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Zhang S, Tamargo RJ, Bergmann J, Gottschalk A, Steppan J. The relationship between intraoperative surrogates of vascular stiffness, cerebral aneurysms, and surgical outcomes. J Stroke Cerebrovasc Dis 2024; 33:108003. [PMID: 39251046 DOI: 10.1016/j.jstrokecerebrovasdis.2024.108003] [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: 04/03/2024] [Revised: 09/05/2024] [Accepted: 09/06/2024] [Indexed: 09/11/2024] Open
Abstract
OBJECTIVE Increased arterial stiffness has been linked to aneurysm formation in the systemic and cerebral circulations, though the role played by arterial stiffness in the cerebral vasculature continues to be refined. This study assesses whether intraoperative surrogates of arterial stiffness differ between patients with cerebral aneurysms and controls, and the extend that these indices relate to outcomes following open surgical treatment. METHODS We evaluated patients in a prospectively maintained database who underwent cerebral aneurysm surgery, and compared them to controls without cerebral aneurysms. Arterial stiffness was estimated using the intraoperative ambulatory arterial stiffness index (AASI) and average pulse pressure (PP). RESULTS We analyzed 214 cerebral aneurysm patients and 234 controls. Patients in the aneurysm group were predominantly female and had a higher incidence of hypertension, diabetes mellitus, and vascular disease. They also demonstrate elevated AASI and average PP. When stratified by the occurrence of subarachnoid hemorrhage (SAH) or unfavorable neurological outcome, the AASI and average PP were not highly associated with the occurrence of SAH but were highly associated with unfavorable neurological outcomes. After multivariable analysis, both the AASI and average PP were no longer associated with unfavorable neurological outcomes, however elevated age, strongly linked with arterial stiffness, became a key predictive variable. CONCLUSION Readily obtained intraoperative surrogates of arterial stiffening demonstrates its presence in those with cerebral aneurysm disease and the extent that it does it may meaningfully direct their clinical course. However, multivariable analysis demonstrates limitations of using arterial stiffness measures to predict clinical outcomes.
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Affiliation(s)
- Shu Zhang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rafael J Tamargo
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jules Bergmann
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Allan Gottschalk
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jochen Steppan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Pescari D, Borlea A, Mihuta S, Stoian D. Development of a comprehensive risk prediction model for arterial stiffness assessment in individuals with obesity. Front Med (Lausanne) 2024; 11:1430437. [PMID: 39224613 PMCID: PMC11368134 DOI: 10.3389/fmed.2024.1430437] [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: 05/09/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Obesity in adults is a known risk factor for cardiovascular events and is associated with a decline in arterial elasticity. This study aims to evaluate the utility of pulse wave analysis (PWA) parameters in routine clinical practice for the primary prevention of cardiovascular events by developing a prediction model for arterial stiffness among obese and overweight individuals. Methods The study enrolled 84 adult patients, aged 18 to 85 years, with varying degrees of weight status, including optimal weight, overweight, and obesity. The lifestyle habits, the personal and family history of cardiometabolic diseases, as well the clinical evaluation that included BMI (body mass index), WHR (waist-to-hip ratio), WC (waist circumferance) were performed. PWA evaluation was conducted using the Mobil-O-Graph device, assessing the following parameters: pulse wave velocity (PWV), augmentation index (AIx), heart rate (HR), central pulse pressure (cPP), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP). Body composition analysis was performed using the TANITA BC-418 body analyzer. Laboratory results from the past 3 months were also collected during initial nutritional consultations for each patient. Results Family history of cardiovascular events showed positive correlations with all PWA parameters, while diabetes history only with PWV and family history of obesity with PWV, DBP, and cSBP. Insufficient sleep duration showed positive associations with all arterial stiffness parameters except cDBP. Smoking status correlated with significantly elevated PWV and Aix values, while insufficient physical activity was associated solely with PWV. Positive correlations were showed between current weight and PWV, while WC demonstrated positive associations with PWV, SBP, and cSBP. Body composition analysis revealed significant associations between trunk adipose tissue mass (%) and PWV, SBP, and cSBP. Hydration status (%) emerged as an independent predictor for PWV, exhibiting an inverse relationship. HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) showed a strong positive correlation with PWV. Negative associations were observed with HDL-c and vitamin D. Threshold values for age, cDBP and Cardiac Index providing positive diagnostic for vascular impairment. Conclusion The assessment of arterial stiffness can be considered a reliable approach to prevent obesity-related cardiovascular events and facilitate the comprehensive management of such pathologies.
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Affiliation(s)
- Denisa Pescari
- Department of Doctoral Studies, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| | - Andreea Borlea
- Center for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Discipline of Endocrinology, Second Department of Internal Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| | - Simina Mihuta
- Center for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| | - Dana Stoian
- Center for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Discipline of Endocrinology, Second Department of Internal Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
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3
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Zhu Y, Li J, Ding M, Qiu F, Zhao Q, Lu H, Ren L, Shi Z. Relationship between carotid-femoral pulse wave velocity and prognosis in maintenance hemodialysis patients. Medicine (Baltimore) 2024; 103:e39099. [PMID: 39121296 PMCID: PMC11315517 DOI: 10.1097/md.0000000000039099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 07/05/2024] [Indexed: 08/11/2024] Open
Abstract
Carotid-femoral pulse wave velocity (Cf-PWV) can well predict the prognosis of the general population. However, whether Cf-PWV can be used as a prognostic indicator in maintenance hemodialysis (MHD) patients remains mysterious. The present study endeavored to explore the prognostic value of Cf-PWV among the MHD population. Patients who received MHD and underwent Cf-PWV examination at the hemodialysis center of Zhejiang Provincial People's Hospital between March 1, 2017 and October 15, 2019 were enrolled. Relevant clinical data were collected from these patients, who were subsequently followed up for a minimum of 1 year. During the follow-up period, the occurrence of all-cause death was recorded as a prognostic indicator. Based on the predetermined inclusion and exclusion criteria 178 patients were included in the final analysis. These patients were categorized into 2 groups based on Cf-PWV values: group 1 (Cf-PWV < 13.8 m/s), and group 2 (Cf-PWV ≥ 13.8 m/s). Thirty-four patients succumbed to their conditions within a median follow-up period of 23.3 months. Kaplan-Meier survival analysis revealed that the median survival time of group 2 was significantly shorter than group 1 (log-rank test, χ2 = 12.413, P < .001). After adjusting for various factors, including age, cardiovascular disease, peripheral arterial diastolic pressure, central arterial diastolic pressure, albumin, blood urea nitrogen, serum creatinine, left ventricular ejection fraction, 25 hydroxyvitamin D3, C-reactive protein and serum phosphorus, it was found that Cf-PWV ≥ 13.8m/s was an independent risk factor for all-cause mortality in MHD patients (relative risk = 3.04, 95% confidence interval [CI] = 1.22-7.57; P = .017). A high level of Cf-PWV (≥13.8 m/s) is an independent risk factor for all-cause death in MHD patients.
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Affiliation(s)
- Yifan Zhu
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Juan Li
- Tongxiang Chinese Medicine Hospital, Tongxiang, Zhejiang Province, China
| | - Min Ding
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Fengping Qiu
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Qi Zhao
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Hulin Lu
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Lingyan Ren
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
| | - Zhanqin Shi
- Department of Nephrology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang Province, China
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Trimarchi G, Pizzino F, Paradossi U, Gueli IA, Palazzini M, Gentile P, Di Spigno F, Ammirati E, Garascia A, Tedeschi A, Aschieri D. Charting the Unseen: How Non-Invasive Imaging Could Redefine Cardiovascular Prevention. J Cardiovasc Dev Dis 2024; 11:245. [PMID: 39195153 DOI: 10.3390/jcdd11080245] [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: 07/11/2024] [Revised: 08/02/2024] [Accepted: 08/03/2024] [Indexed: 08/29/2024] Open
Abstract
Cardiovascular diseases (CVDs) remain a major global health challenge, leading to significant morbidity and mortality while straining healthcare systems. Despite progress in medical treatments for CVDs, their increasing prevalence calls for a shift towards more effective prevention strategies. Traditional preventive approaches have centered around lifestyle changes, risk factors management, and medication. However, the integration of imaging methods offers a novel dimension in early disease detection, risk assessment, and ongoing monitoring of at-risk individuals. Imaging techniques such as supra-aortic trunks ultrasound, echocardiography, cardiac magnetic resonance, and coronary computed tomography angiography have broadened our understanding of the anatomical and functional aspects of cardiovascular health. These techniques enable personalized prevention strategies by providing detailed insights into the cardiac and vascular states, significantly enhancing our ability to combat the progression of CVDs. This review focuses on amalgamating current findings, technological innovations, and the impact of integrating advanced imaging modalities into cardiovascular risk prevention, aiming to offer a comprehensive perspective on their potential to transform preventive cardiology.
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Affiliation(s)
- Giancarlo Trimarchi
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, 98124 Messina, Italy
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Fausto Pizzino
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio-Regione Toscana, 54100 Massa, Italy
| | - Umberto Paradossi
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio-Regione Toscana, 54100 Massa, Italy
| | - Ignazio Alessio Gueli
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio-Regione Toscana, 54100 Massa, Italy
| | - Matteo Palazzini
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Piero Gentile
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Francesco Di Spigno
- Cardiology Unit of Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
| | - Enrico Ammirati
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Andrea Garascia
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Andrea Tedeschi
- Cardiology Unit of Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
| | - Daniela Aschieri
- Cardiology Unit of Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
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Xing C, Xie X, Wu Y, Xu L, Guan X, Li F, Zhan X, Yang H, Li J, Zhou Q, Mu Y, Zhou Q, Ding Y, Wang Y, Wang X, Zheng Y, Sun X, Li H, Zhang C, Zhao C, Qiu S, Yan G, Yang H, Mao Y, Zhan W, Ma C, Gu Y, Chen W, Xie M, Jiang T, Yuan L. Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study. Chin Med J (Engl) 2024; 137:1802-1810. [PMID: 38958034 DOI: 10.1097/cm9.0000000000003156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants. METHODS A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson's correlation, multiple linear regression, and analyses of covariance. RESULTS All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. CONCLUSIONS The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.
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Affiliation(s)
- Changyang Xing
- Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi 710038, China
| | - Xiujing Xie
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Yu Wu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Lei Xu
- Department of Ultrasound, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, Shaanxi 710021, China
| | - Xiangping Guan
- Ultrasound Medical Diagnosis Center, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
| | - Fan Li
- Department of Ultrasound, Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Xiaojun Zhan
- Department of Ultrasound, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi 710002, China
| | - Hengli Yang
- Department of Ultrasound Diagnosis, The Second Affiliated Hospital, Xi'an Medical College, Xi'an, Shaanxi 710038, China
| | - Jinsong Li
- Department of Ultrasound, Xi'an Gem Flower ChangQing Hospital, Xi'an, Shaanxi 710201, China
| | - Qi Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, China, Xi'an, Shaanxi 710004, China
| | - Yuming Mu
- Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Qing Zhou
- Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Yunchuan Ding
- Department of Ultrasound, Yan'an Hospital, The Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650051, China
| | - Yingli Wang
- Department of Ultrasound, Yan'an University Xianyang Hospital, Xianyang, Shaanxi 712000, China
| | - Xiangzhu Wang
- Department of Function Examination, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
| | - Yu Zheng
- Department of Ultrasound, Xi'an Central Hospital, Xi'an, Shaanxi 710004, China
| | - Xiaofeng Sun
- Cadre's Wards Ultrasound Department, Diagnostic Ultrasound Center, First Hospital of Jilin University, Changchun, Jilin 130000, China
| | - Hua Li
- Department of Echocardiography, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi, Xinjiang 830002, China
| | - Chaoxue Zhang
- Department of Ultrasound, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Cheng Zhao
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Shaodong Qiu
- Department of Ultrasound, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China
| | - Guozhen Yan
- Department of Ultrasound, The First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014000, China
| | - Hong Yang
- Department of Medical Ultrasonics, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Yinjuan Mao
- Department of Ultrasound, The Fourth People's Hospital, Xi'an, Shaanxi 710043, China
| | - Weiwei Zhan
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Ying Gu
- Department of Ultrasound Center, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China
| | - Wu Chen
- Department of Ultrasound Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Tianan Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Lijun Yuan
- Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi 710038, China
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Barkas F, Sener YZ, Golforoush PA, Kheirkhah A, Rodriguez-Sanchez E, Novak J, Apellaniz-Ruiz M, Akyea RK, Bianconi V, Ceasovschih A, Chee YJ, Cherska M, Chora JR, D'Oria M, Demikhova N, Kocyigit Burunkaya D, Rimbert A, Macchi C, Rathod K, Roth L, Sukhorukov V, Stoica S, Scicali R, Storozhenko T, Uzokov J, Lupo MG, van der Vorst EPC, Porsch F. Advancements in risk stratification and management strategies in primary cardiovascular prevention. Atherosclerosis 2024; 395:117579. [PMID: 38824844 DOI: 10.1016/j.atherosclerosis.2024.117579] [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: 03/20/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk assessment and management strategies. Although significant progress has been made recently, identifying and managing apparently healthy individuals at a higher risk of developing atherosclerosis and those with subclinical atherosclerosis still poses significant challenges. Traditional risk assessment tools have limitations in accurately predicting future events and fail to encompass the complexity of the atherosclerosis trajectory. In this review, we describe novel approaches in biomarkers, genetics, advanced imaging techniques, and artificial intelligence that have emerged to address this gap. Moreover, polygenic risk scores and imaging modalities such as coronary artery calcium scoring, and coronary computed tomography angiography offer promising avenues for enhancing primary cardiovascular risk stratification and personalised intervention strategies. On the other hand, interventions aiming against atherosclerosis development or promoting plaque regression have gained attention in primary ASCVD prevention. Therefore, the potential role of drugs like statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, omega-3 fatty acids, antihypertensive agents, as well as glucose-lowering and anti-inflammatory drugs are also discussed. Since findings regarding the efficacy of these interventions vary, further research is still required to elucidate their mechanisms of action, optimize treatment regimens, and determine their long-term effects on ASCVD outcomes. In conclusion, advancements in strategies addressing atherosclerosis prevention and plaque regression present promising avenues for enhancing primary ASCVD prevention through personalised approaches tailored to individual risk profiles. Nevertheless, ongoing research efforts are imperative to refine these strategies further and maximise their effectiveness in safeguarding cardiovascular health.
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Affiliation(s)
- Fotios Barkas
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
| | - Yusuf Ziya Sener
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Azin Kheirkhah
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elena Rodriguez-Sanchez
- Division of Cardiology, Department of Medicine, Department of Physiology, and Molecular Biology Institute, UCLA, Los Angeles, CA, USA
| | - Jan Novak
- 2(nd) Department of Internal Medicine, St. Anne's University Hospital in Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic; Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Maria Apellaniz-Ruiz
- Genomics Medicine Unit, Navarra Institute for Health Research - IdiSNA, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Ralph Kwame Akyea
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, United Kingdom
| | - Vanessa Bianconi
- Department of Medicine and Surgery, University of Perugia, Italy
| | - Alexandr Ceasovschih
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ying Jie Chee
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Mariia Cherska
- Cardiology Department, Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Joana Rita Chora
- Unidade I&D, Grupo de Investigação Cardiovascular, Departamento de Promoção da Saúde e Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Universidade de Lisboa, Faculdade de Ciências, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nadiia Demikhova
- Sumy State University, Sumy, Ukraine; Tallinn University of Technology, Tallinn, Estonia
| | | | - Antoine Rimbert
- Nantes Université, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Chiara Macchi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi di Milano, Milan, Italy
| | - Krishnaraj Rathod
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Barts Interventional Group, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Vasily Sukhorukov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - Svetlana Stoica
- "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Institute of Cardiovascular Diseases Timisoara, Timisoara, Romania
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Tatyana Storozhenko
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Prevention and Treatment of Emergency Conditions, L.T. Malaya Therapy National Institute NAMSU, Kharkiv, Ukraine
| | - Jamol Uzokov
- Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | | | - Emiel P C van der Vorst
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52074, Aachen, Germany; Aachen-Maastricht Institute for CardioRenal Disease (AMICARE), RWTH Aachen University, 52074, Aachen, Germany; Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University Munich, 80336, Munich, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52074, Aachen, Germany
| | - Florentina Porsch
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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7
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Bagherzadeh SP, Celestin BE, Santana EJ, Salerno M, Nadeau KC, Sweatt AJ, Zamanian RT, Haddad F. Novel Reference Equations for Pulmonary Artery Size and Pulsatility Using Echocardiography and Their Diagnostic Value in Pulmonary Hypertension. Chest 2024:S0012-3692(24)04615-4. [PMID: 39025204 DOI: 10.1016/j.chest.2024.06.3805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND According to the most recent pulmonary hypertension (PH) guidelines, a main pulmonary artery (MPA) diameter > 25 mm on transthoracic echocardiography supports the diagnosis of PH. However, the size of the pulmonary artery (PA) may vary according to body size, age, and cardiac phases. RESEARCH QUESTION (1) What are the reference limits for PA size on transthoracic echocardiography, considering differences in body size, sex, and age? (2) What is the diagnostic value of the PA size for classifying PH? (3) How does the selection of different reference groups (healthy volunteers vs patients referred for right heart catheterization [RHC]) influence the diagnostic OR (DOR)? STUDY DESIGN AND METHODS The study included a reference cohort of 248 healthy individuals as control patients, 693 patients with PH proven by RHC, and 156 non-PH patients proven by RHC. In the PH cohort, 300 had group 1 PH, 207 had group 2 PH, and 186 had group 3 PH. MPA and right PA diameters and areas were measured in the upper sternal short-axis and suprasternal notch views. Reference limits (5th-95th percentile) were based on absolute values and height-indexed measures. Quantile regression analysis was used to derive median and 95th quantile reference equations for the PA measures. DORs and probability diagnostic plots for PH were then determined using healthy control and non-PH cohorts. RESULTS The 95th percentile for indexed MPA diameter was 15 mm/m in diastole and 19 mm/m in systole in both sexes. Quantile regression analysis revealed a weak age effect (pseudo-R2 of 0.08-0.10 for MPA diameters). Among measures, the MPA size in diastole had the highest DOR (156.2; 95% CI, 68.3-357.5) for detection of group 1 PH. Similarly, the DORs were also high for groups 2 and 3 PH when compared with the control cohort but significantly lower compared with the non-PH cohort. INTERPRETATION This study presents novel reference limits for MPA based on height indexing and quantile regression.
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Affiliation(s)
- Shadi P Bagherzadeh
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA; Stanford Cardiovascular Institute, Stanford University, Stanford, CA.
| | - Bettia E Celestin
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA; Sean N. Parker Center of Allergy and Asthma Research, Stanford, CA
| | - Everton J Santana
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA
| | - Michael Salerno
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA; Stanford Cardiovascular Institute, Stanford University, Stanford, CA
| | - Kari C Nadeau
- Sean N. Parker Center of Allergy and Asthma Research, Stanford, CA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrew J Sweatt
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, CA
| | - Roham T Zamanian
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford, CA
| | - Francois Haddad
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA; Stanford Cardiovascular Institute, Stanford University, Stanford, CA.
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8
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Acampa M, Lazzerini PE, Cartocci A, Iadanza E, Cevenini G, Domenichelli C, Accioli R, Salvini V, Guideri F, Tassi R, Martini G. The Impact of Sex and Arterial Stiffness Interactions on the Outcome after an Acute Ischemic Stroke: A Retrospective Cohort Study. J Clin Med 2024; 13:4095. [PMID: 39064135 PMCID: PMC11278401 DOI: 10.3390/jcm13144095] [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: 05/30/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Arterial stiffness (AS) is an independent predictor of cardiovascular events and is associated with a poor prognosis. While AS may represent a novel therapeutic target, recent evidence shows that it is sexually dimorphic. The aim of this study was to evaluate relative sex differences in arterial stiffness and their possible impact on the outcome of acute ischemic stroke. Methods: We retrospectively evaluated a cohort of adult patients with the following inclusion criteria: acute ischemic stroke, which occurred within 24 h from the onset of symptoms, confirmed through neuroimaging examinations, additional evaluations including extracranial and transcranial arterial ultrasound examinations, transthoracic echocardiography, a 12-lead resting ECG, and continuous 24 h in-hospital blood pressure monitoring. Based on the 24 h blood pressure monitoring, the following parameters were evaluated: systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and arterial stiffness index (ASI). The modified Rankin scale (mRS) was assessed at 90 days to evaluate the 3-month clinical outcome, defining an unfavorable outcome as an mRS score ≥ 3. To assess the factors associated with unfavorable outcomes, a stepwise logistic regression model was performed on the total sample size, and the analyses were replicated after stratifying by sex. Results: A total of 334 patients (176 males, 158 females) were included in the analysis. There was a significant sex-dependent impact of ASI on the 90-day unfavorable Rankin score (mRS score ≥ 3) as only men had a reduced likelihood of favorable outcomes with increasing arterial stiffness (OR:1.54, 95% CI: 1.06-2.23; P-interaction = 0.023). Conclusions: The influence of ASI on the 3-month functional outcome after acute ischemic stroke is at least in part sex-related, suggesting that, in males, higher ASI values are associated with a worse outcome.
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Affiliation(s)
- Maurizio Acampa
- Stroke Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (F.G.); (G.M.)
| | - Pietro Enea Lazzerini
- Electroimmunology Unit, Division of Internal Medicine and Geriatrics, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (P.E.L.); (R.A.); (V.S.)
| | - Alessandra Cartocci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (A.C.); (E.I.); (G.C.)
| | - Ernesto Iadanza
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (A.C.); (E.I.); (G.C.)
| | - Gabriele Cevenini
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (A.C.); (E.I.); (G.C.)
| | - Carlo Domenichelli
- Stroke Unit, Department of Emergency-Urgency and Transplants, Azienda Ospedaliera Universitaria Senese, “Santa Maria alle Scotte” General Hospital, 53100 Siena, Italy; (C.D.); (R.T.)
| | - Riccardo Accioli
- Electroimmunology Unit, Division of Internal Medicine and Geriatrics, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (P.E.L.); (R.A.); (V.S.)
| | - Viola Salvini
- Electroimmunology Unit, Division of Internal Medicine and Geriatrics, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (P.E.L.); (R.A.); (V.S.)
| | - Francesca Guideri
- Stroke Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (F.G.); (G.M.)
| | - Rossana Tassi
- Stroke Unit, Department of Emergency-Urgency and Transplants, Azienda Ospedaliera Universitaria Senese, “Santa Maria alle Scotte” General Hospital, 53100 Siena, Italy; (C.D.); (R.T.)
| | - Giuseppe Martini
- Stroke Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (F.G.); (G.M.)
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9
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Månsson T, Rosso A, Ellström K, Elmståhl S. Elevated pulse pressure preceded incident chronic kidney disease in the general older population in Sweden. Sci Rep 2024; 14:15414. [PMID: 38965357 PMCID: PMC11224232 DOI: 10.1038/s41598-024-66458-3] [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: 12/19/2023] [Accepted: 07/01/2024] [Indexed: 07/06/2024] Open
Abstract
Arterial stiffness (AS) and chronic kidney disease (CKD) are common in the older population. AS results in increased pulsatile pressure, elevated pulse pressure (PP), and is linked to hypertension. PP is a surrogate for AS. The kidney has low vascular resistance mechanisms, presumably making it vulnerable to the increased pulsatile pressure and hypertension associated with AS. The aims of this study were to investigate the impact of PP elevation on incident CKD (glomerular filtration rate < 60 ml/min/1.73 m2) and all-cause mortality. The data was collected from the general population cohort study "Good Aging in Skåne". Cox proportional hazard regression models adjusted for age, sex, diabetes, and smoking habits were used to investigate the impact of three levels of PP elevation on incident CKD (n = 2693) and all-cause mortality (n = 5253). For PP < 60 mmHg, the median survival time was 18.7 years (event incident CKD) and first quartile survival time (event all-cause mortality) 15.4 years. Elevated PP ≥ 80 mmHg was associated with incident CKD (hazard ratio 1.59, CI 1.28-1.97), but not all-cause mortality. Our results suggest that a finding of PP ≥ 80 mmHg in older age should raise concern of kidney function.
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Affiliation(s)
- Tomas Månsson
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Jan Waldenströms Gata 35, pl 13, 205 02, Malmö, Sweden.
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Jan Waldenströms Gata 35, pl 13, 205 02, Malmö, Sweden
| | - Katarina Ellström
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Jan Waldenströms Gata 35, pl 13, 205 02, Malmö, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University and Skåne University Hospital, Jan Waldenströms Gata 35, pl 13, 205 02, Malmö, Sweden
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10
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Shlimon K, Lindenberger M, De Basso R, Cinthio M, Bjarnegård N. Increased diameter and stiffness of elastic but not muscular arteries in men with abdominal aortic aneurysm. J Appl Physiol (1985) 2024; 136:1410-1417. [PMID: 38660725 PMCID: PMC11368529 DOI: 10.1152/japplphysiol.00875.2023] [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: 12/05/2023] [Revised: 04/05/2024] [Accepted: 04/20/2024] [Indexed: 04/26/2024] Open
Abstract
It has been proposed that formation of abdominal aortic aneurysm (AAA) is part of a systemic arterial dilatative disease. However, arteries in the upper extremities are scarcely studied and it remains unclear whether both muscular and elastic arteries are affected by the proposed systemic arterial dilatation. The aim of this study was to investigate the diameter and stiffness of muscular and elastic arteries in arterial branches originating from the aortic arch. Twenty-six men with AAA (69 ± 4 yr) and 57 men without AAA (70 ± 5 yr) were included in the study. Ultrasound was used to examine the distal and proximal brachial artery, axillary artery, and common carotid artery (CCA), and measurement of diameter and diameter change was performed with wall-tracking software. Blood pressure measurements were used to calculate local arterial wall stiffness indices. The AAA cohort presented larger arterial diameters in the CCA and axillary artery after adjustment for body surface area (P = 0.002, respectively), whereas the brachial artery diameters were unchanged. Indices of increased stiffness in CCA (e.g., lower distensibility, P = 0.003) were seen in subjects with AAA after adjustments for body mass index and mean arterial blood pressure. This study supports the theory of a systemic arterial dilating diathesis in peripheral elastic, but not in muscular, arteries. Peripheral elastic arteries also exhibited increased stiffness, in analogy with findings in the aorta in AAA.NEW & NOTEWORTHY We present data partially supporting the notion of abdominal aortic aneurysm being a systemic vascular disease with focal manifestation in the abdominal aorta, from two well-defined groups recruited from a regional screening program. We show that elastic arteries distal from the aorta exhibit vascular alterations without aneurysmal formation in subjects with AAA compared with controls while muscular arteries seem unaffected.
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Affiliation(s)
- Kristian Shlimon
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcus Lindenberger
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Rachel De Basso
- Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Magnus Cinthio
- Department of Electrical Measurements, Lund University, Lund, Sweden
| | - Niclas Bjarnegård
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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11
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Schäfer F, Sturdy J, Hellevik LR. Age and sex-dependent sensitivity analysis of a common carotid artery model. Biomech Model Mechanobiol 2024; 23:825-843. [PMID: 38369558 PMCID: PMC11101589 DOI: 10.1007/s10237-023-01808-0] [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: 09/18/2023] [Accepted: 12/22/2023] [Indexed: 02/20/2024]
Abstract
The common carotid artery (CCA) is an accessible and informative site for assessing cardiovascular function which makes it a prime candidate for clinically relevant computational modelling. The interpretation of supplemental information possible through modelling is encumbered by measurement uncertainty and population variability in model parameters. The distribution of model parameters likely depends on the specific sub-population of interest and delineation based on sex, age or health status may correspond to distinct ranges of typical parameter values. To assess this impact in a 1D-CCA-model, we delineated specific sub-populations based on age, sex and health status and carried out uncertainty quantification and sensitivity analysis for each sub-population. We performed a structured literature review to characterize sub-population-specific variabilities for eight model parameters without consideration of health status; variations for a healthy sub-populations were based on previously established references values. The variabilities of diameter and distensibility found in the literature review differed from those previously established in a healthy population. Model diameter change and pulse pressure were most sensitive to variations in distensibility, while pressure was most sensitive to resistance in the Windkessel model for all groups. Uncertainties were lower when variabilities were based on a healthy sub-population; however, the qualitative distribution of sensitivity indices was largely similar between the healthy and general population. Average sensitivity of the pressure waveform showed a moderate dependence on age with decreasing sensitivity to distal resistance and increasing sensitivity to distensibility and diameter. The female population was less sensitive to variations in diameter but more sensitive to distensibility coefficient than the male population. Overall, as hypothesized input variabilities differed between sub-populations and resulted in distinct uncertainties and sensitivities of the 1D-CCA-model outputs, particularly over age for the pressure waveform and between males and females for pulse pressure.
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Affiliation(s)
- Friederike Schäfer
- Division of Biomechanics, Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelands vei 1A, 7034, Trondheim, Norway.
| | - Jacob Sturdy
- Division of Biomechanics, Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelands vei 1A, 7034, Trondheim, Norway
| | - Leif Rune Hellevik
- Division of Biomechanics, Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelands vei 1A, 7034, Trondheim, Norway
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12
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De Biasio MJ, Furman M, Clarke A, Hui W, Elia Y, Baranger J, Villemain O, Mertens L, Mahmud FH. Abnormal vascular thickness and stiffness in young adults with type 1 diabetes: new insights from cutting-edge ultrasound modalities. Cardiovasc Diabetol 2024; 23:178. [PMID: 38789969 PMCID: PMC11127355 DOI: 10.1186/s12933-024-02280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with Type 1 Diabetes (T1D). Early markers of CVD include increased carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), but these existing ultrasound technologies show limited spatial and temporal resolution in young adults. The purpose of this study is to evaluate the utility of high-resolution ultrasound modalities, including high frequency ultrasound CIMT (hfCIMT) and ultrafast ultrasound PWV (ufPWV), in young adults with Type 1 Diabetes. METHODS This is a prospective single-center observational cohort study including 39 participants with T1D and 25 age and sex matched controls. All participants underwent hfCIMT and ufPWV measurements. hfCIMT and ufPWV measures of T1D were compared with controls and associations with age, sex, BMI, A1c, blood pressure, and lipids were studied. RESULTS Mean age was 24.1 years old in both groups. T1D had a greater body mass index (27.7 [5.7] vs 23.1 [3.2] kg/m2), LDL Cholesterol, and estimated GFR, and had a mean A1c of 7.4 [1.0] % (57 mmol/mol) and diabetes duration of 16.1 [3.7] years with 56% using insulin pumps. In T1D, hfCIMT was significantly increased as compared to controls (0.435 ± 0.06 mm vs 0.379 ± 0.06 mm respectively, p < 0.01). ufPWV measures were significantly increased in T1D (systolic foot PWV: 5.29 ± 0.23 m/s vs 5.50 ± 0.37 m/s, p < 0.01; dicrotic notch PWV = 7.54 ± 0.46 m/s vs 7.92 ± 0.41 m/s, p < 0.01). Further, there was an impact of A1c-measured glycemia on hfCIMT, but this relationship was not seen with ufPWV. No significant statistical correlations between hfCIMT and ufPWV measures in either T1D or healthy controls were observed. CONCLUSION Young adults with T1D present with differences in arterial thickness and stiffness when compared with controls. Use of novel high-resolution ultrasound measures describe important relationships between early structural and vascular pathophysiologic changes and are promising tools to evaluate pre-clinical CVD risk in youth with T1D. TRIAL REGISTRATION ISRCTN91419926.
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Affiliation(s)
- Michael J De Biasio
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Michelle Furman
- Department of Pediatrics, Division of Endocrinology and Metabolism, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Antoine Clarke
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Wei Hui
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yesmino Elia
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Farid H Mahmud
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Division of Endocrinology and Metabolism, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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13
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Chen YS, Lu WA, Hsu LY, Kuo CD. Determinants of hand pulse wave velocity and hand pulse transit time in healthy adults. Sci Rep 2024; 14:10144. [PMID: 38698185 PMCID: PMC11066034 DOI: 10.1038/s41598-024-60927-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/29/2024] [Indexed: 05/05/2024] Open
Abstract
Arterial pulse wave velocity (PWV) is recognized as a convenient method to assess peripheral vascular stiffness. This study explored the clinical characteristics of hand PWV (hPWV) and hand pulse transit time (hPTT) in healthy adults (sixty males = 42.4 ± 13.9 yrs; sixty-four females = 42.8 ± 13.9 yrs) voluntarily participated in this study. The arterial pulse waveform and the anatomical distance from the radial styloid process to the tip of the middle finger of both hands were recorded in the sitting position. The hPWV was calculated as the traversed distance divided by hPTT between those two points. Male subjects showed significantly greater hPWV, systolic blood pressure, and pulse pressure than age-matched female subjects, while the hPTT was not significantly different between genders. Multiple linear regression analysis showed that gender is a common determinant of hPWV and hPTT, and that age and heart rate (HR) were negatively correlated with hPWV and hPTT, respectively. We conclude that male subjects have greater hPWV than female subjects. Ageing is associated with decreased hPWV, while increased HR is associated with a smaller hPTT. The hPWV and hPTT might be used as non-invasive indices to characterise the ageing and arterial stiffness of peripheral blood vessels.
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Affiliation(s)
- Yung-Sheng Chen
- Department of Exercise and Health Sciences, University of Taipei, Taipei, 111, Taiwan
- Exercise and Health Promotion Association, New Taipei City, 241, Taiwan
- Tanyu Research Laboratory, Taipei, 112, Taiwan
| | - Wan-An Lu
- College of LOHAS Industry, Fo-Guang University, Yilan, 262, Taiwan
| | - Ling-Yen Hsu
- Institute of Traditional Medicine, National Yang-Ming Chiao-Tung University School of Medicine, Taipei, 112, Taiwan
| | - Cheng-Deng Kuo
- Tanyu Research Laboratory, Taipei, 112, Taiwan.
- Department of Internal Medicine, Taipei Veterans General Hospital Hsinchu Branch, Hsinchu County, 310, Taiwan.
- Leadtek Research Inc., New Taipei City, 235, Taiwan.
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14
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Gu O, He B, Xiong L, Zhang Y, Li Z, Lang X. Reconstructive interpolation for pulse wave estimation to improve local PWV measurement of carotid artery. Med Biol Eng Comput 2024; 62:1459-1473. [PMID: 38252371 DOI: 10.1007/s11517-023-03008-5] [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: 10/23/2022] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Ultrasonic transit time (TT)-based local pulse wave velocity (PWV) measurement is defined as the distance between two beam positions on a segment of common carotid artery (CCA) divided by the TT in the pulse wave propagation. However, the arterial wall motions (AWMs) estimated from ultrasonic radio frequency (RF) signals with a limited number of frames using the motion tracking are typically discrete. In this work, we develop a method involving motion tracking combined with reconstructive interpolation (MTRI) to reduce the quantification errors in the estimated PWs, and thereby improve the accuracy of the TT-based local PWV measurement for CCA. For each beam position, normalized cross-correlation functions (NCCFs) between the reference (the first frame) and comparison (the remaining frames) RF signals are calculated. Thereafter, the reconstructive interpolation is performed in the neighborhood of the NCCFs' peak to identify the interpolation-deduced peak locations, which are more exact than the original ones. According to which, the improved AWMs are obtained to calculate their TT along a segment of the CCA. Finally, the local PWV is measured by applying a linear regression fit to the time-distance result. In ultrasound simulations based on the pulse wave propagation models of young, middle-aged, and elderly groups, the MTRI method with different numbers of interpolated samples was used to estimate AWMs and local PWVs. Normalized root mean squared errors (NRMSEs) between the estimated and preset values of the AWMs and local PWVs were calculated and compared with ones without interpolation. The means of the NRMSEs for the AWMs and local PWVs based on the MTRI method with one interpolated sample decrease from 1.14% to 0.60% and 7.48% to 4.61%, respectively. Moreover, Bland-Altman analysis and coefficient of variation were used to validate the performance of the MTRI method based on the measured local PWVs of 30 healthy subjects. In conclusion, the reconstructive interpolation for the pulse wave estimation improves the accuracy and repeatability of the carotid local PWV measurement.
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Affiliation(s)
- Ouyang Gu
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Bingbing He
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China.
| | - Li Xiong
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Yufeng Zhang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
| | - Zhiyao Li
- Department of Ultrasound, the Third Affiliated Hospital of Kunming Medical College, Kunming, 650118, China
| | - Xun Lang
- Department of Electronic Engineering, Information School, Yunnan University, Kunming, 650091, Yunnan, China
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15
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Silva MA, Oliveira APD, Queiroz AC, Spaziani AO, Fernandes LA, De Oliveira KA, Lopes VDS, Landim MP, Cosenso-Martin LN, Vilela-Martin JF. Correlation between estimated pulse wave velocity values from two equations in healthy and under cardiovascular risk populations. PLoS One 2024; 19:e0298405. [PMID: 38593112 PMCID: PMC11003621 DOI: 10.1371/journal.pone.0298405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/25/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Equations can calculate pulse wave velocity (ePWV) from blood pressure values (BP) and age. The ePWV predicts cardiovascular events beyond carotid-femoral PWV. We aimed to evaluate the correlation between four different equations to calculate ePWV. METHODS The ePWV was estimated utilizing mean BP (MBP) from office BP (MBPOBP) or 24-hour ambulatory BP (MBP24-hBP). We separated the whole sample into two groups: individuals with risk factors and healthy individuals. The e-PWV was calculated as follows: [Formula: see text] [Formula: see text] We calculated the concordance correlation coefficient (Pc) between e1-PWVOBP vs e2-PWVOBP, e1-PWV24-hBP vs e2-PWV24-hBP, and mean values of e1-PWVOBP, e2-PWVOBP, e1-PWV24-hBP and e2-PWV24-hBP. The multilevel regression model determined how much the ePWVs are influenced by age and MBP values. RESULTS We analyzed data from 1541 individuals; 1374 ones with risk factors and 167 healthy ones. The values are presented for the entire sample, for risk-factor patients and for healthy individuals respectively. The correlation between e1-PWVOBP with e2-PWVOBP and e1-PWV24-hBP with e2-PWV24-hBP was almost perfect. The Pc for e1-PWVOBP vs e2-PWVOBP was 0.996 (0.995-0.996), 0.996 (0.995-0.996), and 0.994 (0.992-0.995); furthermore, it was 0.994 (0.993-0.995), 0.994 (0.994-0.995), 0.987 (0.983-0.990) to the e1-PWV24-hBP vs e2-PWV24-hBP. There were no significant differences between mean values (m/s) for e1-PWVOBP vs e2-PWVOBP 8.98±1.9 vs 8.97±1.8; p = 0.88, 9.14±1.8 vs 9.13±1.8; p = 0.88, and 7.57±1.3 vs 7.65±1.3; p = 0.5; mean values are also similar for e1-PWV24-hBP vs e2-PWV24-hBP, 8.36±1.7 vs 8.46±1.6; p = 0.09, 8.50±1.7 vs 8.58±1.7; p = 0.21 and 7.26±1.3 vs 7.39±1.2; p = 0.34. The multiple linear regression showed that age, MBP, and age2 predicted more than 99.5% of all four e-PWV. CONCLUSION Our data presents a nearly perfect correlation between the values of two equations to calculate the estimated PWV, whether utilizing office or ambulatory blood pressure.
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Affiliation(s)
- Marco Av Silva
- Division of Cardiology, Department of Internal Medicine, Federal University of the Triângulo Mineiro, Uberaba, Brazil
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Ana Ps De Oliveira
- Department of Microbiology, Immunology and Parasitology, Federal University of the Triângulo Mineiro, Uberaba, Brazil
| | | | - Amanda O. Spaziani
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Leticia Ab Fernandes
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Kleber A. De Oliveira
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Valquiria Da S. Lopes
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Manoel P. Landim
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Luciana N. Cosenso-Martin
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
| | - Jose F. Vilela-Martin
- Department of Internal Medicine, São Jose do Rio Preto State Medical School, São José do Rio Preto, Brazil
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16
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Raisi-Estabragh Z, Szabo L, Schuermans A, Salih AM, Chin CWL, Vágó H, Altmann A, Ng FS, Garg P, Pavanello S, Marwick TH, Petersen SE. Noninvasive Techniques for Tracking Biological Aging of the Cardiovascular System: JACC Family Series. JACC Cardiovasc Imaging 2024:S1936-878X(24)00082-2. [PMID: 38597854 DOI: 10.1016/j.jcmg.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/11/2024]
Abstract
Population aging is one of the most important demographic transformations of our time. Increasing the "health span"-the proportion of life spent in good health-is a global priority. Biological aging comprises molecular and cellular modifications over many years, which culminate in gradual physiological decline across multiple organ systems and predispose to age-related illnesses. Cardiovascular disease is a major cause of ill health and premature death in older people. The rate at which biological aging occurs varies across individuals of the same age and is influenced by a wide range of genetic and environmental exposures. The authors review the hallmarks of biological cardiovascular aging and their capture using imaging and other noninvasive techniques and examine how this information may be used to understand aging trajectories, with the aim of guiding individual- and population-level interventions to promote healthy aging.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
| | - Liliana Szabo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Art Schuermans
- Faculty of Medicine, KU Leuven, Leuven, Belgium; Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ahmed M Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Department of Population Health Sciences, University of Leicester, Leicester UK; Department of Computer Science, Faculty of Science, University of Zakho, Zakho, Kurdistan Region, Iraq
| | - Calvin W L Chin
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore; Cardiovascular Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore, Singapore
| | - Hajnalka Vágó
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Fu Siong Ng
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Pankaj Garg
- University of East Anglia, Norwich Medical School, Norwich, United Kingdom; Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy; Padua Hospital, Occupational Medicine Unit, Padua, Italy; University Center for Space Studies and Activities "Giuseppe Colombo" - CISAS, University of Padua, Padua, Italy
| | | | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Health Data Research UK, London, United Kingdom
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17
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Gresele P, Migliacci R, Paciullo F. Measurement of arterial stiffness in antiphospholipid syndrome: a step forward in cardiovascular risk stratification? Rheumatology (Oxford) 2024; 63:912-913. [PMID: 38197575 DOI: 10.1093/rheumatology/keae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Paolo Gresele
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Rino Migliacci
- Department of Internal and Specialized Medicine USL South-East Tuscany, Division of Internal Medicine, Ospedale della Valdichiana 'S Margherita', Cortona, Italy
| | - Francesco Paciullo
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
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18
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Suriani I, Bouwman RA, Mischi M, Lau KD. An in silico study of the effects of cardiovascular aging on carotid flow waveforms and indexes in a virtual population. Am J Physiol Heart Circ Physiol 2024; 326:H877-H899. [PMID: 38214900 DOI: 10.1152/ajpheart.00304.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
Cardiovascular aging is strongly associated with increased risk of cardiovascular disease and mortality. Moreover, health and lifestyle factors may accelerate age-induced alterations, such as increased arterial stiffness and wall dilation, beyond chronological age, making the clinical assessment of cardiovascular aging an important prompt for preventative action. Carotid flow waveforms contain information about age-dependent cardiovascular properties, and their ease of measurement via noninvasive Doppler ultrasound (US) makes their analysis a promising tool for the routine assessment of cardiovascular aging. In this work, the impact of different aging processes on carotid waveform morphology and derived indexes is studied in silico, with the aim of establishing the clinical potential of a carotid US-based assessment of cardiovascular aging. One-dimensional (1-D) hemodynamic modeling was employed to generate an age-specific virtual population (VP) of N = 5,160 realistic carotid hemodynamic waveforms. The resulting VP was statistically validated against in vivo aging trends in waveforms and indexes from the literature, and simulated waveforms were studied in relation to age and underlying cardiovascular parameters. In our study, the carotid flow augmentation index (FAI) significantly increased with age (with a median increase of 50% from the youngest to the oldest age group) and was strongly correlated to local arterial stiffening (r = 0.94). The carotid pulsatility index (PI), which showed less pronounced age variation, was inversely correlated with the reflection coefficient at the carotid branching (r = -0.88) and directly correlated with carotid net forward wave energy (r = 0.90), corroborating previous literature where it was linked to increased risk of cerebrovascular damage in the elderly. There was a high correlation between corrected carotid flow time (ccFT) and cardiac output (CO) (r = 0.99), which was not affected by vascular age. This study highlights the potential of carotid waveforms as a valuable tool for the assessment of cardiovascular aging.NEW & NOTEWORTHY An age-specific virtual population was generated based on a 1-D model of the arterial circulation, including newly defined literature-based specific age variations in carotid vessel properties. Simulated carotid flow/velocity waveforms, indexes, and age trends were statistically validated against in vivo data from the literature. A comprehensive study of the impact of aging on carotid flow waveform morphology was performed, and the mechanisms influencing different carotid indexes were elucidated. Notably, flow augmentation index (FAI) was found to be a strong indicator of local carotid stiffness.
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Affiliation(s)
- Irene Suriani
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R Arthur Bouwman
- Eindhoven University of Technology, Eindhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Massimo Mischi
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Kevin D Lau
- Philips Research, Eindhoven, The Netherlands
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19
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Pilt K, Reiu A. Effect of transmural pressure on the estimation of arterial stiffness index from the photoplethysmographic waveform. Med Biol Eng Comput 2024; 62:1049-1059. [PMID: 38123887 DOI: 10.1007/s11517-023-02992-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to find the effect of transmural pressure on the determination of the photoplethysmographic (PPG) waveform arterial stiffness index (PPGAI). The study was conducted on 51 subjects without diagnosis of cardiovascular disease, aged between 24 and 74 years. The relation between the transmural pressure, which is the difference between the arterial blood pressure and the PPG sensor contact pressure, and the PPGAI was determined. PPG, beat-to-beat blood pressure, and sensor contact pressure signals were recorded from the index, middle, and ring finger. The PPG sensor contact pressure of the index finger was increased from 20 to 120 mmHg. The aortic augmentation index (AIx@75) was estimated with a SphygmoCor device as a reference. High correlation coefficients r = 0.79 and r = 0.83 between PPGAI and AIx@75, and low PPGAI standard deviations were observed at the transmural pressures of 10 and 20 mmHg, respectively. Transmural pressure of 20 mmHg can be considered suitable for the PPG signal registration and PPGAI calculation for the assessment of arterial stiffness. In summary, the contact pressure of the sensor should be selected according to theblood pressure of the subject finger in order to achieve the transmural pressure suitable for the assessment of PPGAI and arterial stiffness.
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Affiliation(s)
- Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia.
| | - Andy Reiu
- Department of Health Technologies, Tallinn University of Technology, Ehitajate Tee 5, 19086, Tallinn, Estonia
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20
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Pereira LCC, Chagas P, Barbosa ECD, Barroso WKS, Oliveira AC, Hillesheim SF, Kohlrausch VC, Chemello D. The usefulness of SAGE score in predicting high pulse wave velocity in hypertensive patients: a retrospective cohort study. Front Cardiovasc Med 2024; 11:1227906. [PMID: 38596694 PMCID: PMC11002898 DOI: 10.3389/fcvm.2024.1227906] [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: 05/24/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Aortic stiffness assessed by pulse wave velocity (PWV) is an important predictor to evaluate the risk of hypertensive patients. However, it is underutilized in clinical practice. We aimed to identify the optimal cutoff SAGE score that would indicate a risk PWV ≥ 10 m/s in Brazilian ambulatory hypertensive patients. Materials and methods A retrospective cohort study. Patients underwent central blood pressure measurement using a validated oscillometric device from August 2020 to December 2021. A ROC curve was constructed using the Youden statistic to define the best score to identify those at high risk for PWV ≥ 10 m/s. Results A total of 212 hypertensive individuals were selected. The mean age was 64.0 ± 12.4 years and 57.5% were female. The following comorbidities were present: overweight (47.6%), obesity (34.3%), and diabetes (25.0%). Most of the sample (68.9%) had PWV < 10 m/s. According to Youden's statistic, a cutoff point of 6 provided the optimal combination of sensitivity and specificity for identifying patients with a PWV ≥ 10 m/s. This cutoff achieved sensitivity of 97.0%, and specificity of 82.9%. In clinical practice, however, a cutoff point of 7 (where score values of at least 7 were considered to indicate high risk) had a positive likelihood ratio of 8.2 and a negative likelihood ration of 0.346, making this the ideal choice by accurately excluding patients who are less likely to have PWV ≥ 10 m/s. Conclusion A SAGE score ≥7 identified Brazilian hypertensive patients with a high risk of PWV ≥ 10 m/s.
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Affiliation(s)
| | - Patrícia Chagas
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Food and Nutrition, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Eduardo Costa Duarte Barbosa
- Department of Cardiology, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre – Cardiologia, Porto Alegre, Brazil
| | - Weimar Kunz Sebba Barroso
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Adriana Camargo Oliveira
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Suélen Feijó Hillesheim
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Diego Chemello
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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21
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Karimpour P, Ferizoli R, May JM, Kyriacou PA. Customisable Silicone Vessels and Tissue Phantoms for In Vitro Photoplethysmography Investigations into Cardiovascular Disease. SENSORS (BASEL, SWITZERLAND) 2024; 24:1681. [PMID: 38475217 DOI: 10.3390/s24051681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/23/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024]
Abstract
Age-related vessel deterioration leads to changes in the structure and function of the heart and blood vessels, notably stiffening of vessel walls, increasing the risk of developing cardiovascular disease (CVD), which accounts for 17.9 million global deaths annually. This study describes the fabrication of custom-made silicon vessels with varying mechanical properties (arterial stiffness). The primary objective of this study was to explore how changes in silicone formulations influenced vessel properties and their correlation with features extracted from signals obtained from photoplethysmography (PPG) reflectance sensors in an in vitro setting. Through alterations in the silicone formulations, it was found that it is possible to create elastomers exhibiting an elasticity range of 0.2 MPa to 1.22 MPa. It was observed that altering vessel elasticity significantly impacted PPG signal morphology, particularly reducing amplitude with increasing vessel stiffness (p < 0.001). A p-value of 5.176 × 10-15 and 1.831 × 10-14 was reported in the red and infrared signals, respectively. It has been concluded in this study that a femoral artery can be recreated using the silicone material, with the addition of a softener to achieve the required mechanical properties. This research lays the foundation for future studies to replicate healthy and unhealthy vascular systems. Additional pathologies can be introduced by carefully adjusting the elastomer materials or incorporating geometrical features consistent with various CVDs.
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Affiliation(s)
- Parmis Karimpour
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK
| | - Redjan Ferizoli
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK
| | - James M May
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK
| | - Panicos A Kyriacou
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK
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22
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Xie Y, Yu C, Zhou W, Zhu L, Wang T, Bao H, Cheng X. Relationship between normal weight central obesity and arterial stiffness in Chinese adults with hypertension. Nutr Metab Cardiovasc Dis 2024; 34:343-352. [PMID: 38145917 DOI: 10.1016/j.numecd.2023.09.026] [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: 07/21/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND AND AIMS Normal weight central obesity (NWCO) is a category of obesity that is characterized by having a normal BMI and presence of abdominal obesity. Recently, studies have reported that NWCO was associated with the cardiovascular diseases. The researches exploring the relationship between NWCO and arterial stiffness are limited. So this study intended to investigate the relationship between NWCO and arterial stiffness in Chinese adults with hypertension. METHODS AND RESULTS This study is a sub-study of the China H-type Hypertension Registry Study. We included 8580 Chinese hypertensive patients with normal weight (18.5 kg/m2 ≤BMI <24 kg/m2). Central obesity was defined as waist-height ratio ≥0.5, and participants were categorized into two groups: NWCO and normal weight and no central obesity (NWNO). Using the brachial-ankle pulse wave conduction velocity (baPWV) assessed the arterial stiffness. Multiple linear regression analysis was used to evaluate relationship between NWCO and baPWV. Multiple logistic regression analysis was used to evaluate relationship between NWCO and arterial stiffness. Of 8580 participants, 4327 (50.4 %) were NWCO. The multiple linear regression analysis demonstrated that people with NWCO had higher baPWV value (total people: β = 38.33, 95%CI 22.82-53.84; men: β = 39.87, 95%CI 18.43-61.32; women: β = 29.65, 95%CI 7.20-52.09) compared with NWNO. The baPWV ≥1800 cm/s was defined as arterial stiffness, and the multiple logistic regression analysis showed that people with NWCO associated higher arterial stiffness risk (total people: OR = 1.25, 95%CI 1.12-1.39; men: OR = 1.29, 95%CI 1.11-1.50; women: OR = 1.18, 95%CI 1.01-1.38). CONCLUSION NWCO is significantly related to increased risk of arterial stiffness in Chinese adults with hypertension.
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Affiliation(s)
- Yanyou Xie
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Chao Yu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, China; Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, China.
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23
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Ballenger BK, Carter SL, Norman G, Brown SP, Fernhall B, Motl RW, Agiovlasitis S. Physical activity and arterial stiffness: is body fat a mediator? Eur J Appl Physiol 2024; 124:527-535. [PMID: 37578537 DOI: 10.1007/s00421-023-05296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE Physical activity (PA) and body fat percentage (%BF) are independently associated with arterial stiffness, but it has not been explored if there is an associative pathway among these variables. This study examined whether %BF mediates the relationship between PA or sedentary behavior levels with arterial stiffness. METHODS Fifty adults (1:1 men:women; age 28 ± 11 year) had carotid-femoral pulse wave velocity (CF-PWV) measured by applanation tonometry, %BF by bioelectrical impedance, and PA levels by accelerometry. Accelerometer data determined minutes per day spent in sedentary, light, moderate-to-vigorous physical activity (MVPA), and Total PA. RESULTS Pearson correlation indicated statistically significant associations among age, %BF, CF-PWV, MVPA, and Total PA (r = 0.34-0.65, p < 0.05). Sedentary and light PA were not associated with CF-PWV. Mediation analysis indicated significant total effects of MVPA (β = - 0.34, p = 0.044) and age (β = 0.65, p < 0.001) on CF-PWV. %BF mediated the relationship between Total PA and CF-PWV due to indirect effect of Total PA on %BF (β = - 0.34, p = 0.02) and %BF on CF-PWV (β = 0.44, p = 0.002), and partially mediated the relationship between age and CF-PWV (β = 0.54, p < 0.001). Total PA retained its significant effect on %BF (β = - 0.28, p = 0.04) and the effect of %BF on CF-PWV remained significant (β = 0.26, p = 0.03), despite age having a significant effect on both %BF (β = 0.31, p = 0.023) and CF-PWV (β = 0.54, p < 0.001). CONCLUSIONS %BF mediated the relationship between Total PA and arterial stiffness, even after accounting for age. Engagement in more Total PA may help to reduce %BF, resulting in decreased arterial stiffness.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA.
| | - Sydni L Carter
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Grant Norman
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Stanley P Brown
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Bo Fernhall
- Department of Exercise and Health Science, University of Massachusetts Boston, Boston, MA, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, Univeristy of Illinois Chicago, Chicago, IL, USA
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24
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Dinh QN, Lo C, Zhang DW, Tran V, Gibson-Hughes T, Sheriff A, Diep H, Kim HA, Zhang SR, Barreto-Arce LJ, Jelinic M, Vinh A, Arumugam TV, Chan ST, Lim R, Drummond GR, Sobey CG, De Silva TM. Human amnion epithelial cell therapy reduces hypertension-induced vascular stiffening and cognitive impairment. Sci Rep 2024; 14:1837. [PMID: 38246932 PMCID: PMC10800338 DOI: 10.1038/s41598-024-52214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Vascular inflammation and fibrosis are hallmarks of hypertension and contribute to the development of cardiovascular disease and cognitive impairment. However, current anti-hypertensive drugs do not treat the underlying tissue damage, such as inflammation-associated fibrosis. Human amnion epithelial cells have several properties amenable for treating vascular pathology. This study tested the effect of amnion epithelial cells on vascular pathology and cognitive impairment during hypertension. Male C57Bl6 mice (8-12 weeks) were administered vehicle (saline; n = 58) or angiotensin II (0.7 mg/kg/d, n = 56) subcutaneously for 14 d. After surgery, a subset of mice were injected with 106 amnion epithelial cells intravenously. Angiotensin II infusion increased systolic blood pressure, aortic pulse wave velocity, accumulation of aortic leukocytes, and aortic mRNA expression of collagen subtypes compared to vehicle-infused mice (n = 9-11, P < 0.05). Administration of amnion epithelial cells attenuated these effects of angiotensin II (P < 0.05). Angiotensin II-induced cognitive impairment was prevented by amnion epithelial cell therapy (n = 7-9, P < 0.05). In the brain, amnion epithelial cells modulated some of the inflammatory genes that angiotensin II promoted differential expression of (n = 6, p-adjusted < 0.05). These findings suggest that amnion epithelial cells could be explored as a potential therapy to inhibit vascular pathology and cognitive impairment during hypertension.
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Affiliation(s)
- Quynh Nhu Dinh
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Cecilia Lo
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - David Wong Zhang
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Vivian Tran
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Tayla Gibson-Hughes
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Ashleigh Sheriff
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Henry Diep
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Hyun Ah Kim
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Shenpeng R Zhang
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Liz J Barreto-Arce
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Maria Jelinic
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Antony Vinh
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Thiruma V Arumugam
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Siow Teng Chan
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Rebecca Lim
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Grant R Drummond
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Christopher G Sobey
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia.
| | - T Michael De Silva
- Department of Microbiology, Anatomy, Physiology and Pharmacology, Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, 3086, Australia.
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25
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Rolnick N, Licameli N, Moghaddam M, Marquette L, Walter J, Fedorko B, Werner T. Autoregulated and Non-Autoregulated Blood Flow Restriction on Acute Arterial Stiffness. Int J Sports Med 2024; 45:23-32. [PMID: 37562444 PMCID: PMC10776212 DOI: 10.1055/a-2152-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/05/2023] [Indexed: 08/12/2023]
Abstract
This study aimed to investigate the acute effects of autoregulated and non-autoregulated applied pressures during blood flow restriction resistance exercise to volitional fatigue on indices of arterial stiffness using the Delfi Personalized Tourniquet System. Following a randomized autoregulated or non-autoregulated blood flow restriction familiarization session, 20 physically active adults (23±5 years; 7 females) participated in three randomized treatment-order sessions with autoregulated and non-autoregulated and no blood flow restriction training. Participants performed four sets of dumbbell wall squats to failure using 20% of one repetition maximum. Blood flow restriction was performed with 60% of supine limb occlusion pressure. Testing before and post-session included an ultrasonic scan of the carotid artery, applanation tonometry, and blood pressure acquisition.Carotid-femoral pulse wave velocity increased in the non-autoregulated and no blood flow restriction training groups following exercise while carotid-radial pulse wave velocity increased in the no blood flow restriction training group (all p<0.05). Carotid-femoral pulse wave velocity exhibited an interaction effect between autoregulated and non-autoregulated blood flow restriction in favor of autoregulated blood flow restriction (p<0.05). Autoregulated blood flow restriction training does not influence indices of arterial stiffness while non-autoregulated and no blood flow restriction training increases central stiffness.
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Affiliation(s)
- Nicholas Rolnick
- Exercise Science, Lehman College, Bronx, United States
- Physical Therapy, The Human Performance Mechanic, Manhattan, United
States
| | | | - Masoud Moghaddam
- Physical Therapy, University of Maryland Eastern Shore, Princess Anne,
United States
| | - Lisa Marquette
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Jessica Walter
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Brent Fedorko
- Exercise Science, Salisbury University, Salisbury, United
States
| | - Tim Werner
- Exercise Science, Salisbury University, Salisbury, United
States
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Moreau KL, Clayton ZS, DuBose LE, Rosenberry R, Seals DR. Effects of regular exercise on vascular function with aging: Does sex matter? Am J Physiol Heart Circ Physiol 2024; 326:H123-H137. [PMID: 37921669 PMCID: PMC11208002 DOI: 10.1152/ajpheart.00392.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Vascular aging, featuring endothelial dysfunction and large elastic artery stiffening, is a major risk factor for the development of age-associated cardiovascular diseases (CVDs). Vascular aging is largely mediated by an excessive production of reactive oxygen species (ROS) and increased inflammation leading to reduced bioavailability of the vasodilatory molecule nitric oxide and remodeling of the arterial wall. Other cellular mechanisms (i.e., mitochondrial dysfunction, impaired stress response, deregulated nutrient sensing, cellular senescence), termed "hallmarks" or "pillars" of aging, may also contribute to vascular aging. Gonadal aging, which largely impacts women but also impacts some men, modulates the vascular aging process. Regular physical activity, including both aerobic and resistance exercise, is a first-line strategy for reducing CVD risk with aging. Although exercise is an effective intervention to counter vascular aging, there is considerable variation in the vascular response to exercise training with aging. Aerobic exercise improves large elastic artery stiffening in both middle-aged/older men and women and enhances endothelial function in middle-aged/older men by reducing oxidative stress and inflammation and preserving nitric oxide bioavailability; however, similar aerobic exercise training improvements are not consistently observed in estrogen-deficient postmenopausal women. Sex differences in adaptations to exercise may be related to gonadal aging and declines in estrogen in women that influence cellular-molecular mechanisms, disconnecting favorable signaling in the vasculature induced by exercise training. The present review will summarize the current state of knowledge on vascular adaptations to regular aerobic and resistance exercise with aging, the underlying mechanisms involved, and the moderating role of biological sex.
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Affiliation(s)
- Kerrie L Moreau
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Lyndsey E DuBose
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Ryan Rosenberry
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Aizawa K, Gates PE, Mawson DM, Casanova F, Gooding KM, Hope SV, Goncalves I, Nilsson J, Khan F, Colhoun HM, Natali A, Palombo C, Shore AC. Type 2 diabetes exacerbates changes in blood pressure-independent arterial stiffness: cross-sectional and longitudinal evidence from the SUMMIT study. J Appl Physiol (1985) 2024; 136:13-22. [PMID: 37969084 PMCID: PMC11208039 DOI: 10.1152/japplphysiol.00283.2023] [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: 05/04/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 11/17/2023] Open
Abstract
Greater central artery stiffness is observed in people with type 2 diabetes (T2DM). Elevated blood pressure (BP) and altered arterial wall structure/composition in T2DM are generally considered as main drivers for this alteration. However, because conventional arterial stiffness measures are BP-dependent and as such an influence of BP remains in a measure, it is unclear if greater central artery stiffness is a function of greater BP, or due to changes in the structure and composition of the arterial wall. We aimed to measure BP-independent arterial stiffness (β0) cross-sectionally and longitudinally in T2DM. We studied 753 adults with T2DM (DM+) and 436 adults without (DM-) at baseline (Phase 1), and 310 DM+ and 210 DM- adults at 3-yr follow-up (Phase 2). We measured carotid-femoral pulse wave velocity and used it to calculate β0. In Phase 1, β0 was significantly greater in DM+ than DM- after adjusting for age and sex [27.5 (26.6-28.3) vs. 23.6 (22.4-24.8) au, P < 0.001]. Partial correlation analyses after controlling for age and sex showed that β0 was significantly associated with hemoglobin A1c (r = 0.15 P < 0.001) and heart rate [(HR): r = 0.23 P < 0.001)] in DM+. In Phase 2, percentage-change in β0 was significantly greater in DM+ than DM- [19.5 (14.9-24.0) vs. 5.0 (-0.6 to 10.6) %, P < 0.001] after adjusting for age, sex, and baseline β0. β0 was greater in DM+ than DM- and increased much more in DM+ than in DM- over 3 yr. This suggests that T2DM exacerbates BP-independent arterial stiffness and may have a complemental utility to existing arterial stiffness indices.NEW & NOTEWORTHY We demonstrate in this study a greater BP-independent arterial stiffness β0 in people with type 2 diabetes (T2DM) compared to those without, and also a greater change in β0 over 3 yr in people with T2DM than those without. These findings suggest that the intrinsic properties of the arterial wall may change in a different and more detrimental way in people with T2DM and likely represents accumulation of cardiovascular risk.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - David M Mawson
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Kim M Gooding
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Suzy V Hope
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Isabel Goncalves
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Faisel Khan
- Division of Systems Medicine, University of Dundee, Dundee, United Kingdom
| | - Helen M Colhoun
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Palombo
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
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Ivanytska TA, Kazakov YM, Petrov YY, Burmak YH, Ivanytskyi IV, Chekalina NI, Shut SV. Changes in the indicators of stiffness and remodeling of magistral arteries in young patients at the early stage of essential hypertension under conditions of syntropy with obesity. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:30-35. [PMID: 38518230 DOI: 10.36740/merkur202401105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Aim: The study and analysis of indicators of remodeling and rigidity of magistral vessels in young essential hypertension patients with abdominal obesity and determination of the detected changes as a possible criterion for their remodeling.. PATIENTS AND METHODS Materials and Methods: 98 young people with essential hypertension and obesity were included in the study. The structure of the carotid artery and its stiffness were assessed using the ultrasound method, and the level of abdominal fat was determined using dual-energy X-ray absorptiometry. RESULTS Results: Carotid Intima-Media Thickness in patients with essential hypertension reliably exceeded the corresponding indicator of the control group. We observed a significant increase in arterial stiffness indicators, which is explained by the increased stiffness of blood vessels in patients with obesity. During the correlation analysis, it was established that the relationship between the level of abdominal fat and the elasticity of the vascular wall was positive and strong, which indicated the dominant role of the abdominal type of obesity in the remodeling of the vascular wall in young patients with essential hypertension in combination with obesity. CONCLUSION Conclusions: In young patients at the early stage of the formation of essential hypertension, there are signs of a decrease in resilient-elastic properties and remodeling of magistral vessels, whose severity is significantly stronger in combination with abdominal obesity.
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Roth L, Dogan S, Tuna BG, Aranyi T, Benitez S, Borrell-Pages M, Bozaykut P, De Meyer GRY, Duca L, Durmus N, Fonseca D, Fraenkel E, Gillery P, Giudici A, Jaisson S, Johansson M, Julve J, Lucas-Herald AK, Martinet W, Maurice P, McDonnell BJ, Ozbek EN, Pucci G, Pugh CJA, Rochfort KD, Roks AJM, Rotllan N, Shadiow J, Sohrabi Y, Spronck B, Szeri F, Terentes-Printzios D, Tunc Aydin E, Tura-Ceide O, Ucar E, Yetik-Anacak G. Pharmacological modulation of vascular ageing: A review from VascAgeNet. Ageing Res Rev 2023; 92:102122. [PMID: 37956927 DOI: 10.1016/j.arr.2023.102122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
Vascular ageing, characterized by structural and functional changes in blood vessels of which arterial stiffness and endothelial dysfunction are key components, is associated with increased risk of cardiovascular and other age-related diseases. As the global population continues to age, understanding the underlying mechanisms and developing effective therapeutic interventions to mitigate vascular ageing becomes crucial for improving cardiovascular health outcomes. Therefore, this review provides an overview of the current knowledge on pharmacological modulation of vascular ageing, highlighting key strategies and promising therapeutic targets. Several molecular pathways have been identified as central players in vascular ageing, including oxidative stress and inflammation, the renin-angiotensin-aldosterone system, cellular senescence, macroautophagy, extracellular matrix remodelling, calcification, and gasotransmitter-related signalling. Pharmacological and dietary interventions targeting these pathways have shown potential in ameliorating age-related vascular changes. Nevertheless, the development and application of drugs targeting vascular ageing is complicated by various inherent challenges and limitations, such as certain preclinical methodological considerations, interactions with exercise training and sex/gender-related differences, which should be taken into account. Overall, pharmacological modulation of endothelial dysfunction and arterial stiffness as hallmarks of vascular ageing, holds great promise for improving cardiovascular health in the ageing population. Nonetheless, further research is needed to fully elucidate the underlying mechanisms and optimize the efficacy and safety of these interventions for clinical translation.
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Affiliation(s)
- Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium.
| | - Soner Dogan
- Department of Medical Biology, School of Medicine, Yeditepe University, Istanbul, Turkiye
| | - Bilge Guvenc Tuna
- Department of Biophysics, School of Medicine, Yeditepe University, Istanbul, Turkiye
| | - Tamas Aranyi
- Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary; Department of Molecular Biology, Semmelweis University, Budapest, Hungary
| | - Sonia Benitez
- CIBER de Diabetes y enfermedades Metabólicas asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Biochemistry, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Maria Borrell-Pages
- Cardiovascular Program ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
| | - Perinur Bozaykut
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkiye
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Laurent Duca
- UMR CNRS 7369 Matrice Extracellulaire et Dynamique Cellulaire (MEDyC), Team 2 "Matrix Aging and Vascular Remodelling", Université de Reims Champagne Ardenne (URCA), Reims, France
| | - Nergiz Durmus
- Department of Pharmacology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkiye
| | - Diogo Fonseca
- Laboratory of Pharmacology and Pharmaceutical Care, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Emil Fraenkel
- 1st Department of Internal Medicine, University Hospital, Pavol Jozef Šafárik University of Košice, Košice, Slovakia
| | - Philippe Gillery
- UMR CNRS 7369 Matrice Extracellulaire et Dynamique Cellulaire (MEDyC), Team 2 "Matrix Aging and Vascular Remodelling", Université de Reims Champagne Ardenne (URCA), Reims, France; Laboratoire de Biochimie-Pharmacologie-Toxicologie, Centre Hospitalier et Universitaire de Reims, Reims, France
| | - Alessandro Giudici
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, the Netherlands
| | - Stéphane Jaisson
- UMR CNRS 7369 Matrice Extracellulaire et Dynamique Cellulaire (MEDyC), Team 2 "Matrix Aging and Vascular Remodelling", Université de Reims Champagne Ardenne (URCA), Reims, France; Laboratoire de Biochimie-Pharmacologie-Toxicologie, Centre Hospitalier et Universitaire de Reims, Reims, France
| | | | - Josep Julve
- CIBER de Diabetes y enfermedades Metabólicas asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Endocrinology, Diabetes and Nutrition group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | | | - Wim Martinet
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Pascal Maurice
- UMR CNRS 7369 Matrice Extracellulaire et Dynamique Cellulaire (MEDyC), Team 2 "Matrix Aging and Vascular Remodelling", Université de Reims Champagne Ardenne (URCA), Reims, France
| | - Barry J McDonnell
- Centre for Cardiovascular Health and Ageing, Cardiff Metropolitan University, Cardiff, UK
| | - Emine Nur Ozbek
- Department of Pharmacology, Faculty of Pharmacy, Ege University, Izmir, Turkiye
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Christopher J A Pugh
- Centre for Cardiovascular Health and Ageing, Cardiff Metropolitan University, Cardiff, UK
| | - Keith D Rochfort
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - Anton J M Roks
- Department of Internal Medicine, Division of Vascular Disease and Pharmacology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Noemi Rotllan
- CIBER de Diabetes y enfermedades Metabólicas asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Pathophysiology of lipid-related diseases, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - James Shadiow
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Yahya Sohrabi
- Molecular Cardiology, Dept. of Cardiology I - Coronary and Peripheral Vascular Disease, University Hospital Münster, Westfälische Wilhelms-Universität, 48149 Münster, Germany; Department of Medical Genetics, Third Faculty of Medicine, Charles University, 100 00 Prague, Czechia
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, the Netherlands; Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Flora Szeri
- Institute of Enzymology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elif Tunc Aydin
- Department of Cardiology, Hospital of Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkiye
| | - Olga Tura-Ceide
- Biomedical Research Institute-IDIBGI, Girona, Spain; Department of Pulmonary Medicine, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias, Madrid, Spain
| | - Eda Ucar
- Department of Biophysics, School of Medicine, Yeditepe University, Istanbul, Turkiye
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Ege University, Izmir, Turkiye; Department of Pharmacology, Faculty of Pharmacy, Acıbadem Mehmet Aydinlar University, Istanbul, Turkiye.
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30
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Cheng L, Yue H, Zhang H, Liu Q, Du L, Liu X, Xie J, Shen Y. The influence of microenvironment stiffness on endothelial cell fate: Implication for occurrence and progression of atherosclerosis. Life Sci 2023; 334:122233. [PMID: 37918628 DOI: 10.1016/j.lfs.2023.122233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Atherosclerosis, the primary cause of cardiovascular diseases (CVDs), is characterized by phenotypic changes in fibrous proliferation, chronic inflammation and lipid accumulation mediated by vascular endothelial cells (ECs) and vascular smooth muscle cells (SMCs) which are correlated with the stiffening and ectopic remodeling of local extracellular matrix (ECM). The native residents, ECs and SMCs, are not only affected by various chemical factors including inflammatory mediators and chemokines, but also by a range of physical stimuli, such as shear stress and ECM stiffness, presented in the microenvironmental niche. Especially, ECs, as a semi-selective barrier, can sense mechanical forces, respond quickly to changes in mechanical loading and provide context-specific adaptive responses to restore homeostasis. However, blood arteries undergo stiffening and lose their elasticity with age. Reports have shown that the ECM stiffening could influence EC fate by changing the cell adhesion, spreading, proliferation, cell to cell contact, migration and even communication with SMCs. The cell behaviour changes mediated by ECM stiffening are dependent on the activation of a signaling cascade of mechanoperception and mechanotransduction. Although the substantial evidence directly indicates the importance of ECM stiffening on the native ECs, the understanding about this complex interplay is still largely limited. In this review, we systematically summarize the roles of ECM stiffening on the behaviours of endothelial cells and elucidate the underlying details in biological mechanism, aiming to provide the process of how ECs integrate ECM mechanics and the highlights for bioaffinity of tissue-specific engineered scaffolds.
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Affiliation(s)
- Lin Cheng
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Hongyan Yue
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Huaiyi Zhang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Qiao Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Lingyu Du
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Xiaoheng Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Jing Xie
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yang Shen
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China; JinFeng Laboratory, Chongqing 401329, China.
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Nayor M, Gajjar P, Miller P, Murthy VL, Shah RV, Houstis NE, Velagaleti RS, Larson MG, Vasan RS, Lewis GD, Mitchell GF. Arterial Stiffness and Cardiorespiratory Fitness Impairment in the Community. J Am Heart Assoc 2023; 12:e029619. [PMID: 37850464 PMCID: PMC10727403 DOI: 10.1161/jaha.123.029619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/13/2023] [Indexed: 10/19/2023]
Abstract
Background During exercise, a healthy arterial system facilitates increased blood flow and distributes it effectively to essential organs. Accordingly, we sought to understand how arterial stiffening might impair cardiorespiratory fitness in community-dwelling individuals. Methods and Results Arterial tonometry and maximum effort cardiopulmonary exercise testing were performed on Framingham Heart Study participants (N=2898, age 54±9 years, 53% women, body mass index 28.1±5.3 kg/m2). We related 5 arterial stiffness measures (carotid-femoral pulse wave velocity [CFPWV]: a measure of aortic wall stiffness; central pulse pressure, forward wave amplitude, characteristic impedance: measures of pressure pulsatility; and augmentation index: a measure of relative wave reflection) to multidimensional exercise responses using linear models adjusted for age, sex, resting heart rate, habitual physical activity, and clinical risk factors. Greater CFPWV, augmentation index, and characteristic impedance were associated with lower peak oxygen uptake (VO2; all P<0.0001). We observed consistency of associations of CFPWV with peak oxygen uptake across age, sex, and cardiovascular risk profile (interaction P>0.05). However, the CFPWV-peak oxygen uptake relation was attenuated in individuals with obesity (P=0.002 for obesity*CFPWV interaction). Higher CPFWV, augmentation index, and characteristic impedance were also related to cardiopulmonary exercise testing measures reflecting adverse O2 kinetics and lower stroke volume and peripheral O2 extraction but not to ventilatory efficiency, a prognostic measure of right ventricular-pulmonary vascular performance. Conclusions Our findings delineate relations of arterial stiffness and cardiorespiratory fitness in community-dwelling individuals. Future studies are warranted to evaluate whether the physiological measures implicated here may represent potential targets for improving cardiorespiratory fitness in the general population.
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Affiliation(s)
- Matthew Nayor
- Cardiovascular Medicine Section, Department of MedicineBoston University School of MedicineBostonMAUSA
- Preventive Medicine and Epidemiology Section, Department of MedicineBoston University School of MedicineBostonMAUSA
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
| | - Priya Gajjar
- Cardiovascular Medicine Section, Department of MedicineBoston University School of MedicineBostonMAUSA
| | - Patricia Miller
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | - Venkatesh L. Murthy
- Division of Cardiovascular Medicine and Frankel Cardiovascular Center, Department of MedicineUniversity of MichiganAnn ArborMIUSA
| | - Ravi V. Shah
- Vanderbilt Translational and Clinical Research Center, Cardiology DivisionVanderbilt University Medical CenterNashvilleTNUSA
| | - Nicholas E. Houstis
- Cardiology Division, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
| | - Raghava S. Velagaleti
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- Cardiology Section, Department of MedicineBoston VA Healthcare SystemWest RoxburyMAUSA
| | - Martin G. Larson
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | - Ramachandran S. Vasan
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- University of Texas School of Public Health San AntonioUniversity of Texas Health Science CenterSan AntonioTXUSA
- Departments of Medicine and Population Health SciencesUniversity of Texas Health Science CenterSan AntonioTXUSA
| | - Gregory D. Lewis
- Cardiology Division, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
- Pulmonary Critical Care Unit, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
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32
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Vervloet MG. Can we reverse arterial stiffness by intervening on CKD-MBD biomarkers? Clin Kidney J 2023; 16:1766-1775. [PMID: 37915898 PMCID: PMC10616505 DOI: 10.1093/ckj/sfad112] [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: 04/01/2023] [Indexed: 11/03/2023] Open
Abstract
The increased cardiovascular risk of chronic kidney disease may in part be the consequence of arterial stiffness, a typical feature of kidney failure. Deranged homeostasis of minerals and hormones involved (CKD-MBD), are also strongly associated with this increased risk. It is well established that CKD-MBD is a main driver of vascular calcification, which in turn worsens arterial stiffness. However, there are other contributors to arterial stiffness in CKD than calcification. An overlooked possibility is that CKD-MBD may have detrimental effects on this potentially better modifiable component of arterial stiffness. In this review, the individual contributions of short-term changes in calcium, phosphate, PTH, vitamin D, magnesium, and FGF23 to arterial stiffness, in most studies assessed as pulse wave velocity, is summarized. Indeed, there is evidence from both observational studies and interventional trials that higher calcium concentrations can worsen arterial stiffness. This, however, has not been shown for phosphate, and it seems unlikely that, apart from being a contributor to vascular calcification and having effects on the microcirculation, phosphate has no acute effect on large artery stiffness. Several interventional studies, both by infusing PTH and by abrupt lowering PTH by calcimimetics or surgery, virtually ruled out direct effects on large artery stiffness. A well-designed trial using both active and nutritional vitamin D as intervention found a beneficial effect for the latter. Unfortunately, the study had a baseline imbalance and other studies did not support its finding. Both magnesium and FGF23 do not seem do modify central arterial stiffness.
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Affiliation(s)
- Marc G Vervloet
- Amsterdam University Medical Centres, Nephrology, Amsterdam, The Netherlands
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Hof A, Guthoff H, Ahdab M, Landerer M, Schäkel J, Niehues J, Schorscher M, Zimmermann O, Winkels H, von Stein P, Geißen S, Baldus S, Adam M, Mollenhauer M, Mehrkens D. Vascular Ultrasound for In Vivo Assessment of Arterial Pathologies in a Murine Model of Atherosclerosis and Aortic Aneurysm. Int J Mol Sci 2023; 24:15261. [PMID: 37894941 PMCID: PMC10607567 DOI: 10.3390/ijms242015261] [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: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Vascular diseases like atherosclerosis and abdominal aortic aneurysm (AAA) are common pathologies in the western world, promoting various potentially fatal conditions. Here, we evaluate high-resolution (HR) ultrasound in mouse models of atherosclerosis and AAA as a useful tool for noninvasive monitoring of early vascular changes in vivo. We used Apolipoprotein E-deficient (ApoE-/-) mice as an atherosclerosis model and induced AAA development by the implementation of Angiotensin II-releasing osmotic minipumps. HR ultrasound of the carotid artery or the abdominal aorta was performed to monitor vascular remodeling in vivo. Images were analyzed by speckle tracking algorithms and correlated to histological analyses and subsequent automated collagen quantification. Consistent changes were observed via ultrasound in both models: Global radial strain (GRS) was notably reduced in the AAA model (23.8 ± 2.8% vs. 12.5 ± 2.5%, p = 0.01) and in the atherosclerotic mice (20.6 ± 1.3% vs. 15.8 ± 0.9%, p = 0.02). In mice with AAA, vessel distensibility was significantly reduced, whereas intima-media thickness was increased in atherosclerotic mice. The area and collagen content of the tunica media were increased in diseased arteries of both models as measured by automated image analysis of Picrosirius Red-stained aortic sections. Correlation analysis revealed a strong correlation of multiple parameters, predicting early vascular damage in HR ultrasound and histological examinations. In conclusion, our findings underscore the potential of HR ultrasound in effectively tracing early alterations in arterial wall properties in murine models of atherosclerosis and AAA.
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Affiliation(s)
- Alexander Hof
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Henning Guthoff
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Maysam Ahdab
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
| | - Max Landerer
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
| | - Jasper Schäkel
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Jana Niehues
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
| | - Maximilian Schorscher
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Oscar Zimmermann
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Holger Winkels
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Philipp von Stein
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
| | - Simon Geißen
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Stephan Baldus
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Matti Adam
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Martin Mollenhauer
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
| | - Dennis Mehrkens
- Department for Experimental Cardiology, Faculty of Medicine, University of Cologne, Clinic III for Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.H.); (M.A.); (M.L.); (J.S.); (J.N.); (M.S.); (O.Z.); (H.W.); (P.v.S.); (S.G.); (S.B.); (M.A.); (M.M.)
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and Faculty of Mathematics and Natural Sciences, University of Cologne, 50937 Cologne, Germany
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Yilmaz G, Ong JL, Ling LH, Chee MWL. Insights into vascular physiology from sleep photoplethysmography. Sleep 2023; 46:zsad172. [PMID: 37379483 PMCID: PMC10566244 DOI: 10.1093/sleep/zsad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/19/2023] [Indexed: 06/30/2023] Open
Abstract
STUDY OBJECTIVES Photoplethysmography (PPG) in consumer sleep trackers is now widely available and used to assess heart rate variability (HRV) for sleep staging. However, PPG waveform changes during sleep can also inform about vascular elasticity in healthy persons who constitute a majority of users. To assess its potential value, we traced the evolution of PPG pulse waveform during sleep alongside measurements of HRV and blood pressure (BP). METHODS Seventy-eight healthy adults (50% male, median [IQR range] age: 29.5 [23.0, 43.8]) underwent overnight polysomnography (PSG) with fingertip PPG, ambulatory blood pressure monitoring, and electrocardiography (ECG). Selected PPG features that reflect arterial stiffness: systolic to diastolic distance (∆T_norm), normalized rising slope (Rslope) and normalized reflection index (RI) were derived using a custom-built algorithm. Pulse arrival time (PAT) was calculated using ECG and PPG signals. The effect of sleep stage on these measures of arterial elasticity and how this pattern of sleep stage evolution differed with participant age were investigated. RESULTS BP, heart rate (HR) and PAT were reduced with deeper non-REM sleep but these changes were unaffected by the age range tested. After adjusting for lowered HR, ∆T_norm, Rslope, and RI showed significant effects of sleep stage, whereby deeper sleep was associated with lower arterial stiffness. Age was significantly correlated with the amount of sleep-related change in ∆T_norm, Rslope, and RI, and remained a significant predictor of RI after adjustment for sex, body mass index, office BP, and sleep efficiency. CONCLUSIONS The current findings indicate that the magnitude of sleep-related change in PPG waveform can provide useful information about vascular elasticity and age effects on this in healthy adults.
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Affiliation(s)
- Gizem Yilmaz
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lieng-Hsi Ling
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore and
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Baranger J, Villemain O, Goudot G, Dizeux A, Le Blay H, Mirault T, Messas E, Pernot M, Tanter M. The fundamental mechanisms of the Korotkoff sounds generation. SCIENCE ADVANCES 2023; 9:eadi4252. [PMID: 37792931 PMCID: PMC10550233 DOI: 10.1126/sciadv.adi4252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023]
Abstract
Blood pressure measurement is the most widely performed clinical exam to predict mortality risk. The gold standard for its noninvasive assessment is the auscultatory method, which relies on listening to the so-called "Korotkoff sounds" in a stethoscope placed at the outlet of a pneumatic arm cuff. However, more than a century after their discovery, the origin of these sounds is still debated, which implies a number of clinical limitations. We imaged the Korotkoff sound generation in vivo at thousands of images per second using ultrafast ultrasound. We showed with both experience and theory that Korotkoff sounds are paradoxically not sound waves emerging from the brachial artery but rather shear vibrations conveyed in surrounding tissues by the nonlinear pulse wave propagation. When these shear vibrations reached the stethoscope, they were synchronous, correlated, and comparable in intensity with the Korotkoff sounds. Understanding this mechanism could ultimately improve blood pressure measurement and provide additional understanding of arterial mechanical properties.
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Affiliation(s)
- Jerome Baranger
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Olivier Villemain
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Guillaume Goudot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alexandre Dizeux
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Heiva Le Blay
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Tristan Mirault
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Emmanuel Messas
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Mathieu Pernot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Mickael Tanter
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
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Anastasiou M, Oikonomou E, Theofilis P, Papamikroulis GA, Gazouli M, Kalogeras K, Lygkoni S, Pesiridis T, Goliopoulou A, Papatheodoridi A, Psyrri A, Zagouri F, Siasos G, Tousoulis D. Prolonged impact of anti-cancer therapy on endothelial function and arterial stiffness in breast cancer patients. Vascul Pharmacol 2023; 152:107195. [PMID: 37455009 DOI: 10.1016/j.vph.2023.107195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Cardiotoxicity restricts anthracycline and trastuzumab treatment of Human Epidermal Growth Factor Receptor 2 positive early breast cancer. Endothelial dysfunction and arteriosclerosis are significant cardiovascular risk factors. OBJECTIVES We studied the effect of anthracycline-based chemotherapy, with or without trastuzumab, on endothelium and arteriosclerosis in patients with breast cancer. METHODS In this case-control study, 52 women with breast cancer and 104 women without breast cancer were examined longitudinally up to 15 months following (in the breast cancer group) initiation of chemotherapy. Arterial stiffness was evaluated through pulse wave velocity (PWV), while endothelial function via flow-mediated dilatation (FMD) at baseline (T0), 3 (T1), 6 (T2), and 15 (T3) months later. RESULTS There was no difference between subjects with breast cancer and control in PWV and FMD at baseline. Longitudinally, participants with breast cancer exhibited considerable impairment of PWV and FMD compared to the control group (p for interaction <0.001 for both parameters). In breast cancer patients, there was a significant increase from T0 to T3 in PWV (7.43 ± 1.68 m/s vs. 8.18 ± 2.00 m/s, p = 0.01) and decrease in FMD (6.95 ± 2.86% vs. 5.03 ± 2.83%, p = 0.006). The addition of trastuzumab in the treatment did not have any effect on PWV (p = 0.74) or FMD (p = 0.91). CONCLUSIONS In patients with breast cancer, there is progression of endothelial dysfunction and arteriosclerosis up to 15 months following initiation of anthracycline-based chemotherapy. Trastuzumab has no additive effect on endothelial function or arterial stiffness.
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Affiliation(s)
- Maria Anastasiou
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Panagiotis Theofilis
- 1st Cardiology Department, "Hippokration" General Hospital, Medical School, University of Athens, 11527 Athens, Greece
| | - George Angelos Papamikroulis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Maria Gazouli
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Stavroula Lygkoni
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Theodoros Pesiridis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Athina Goliopoulou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Alkistis Papatheodoridi
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens School of Medicine, 11528 Athens, Greece
| | - Amanda Psyrri
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Flora Zagouri
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens School of Medicine, 11528 Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, "Hippokration" General Hospital, Medical School, University of Athens, 11527 Athens, Greece
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Xuereb RA, Magri CJ, Xuereb RG. Arterial Stiffness and its Impact on Cardiovascular Health. Curr Cardiol Rep 2023; 25:1337-1349. [PMID: 37676581 DOI: 10.1007/s11886-023-01951-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular diseases are the leading cause of mortality globally. Identifying patients at risk is important to initiate preventive strategies. Over the last few decades, the role of the endothelium and its impact on arterial stiffness have been recognised as playing a pivotal role in cardiovascular disease. This review will focus on the effect of arterial stiffness in different patient cohorts with regard to cardiovascular morbidity and mortality, as well as its use in clinical practice. RECENT FINDINGS Arterial stiffness is associated with a range of cardiovascular risk factors and is an independent predictor of cardiovascular mortality. The gold standard for evaluating arterial stiffness is pulse wave velocity. Recently, cardio-ankle vascular index has been implemented as an easy and highly reproducible measure of arterial stiffness. Moreover, certain pharmacologic agents may modify arterial stiffness and alter progression of cardiovascular disease. The endothelium plays an important role in cardiovascular disease. Implementing assessment of arterial stiffness in clinical practice will improve stratification of patients at risk of cardiovascular disease and help modify disease progression.
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Affiliation(s)
| | - Caroline J Magri
- Department of Cardiology, Mater Dei Hospital, Msida, Malta
- University of Malta, Msida, Malta
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Obajed Al-Ali N, Tóth SR, Váróczy L, Pinczés LI, Soltész P, Szekanecz Z, Kerekes G. One Step Back from Bedside to the Bench-How Do Different Arterial Stiffness Parameters Behave in Relation to Peripheral Resistance? Diagnostics (Basel) 2023; 13:2897. [PMID: 37761264 PMCID: PMC10528548 DOI: 10.3390/diagnostics13182897] [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: 07/20/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The investigation of arterial stiffening is a promising approach to estimating cardiovascular risk. Despite the widespread use of different methods, the dynamic nature of measured and calculated stiffness parameters is marginally investigated. We aimed to determine the stability of large artery elasticity parameters assessed via commonly used, ultrasound-based and oscillometric methods in relation to peripheral resistance modulation. A human experimental environment was composed, and fifteen young males were investigated at rest after extremity heating and external compression. Functional vascular parameters were monitored in each session, and several arterial stiffness parameters were analysed. The distensibility coefficient (DC) did not show significant changes during heat provocation and extremity compression, while DC's stability seemed to be acceptable. The same stability of carotid-femoral pulse wave velocity (PWV) was detected with ultrasound measurement (5.43 ± 0.79, 5.32 ± 0.86 and 5.28 ± 0.77, with p = 0.38, p = 0.27 and p = 0.76, respectively) with excellent intersession variability (intraclass correlation coefficient of 0.90, 0.88 and 0.91, respectively). However, the oscillometric PWV (oPWV) did change significantly between the heating and outer compression phase of the study (7.46 ± 1.37, 7.10 ± 1.18 and 7.60 ± 1.21, with p = 0.05, p = 0.68 and p < 0.001, respectively), the alteration of which is closely related to wave reflection, represented by the changes in reflection time. Our results indicate the good stability of directly measured elastic parameters such as DC and PWV, despite the extreme modulation of peripheral resistance. However, the oscillometric, indirectly detected PWV might be altered by physical interventions, which depend on wave reflection. The effective modulation of wave reflection was characterized by changes in the augmentation index, detected using both oscillometry and applanation tonometry. Thus, the environment during oscillometric measurement should be rigorously standardized. Furthermore, our results suggest the dynamic nature of the reflection point, rather than being a fixed anatomical point, proposed previously as aortic bifurcation.
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Affiliation(s)
- Nóra Obajed Al-Ali
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.V.); (L.I.P.)
| | - Sára Rebeka Tóth
- Department of Cardiology, Medical Centre, Hungarian Defence Forces, 1134 Budapest, Hungary;
| | - László Váróczy
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.V.); (L.I.P.)
| | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (L.V.); (L.I.P.)
| | - Pál Soltész
- Division of Angiology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - György Kerekes
- Division of Intensive Care, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
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Neutel CHG, Wesley CD, De Meyer GRY, Martinet W, Guns PJ. The effect of cyclic stretch on aortic viscoelasticity and the putative role of smooth muscle focal adhesion. Front Physiol 2023; 14:1218924. [PMID: 37637147 PMCID: PMC10450742 DOI: 10.3389/fphys.2023.1218924] [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: 05/08/2023] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Due to its viscoelastic properties, the aorta aids in dampening blood pressure pulsatility. At the level of resistance-arteries, the pulsatile flow will be transformed into a continuous flow to allow for optimal perfusion of end organs such as the kidneys and the brain. In this study, we investigated the ex vivo viscoelastic properties of different regions of the aorta of healthy C57Bl6/J adult mice as well as the interplay between (altered) cyclic stretch and viscoelasticity. We demonstrated that the viscoelastic parameters increase along the distal aorta and that the effect of altered cyclic stretch is region dependent. Increased cyclic stretch, either by increased pulse pressure or pulse frequency, resulted in decreased aortic viscoelasticity. Furthermore, we identified that the vascular smooth muscle cell (VSMC) is an important modulator of viscoelasticity, as we have shown that VSMC contraction increases viscoelastic parameters by, in part, increasing elastin fiber tortuosity. Interestingly, an acute increase in stretch amplitude reverted the changes in viscoelastic properties induced by VSMC contraction, such as a decreasing contraction-induced elastin fiber tortuosity. Finally, the effects of altered cyclic stretch and VSMC contraction on viscoelasticity were more pronounced in the abdominal infrarenal aorta, compared to both the thoracic ascending and descending aorta, and were attributed to the activity and stability of VSMC focal adhesion. Our results indicate that cyclic stretch is a modulator of aortic viscoelasticity, acting on VSMC focal adhesion. Conditions of (acute) changes in cyclic stretch amplitude and/or frequency, such as physical exercise or hypertension, can alter the viscoelastic properties of the aorta.
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Affiliation(s)
- Cédric H. G. Neutel
- Laboratory of Physiopharmacology, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
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Edwards S, Foster M, Ahmed SF, Lucas-Herald AK. Preventative interventions that target cardiovascular dysfunction in children and young people: a systematic review of their effectiveness and an investigation of sexual dimorphism. J Hum Hypertens 2023; 37:726-734. [PMID: 36463360 PMCID: PMC10403341 DOI: 10.1038/s41371-022-00780-z] [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: 08/01/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Given that cardiovascular diseases remain a primary cause of mortality and morbidity, there is a need to consider preventative strategies to improve vascular function from early in life. The aims of this study were therefore to investigate which interventions may improve endothelial function, intima media thickness and arterial stiffness in children and young people and to assess whether these interventions differ in boys and girls. A systematic literature search of Science Direct, Pubmed, Google Scholar and the Cochrane Library by two independent reviewers was performed to source articles. Inclusion criteria were any studies including any child ≤18 years of age receiving an intervention, which measured vascular function other than blood pressure. Exclusion criteria were studies assessing children with chronic medical conditions. A total of 72 studies were identified, which met the inclusion criteria. A measurable change in outcome was more likely to be reported in studies investigating endothelial function (p = 0.03). Interventions which improved vascular function included physical activity and dietary programmes. Under 10% of studies considered sex differences. In conclusion, school-based physical activity interventions are most likely to result in improvements in vascular function. Endothelial function may be the first variable of vascular function to change secondary to an intervention. Standardisation of reporting of differences between the sexes is essential to be able to ensure interventions are equally effective for boys and girls.
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Affiliation(s)
- Sophie Edwards
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Murray Foster
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - S Faisal Ahmed
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Angela K Lucas-Herald
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK.
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Chen X, Li LH. Remnant Cholesterol, a Valuable Biomarker for Assessing Arteriosclerosis and Cardiovascular Risk: A Systematic Review. Cureus 2023; 15:e44202. [PMID: 37767252 PMCID: PMC10521762 DOI: 10.7759/cureus.44202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
Arteriosclerosis, as the foundation for the development of cardiovascular diseases, is influenced by disturbances in lipid metabolism. Extensive research has consistently shown a correlation between conventional lipid parameters, arteriosclerosis, and cardiovascular diseases. Guidelines highlight the importance of targeting low-density lipoprotein cholesterol (LDL-C) for primary and secondary prevention of cardiovascular diseases, with reducing LDL-C remaining the primary lipid-lowering strategy. However, even when LDL-C is lowered to optimal levels, there is a residual risk of cardiovascular disease. Recent findings have brought attention to remnant cholesterol (RC) as a significant factor contributing to this residual risk. The close association between RC, arteriosclerosis, and cardiovascular diseases presents exciting opportunities for lifestyle interventions and medical treatments to control and lower RC levels, offering new targets for preventing and managing related cardiovascular conditions. Our systematic review sheds light on the importance of considering RC as a valuable biomarker in assessing arteriosclerosis and its potential impact on cardiovascular health. By understanding the link between remnant cholesterol and arteriosclerosis, researchers and healthcare professionals can develop targeted interventions to mitigate cardiovascular risks, thus improving public health outcomes and reducing the economic burden associated with cardiovascular diseases.
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Affiliation(s)
- Xiang Chen
- Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
| | - Li-Hua Li
- Gerontology, The First Affiliated Hospital of Dali University, Dali, CHN
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Beeckman S, Li Y, Aasmul S, Baets R, Boutouyrie P, Segers P, Madhu N. Enhancing Multichannel Laser-Doppler Vibrometry Signals with Application to (Carotid-Femoral) Pulse Transit Time Estimation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-7. [PMID: 38083013 DOI: 10.1109/embc40787.2023.10340553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Pulse-wave velocity (PWV) can be used to quantify arterial stiffness, allowing for a diagnosis of this condition. Multi-beam laser-doppler vibrometry offers a cheap, non-invasive and user-friendly alternative to measuring PWV, and its feasibility has been previously demonstrated in the H2020 project CARDIS. The two handpieces of the prototype CARDIS device measure skin displacement above main arteries at two different sites, yielding an estimate of the pulse-transit time (PTT) and, consequently, PWV. The presence of multiple beams (channels) on each handpiece can be used to enhance the underlying signal, improving the quality of the signal for PTT estimation and further analysis. We propose two methods for multi-channel LDV data processing: beamforming and beamforming-driven ICA. Beamforming is done by an SNR-weighted linear combination of the time-aligned channels, where the SNR is blindly estimated from the signal statistics. ICA uses the beamformer to resolve its inherent permutation and scale ambiguities. Both methods yield a single enhanced signal at each handpiece, where spurious peaks in the individual channels as well as stochastic noise are well suppressed in the output. Using the enhanced signals yields individual PTT estimates with a low spread compared to the baseline approach. While the enhancement is introduced in the context of PTT estimation, the approaches can be used to enhance signals in other biomedical applications of multi-channel LDV as well.
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Jannasz I, Sondej T, Targowski T, Mańczak M, Obiała K, Dobrowolski AP, Olszewski R. Relationship between the Central and Regional Pulse Wave Velocity in the Assessment of Arterial Stiffness Depending on Gender in the Geriatric Population. SENSORS (BASEL, SWITZERLAND) 2023; 23:5823. [PMID: 37447671 DOI: 10.3390/s23135823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
Artery stiffness is a risk factor for cardiovascular disease (CVD). The measurement of pulse wave velocity (PWV) between the carotid artery and the femoral artery (cfPWV) is considered the gold standard in the assessment of arterial stiffness. A relationship between cfPWV and regional PWV has not been established. The aim of this study was to evaluate the influence of gender on arterial stiffness measured centrally and regionally in the geriatric population. The central PWV was assessed by a SphygmoCor XCEL, and the regional PWV was assessed by a new device through the photoplethysmographic measurement of multi-site arterial pulse wave velocity (MPPT). The study group included 118 patients (35 males and 83 females; mean age 77.2 ± 8.1 years). Men were characterized by statistically significantly higher values of cfPWV than women (cfPWV 10.52 m/s vs. 9.36 m/s; p = 0.001). In the measurement of regional PWV values using MPPT, no such relationship was found. Gender groups did not statistically differ in the distribution of atherosclerosis risk factors. cfPWV appears to be more accurate than regional PWV in assessing arterial stiffness in the geriatric population.
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Affiliation(s)
- Iwona Jannasz
- Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Tadeusz Sondej
- Faculty of Electronics, Military University of Technology, 00-908 Warsaw, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Małgorzata Mańczak
- Gerontology, Public Health and Education Department, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Karolina Obiała
- Gerontology, Public Health and Education Department, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | | | - Robert Olszewski
- Gerontology, Public Health and Education Department, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
- Department of Ultrasound, Institute of Fundamental Technological Research Polish Academy of Sciences, 02-106 Warsaw, Poland
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Rasouli R, Baranger J, Slorach C, Hui W, Venet M, Nguyen MB, Henry M, Gopaul J, Nathan PC, Mertens L, Villemain O. Local arterial stiffness measured by ultrafast ultrasound imaging in childhood cancer survivors treated with anthracyclines. Front Cardiovasc Med 2023; 10:1150214. [PMID: 37346288 PMCID: PMC10279856 DOI: 10.3389/fcvm.2023.1150214] [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: 01/23/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
Background There is conflicting literature regarding the long-term effect of anthracycline treatment on arterial stiffness. This study assessed local arterial stiffness using ultrafast ultrasound imaging (UUI) in anthracycline treated childhood cancer survivors, at rest and during exercise. Methods 20 childhood cancer survivors (mean age 21.02 ± 9.45 years) treated with anthracyclines (mean cumulative dose 200.7 ± 126.80 mg/m2) and 21 healthy controls (mean age 26.00 ± 8.91 years) were included. Participants completed a demographic survey, fasting bloodwork for cardiovascular biomarkers, and performed a submaximal exercise test on a semi-supine bicycle. Pulse wave velocity (PWV) was measured in the left common carotid artery by direct pulse wave imaging using UUI at rest and submaximal exercise. Both PWV at the systolic foot (PWV-SF) and dicrotic notch (PWV-DN) were measured. Central (carotid-femoral) PWV was obtained by applanation tonometry. Carotid measurements were taken by conventional ultrasound. Measures were compared using two-tailed Students t-test or Chi-squared test, as appropriate. Results There was no statistically significant difference (p > 0.05) between childhood cancer survivors and healthy controls in demographic parameters (age, sex, weight, height, BMI), blood biomarkers (total cholesterol, triglycerides, LDL-c, HDL-c, hs-CRP, fasting glucose, insulin, Hb A1c), cardiovascular parameters (intima media thickness, systolic and diastolic blood pressure, heart rate, carotid diameters, distensibility) or PWV measured by UUI at rest or at exercise. There was also no difference in the cardiovascular adaptation between rest and exercise in the two groups (p > 0.05). Multivariate analysis revealed age (p = 0.024) and LDL-c (p = 0.019) to be significant correlates of PWV-SF in childhood cancer survivors, in line with previously published data. Conclusion We did not identify a significant impact of anthracycline treatment in young survivors of childhood cancer on local arterial stiffness in the left common carotid artery as measured by UUI.
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Affiliation(s)
- Rahna Rasouli
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Cameron Slorach
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Wei Hui
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Maelys Venet
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Minh B. Nguyen
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Matthew Henry
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Josh Gopaul
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Paul C. Nathan
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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da Silva DVT, Baião DDS, Almeida CC, Paschoalin VMF. A Critical Review on Vasoactive Nutrients for the Management of Endothelial Dysfunction and Arterial Stiffness in Individuals under Cardiovascular Risk. Nutrients 2023; 15:nu15112618. [PMID: 37299579 DOI: 10.3390/nu15112618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
Pathophysiological conditions such as endothelial dysfunction and arterial stiffness, characterized by low nitric oxide bioavailability, deficient endothelium-dependent vasodilation and heart effort, predispose individuals to atherosclerotic lesions and cardiac events. Nitrate (NO3-), L-arginine, L-citrulline and potassium (K+) can mitigate arterial dysfunction and stiffness by intensifying NO bioavailability. Dietary compounds such as L-arginine, L-citrulline, NO3- and K+ exert vasoactive effects as demonstrated in clinical interventions by noninvasive flow-mediated vasodilation (FMD) and pulse-wave velocity (PWV) prognostic techniques. Daily L-arginine intakes ranging from 4.5 to 21 g lead to increased FMD and reduced PWV responses. Isolated L-citrulline intake of at least 5.6 g has a better effect compared to watermelon extract, which is only effective on endothelial function when supplemented for longer than 6 weeks and contains at least 6 g of L-citrulline. NO3- supplementation employing beetroot at doses greater than 370 mg promotes hemodynamic effects through the NO3--NO2-/NO pathway, a well-documented effect. A potassium intake of 1.5 g/day can restore endothelial function and arterial mobility, where decreased vascular tone takes place via ATPase pump/hyperpolarization and natriuresis, leading to muscle relaxation and NO release. These dietary interventions, alone or synergically, can ameliorate endothelial dysfunction and should be considered as adjuvant therapies in cardiovascular diseases.
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Affiliation(s)
- Davi Vieira Teixeira da Silva
- Instituto de Química, Programa de Pós-Graduação em Ciência de Alimentos e Programa de Pós-Graduação em Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, sala 545, Cidade Universitária, Rio de Janeiro 21941-909, RJ, Brazil
| | - Diego Dos Santos Baião
- Instituto de Química, Programa de Pós-Graduação em Ciência de Alimentos e Programa de Pós-Graduação em Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, sala 545, Cidade Universitária, Rio de Janeiro 21941-909, RJ, Brazil
| | - Cristine Couto Almeida
- Instituto de Química, Programa de Pós-Graduação em Ciência de Alimentos e Programa de Pós-Graduação em Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, sala 545, Cidade Universitária, Rio de Janeiro 21941-909, RJ, Brazil
| | - Vania Margaret Flosi Paschoalin
- Instituto de Química, Programa de Pós-Graduação em Ciência de Alimentos e Programa de Pós-Graduação em Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, sala 545, Cidade Universitária, Rio de Janeiro 21941-909, RJ, Brazil
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Triantafyllias K, Thiele LE, Cavagna L, Baraliakos X, Bertsias G, Schwarting A. Arterial Stiffness as a Surrogate Marker of Cardiovascular Disease and Atherosclerosis in Patients with Arthritides and Connective Tissue Diseases: A Literature Review. Diagnostics (Basel) 2023; 13:diagnostics13111870. [PMID: 37296720 DOI: 10.3390/diagnostics13111870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The increased cardiovascular (CV) risk among patients with autoimmune rheumatic diseases, such as arthritides and connective tissue diseases, has been extensively documented. From a pathophysiological standpoint, systemic inflammation in the context of the disease can lead to endothelial dysfunction, accelerated atherosclerosis, and structural changes in vessel walls, which, in turn, are associated with exaggerated CV morbidity and mortality. In addition to these abnormalities, the increased prevalence of traditional CV risk factors, such as obesity, dyslipidemia, arterial hypertension, and impaired glucose metabolism, can further worsen the status of and overall prognosis for CV in rheumatic patients. However, data on appropriate CV screening methods for patients with systemic autoimmune diseases are scarce, and traditional algorithms may lead to an underestimation of the true CV risk. The reason for this is that these calculations were developed for the general population and thus do not take into account the effect of the inflammatory burden, as well as other chronic-disease-associated CV risk factors. In recent years, different research groups, including ours, have examined the value of different CV surrogate markers, including carotid sonography, carotid-femoral pulse wave velocity, and flow-mediated arterial dilation, in the assessment of CV risk in healthy and rheumatic populations. In particular, arterial stiffness has been thoroughly examined in a number of studies, showing high diagnostic and predictive value for the occurrence of CV events. To this end, the present narrative review showcases a series of studies examining aortic and peripheral arterial stiffness as surrogates of all-cause CV disease and atherosclerosis in patients with rheumatoid and psoriatic arthritis, as well as in systemic lupus erythematosus and systemic sclerosis. Moreover, we discuss the associations of arterial stiffness with clinical, laboratory, and disease-specific parameters.
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Affiliation(s)
- Konstantinos Triantafyllias
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Leif-Erik Thiele
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
| | - Lorenzo Cavagna
- Department of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation Pavia, 27100 Pavia, Italy
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, 44649 Herne, Germany
| | - George Bertsias
- Department of Internal Medicine and Rheumatology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Andreas Schwarting
- Rheumatology Center Rhineland-Palatinate, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany
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Tomoto T, Tarumi T, Zhang R. Central arterial stiffness, brain white matter hyperintensity and total brain volume across the adult lifespan. J Hypertens 2023; 41:819-829. [PMID: 36883450 PMCID: PMC10079586 DOI: 10.1097/hjh.0000000000003404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVES Mounting evidence suggests that central arterial stiffening is associated with brain ageing in older adults. The purpose of this study was to determine the associations of age with carotid arterial stiffness and carotid-femoral pulse wave velocity (cfPWV), both measurements of central arterial stiffness, the relationship between age-related arterial stiffness, brain white matter hyperintensity (WMH) and total brain volume (TBV), and whether effects of central arterial stiffness on WMH volume and TBV are mediated by pulsatile cerebral blood flow (CBF). METHODS One hundred and seventy-eight healthy adults (21-80 years) underwent measurements of central arterial stiffness using tonometry and ultrasonography, WMH and TBV via MRI, and pulsatile CBF at the middle cerebral artery via transcranial Doppler. RESULTS Advanced age was associated with increases in both carotid arterial stiffness and cfPWV, increases in WMH volume and decreases in TBV (all P < 0.01). Multiple linear regression analysis showed that carotid β-stiffness was positively associated with WMH volume (B = 0.015, P = 0.017) and cfPWV negatively with TBV (B = -0.558, P < 0.001) after adjustment for age, sex and arterial pressure. Pulsatile CBF mediates the associations between carotid β-stiffness and WMH (95% confidence interval: 0.0001-0.0079). CONCLUSION These findings suggest that age-related central arterial stiffness is associated with increased WMH volume and decreased TBV, which is likely mediated by increased arterial pulsation.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [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: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly. J Clin Med 2023; 12:jcm12062321. [PMID: 36983321 PMCID: PMC10058400 DOI: 10.3390/jcm12062321] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Multimorbidity, the coexistence of multiple health conditions in an individual, has emerged as one of the greatest challenges facing health services, and this crisis is partly driven by the aging population. Aging is associated with increased aortic stiffness (AoStiff), which in turn is linked with several morbidities frequently affecting and having disastrous consequences for the elderly. These include hypertension, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, anemia, ischemic stroke, and dementia. Two or more of these disorders (multimorbidity) often coexist in the same elderly patient and the specific multimorbidity pattern depends on several factors including sex, ethnicity, common morbidity routes, morbidity interactions, and genomics. Regular exercise, salt restriction, statins in patients at high atherosclerotic risk, and stringent blood pressure control are interventions that delay progression of AoStiff and most likely decrease multimorbidity in the elderly.
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50
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Pewowaruk RJ, Korcarz C, Stein JH, Bluemke D, Tedla Y, Gepner AD. Methods of arterial stiffness calculation and cardiovascular disease events: the multiethnic study of atherosclerosis. J Hypertens 2023; 41:486-493. [PMID: 36728257 PMCID: PMC10038853 DOI: 10.1097/hjh.0000000000003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND A wide variety of different formulae have been used to calculate local arterial stiffness with little external validation in relationship to cardiovascular events. We compared the associations of several arterial stiffness calculations in a large, multiethnic cohort. METHODS The multi-ethnic study of atherosclerosis (MESA) is a longitudinal study of 6814 adults without clinical cardiovascular disease (CVD) at enrollment. MESA participants with CVD surveillance through year 2018 and carotid ultrasound ( n = 5873) or aorta MRI ( n = 3175) at the baseline exam (2000-2002) were included. We analyzed 21 different calculations of local arterial stiffness. Cross-sectional and longitudinal statistical analyses were performed in addition to Cox hazard modeling for associations with CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, adjudicated angina, and cardiovascular death). RESULTS Carotid artery stiffness calculations had variable correlations with each other ( r = 0.56-0.99); aortic stiffness measures were similar ( r = 0.66-0.99). Nevertheless, for CVD events, the hazard ratio (HR) per standard deviation change were similar for all carotid stiffness calculations with HRs in the range of 1.00-1.10 (equivalence P < 0.001). For the aorta, aortic distensibility coefficient had a stronger association with CVD events (HR 1.18 [1.02-1.37]) compared to aorta Peterson's elastic modulus (HR 0.98 [0.89-1.07]) and aorta pulse wave velocity (HR 1.00 [0.90-1.11]). HRs between all other aortic stiffness calculations were equivalent ( P < 0.01). CONCLUSION Different methods of calculating local arterial stiffness largely gave equivalent results, indicating that the variety of different arterial stiffness calculations in use do not cause inconsistent findings.
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Affiliation(s)
- Ryan J Pewowaruk
- University of Wisconsin School of Medicine and Public Health
- William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin
| | - Claudia Korcarz
- University of Wisconsin School of Medicine and Public Health
| | - James H Stein
- University of Wisconsin School of Medicine and Public Health
| | - David Bluemke
- University of Wisconsin School of Medicine and Public Health
| | - Yacob Tedla
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Adam D Gepner
- University of Wisconsin School of Medicine and Public Health
- William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin
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