular disease (CVD) among mid-life and older women. Prospective studies of arterial change throughout pregnancy are needed to provide insight into potential mechanisms. This study assessed vascular adaptation across pregnancy in healthy first-time pregnant women. Methods The Maternal Vascular Adaptation to Healthy Pregnancy Study (Pittsburgh, PA, 2010–2015) assessed 37 primigravid women each trimester, 6–8 weeks after delivery and 1–5 years postpartum, with B-mode ultrasound imaging of common carotid artery (CCA) intima-media thickness (IMT) and inter-adventitial diameter (IAD) to assess associations with physical and cardiometabolic measures. Results Thirty-seven women (age 28.2 ± 4.5 years, pre-pregnant BMI 24.4 ± 3.2 kg/m2) experienced uncomplicated pregnancies. After adjustment for age and pre-pregnancy BMI, mean (SE) IAD (mm) increased each trimester, from 6.38 (0.08) in the 1st trimester to 6.92 (0.09) in the 3rd trimester, and then returned to 1st trimester levels postpartum (6.35 [0.07], P < 0.001). In contrast, mean (SE) CCA IMT (mm) increased from the 2nd trimester (i.e., 0.546 [0.01]) onward, and remained higher at an average of 2.7 years postpartum (0.581 [0.02], P = 0.03). Weight partially explained changes in IAD. Conclusions In uncomplicated first pregnancies, IAD increased and returned to 1st trimester levels postpartum. In contrast, CCA IMT remained increased 2 years postpartum. Maternal weight explained vascular changes better than did metabolic changes. Increased postpartum CCA IMT may persist and contribute to long-term CVD risk. Electronic supplementary material The online version of this article (10.1186/s12884-018-1841-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nancy Anderson Niemczyk
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA. .,Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA, 15261, USA.
| | - Marianne Bertolet
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Janet M Catov
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.,Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15213, USA.,Department of Clinical and Translational Research, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15213, USA
| | - Mansi Desai
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Candace K McClure
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - James M Roberts
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.,Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15213, USA.,Department of Clinical and Translational Research, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15213, USA.,Magee-Womens Research Institute, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC), 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Ping Guo Tepper
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Emma J Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| |
Collapse
|
16
|
Lorenz MW, Gao L, Ziegelbauer K, Norata GD, Empana JP, Schmidtmann I, Lin HJ, McLachlan S, Bokemark L, Ronkainen K, Amato M, Schminke U, Srinivasan SR, Lind L, Okazaki S, Stehouwer CDA, Willeit P, Polak JF, Steinmetz H, Sander D, Poppert H, Desvarieux M, Ikram MA, Johnsen SH, Staub D, Sirtori CR, Iglseder B, Beloqui O, Engström G, Friera A, Rozza F, Xie W, Parraga G, Grigore L, Plichart M, Blankenberg S, Su TC, Schmidt C, Tuomainen TP, Veglia F, Völzke H, Nijpels G, Willeit J, Sacco RL, Franco OH, Uthoff H, Hedblad B, Suarez C, Izzo R, Zhao D, Wannarong T, Catapano A, Ducimetiere P, Espinola-Klein C, Chien KL, Price JF, Bergström G, Kauhanen J, Tremoli E, Dörr M, Berenson G, Kitagawa K, Dekker JM, Kiechl S, Sitzer M, Bickel H, Rundek T, Hofman A, Mathiesen EB, Castelnuovo S, Landecho MF, Rosvall M, Gabriel R, de Luca N, Liu J, Baldassarre D, Kavousi M, de Groot E, Bots ML, Yanez DN, Thompson SG. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. PLoS One 2018; 13:e0191172. [PMID: 29649236 PMCID: PMC5896895 DOI: 10.1371/journal.pone.0191172] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/29/2017] [Indexed: 12/28/2022] Open
Abstract
AIMS Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
Collapse
Affiliation(s)
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Cambridge, United Kingdom
| | | | - Giuseppe Danilo Norata
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy
| | - Jean Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), University Paris Descartes, Sorbonne Paris Cité, UMR, Paris, France
| | - Irene Schmidtmann
- Institut fuer Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitaetsmedizin Mainz, Mainz, Germany
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Stela McLachlan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, Institution for Medicin, Department for Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Sathanur R. Srinivasan
- Center for Cardiovascular Health, Department of Epidemiology, Biochemistry, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Coen D. A. Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Joseph F. Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Dirk Sander
- Department of Neurology, Benedictus Hospital Tutzing & Feldafing, Feldafing, Germany
| | - Holger Poppert
- Department of Neurology, Technische Universität München, Munich, Germany
| | - Moise Desvarieux
- Department of Epidemiology,Mailman School of Public Health,Columbia University, New York, United States of America
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stein Harald Johnsen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Daniel Staub
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Cesare R. Sirtori
- Center of Dyslipidemias, Niguarda Ca’ Granda Hospital, Milano, Italy
| | - Bernhard Iglseder
- Parcelsus Medical University, Salzburg, Austria
- Department of Geriatric Medicine, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik, Salzburg, Austria
| | - Oscar Beloqui
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Alfonso Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Wuxiang Xie
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Liliana Grigore
- Centro Sisa per lo Studio della Aterosclerosi, Bassini Hospital, Cinisello Balsamo, Italy
| | - Matthieu Plichart
- Assistance Publique, Hôpitaux de Paris, Hôpital Broca, Paris, France
| | - Stefan Blankenberg
- 2nd Department of Medicine, Johannes Gutenberg-Universität, Mainz, Germany
- Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | | | - Henry Völzke
- German Center for Cardiovascular Research (DZHK),partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, Greifswald, Germany
| | - Giel Nijpels
- Department of General Practice, VU University Medical Center, Amsterdam, the Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Raffaele Izzo
- School of Medicine, Federico II University, Naples, Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Thapat Wannarong
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Alberico Catapano
- IRCSS Multimedica, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | | | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health,National Taiwan University, Taipei, Taiwan
| | - Jackie F. Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, Gothenburg University, Götheborg, Sweden
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Elena Tremoli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Marcus Dörr
- Department B for Internal Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Gerald Berenson
- Department of Medicine, Pediatrics, Biochemistry, Epidemiology, Tulane University School of Medicine and School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Horst Bickel
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Uit The Arctic University of Norway, Tromsø, Norway
| | | | - Manuel F. Landecho
- Department of Internal Medicine, University Clinic of Navarra, Navarra, Spain
| | - Maria Rosvall
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Rafael Gabriel
- Escuela National de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Nicola de Luca
- School of Medicine, Federico II University, Naples, Italy
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases,Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Maryam Kavousi
- Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Eric de Groot
- Imagelabonline & Cardiovascular, Eindhoven and Lunteren, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - David N. Yanez
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Simon G. Thompson
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | | |
Collapse
|
17
|
Association between common carotid artery diameter and target organ damage in essential hypertension. J Hypertens 2018; 36:537-543. [DOI: 10.1097/hjh.0000000000001590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Watase H, Sun J, Hippe DS, Balu N, Li F, Zhao X, Mani V, Fayad ZA, Fuster V, Hatsukami TS, Yuan C. Carotid Artery Remodeling Is Segment Specific: An In Vivo Study by Vessel Wall Magnetic Resonance Imaging. Arterioscler Thromb Vasc Biol 2018; 38:927-934. [PMID: 29472231 DOI: 10.1161/atvbaha.117.310296] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/07/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Early atherosclerosis is often undetected due in part to compensatory enlargement of the outer wall, termed positive remodeling. Variations in hemodynamic conditions and clinical factors influence the patterns of remodeling. The carotid artery provides an opportunity to examine these variations because of the unique geometry of the carotid bulb. This study aimed to determine differences in remodeling of the common, internal, and bifurcation segments of the carotid using magnetic resonance imaging. APPROACH AND RESULTS Carotid arteries of 525 subjects without history of cardiovascular disease were imaged by magnetic resonance imaging. The carotid artery was divided into 3 segments: common carotid artery; bifurcation; and internal carotid artery. Remodeling patterns were characterized using linear regression analysis of lumen and total vessel areas (dependent variables) compared with maximum wall thickness (independent variable) for each segment, adjusted for age, sex, and height. The common carotid artery demonstrated a pattern consistent with positive remodeling, whereas the bifurcation demonstrated negative remodeling. The internal carotid artery demonstrated a mixed pattern of outer wall expansion and lumen constriction. Females and subjects with diabetes mellitus showed more positive remodeling, hypertension was associated with attenuated positive remodeling, and those with hypercholesterolemia showed more negative remodeling. CONCLUSIONS In this cohort of 55- to 80-year-old individuals without history of cardiovascular disease, the pattern of early carotid artery remodeling was segment specific and appeared to be associated with sex and clinical characteristics. These findings provide the groundwork for longitudinal studies to define local and systemic factors such as hemodynamic and clinical conditions on carotid artery remodeling.
Collapse
Affiliation(s)
- Hiroko Watase
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Jie Sun
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Daniel S Hippe
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Niranjan Balu
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Feiyu Li
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Xihai Zhao
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Venkatesh Mani
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Zahi A Fayad
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Valentin Fuster
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Thomas S Hatsukami
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.)
| | - Chun Yuan
- From the Department of Surgery (H.W., T.S.H.) and Department of Radiology (J.S., D.S.H., N.B., C.Y.), University of Washington, Seattle; Department of Radiology, Peking University First Hospital, Beijing, China (F.L.); Department of Biomedical Engineering, Tsinghua University, Beijing, China (X.Z.); Translational and Molecular Imaging Institute (V.M., Z.A.F.) and Cardiovascular Institute (V.F.), Icahn School of Medicine at Mount Sinai, New York; and Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (V.F.).
| |
Collapse
|
19
|
Chnafa C, Bouillot P, Brina O, Delattre BMA, Vargas MI, Lovblad KO, Pereira VM, Steinman DA. Vessel calibre and flow splitting relationships at the internal carotid artery terminal bifurcation. Physiol Meas 2017; 38:2044-2057. [DOI: 10.1088/1361-6579/aa92bf] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
20
|
Xu X, Wang B, Ren C, Hu J, Greenberg DA, Chen T, Xie L, Jin K. Age-related Impairment of Vascular Structure and Functions. Aging Dis 2017; 8:590-610. [PMID: 28966804 PMCID: PMC5614324 DOI: 10.14336/ad.2017.0430] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/30/2017] [Indexed: 12/12/2022] Open
Abstract
Among age-related diseases, cardiovascular and cerebrovascular diseases are major causes of death. Vascular dysfunction is a key characteristic of these diseases wherein age is an independent and essential risk factor. The present work will review morphological alterations of aging vessels in-depth, which includes the discussion of age-related microvessel loss and changes to vasculature involving the capillary basement membrane, intima, media, and adventitia as well as the accompanying vascular dysfunctions arising from these alterations.
Collapse
Affiliation(s)
- Xianglai Xu
- 1Zhongshan Hospital, Fudan University, Shanghai 200032, China.,2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | - Brian Wang
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | - Changhong Ren
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA.,4Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University. Beijing, China
| | - Jiangnan Hu
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | | | - Tianxiang Chen
- 6Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Liping Xie
- 3Department of Urology, the First Affiliated Hospital, Zhejiang University, Zhejiang Province, China
| | - Kunlin Jin
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| |
Collapse
|
21
|
LeBlanc S, Bibeau K, Bertrand OF, Lévesque V, Deschênes St-Pierre B, Pibarot P, Després JP, Larose E. Carotid versus coronary atherosclerosis burdens in acute compared with chronic symptomatic coronary artery disease. Can J Physiol Pharmacol 2017; 95:878-887. [PMID: 28520469 DOI: 10.1139/cjpp-2016-0588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Prediction of coronary events remains elusive. Carotid atherosclerosis may be a surrogate for coronary risk, as carotid and coronary diseases occur simultaneously - albeit at times with a weak association - depending on clinical presentation. We investigated carotid and coronary atherosclerosis in men with new-onset unstable coronary artery disease (CAD) presenting with acute ST-segment elevation myocardial infarction (STEMI) vs. long-standing severe chronic stable angina (CSA). Bilateral carotid artery and 3-vessel coronary artery atherosclerosis burdens were measured within 1 month, respectively, by 3D-volumetric carotid magnetic resonance imaging and coronary angiography-derived modified CASS-50 score. Men with STEMI (n = 50) and long-standing CSA (n = 50), matched for age, were enrolled (58.6 ± 8.8 years). All of them had carotid atherosclerosis. Atherosclerosis burden was greater in the carotid arteries of STEMI vs. CSA (wall volume: 196.2 ± 44.4 vs. 169.2 ± 38.0 mm3/4 mm, p = 0.002), but greater in the coronary arteries of CSA vs. STEMI (modified CASS-50 score: 3 vs. 1, p < 0.0001). Normalized wall index (NWI) of internal carotid was associated with modified CASS-50 score in STEMI (ρ = 0.40, p = 0.022) and in CSA (ρ = -0.39, p = 0.031). Carotid atherosclerosis was observed in all CAD patients, and atherosclerosis burden in carotid and in coronary arteries varied according to clinical presentation.
Collapse
Affiliation(s)
- Stéphanie LeBlanc
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Karine Bibeau
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada
| | - Olivier F Bertrand
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Valérie Lévesque
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Béatrice Deschênes St-Pierre
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Philippe Pibarot
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Jean-Pierre Després
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Eric Larose
- a Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Québec City, QC G1V 4G5, Canada.,b Département de médecine, Faculté de médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| |
Collapse
|
22
|
García García J, Roquer J, Serena J, Castillo J, Blanco M, Díaz-Maroto I, Segura T. Carotid Intima-Media Thickness is Not Associated with Markers of Atherosclerosis in Stroke Patients. J Stroke Cerebrovasc Dis 2016; 25:1070-1075. [PMID: 26853138 DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 10/26/2015] [Accepted: 01/02/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND It has been argued that carotid intima-media thickness (IMT) could better reflect an adaptive response of the vessel wall rather than being a marker of atherosclerosis. We explore this hypothesis by analyzing the ARTICO data. METHODS The ARTICO study was designed to evaluate the prognostic value of the pathological ankle-brachial index (ABI) for the emergence of new vascular events in patients who have suffered a noncardioembolic stroke. Collected variables were as follows: vascular risk factors, mean waist perimeter, quantification of carotid IMT, characteristics of carotid plaques, ABI, and presence of microalbuminuria. RESULTS A total of 591 patients with a complete carotid evaluation were available. There was no correlation between ABI and IMT (Spearman's, p NS). Logistic regression revealed that pathological ABI correlated significantly only with internal carotid artery stenosis greater than or equal to 50% (OR [odds ratio] 2.80, 1.66-4.71, P < .01) and peripheral artery disease (OR 3.33, 1.63-6.78, P < .01). However, multivariate regression analysis demonstrated that carotid IMT was independently associated with age (OR 1.05, 95% confidence interval [CI] 1.02-1.09, P < .01), hypertension (OR 1.83, 95% CI 1.02-3.26, P = .04), waist circumference (OR 1.03, 95% CI 1.01-1.05, P < .01), and microalbuminuria (OR 2.02, 95% CI 1.22-3.35, P < .01). CONCLUSION In our patients, carotid IMT does not seem to be associated with unequivocal markers of atheromatosis such as the existence of relevant carotid plaques or pathological ABI. These results as well as the association of IMT with age, hypertension, microalbuminuria, and mean waist perimeter support the hypothesis that IMT must be considered a risk factor for general vascular disease rather than a marker of atherosclerotic burden.
Collapse
Affiliation(s)
- Jorge García García
- Department of Neurology, Hospital Universitario de Albacete, Albacete, Spain.
| | - Jaume Roquer
- Department of Neurology, Hospital Universitari del Mar, Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), DCEXS Universitat Pompeu Fabra, Barcelona, Spain
| | - Joaquín Serena
- Department of Neurology, Hospital Universitario Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona, Girona, Spain
| | - José Castillo
- Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Blanco
- Department of Neurology, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Tomás Segura
- Department of Neurology, Hospital Universitario de Albacete, Albacete, Spain
| | | |
Collapse
|
23
|
Krishnamurthy VN, Naeem M, Murphy TP, Cerezo J, Jordan PG, Goldberg SH, Ershow AG, Hirsch AT, Oldenburg N, Cutlip DE. The effect of gender on outcomes of aortoiliac artery interventions for claudication. Clin Imaging 2015; 40:96-100. [PMID: 26439658 DOI: 10.1016/j.clinimag.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/19/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the relationship between gender, native artery diameters, and outcomes of stent revascularization (ST) in the "Claudication: Exercise versus Endoluminal Revascularization" trial. METHODS A comparative analysis was performed of the impact of gender, age, weight, height, body mass index, and body surface area on revascularization outcomes at baseline and 6months in 55 arterial segments of aorta, common iliac artery, and external iliac artery (EIA). RESULTS Women demonstrated smaller diameter of the EIA. However, the clinical outcomes of revascularization were not negatively affected by the gender-based differences. CONCLUSION Gender-based differences are unlikely to significantly impact outcome of ST.
Collapse
Affiliation(s)
| | - Muhammad Naeem
- Vascular Disease Research Center, Department of Diagnostic Imaging, Division of Vascular and Interventional Radiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Timothy P Murphy
- Vascular Disease Research Center, Department of Diagnostic Imaging, Division of Vascular and Interventional Radiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Joselyn Cerezo
- Vascular Disease Research Center, Department of Diagnostic Imaging, Division of Vascular and Interventional Radiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Paul Gaither Jordan
- Vascular Disease Research Center, Department of Diagnostic Imaging, Division of Vascular and Interventional Radiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Suzanne H Goldberg
- Nutrition Branch, Division of Cardiovascular Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, MD, USA
| | - Abby G Ershow
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 8160, MSC 7956, Bethesda, MD, USA.
| | - Alan T Hirsch
- Cardiovascular Division and Lillehei Heart Institute, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, USA.
| | - Niki Oldenburg
- Cardiovascular Division and Lillehei Heart Institute, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, USA.
| | - Donald E Cutlip
- Clinical Investigations, Harvard Clinical Research Institute, 930 Commonwealth Avenue, Boston, MA, USA.
| |
Collapse
|
24
|
Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, Kavousi M, Dörr M, Stensland E, Ducimetiere P, Ronkainen K, Kiechl S, Sitzer M, Rundek T, Lind L, Liu J, Bergström G, Grigore L, Bokemark L, Friera A, Yanez D, Bickel H, Ikram MA, Völzke H, Johnsen SH, Empana JP, Tuomainen TP, Willeit P, Steinmetz H, Desvarieux M, Xie W, Schmidt C, Norata GD, Suarez C, Sander D, Hofman A, Schminke U, Mathiesen E, Plichart M, Kauhanen J, Willeit J, Sacco RL, McLachlan S, Zhao D, Fagerberg B, Catapano AL, Gabriel R, Franco OH, Bülbül A, Scheckenbach F, Pflug A, Gao L, Thompson SG. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care 2015; 38:1921-9. [PMID: 26180107 PMCID: PMC4580609 DOI: 10.2337/dc14-2732] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 06/20/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 population-based cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference in mean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97 mm across cohorts in people with diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between -0.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.
Collapse
Affiliation(s)
- Matthias W Lorenz
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Jackie F Price
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Christine Robertson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joseph F Polak
- Tufts University School of Medicine, Tufts Medical Center, Boston, MA
| | - Holger Poppert
- Department of Neurology, University Hospital of the Technical University of Munich, Munich, Germany
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marcus Dörr
- Department of Internal Medicine B/Cardiology, Greifswald University Clinic, Greifswald, Germany
| | - Eva Stensland
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | | | - Kimmo Ronkainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Matthias Sitzer
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany Department of Neurology, Klinikum Herford, Herford, Germany
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Lars Lind
- Department of Medicine, Uppsala University, Uppsala, Sweden
| | - Jing Liu
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Liliana Grigore
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy IRCCS MultiMedica, Milan, Italy
| | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Alfonsa Friera
- Radiology Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - David Yanez
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Horst Bickel
- Department of Psychiatry, University Hospital of the Technical University of Munich, Munich, Germany
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University of Greifswald, Greifswald, Germany German Centre for Cardiovascular Research, Greifswald, Germany
| | - Stein Harald Johnsen
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Neurology and Neurophysiology, University Hospital of Northern Norway, Tromsø, Norway
| | | | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
| | - Helmuth Steinmetz
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY École des Hautes Études en Santé Publique, Paris, France INSERM U 738, Paris, France
| | - Wuxiang Xie
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Giuseppe D Norata
- SISA Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Carmen Suarez
- Internal Medicine Department, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Dirk Sander
- Department of Neurology, University Hospital of the Technical University of Munich, Munich, Germany Department of Neurology, Benedictus Hospital Tutzing and Feldafing, Feldafing, Germany
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Ulf Schminke
- Department of Neurology, Greifswald University Clinic, Greifswald, Germany
| | - Ellisiv Mathiesen
- Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Neurology and Neurophysiology, University Hospital of Northern Norway, Tromsø, Norway
| | - Matthieu Plichart
- INSERM U 970, Paris, France Gerontology Department, Broca Hospital, Paris, France
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Stela McLachlan
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, U.K
| | - Dong Zhao
- Department of Epidemiology, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Björn Fagerberg
- Wallenberg Laboratory for Cardiovascular Research, University of Gothenburg, Gothenburg, Sweden
| | - Alberico L Catapano
- IRCCS MultiMedica, Milan, Italy Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Rafael Gabriel
- Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Alpaslan Bülbül
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Frank Scheckenbach
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Anja Pflug
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Lu Gao
- MRC Biostatistics Unit, Institute of Public Health, Cambridge, U.K
| | - Simon G Thompson
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K
| |
Collapse
|
25
|
Kozakova M, Palombo C, Morizzo C, Højlund K, Hatunic M, Balkau B, Nilsson PM, Ferrannini E. Obesity and carotid artery remodeling. Nutr Diabetes 2015; 5:e177. [PMID: 26302064 PMCID: PMC4558557 DOI: 10.1038/nutd.2015.26] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 06/18/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/OBJECTIVE The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions characterized by body size-dependent increase in stroke volume (SV) and blood pressure (BP). SUBJECTS/METHODS Common carotid artery (CCA) luminal diameter (LD), IMT and CWS were measured in three different populations in order to study: (A) cross-sectional associations between SV, BP, anthropometric parameters and CCA LD (266 healthy subjects with wide range of body weight (24-159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects without CV complications and 88 non-obese subjects matched for gender and age). RESULTS CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile was significantly higher (28±3 μm) as compared with those in the lower quartiles (8±3, 16±4 and 16±3 μm, P=0.001, P<0.05 and P=0.01, respectively). In addition, CCA CWS decreased during the observational period in the highest LD quartile (from 54.2±8.6 to 51.6±7.4 kPa, P<0.0001). As compared with gender- and age-matched lean individuals, obese subjects had highly increased CCA LD and BP (P<0.0001 for both), but only slightly higher CWS (P=0.05) due to a significant increase in IMT (P=0.005 after adjustment for confounders). CONCLUSIONS Our findings suggest that in obese subjects, the CCA wall thickens to compensate the luminal enlargement caused by body size-induced increase in SV, and therefore, to normalize the wall stress. CCA diameter in obesity could represent an additional biomarker, depicting the impact of altered hemodynamics on arterial wall.
Collapse
Affiliation(s)
- M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - C Morizzo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - K Højlund
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - M Hatunic
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - B Balkau
- INSERM, CESP, Center for Research in Epidemiology and Population Health, U1018, University Paris Sud, Villejuif, France
| | - P M Nilsson
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - E Ferrannini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
26
|
Rashid SA, Mahmud SA. Correlation between Carotid Artery Intima-Media Thickness and Luminal Diameter with Body Mass Index and Other Cardiovascular Risk Factors in Adults. Sultan Qaboos Univ Med J 2015; 15:e344-50. [PMID: 26357554 DOI: 10.18295/squmj.2015.15.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 02/18/2015] [Accepted: 03/29/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES This study aimed to examine the correlation between carotid artery intima-media thickness (IMT) and luminal diameter (LD) with body mass index (BMI) and other cardiovascular risk factors. METHODS This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects ≥20 years old (n = 140) were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension (HTN), diabetes (DM), smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride (TG) levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. RESULTS The mean IMT was 0.8 ± 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI (P = 0.04), but not between BMI and LD (P = 0.3). No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels (P <0.001). An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. CONCLUSION Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis.
Collapse
Affiliation(s)
- Sameeah A Rashid
- Departments of Surgery, College of Medicine, Hawler Medical University, Hawler, Iraq
| | - Sarbast A Mahmud
- Radiology, College of Medicine, Hawler Medical University, Hawler, Iraq
| |
Collapse
|
27
|
Chien CY, Liu CC, Po HL, Yen CH, Hou CJY, Kuo JY, Hung CL, Wang SS, Yeh HI, Lam CSP. The Relationship among Carotid Artery Remodeling, Cardiac Geometry, and Serum N-Terminal Pro-B-Type Natriuretic Peptide Level in Asymptomatic Asians: Sex-Differences and Longitudinal GEE Study. PLoS One 2015; 10:e0131440. [PMID: 26132728 PMCID: PMC4489394 DOI: 10.1371/journal.pone.0131440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/01/2015] [Indexed: 11/28/2022] Open
Abstract
Background Carotid artery remodeling is known to be associated with a variety of cardiovascular diseases. However, there is limited information regarding gender differences in carotid remodeling. We sought to investigate the associations among blood pressure (BP), carotid artery remodeling and cardiac geometries, and further explore gender differences. Materials and Methods In a large cohort of asymptomatic adults undergoing routine health screening with repeated observations, we related measures of carotid artery diameter (CCAD) to various BP components, cardiac geometries and blood N-terminal pro-brain natriuretic peptide (NT-proBNP) level, both from baseline cross-sectional and longitudinal dataset using generalized estimating equations (GEE). Results A total of 2,914 person-visits (baseline: n=998, mean age: 47 ± 8.9 years, 34% female) were studied (median: 6 ± 1.73 years follow up). We observed that CCAD was larger in men (p<0.01) and positively related to baseline age or all blood pressure components (including systolic BP [SBP], diastolic BP [DBP] and pulse pressure [PP], all p<0.01) even after accounting for clinical covariates, which did not change significantly at follow up (repeat-visit longitudinal GEE models). At baseline, per each increased unit of CCAD was associated with elevated LV mass index (β-coef: 6.72, with odds ratio [OR]: 1.47, 95% CI: 1.06 to 2.07 for ventricular hypertrophy; AUROC: 0.65, CCAD cut-off: 7.25mm) and NT-proBNP (β-coef: 5.35, OR: 4.22, 95% CI: 1.42 to 12.6 for >=300pg/mL; AUROC: 0.79, CCAD cut-off: 7.95mm, all p<0.05), which remained significant in multi-variate and longitudinal models. There was a prominent sex interaction (p for interaction with age and systolic BP: 0.004 and 0.028 respectively), where the longitudinal associations of age and systolic BP with increasing CCAD as more pronounced in women than men. Conclusion These data demonstrated that carotid artery remodeling may parallel subclinical biomarker of cardiac dysfunction, and further showed greater effects of aging and higher blood pressure on such remodeling process in women than men. Further study is warranted to understand how this predisposition of elderly hypertensive women to vascular remodeling may play a role in clinical settings.
Collapse
Affiliation(s)
- Chen-Yen Chien
- Division of Cardiovascular Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Chuan-Chuan Liu
- Mackay Medical College, New Taipei City, Taiwan
- Health Evaluation Center, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medical Technology, Yuanpei University of Science and Technology, Hsin-Chu, Taiwan
- Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Helen L. Po
- Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chih-Hsuan Yen
- Mackay Medical College, New Taipei City, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Charles Jia-Yin Hou
- Mackay Medical College, New Taipei City, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Jen-Yuan Kuo
- Mackay Medical College, New Taipei City, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Chung-Lieh Hung
- Mackay Medical College, New Taipei City, Taiwan
- Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
- Department of Health Industry Management, Kainan University, Taoyuan, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| | - Shoei-Shen Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-I Yeh
- Mackay Medical College, New Taipei City, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Carolyn S. P. Lam
- Yong Loo Lin School of Medicine, NUS, National University Health System, Singapore, Singapore
| |
Collapse
|
28
|
Xu X, Su S, Wang X, Barnes V, De Miguel C, Ownby D, Pollock J, Snieder H, Chen W, Wang X. Obesity is associated with more activated neutrophils in African American male youth. Int J Obes (Lond) 2014; 39:26-32. [PMID: 25388404 PMCID: PMC4286492 DOI: 10.1038/ijo.2014.194] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/30/2014] [Accepted: 10/13/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is emerging evidence suggesting the role of peripheral blood leukocytes in the pathogenesis of obesity and related diseases. However, few studies have taken a genome-wide approach to investigating gene expression profiles in peripheral leukocytes between obese and lean individuals with the consideration of obesity-related shifts in leukocyte types. METHOD We conducted this study in 95 African Americans (AAs) of both genders (age 14-20 years, 46 lean and 49 obese). Complete blood count with differential test (CBC) was performed in whole blood. Genome-wide gene expression analysis was obtained using the Illumina HumanHT-12 V4 Beadchip with RNA extracted from peripheral leukocytes. Out of the 95 participants, 64 had neutrophils stored. The validation study was based on real-time PCR with RNA extracted from purified neutrophils. RESULTS CBC test suggested that, in males, obesity was associated with increased neutrophil percentage (P=0.03). Genome-wide gene expression analysis showed that, in males, the majority of the most differentially expressed genes were related to neutrophil activation. Validation of the gene expression levels of ELANE (neutrophil elastase) and MPO (myeloperoxidase) in purified neutrophils demonstrated that the expression of these two genes--important biomarkers of neutrophils activation--were significantly elevated in obese males (P=0.01 and P=0.02, respectively). CONCLUSION The identification of increased neutrophil percentage and activation in obese AA males suggests that neutrophils have an essential role in the pathogenesis of obesity-related disease. Further functional and mechanistic studies on neutrophils may contribute to the development of novel intervention strategies reducing the burden associated with obesity-related health problems.
Collapse
Affiliation(s)
- X Xu
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - S Su
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - X Wang
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - V Barnes
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| | - C De Miguel
- Cardio-Rental Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Ownby
- Department of Experimental Medicine, Georgia Regents University, Augusta, GA, USA
| | - J Pollock
- Cardio-Rental Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - H Snieder
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - W Chen
- Department of Physiology and Endocrinology, Georgia Regents University, Augusta, GA, USA
| | - X Wang
- Department of Pediatrics, Georgia Prevention Center, Institute of Public and Preventive Health, Georgia Regents University, Augusta, GA, USA
| |
Collapse
|
29
|
Mensel B, Quadrat A, Schneider T, Kühn JP, Dörr M, Völzke H, Lieb W, Hegenscheid K, Lorbeer R. MRI-based determination of reference values of thoracic aortic wall thickness in a general population. Eur Radiol 2014; 24:2038-44. [PMID: 24816934 DOI: 10.1007/s00330-014-3188-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/13/2014] [Accepted: 04/14/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To provide age- and sex-specific reference values for MRI-derived wall thickness of the ascending and descending aorta in the general population. MATERIALS AND METHODS Data of 753 subjects (311 females) aged 21-81 years were analysed. MRI was used to determine the aortic wall thickness (AWT). Equations for reference value calculation according to age were established for females and males. RESULTS Median wall thickness of the ascending aorta was 1.46 mm (5th-95th range: 1.15-1.88 mm) for females and 1.56 mm (1.22-1.99 mm) for males. Median wall thickness of the descending aorta was 1.26 mm (0.97-1.58 mm) in females and 1.36 mm (1.04-1.75 mm) in males. While median and 5th and 95th percentiles for the ascending and descending aorta increased with age in both sexes, the association between age and median AWT was stronger in males than in females for both the ascending and descending aorta. CONCLUSIONS Reference values for the ascending and descending AWT are provided. In a healthy sample from the general population, the wall of the ascending aorta is thicker than the wall of the descending aorta, and both walls are thicker in males than females. The increase in wall thickness with age is greater in males. KEY POINTS Ascending aortic wall thickness is greater than descending aortic wall thickness. Ascending and descending aortic wall thickness is greater in males. Thoracic aortic wall thickness increases with age in both sexes. The age-related increase in aortic wall thickness is stronger in males.
Collapse
Affiliation(s)
- Birger Mensel
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany,
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
An inflammatory pathway links atherosclerotic cardiovascular disease risk to neural activity evoked by the cognitive regulation of emotion. Biol Psychiatry 2014; 75:738-45. [PMID: 24267410 PMCID: PMC3989430 DOI: 10.1016/j.biopsych.2013.10.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 09/19/2013] [Accepted: 10/11/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cognitive reappraisal is a form of emotion regulation that alters emotional responding by changing the meaning of emotional stimuli. Reappraisal engages regions of the prefrontal cortex that support multiple functions, including visceral control functions implicated in regulating the immune system. Immune activity plays a role in the preclinical pathophysiology of atherosclerotic cardiovascular disease (CVD), an inflammatory condition that is highly comorbid with affective disorders characterized by problems with emotion regulation. Here, we tested whether prefrontal engagement by reappraisal would be associated with atherosclerotic CVD risk and whether this association would be mediated by inflammatory activity. METHODS Community volunteers (n = 157; 30-54 years of age; 80 women) without DSM-IV Axis-1 psychiatric diagnoses or cardiovascular or immune disorders performed a functional neuroimaging task involving the reappraisal of negative emotional stimuli. Carotid artery intima-media thickness and inter-adventitial diameter were measured by ultrasonography and used as markers of preclinical atherosclerosis. Also measured were circulating levels of interleukin-6 (IL-6), an inflammatory cytokine linked to CVD risk and prefrontal neural activity. RESULTS Greater reappraisal-related engagement of the dorsal anterior cingulate cortex was associated with greater preclinical atherosclerosis and IL-6. Moreover, IL-6 mediated the association of dorsal anterior cingulate cortex engagement with preclinical atherosclerosis. These results were independent of age, sex, race, smoking status, and other known CVD risk factors. CONCLUSIONS The cognitive regulation of emotion might relate to CVD risk through a pathway involving the functional interplay between the anterior cingulate region of the prefrontal cortex and inflammatory activity.
Collapse
|
31
|
Kappus RM, Fahs CA, Smith D, Horn GP, Agiovlasitis S, Rossow L, Jae SY, Heffernan KS, Fernhall B. Obesity and overweight associated with increased carotid diameter and decreased arterial function in young otherwise healthy men. Am J Hypertens 2014; 27:628-34. [PMID: 24048148 DOI: 10.1093/ajh/hpt152] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Obesity is linked to cardiovascular disease, stroke, increased mortality and vascular remodeling. Although increased arterial diameter is associated with multiple cardiovascular risk factors and obesity, it is unknown whether lumen enlargement is accompanied by unfavorable vascular changes in young and otherwise healthy obese individuals. The purpose of this study was to compare carotid and brachial artery diameter, blood pressure, arterial stiffness, and endothelial function in young, apparently healthy, normal-weight, overweight, and obese male subjects. METHODS One hundred sixty-five male subjects (27.39±0.59 years) were divided into 3 groups (normal weight, overweight, and obese) according to body mass index. Subjects underwent cardiovascular measurements to determine arterial diameter, function, and stiffness. RESULTS After adjusting for age, the obese group had significantly greater brachial, carotid, and aortic pressures, brachial pulse wave velocity, carotid intima media thickness, and carotid arterial diameter compared with both the overweight and normal-weight groups. CONCLUSIONS Obesity is associated with a much worse arterial profile, as an increased carotid lumen size was accompanied by higher blood pressure, greater arterial stiffness, and greater carotid intima media thickness in obese compared with overweight or normal-weight individuals. These data suggest that although obesity may be a factor in arterial remodeling, such remodeling is also accompanied by other hemodynamic and arterial changes consistent with reduced arterial function and increased cardiovascular risk.
Collapse
Affiliation(s)
- Rebecca M Kappus
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
Carotid artery intima-media thickness (IMT) is a biomarker for cardiovascular disease that also predicts the risk of cardiovascular mortality. Angiotensin-converting enzyme (ACE) inhibition is a unique therapeutic modality because it both treats hypertension and improves arterial health and cardiovascular disease outcomes. Controversy exists regarding the role of ACE inhibitors and angiotensin receptor blockers (ARBs) in IMT regression. Our article provides an update on how ACE inhibitors and ARBs could play a role in decreasing IMT.
Collapse
Affiliation(s)
| | - Luke P. Brewster
- Assistant Professor of Vascular Surgery, Medical Director of Vascular Lab, Department of Surgery, Emory University School of Medicine, Atlanta, GA; Georgia Institute of Technology, Institute of Bioengineering and Biosciences, Atlanta, GA
| |
Collapse
|
33
|
Owolabi M, Agunloye A. Risk factors for stroke among patients with hypertension: A case–control study. J Neurol Sci 2013; 325:51-6. [DOI: 10.1016/j.jns.2012.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/20/2012] [Accepted: 11/27/2012] [Indexed: 12/13/2022]
|
34
|
Common carotid artery diameter and cardiovascular risk factors in overweight or obese postmenopausal women. Int J Vasc Med 2012; 2012:169323. [PMID: 22957258 PMCID: PMC3432379 DOI: 10.1155/2012/169323] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 06/01/2012] [Indexed: 12/24/2022] Open
Abstract
Arterial diameter is an underutilized indicator of vascular health. We hypothesized that interadventitial and lumen diameter of the common carotid artery would be better indicators of vascular health than carotid plaque or intima media thickness (IMT). Participants were 491 overweight or obese, postmenopausal women who were former or current hormone therapy (HT) users, 52-62 years, with waist circumference >80 cm. We evaluated cross-sectional associations of cardiovascular risk factors with carotid measures, by HT status. Former HT users had a worse cardiovascular profile than current HT users: larger adventitial (6.94 mm versus 6.79 mm) and lumen diameter (5.44 mm versus 5.31 mm, both P < 0.01) independent of cardiovascular risk factors; IMT and plaque were similar. Larger diameters were best explained by former HT use, higher pulse pressure, and greater weight. Independent of potential confounders, overweight and obese postmenopausal former HT users had larger carotid diameters than current HT users. Carotid diameter should be considered in studies of HT.
Collapse
|
35
|
Foresta C, Caretta N, Palego P, Ferlin A, Zuccarello D, Lenzi A, Selice R. Reduced artery diameters in Klinefelter syndrome. ACTA ACUST UNITED AC 2012; 35:720-5. [DOI: 10.1111/j.1365-2605.2012.01269.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
|
37
|
Montalcini T, Gorgone G, Gazzaruso C, Garzaniti A, Pujia A. Large brachial artery diameter and diabetes in post-menopausal women. Nutr Metab Cardiovasc Dis 2011; 21:830-834. [PMID: 20674310 DOI: 10.1016/j.numecd.2010.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 12/21/2009] [Accepted: 02/04/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Vascular remodelling is one of the possible compensatory mechanisms in response to artery wall injury. It was demonstrated that post-menopausal women with carotid atherosclerosis had a larger brachial artery diameter (BAD) than women without carotid plaques. Therefore, it is possible to hypothesise that artery enlargement could be a marker of early atherosclerosis. To investigate the eventual association between carotid and brachial artery diameter and disease affecting the vascular wall, we performed a case-control study in post-menopausal women with or without type II diabetes mellitus. METHODS AND RESULTS We enrolled 28 cases (with diabetes) and 56 controls (without diabetes) matched for age and carotid atherosclerosis presence and severity. On the t-test, women with diabetes showed significantly larger brachial and common carotid artery diameters and, as expected, higher plasma glucose level and homeostasis model assessment (HOMA) than women without diabetes. On the univariate analysis, only plasma glucose level results correlated to BAD in the whole sample. Multivariate analysis confirmed that diabetes was a good predictor of brachial and carotid artery diameter, while age, systolic blood pressure and triglycerides were correlated only to the carotid diameter. CONCLUSIONS Our data confirm that vascular remodelling is a systemic process occurring in conditions related to atherosclerosis, such as type II diabetes. Indeed, artery diameter could be a marker of early response of vessel wall to injury.
Collapse
|
38
|
Polak JF, Wong Q, Johnson WC, Bluemke DA, Harrington A, O'Leary DH, Yanez ND. Associations of cardiovascular risk factors, carotid intima-media thickness and left ventricular mass with inter-adventitial diameters of the common carotid artery: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2011; 218:344-9. [PMID: 21726862 PMCID: PMC3186064 DOI: 10.1016/j.atherosclerosis.2011.05.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 05/20/2011] [Accepted: 05/23/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Common carotid artery inter-adventitial diameter (IAD) and intima-media thickness (IMT) are measurable by ultrasound. IAD may be associated with left ventricular mass (LV mass) while IMT is a marker of subclinical atherosclerosis. It is not clear if IAD is associated with LV mass after accounting for IMT and traditional cardiovascular risk factors. METHODS IAD and IMT were measured on participants of the Multi-Ethnic Study of Atherosclerosis (MESA) IMT progression study. A total of 5641 of the originally enrolled 6814 MESA participants were studied. LV mass was measured by magnetic resonance imaging. Multivariable linear regression was used with IAD as the outcome and adjustment for risk factors, as well as IMT and LV mass. RESULTS Traditional cardiovascular risk factors, height, weight and ethnicity were significantly associated with IAD. After adjustment for risk factors, a 1mm difference in IMT was associated with a 1.802mm (95% CI: 1.553, 2.051) higher mean IAD. A 1g difference in LV mass was associated with a 0.006mm (95% CI: 0.005, 0.007) higher mean IAD. After adjusting for cardiovascular risk factors and IMT, a 1g difference in LV mass was associated with a 0.006mm (95% CI: 0.005, 0.008) higher mean IAD for women and 0.004mm (95% CI: 0.003, 0.005) higher IAD for men. CONCLUSIONS Inter-adventitial diameters are associated with left ventricular mass after adjusting for cardiovascular risk factors and IMT. IAD might serve as a surrogate for left ventricular mass and have predictive value for cardiovascular outcomes.
Collapse
Affiliation(s)
- Joseph F Polak
- Department of Radiology, Tufts Medical Center, Boston, MA, USA.
| | | | | | | | | | | | | |
Collapse
|
39
|
El-Eshmawy MM, El-Adawy EH, Mousa AA, Zeidan AE, El-Baiomy AA, Abdel-Samie ER, Saleh OM. Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women. BMC WOMENS HEALTH 2011; 11:1. [PMID: 21247478 PMCID: PMC3031240 DOI: 10.1186/1472-6874-11-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 01/19/2011] [Indexed: 01/01/2023]
Abstract
BACKGROUND Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. OBJECTIVES To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests. METHODS Thirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. MEASUREMENTS The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio. RESULTS Serum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC. CONCLUSION Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.
Collapse
Affiliation(s)
- Mervat M El-Eshmawy
- Internal Medicine Department, Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | | | | | | | | | | | | |
Collapse
|
40
|
Gando Y, Yamamoto K, Kawano H, Murakami H, Ohmori Y, Kawakami R, Sanada K, Higuchi M, Tabata I, Miyachi M. Attenuated Age-Related Carotid Arterial Remodeling in Adults with a High Level of Cardiorespiratory Fitness. J Atheroscler Thromb 2011; 18:248-54. [DOI: 10.5551/jat.6924] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
41
|
Abstract
OBJECTIVES To test associations of circulating microparticles with large artery remodeling before atherosclerosis is detectable. METHODS In 232 untreated symptom-free individuals, we measured microparticles of various cellular origins (platelet, endothelial and leukocyte) by specific anti-GPIb (glycoprotein Ib), anti-cluster of differentiation (CD) 105 and anti-CD11a antibodies, and common carotid artery intima-media thickness (IMT), internal and external diameters by ultrasound. RESULTS Except for CD105 microparticles with IMT to lumen ratio (IMT/D, P < 0.05), microparticles correlated with no carotid dimensions. Significant interactions existed between each microparticle type and IMT on internal and external diameters (GPIb, P < 0.01; CD105 and CD11a microparticles P < 0.001) consisting of lower trend in increased diameter with increasing IMT in individuals with high than in those with low microparticle level (according to the median) of each origin. As a result, individuals within the third IMT tertile had lower internal diameter in the presence of high than in the presence of low level of GPIb, CD105 or CD11a microparticles (P = 0.001, <0.05 or 0.01, respectively), and lower external diameter in the presence of high than in the presence of low level of GPIb and CD11a microparticles (P = 0.001 and 0.01). Also, individuals within third IMT tertile exhibited positive correlations of IMT with CD105 and CD11a microparticles (P < 0.05), negative correlations of internal diameter with GPIb (P < 0.05), CD105 (P < 0.05) and CD11a microparticles (P < 0.01) and of external diameter with GPIb and CD11a microparticles (P < 0.05), and positive correlations of IMT/D with CD105 and CD11a microparticles (P < 0.001). CONCLUSION Increased levels of leukocyte and endothelial-derived microparticles are associated with carotid inward remodeling in individuals with the greatest IMT before atherosclerosis is detectable.
Collapse
|
42
|
Straczek C, Tafflet M, Barberger-Gateau P, Bertrand M, Dupuy AM, Ducimetière P, Empana JP. Do lipids and apolipoproteins predict coronary heart disease under statin and fibrate therapy in the primary prevention setting in community-dwelling elderly subjects? The 3C Study. Atherosclerosis 2010; 214:426-31. [PMID: 21129746 DOI: 10.1016/j.atherosclerosis.2010.10.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 10/25/2010] [Accepted: 10/25/2010] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate associations of standard lipids and apolipoproteins with incident coronary heart disease (CHD) in older adults according to lipid-lowering treatment (LLT) in the primary prevention setting. METHODS Within the 3C Study of men and women aged ≥ 65 years, standard lipids, apolipoproteins A-1 and B100 and hs-CRP were measured in baseline blood samples from 199 participants who developed a first CHD event over 4 years of follow-up and from 1081 subjects randomly selected from the initial cohort (case cohort study). Standardized hazard ratios (HRs) were estimated by the Cox proportional hazard model. RESULTS In the random sample, 75.3% were free of LLT (non-users), 11.5% received statins and 13.4% fibrates. Among the non-users, all lipid parameters were significantly associated with future CHD (n = 145) after adjustment for age, gender, study center and educational level, and their HRs were comparable. For instance, the HR for LDL-cholesterol was 1.38 (95% CI: 1.13-1.69). These associations also existed and were stronger among statin users (n = 27 CHD), as shown by an HR for LDL-cholesterol of 2.20 (95% CI: 1.27-3.81). Additional adjustment for traditional risk factors and hs-CRP marginally modified HR estimates in those receiving or not receiving statins. Among fibrate users (n = 27 CHD), significant associations were observed for triglycerides only (1.68; 95% CI = 1.04-2.72) in fully adjusted analyses. CONCLUSION In older adults, standard lipids and apolipoproteins are stronger predictors of CHD in those receiving statins than in those who are not in the primary prevention setting. Under fibrate treatment, only triglycerides were independent predictors of CHD.
Collapse
Affiliation(s)
- C Straczek
- INSERM U970, Paris Cardiovascular Research Center, Paris Descartes University, UMR-S970, Paris, France.
| | | | | | | | | | | | | |
Collapse
|
43
|
Zyriax BC, Lau K, Klähn T, Boeing H, Völzke H, Windler E. Association between alcohol consumption and carotid intima-media thickness in a healthy population: data of the STRATEGY study (Stress, Atherosclerosis and ECG Study). Eur J Clin Nutr 2010; 64:1199-206. [PMID: 20664623 DOI: 10.1038/ejcn.2010.144] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES Epidemiological evidence suggests a protective effect of moderate alcohol consumption on cardiovascular events. However, studies assessing the association between alcohol intake and intima-media thickness (IMT) as a marker of subclinical atherosclerosis have provided inconsistent results. The aim of this analysis of the Stress Atherosclerosis and ECG Study (STRATEGY study) was to investigate the relation between alcohol intake and IMT in a selectively healthy population. SUBJECTS/METHODS In a cross-sectional study, laboratory values, anthropometric data, nutrition habits and physical activity were assessed in 106 men and 107 women, evenly distributed between 30 and 70 years. Carotid IMT was determined by B-mode ultrasonography according to the standardized protocol of the Study of Health in Pomerania. RESULTS In men, a significant positive correlation between daily alcohol consumption and IMT was observed (P<0.0001), whereas in women the positive correlation was not significant. The type of beverage consumed did not affect this finding. The mean IMT was significantly higher in men with an alcohol intake above the upper limit of 20 g/day than in men with an alcohol intake <20 g/day (P<0.001). According to a stepwise linear regression model adjusted for age, conventional risk factors, nutrition and physical activity, the IMT increases by 0.0253 mm per 21.4 g/day intake of alcohol in men (P<0.05). CONCLUSIONS The STRATEGY study revealed a positive association between alcohol consumption and carotid IMT in healthy men aged 30-70 years. This relationship remained significant after adjustment for nutrition, physical activity, anthropometry and conventional cardiovascular risk factors.
Collapse
Affiliation(s)
- B-C Zyriax
- Endocrinology and Metabolism of Ageing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | | | | | | | | |
Collapse
|
44
|
Astor BC, Sharrett AR, Coresh J, Chambless LE, Wasserman BA. Remodeling of carotid arteries detected with MR imaging: atherosclerosis risk in communities carotid MRI study. Radiology 2010; 256:879-86. [PMID: 20651061 DOI: 10.1148/radiol.10091162] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the extent of thickening of the carotid arterial walls that may be accommodated by outward remodeling. MATERIALS AND METHODS Institutional review board approval was obtained at each participating site, and informed consent was obtained from each participant. All study sites conducted this study in compliance with HIPAA requirements. A total of 2066 participants (age range, 60-85 years) from the Atherosclerosis Risk in Communities (ARIC) study were enrolled in the ARIC Carotid MRI Study. Maximum wall thickness and luminal area were measured with gadolinium-enhanced magnetic resonance (MR) imaging in both common carotid arteries (CCAs) and in one internal carotid artery (ICA) 2 mm above the flow divider. Complete data were available for 1064 ICAs and 3348 CCAs. The association of maximum wall thickness with lumen area was evaluated with linear regression, and adjustments were made for participant age, sex, race, height, and height squared. RESULTS In the ICA, lumen area was relatively constant across patients with a wall thickness of 1.38 mm or less. In patients with a wall thickness of more than 1.38 mm, however, lumen area decreased linearly as wall thickness increased. Wall area represented a median of 61.9% of the area circumscribed by the vessel at a maximum wall thickness of 1.50 mm +/- 0.05 (standard deviation) and 75.4% at a maximum wall thickness of 4.0 mm +/- 0.10. In the CCA, lumen area was preserved across wall thicknesses less than 2.06 mm, representing 99% of vessels. CONCLUSION Atherosclerotic thickening in the ICA appears to be accommodated for vessels with a maximum wall thickness of less than 1.5 mm. Beyond this threshold, greater thickness is associated with a smaller lumen. The CCA appears to accommodate a wall thickness of less than 2.0 mm. These estimates indicate that the carotid arteries are able to compensate for a greater degree of thickening than are the coronary arteries.
Collapse
Affiliation(s)
- Brad C Astor
- Welch Center for Prevention, Epidemiology and Clinical Research and Departments of Epidemiology and Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA.
| | | | | | | | | |
Collapse
|
45
|
Kwagyan J, Hussein S, Xu S, Ketete M, Maqbool AR, Schneider RH, Randall OS. The Relationship Between Flow-Mediated Dilatation of the Brachial Artery and Intima-Media Thickness of the Carotid Artery to Framingham Risk Scores in Older African Americans. J Clin Hypertens (Greenwich) 2009; 11:713-9. [DOI: 10.1111/j.1751-7176.2009.00175.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Lee YH, Shin MH, Kweon SS, Choi SW, Kim HY, Ryu SY, Kim BH, Rhee JA, Choi JS. Alcohol consumption and carotid artery structure in Korean adults aged 50 years and older. BMC Public Health 2009; 9:358. [PMID: 19775442 PMCID: PMC2761892 DOI: 10.1186/1471-2458-9-358] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 09/23/2009] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Epidemiologic studies of the association between alcohol consumption and carotid artery structure have reported conflicting results. We investigated the association between alcohol consumption and carotid atherosclerosis by evaluating the effects of alcohol intake on carotid artery enlargement. METHODS The study population consisted of 4302 community-dwelling Koreans (1577 men and 2725 women) aged 50 years and over. All the subjects had participated in the baseline survey of the Dong-gu Study conducted between 2007 and 2008. Daily alcohol consumption was determined by the number and frequency of alcoholic beverages consumed. We measured common carotid artery intima-media thickness (CCA-IMT), common carotid and bulb IMT (CB-IMT), carotid plaques, and the diameter of the common carotid artery (CCA-diameter) using high-resolution B-mode ultrasonography. We used analysis of covariance and multiple logistic regressions to determine the relationship between alcohol consumption and carotid artery parameters. RESULTS CCA-IMT and CB-IMT were negatively correlated with alcohol consumption after controlling for cardiovascular risk factors in men (p for linear trend = 0.009 and = 0.038, respectively). The multivariate-adjusted odds ratio (OR) for carotid plaques was significantly higher in men who consumed >40.0 g/d (OR = 1.81, 95% CI = 1.13-2.91), although a significant positive correlation was observed between alcohol consumption and carotid plaques (p for linear trend = 0.027). Neither carotid IMT nor carotid plaques were correlated with alcohol intake in women. Alcohol intake was positively correlated with CCA-diameter adjusted for carotid IMT and plaques in the multivariate-adjusted model in both sexes (p for linear trend <0.001 for men and 0.020 for women). CONCLUSION The results of our study indicate that alcohol consumption is inversely related to carotid IMT and positively related to carotid plaques in men, but not women. However, alcohol intake is positively associated with CCA-diameter in both men and women. Additional large population-based prospective studies are needed to confirm the effects of alcohol consumption on carotid artery structure.
Collapse
Affiliation(s)
- Young-Hoon Lee
- Department of Preventive Medicine, Seonam University College of Medicine, 720, Kwangchi-dong, Namwon, Jeollabukdo 590-711, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, South Korea
| | - Sun-Seog Kweon
- Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanamdo 519-809, South Korea
| | - Sung-Woo Choi
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, South Korea
| | - Hye-Yeon Kim
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, South Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, College of Medicine, Chosun University, 375, Seosuk-dong, Dong-gu, Gwangju 501-759, South Korea
| | - Bok-Hee Kim
- Department of Food & Nutrition, College of Natural Sciences, Chosun University, 375, Seosuk-dong, Dong-gu, Gwangju 501-759, South Korea
| | - Jung-Ae Rhee
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, South Korea
| | - Jin-Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, South Korea
| |
Collapse
|
47
|
Rossi R, Nuzzo A, Guaraldi G, Squillace N, Orlando G, Esposito R, Lattanzi A, Modena MG. Metabolic disorders induced by highly active antiretroviral therapy and their relationship with vascular remodeling of the brachial artery in a population of HIV-infected patients. Metabolism 2009; 58:927-33. [PMID: 19394974 DOI: 10.1016/j.metabol.2009.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 02/17/2009] [Indexed: 11/26/2022]
Abstract
Antiretroviral therapy has positively modified the natural history of HIV infection; but this treatment can induce metabolic abnormalities, including dyslipidemia, fat redistribution, high blood pressure, and insulin resistance. The metabolic syndrome, a clustering of the metabolic disorders, is frequently detected among HIV patients, especially those on antiretroviral treatment. All the arteries can modify their diameter in response to a chronic injury. This process, defined vascular remodeling, was demonstrated for the brachial artery. It is well known that the diameter of the brachial artery was correlated with the number of the elements of the metabolic syndrome and was associated with the severity of coronary artery disease. On this basis, we postulate that brachial arterial enlargement may be a process potentially correlated with the metabolic disorders induced by antiretroviral therapy. We tested this hypothesis in a large population of HIV-infected patients in which we measured brachial artery diameter, as an indicator of artery remodeling, by noninvasive, ultrasonographic technique. Our population consisted of 570 patients, with a mean age of 46.3 +/- 7.1 years. All the patients were chronically treated with highly active antiretroviral therapy. Brachial artery diameter was correlated with insulin resistance, evaluated by the homeostasis model assessment of insulin resistance index (r = 0.18, P < .0001). There was a significant linear increase in brachial artery diameter as the number of components of the metabolic syndrome increased: brachial artery diameter for those with 0, 1, 2, 3, or + characteristics was 39.3 +/- 7.2, 41.0 +/- 6.8, 42.0 +/- 7.3, and 43.8 +/- 7.9 mm, respectively (P < .001 for trend). In multivariable logistic regression analysis, brachial artery diameter was independently correlated with the presence of metabolic syndrome. Our results are in line with the hypothesis that, among HIV-infected patients chronically treated with antiretroviral therapy, those with a larger brachial artery diameter are at high risk for metabolic disorders, including a more severe insulin resistance and the presence of metabolic syndrome.
Collapse
Affiliation(s)
- Rosario Rossi
- Institute of Cardiology, University of Modena and Reggio Emilia. Policlinico Hospital, Modena, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Kochanowicz J, Turek G, Rutkowski R, Mariak Z, Szydlik P, Lyson T, Krejza J. Normal reference values of ratios of blood flow velocities in internal carotid artery to those in common carotid artery using Doppler sonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2009; 37:208-211. [PMID: 18561343 DOI: 10.1002/jcu.20502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The ratios of of blood flow velocities in the internal carotid artery (ICA) to those in the common carotid artery (CCA) (V(ICA)/V(CCA)) are used to identify patients with critical ICA narrowing, but their normal reference values have not been established. We provide reference data for the V(ICA)/V(CCA) ratios for the peak systolic velocity (PSV), mean velocity (MV), and end-diastolic velocity (EDV) measured in a large group of healthy subjects. METHODS We examined 343 healthy subjects with color duplex sonography. They were divided into 3 age groups: group I, <40 years; group II, 40-60 years; group III, >60 years. RESULTS The values of V(ICA)/V(CCA) ratio for the PSV were as follows [mean (upper and lower reference values)]. In women, group I: 0.81 (0.48-1.14), group II: 0.88 (0.36-1.40), group III: 0.9 (0.36-1.40). In men, group I: 0.65 (0.32-0.98), group II: 0.72 (0.39-1.05), group III: 0.91 (0.27-1.56). The V(ICA)/V(CCA) ratio for PSV increased with age only in men and its values were significantly higher in women than in men in the group I and group II age groups. CONCLUSION This study provides normal reference values for the V(ICA)/V(CCA) ratios for PSV and shows that the ratio varies with age and sex. The upper reference limit for the ratio can serve as an aid in the more specific identification of patients with minor or mild ICA narrowing.
Collapse
Affiliation(s)
- Jan Kochanowicz
- Department of Neurosurgery, Medical University of Bialystok, Bialystok, Poland
| | | | | | | | | | | | | |
Collapse
|
49
|
Arnaud J, Akbaraly TN, Hininger-Favier I, Berr C, Roussel AM. Fibrates but not statins increase plasma selenium in dyslipidemic aged patients--the EVA study. J Trace Elem Med Biol 2009; 23:21-8. [PMID: 19203713 DOI: 10.1016/j.jtemb.2008.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 04/01/2008] [Accepted: 08/13/2008] [Indexed: 12/12/2022]
Abstract
This secondary analysis of "Etude du Vieillissement Artériel" (EVA) study reports the effect of fibrates and statins on plasma selenium concentration and its 9-year change in free-living dyslipidemic elderly. Dyslipidemic patients were categorized in three sub-groups according to final low-density lipoprotein (LDL)-cholesterol level or hypolipidemic treatment: non-treated dyslipidemic (LDL-cholesterol >4.41 mmol/L, n=84); dyslipidemics who were treated exclusively by fibrates (n=47) or by statins (n=25) whatever their serum LDL-cholesterol concentration. The influence of lipid-lowering treatments on plasma selenium concentrations and its 9-year change was evaluated by analysis of variance (ANOVA) and multivariate linear regression models taking into account cardiovascular risk and changes in lipid-profile parameters. Multivariate linear regression indicated that the plasma selenium decline was associated with the longitudinal variation in LDL (beta=-0.039+/-0.019, p=0.04) and high-density lipoprotein (HDL)-cholesterol concentrations (beta=0.187+/-0.059, p=0.002) but not with triglycerides (beta=-0.018+/-0.031, p=0.57). During the 9-year follow-up, similar plasma selenium declines were observed in all the sub-groups (p=0.33) despite plasma selenium levels being higher in fibrate users and lower in statin users (p=0.0004). The mechanisms underlying these data are not yet totally understood, but considering the risk of selenium deficiency in the elderly and its relationship with poor health status further clinical trial is needed to verify the proposed hypotheses.
Collapse
|
50
|
Associations of endogenous sex hormones with the vasculature in menopausal women: the Study of Women's Health Across the Nation (SWAN). Menopause 2008; 15:414-21. [PMID: 18209686 DOI: 10.1097/gme.0b013e318154b6f5] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE As associations between endogenous sex hormones and the vasculature are not well characterized, the objective was to examine the cross-sectional associations of menopausal status and endogenous sex hormones with vascular characteristics. DESIGN Common carotid artery adventitial diameter and intima-media thickness were determined using B-mode ultrasonography among 483 middle-aged women enrolled in the Pittsburgh and Chicago sites of the Study of Women's Health Across the Nation. RESULTS Sixty-two percent of women were pre- or early perimenopausal (<3 mo amenorrhea), 12% were late perimenopausal (3-12 mo amenorrhea), and 27% were postmenopausal (>or=12 mo amenorrhea). After adjustment for age, compared with pre-/early perimenopause, late perimenopause was associated with a 0.28-mm larger adventitial diameter (P=0.001), whereas postmenopause was associated with a 0.15-mm larger adventitial diameter (P=0.040). Adjustment for traditional cardiovascular risk factors slightly attenuated these associations, but the association with late perimenopause remained statistically significant (P=0.001). Each SD lower log estradiol value was associated with a 0.07-mm larger adventitial diameter after adjustment for traditional cardiovascular risk factors (P=0.023), whereas other endogenous hormones showed no associations. Intima-media thickness values were not significantly associated with menopausal status or endogenous sex hormones after adjustment for age. CONCLUSIONS The menopausal transition and declining estrogen levels are associated with alterations of the peripheral vasculature, which may help to explain the increased risk of cardiovascular disease with postmenopause.
Collapse
|