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Badhwar S, Marais L, Khettab H, Poli F, Li Y, Segers P, Aasmul S, de Melis M, Baets R, Greenwald S, Bruno RM, Boutouyrie P. Clinical Validation of Carotid-Femoral Pulse Wave Velocity Measurement Using a Multi-Beam Laser Vibrometer: The CARDIS Study. Hypertension 2024; 81:1986-1995. [PMID: 38934112 PMCID: PMC11319084 DOI: 10.1161/hypertensionaha.124.22729] [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: 01/10/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for noninvasive arterial stiffness assessment, an independent predictor of cardiovascular disease, and a potential parameter to guide therapy. However, cfPWV is not routinely measured in clinical practice due to the unavailability of a low-cost, operator-friendly, and independent device. The current study validated a novel laser Doppler vibrometry (LDV)-based measurement of cfPWV against the reference technique. METHODS In 100 (50 men) hypertensive patients, cfPWV was measured using applanation tonometry (Sphygmocor) and the novel LDV device. This device has 2 handpieces with 6 laser beams each that simultaneously measure vibrations from the skin surface at carotid and femoral sites. Pulse wave velocity is calculated using ECG for the identification of cardiac cycles. An ECG-independent method was also devised. Cardiovascular risk score was calculated for patients between 40 and 75 years old using the WHO risk scoring chart. RESULTS LDV-based cfPWV correlated significantly with tonometry (r=0.86, P<0.0001 ECG-dependent [cfPWVLDV_ECG] and r=0.80, P<0.001 ECG-independent [cfPWVLDV_w/oECG] methods). Bland-Altman analysis showed nonsignificant bias (0.65 m/s) and acceptable SD (1.27 m/s) between methods. Intraobserver coefficient of variance for LDV was 4.7% (95% CI, 3.0%-5.5%), and interobserver coefficient of variance was 5.87%. CfPWV correlated significantly with CVD risk (r=0.64, P<0.001; r=0.41, P=0.003; and r=0.37, P=0.006 for tonometry, LDV-with, and LDV-without ECG, respectively). CONCLUSIONS The study demonstrates clinical validity of the LDV device. The LDV provides a simple, noninvasive, operator-independent method to measure cfPWV for assessing arterial stiffness, comparable to the standard existing techniques. REGISTRATION URL: https://clinicaltrials.gov/study/NCT03446430; Unique identifier: NCT03446430.
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Affiliation(s)
- Smriti Badhwar
- Paris Cardiovascular Research Center (PARCC) Institut National de la Santé Et de la Researche Médicale (INSERM), Paris, France (S.B., L.M., F.P., R.M.B., P.B.)
| | - Louise Marais
- Paris Cardiovascular Research Center (PARCC) Institut National de la Santé Et de la Researche Médicale (INSERM), Paris, France (S.B., L.M., F.P., R.M.B., P.B.)
| | - Hakim Khettab
- Hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (APHP), Paris, France (H.K., R.M.B, P.B.)
| | - Federica Poli
- Paris Cardiovascular Research Center (PARCC) Institut National de la Santé Et de la Researche Médicale (INSERM), Paris, France (S.B., L.M., F.P., R.M.B., P.B.)
| | - Yanlu Li
- Photonics Research Group, Ghent University-imec, Belgium (Y.L., R.B.)
- Center for Nano- and Biophotonics, Ghent University, Belgium (Y.L., R.B.)
| | | | - Soren Aasmul
- Medtronic Bakken Research Center, Maastricht, The Netherlands (S.A., M.d.M.)
| | - Mirko de Melis
- Medtronic Bakken Research Center, Maastricht, The Netherlands (S.A., M.d.M.)
| | - Roel Baets
- Photonics Research Group, Ghent University-imec, Belgium (Y.L., R.B.)
- Center for Nano- and Biophotonics, Ghent University, Belgium (Y.L., R.B.)
| | - Steve Greenwald
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (S.G.)
| | - Rosa Maria Bruno
- Paris Cardiovascular Research Center (PARCC) Institut National de la Santé Et de la Researche Médicale (INSERM), Paris, France (S.B., L.M., F.P., R.M.B., P.B.)
- Hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (APHP), Paris, France (H.K., R.M.B, P.B.)
- Université Paris Cité, Faculté de Médecine, France (R.M.B, P.B.)
| | - Pierre Boutouyrie
- Paris Cardiovascular Research Center (PARCC) Institut National de la Santé Et de la Researche Médicale (INSERM), Paris, France (S.B., L.M., F.P., R.M.B., P.B.)
- Hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (APHP), Paris, France (H.K., R.M.B, P.B.)
- Université Paris Cité, Faculté de Médecine, France (R.M.B, P.B.)
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Backes A, Collings PJ, Portugal B, Quintero LC, Vahid F, Le Coroller G, Malisoux L, Alkerwi A, Noppe S, Delagardelle C, Beissel J, Chioti A, Stranges S, Schmit JC, Lair ML, D’Incau M, Pastore J, Aguayo GA, Appenzeller B, Couffignal S, Gantenbein M, Devaux Y, Vaillant M, Huiart L, Bejko D, Perquin M, Ruiz M, Ernens I, Fagherazzi G. Associations of movement behaviours and dietary intake with arterial stiffness: results from the ORISCAV-LUX 2 cross-sectional study. BMJ Open 2024; 14:e084933. [PMID: 39067878 PMCID: PMC11287072 DOI: 10.1136/bmjopen-2024-084933] [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: 02/01/2024] [Accepted: 07/05/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE Adopting a physically active lifestyle and maintaining a diet rich in antioxidants can reduce the risk of vascular diseases. Arterial stiffness is an early marker for cardiovascular diseases, indicating vascular damage. This study investigates the relationship between physical activity (PA), sedentary behaviour (SB), dietary antioxidant, trace elements intake and vascular health in men and women, with a focus on pulse wave velocity (PWV), the gold standard for assessing arterial stiffness. DESIGN This is a nationwide population-based cross-sectional study (Observation of Cardiovascular Risk Factors in Luxembourg 2 (ORISCAV-LUX 2)). SETTING The study was conducted in Luxembourg, between November 2016 and January 2018. PARTICIPANTS In total, 988 participants from the ORISCAV-LUX 2 study, who were Luxembourg residents, aged 25-79 years, underwent the required physical examination, agreed to wear an accelerometer for 1 week and presented no personal history of myocardial infarction or stroke, were included in the analysis. PRIMARY OUTCOME MEASURE PWV was assessed with the validated Complior instrument. Elastic-net models were used to investigate the associations of dietary intake (antioxidant and trace elements) and movement behaviours (PA and SB) with PWV in men and women. RESULTS The findings reveal diverse associations between PA, SB, dietary intake and PWV, with distinct patterns observed in men and women. In women, a longer median moderate-to-vigorous PA bout length (mean coefficient (β)=-0.039), a higher long-range temporal correlation (higher scaling exponent alpha) at larger time scales (>120 min; β=-1.247) and an increased intake of vitamin C (β=-1.987) and selenium (β=-0.008) were associated with lower PWV. In men, a shorter median SB bout length (β=0.019) and a lower proportion of SB time accumulated in bouts longer than 60 min (β=1.321) were associated with lower PWV. Moreover, a higher daily intake of polyphenols (β=-0.113) and selenium (β=-0.004) was associated with lower PWV in men. CONCLUSION This study underscores the multifaceted nature of the associations between movement behaviours and dietary intake with PWV, as well as sex differences. These findings highlight the significance of considering both movement behaviours and dietary antioxidant intake in cardiovascular health assessments.
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Affiliation(s)
- Anne Backes
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Paul J Collings
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Berta Portugal
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Lilly Carina Quintero
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Farhad Vahid
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Gwenaëlle Le Coroller
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - on behalf of the ORISCAV-LUX Study Group
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Ala’a Alkerwi
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Stephanie Noppe
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Charles Delagardelle
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jean Beissel
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Chioti
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Saverio Stranges
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jean-Claude Schmit
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Marie-Lise Lair
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Marylène D’Incau
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jessica Pastore
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Gloria A Aguayo
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Brice Appenzeller
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Sophie Couffignal
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Manon Gantenbein
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Yvan Devaux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Michel Vaillant
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Laetitia Huiart
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Dritan Bejko
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Magali Perquin
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Ruiz
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Isabelle Ernens
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg
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Yang D, Tao S, Shao M, Huang L, Xiao X, Zhang J, Yao R, Sun Z. Effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women: a systematic review and meta-analysis. Syst Rev 2024; 13:169. [PMID: 38956626 PMCID: PMC11221034 DOI: 10.1186/s13643-024-02589-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/18/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The acute and long-term benefits of exercise training on cardiovascular health have been well established. The systematic review and meta-analysis aimed to systematically assess the effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women with elevated blood pressure. METHODS A comprehensive search was conducted on PubMed, Embase, Web of Science, ProQuest, Cochrane Library, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov website from inception to September 30, 2023, to identify the randomized controlled trials (RCTs), which evaluated the effectiveness of exercise training on arterial stiffness and blood pressure in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random/fixed effects models. Quality assessment was performed using the modified Jadad scale and the Cochrane Risk of Bias Tool. Sensitivity analysis and subgroup analysis were conducted based on drug dosage, treatment duration, and age of administration to further explore potential heterogeneity. Funnel plots were performed to assess publication bias and Begg's regression test was carried out for funnel plot asymmetry. RESULTS Twenty-two RCTs involving 1978 participants were included in the quantitative analysis. The mean quality of eligible studies was 4.2 out of 7 based on the modified Jadad scale. The results indicated that exercise training had a significant effect on reducing brachial-ankle pulse wave velocity [MD = - 0.69, 95%CI (- 1.11, - 0.27), P = 0.001], decreasing augmentation index (AIx) [MD = - 6.00, 95%CI (- 6.39, - 5.61), P < 0.00001] and AIx normalized to a heart rate of 75 beats per minute (AIx@75%) [MD = - 7.01, 95%CI - 7.91 to - 6.12, P < 0.00001], lowering systolic blood pressure [MD = - 6.19, 95%CI - 9.24 to - 3.15, P < 0.0001], diastolic blood pressure [MD = - 3.57, 95%CI (- 6.10, - 1.03), P = 0.006) and pulse pressure [MD = - 8.52, 95%CI (- 16.27, - 0.76), P = 0.03]. Subgroup analysis revealed that baseline blood pressure levels had a large impact on the effect of exercise training. CONCLUSIONS The systematic review and meta-analysis suggested that exercise training may ameliorate arterial stiffness and reduce blood pressure in postmenopausal women with elevated blood pressure. However, the optimal mode of exercise training that improves arterial stiffness and blood pressure in this population requires further investigation. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021211268.
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Affiliation(s)
- Deshuang Yang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Shiyi Tao
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Mingjing Shao
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China.
| | - Li Huang
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Xiang Xiao
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Jin Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Ruiqi Yao
- Department of Internal Medicine, Shenzhen Nanshan Chinese Medicine Hospital, Guangdong, China
| | - Ziyi Sun
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
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4
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Joshi A, Kaur S, Taneja SK, Mandal R. Review Article on Molecular Mechanism of Regulation of Hypertension by Macro-elements (Na, K, Ca and Mg), Micro-elements/Trace Metals (Zn and Cu) and Toxic Elements (Pb and As). Biol Trace Elem Res 2024; 202:1477-1502. [PMID: 37523058 DOI: 10.1007/s12011-023-03784-z] [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: 05/07/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Hypertension (HT) is a medical condition arising due to increase in blood pressure (BP) prevalent worldwide. The balanced dietary intakes of macro-elements and micro-elements including Na, K, Ca, Mg, Zn, and Cu have been described to maintain BP in humans by regulating the osmolarity of blood, cells/tissues, prevention of generation of oxidative and nitrosative stress (OANS), and endothelial damage through their functioning as important components of renin-angiotensin-aldosterone system (RAAS), antioxidant enzyme defense system, and maintenance of blood vascular-endothelial and vascular smooth muscle cell (VSMC) functions. However, inadequate/excess dietary intakes of Na/K, Ca/Mg, and Zn/Cu along with higher Pb and As exposures recognized to induce HT through common mechanisms including the followings: endothelial dysfunctions due to impairment of vasodilatation, increased vasoconstriction and arterial stiffness, blood clotting, inflammation, modification of sympathetic activity and higher catecholamine release, increased peripheral vascular resistance, and cardiac output; increased OANS due to reduced and elevated activities of extracellular superoxide dismutase and NAD(P)H oxidase, less nitric oxide bioavailability, decrease in cGMP and guanylate cyclase activity, increase in intracellular Ca2+ ions in VSMCs, and higher pro-inflammatory cytokines; higher parathyroid and calcitriol hormones; activation/suppression of RAAS resulting imbalance in blood Na+, K+, and water regulated by renin, angiotensin II, and aldosterone through affecting natriuresis/kaliuresis/diuresis; elevation in serum cholesterol and LDL cholesterol, decrease in HDL cholesterol due to defect in lipoprotein metabolism. The present study recommends the need to review simple dietary mineral intervention studies/supplementation trials before keeping their individual dietary excess intakes/exposures in consideration because their interactions lead to elevation and fall of their concentrations in body affecting onset of HT.
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Affiliation(s)
- Amit Joshi
- PG Department of Biotechnology and Microbial Biotechnology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India
| | - Sukhbir Kaur
- Department of Zoology, Panjab University, Sector-14, Chandigarh, UT, India
| | | | - Reshu Mandal
- PG Department of Zoology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India.
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Cao C, Han Y, Hu H, He Y, Luo J. Non-linear relationship between pulse pressure and the risk of pre-diabetes: a secondary retrospective Chinese cohort study. BMJ Open 2024; 14:e080018. [PMID: 38521517 PMCID: PMC10961532 DOI: 10.1136/bmjopen-2023-080018] [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: 09/19/2023] [Accepted: 03/01/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE Previous research has shown that pulse pressure (PP) has a significant role in the start and development of type 2 diabetes mellitus. However, there is little proof that PP and pre-diabetes mellitus (Pre-DM) are related. Our study aimed to investigate the relationship between PP and incident pre-DM in a substantial cohort of Chinese participants. DESIGN The 'DATADRYAD' database (www.Datadryad.org) was used to retrieve the data for this secondary retrospective cohort analysis. PARTICIPANTS Data from 182 672 Chinese individuals who participated in the medical examination programme were recorded in this retrospective cohort study between 2010 and 2016 across 32 sites and 11 cities in China. SETTING PP assessed at baseline and incident pre-DM during follow-up were the target-independent and dependent variables. The association between PP and pre-DM was investigated using Cox proportional hazards regression. PRIMARY OUTCOME MEASURES The outcome was incident pre-DM. Impaired fasting glucose levels (fasting blood glucose between 5.6 and 6.9 mmol/L) were used to define pre-DM. RESULTS After controlling for confounding variables, PP was positively correlated with incident pre-DM among Chinese adults (HR 1.009, 95% CI 1.007 to 1.010). Additionally, at a PP inflection point of 29 mm Hg, a non-linear connection between the PP and incident pre-DM was discovered. Increased PP was an independent risk factor for developing pre-DM when PP was greater than 29 mm Hg. However, their association was not significant when PP was less than 29 mm Hg. According to subgroup analyses, females, never-smokers and non-obesity correlated more significantly with PP and pre-DM. CONCLUSION We discovered that higher PP independently correlated with pre-DM risk in this study of Chinese participants. The connection between PP and incident pre-DM was also non-linear. High PP levels were related to a higher risk of pre-DM when PP was above 29 mm Hg. ARTICLE FOCUS Our study investigated the relationship between PP and incident pre-DM in a secondary retrospective cohort of Chinese participants.
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Affiliation(s)
- Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen University First Affiliated Hospital, Shenzhen, Guangdong, China
| | - Yongcheng He
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
- Department of Nephrology, Shenzhen Hengsheng Hospital, Shenzhen, Guangdong Province, China
| | - Jiao Luo
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Dapeng New District, Guangdong Province, China
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Abdullah N, Blin JA, Kamalul Arifin AS, Abd Jalal N, Ismail N, Mohd Yusof NA, Abdullah MS, Husin NF, Dauni A, Kamaruddin MA, Mohammed Nawi A, Ahmad N, Hassan MR, Jamal R. Cardiovascular risk prediction with cardio-ankle vascular index in the malaysian cohort study. Curr Probl Cardiol 2024; 49:102192. [PMID: 37952789 DOI: 10.1016/j.cpcardiol.2023.102192] [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: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
The cardio-ankle vascular index (CAVI) is an important parameter assessing arterial function. It reflects arterial stiffness from the origin of the aorta to the ankle, and the algorithm is blood pressure independent. Recent data have suggested that a high CAVI score can predict future cardiovascular disease (CVD) events; however, to date, no study has been done in Malaysia. We conducted a prospective study on 2,168 The Malaysian Cohort (TMC) CVD-free participants (971 men and 1,197 women; mean age 51.64 ± 8.38 years old) recruited from November 2011 to March 2012. This participants were followed-up until the emergence of CVD incidence and mortality (endpoint between May to September 2019; duration of 7.5 years). Eligible participants were assessed based on CAVI baseline measurement which categorised them into low (CAVI <9.0) and high (CAVI ≥ 9.0) scores. The CVD events in the group with high CAVI (6.5 %) were significantly higher than in the low CAVI (2.6 %) group (p < 0.05). CAVI with cut-off point ≥ 9.0 was a significant independent predictor for CVD event even after adjustment for male, ethnicity, age, and intermediate atherogenic index of plasma (AIP). Those who have higher CAVI have 78 % significantly higher risk of developing CVD compared to those with the low CAVI (adjusted OR [95 % CI] = 1.78 [1.04 - 3.05], p =0.035). In addition, the participants with higher CAVI have significantly lower survival probability than those who have lower CAVI values. Thus, this study indicated that the CAVI can predict CVD event independently among the TMC participants.
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Affiliation(s)
| | - Joan Anak Blin
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | | | - Nurul Faeizah Husin
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | - Andri Dauni
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
| | | | - Azmawati Mohammed Nawi
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, UKM, Kuala Lumpur 56000, Malaysia.
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur 56000, Malaysia.
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Zhang Z, Fu X, Zhou F, Zhang D, Xu Y, Fan Z, Wen S, Shao Y, Yao Z, He Y. Huaju Xiaoji Formula Regulates ERS-lncMGC/miRNA to Enhance the Renal Function of Hypertensive Diabetic Mice with Nephropathy. J Diabetes Res 2024; 2024:6942156. [PMID: 38282657 PMCID: PMC10821808 DOI: 10.1155/2024/6942156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024] Open
Abstract
Background Better therapeutic drugs are required for treating hypertensive diabetic nephropathy. In our previous study, the Huaju Xiaoji (HJXJ) formula promoted the renal function of patients with diabetes and hypertensive nephropathy. In this study, we investigated the therapeutic effect and regulation mechanism of HJXJ in hypertensive diabetic mice with nephropathy. Methods We constructed a mouse hypertensive diabetic nephropathy (HDN) model by treating mice with streptozotocin (STZ) and nomega-nitro-L-arginine methyl ester (LNAME). We also constructed a human glomerular mesangial cell (HGMC) model that was induced by high doses of sugar (30 mmol/mL) and TGFβ1 (5 ng/mL). Pathological changes were evaluated by hematoxylin and eosin (H&E) staining, periodic acid Schiff (PAS) staining, and Masson staining. The fibrosis-related molecules (TGFβ1, fibronectin, laminin, COL I, COL IV, α-SMA, and p-smad2/3) were detected by enzyme-linked immunosorbent assay (ELISA). The mRNA levels and protein expression of endoplasmic reticulum stress, fibrosis molecules, and their downstream molecules were assessed using qPCR and Western blotting assays. Results Administering HJXJ promoted the renal function of HDN mice. HJXJ reduced the expression of ER stress makers (CHOP and GRP78) and lncMGC, miR379, miR494, miR495, miR377, CUGBP2, CPEB4, EDEM3, and ATF3 in HDN mice and model HGMCs. The positive control drugs (dapagliflozin and valsartan) also showed similar effects after treatment with HJXJ. Additionally, in model HGMCs, the overexpression of CHOP or lncMGC decreased the effects of HJXJ-M on the level of fibrosis molecules and downstream target molecules. Conclusion In this study, we showed that the HJXJ formula may regulate ERS-lncMGC/miRNA to enhance renal function in hypertensive diabetic mice with nephropathy. This study may act as a reference for further investigating whether combining HJXJ with other drugs can enhance its therapeutic effect. The findings of this study might provide new insights into the clinical treatment of hypertensive diabetic nephropathy with HJXJ.
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Affiliation(s)
- Zeng Zhang
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiaodong Fu
- Department of Integrated Traditional Chinese and Western Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Fengzhu Zhou
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Duanchun Zhang
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yanqiu Xu
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Zhaohua Fan
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Shimei Wen
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yanting Shao
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Zheng Yao
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yanming He
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
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8
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Fu T, Pan Y, Sun Q, Zhang X, Cong T, Jiang Y, Liu Y. Associations of brachial-ankle pulse wave velocity with left atrial stiffness and left atrial phasic function in inpatients with hypertension. Hypertens Res 2023; 46:2378-2387. [PMID: 37532950 DOI: 10.1038/s41440-023-01390-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/29/2023] [Accepted: 07/01/2023] [Indexed: 08/04/2023]
Abstract
Hypertension induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. This study aimed to investigate the associations of brachial-ankle pulse wave velocity (baPWV) with LA stiffness and LA phasic function in hypertension. A total of 305 hypertensive inpatients enrolled and were divided into two groups based on baPWV [Group I, baPWV ≤ 1515 (cm/s), n = 153; Group II, baPWV > 1515 (cm/s), n = 152]. Two-dimensional speckle tracking echocardiography (2D-STE) based LA phasic strains (LAS-S, LAS-E, LAS-A) and LV global longitudinal strain (LVGLS) were evaluated. LA stiffness index (LASI) was defined as the ratio of E/e' to LAS-S. Multivariate linear regression modeling was used to analyze the associations of baPWV with LASI and LA phasic function in all patients as well as age-specific and sex-specific subgroups. LASI was significantly higher in Group II [0.35(0.26, 0.52)] compared with Group I [0.26(0.20, 0.36)] (P < 0.001). After adjusting cardiovascular risk factors, medication, and LV structural and functional parameters (LVEF, LVMI, E/A ratio, and LVGLS), baPWV remained significantly correlated with LASI (P < 0.05). We also evaluated the predictive value of baPWV for LASI, the area under the curve (AUC) was 0.663 (95% CI: 0.607-0.716, P < 0.001). In conclusion, BaPWV was independently associated with LA stiffness in hypertensive inpatients. BaPWV also exhibited a certain predictive value for LA stiffness in these inpatients. Measuring arterial stiffness can provide clinicians clues for early cardiac target organ damage (TOD) in addition to vascular TOD.
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Affiliation(s)
- Tingting Fu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yu Pan
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qiaobing Sun
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiujie Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Tao Cong
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Yinong Jiang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Yan Liu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
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9
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Polo-López A, Calatayud J, Núñez-Cortés R, Andersen LL, Moya-Ramón M, López-Bueno R. Dose-Response Association Between Handgrip Strength and Hypertension: A Longitudinal Study of 76,503 European Older Adults. Curr Probl Cardiol 2023; 48:101813. [PMID: 37209803 DOI: 10.1016/j.cpcardiol.2023.101813] [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: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
To examine the prospective dose-response association between handgrip strength and the incidence of hypertension in a representative sample of older European adults. We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, 7, and 8. Handgrip strength was measured and participants reported whether they had a medical diagnosis of hypertension. We assessed the longitudinal dose-response associations of handgrip strength with hypertension using restricted cubic splines. During the follow-up, 27,149 (35.5%) were diagnosed with incident hypertension. At the fully adjusted model, the minimum and optimal dose of handgrip strength for a significant reduction in the risk of hypertension was 28 Kg (HR: 0.92; 95% CI: 0.89-0.96) and 54 Kg (HR: 0.83; 95% CI: 0.78-0.89), respectively. There exists an association between increased handgrip strength and reduced risk of developing hypertension in older European adults.
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Affiliation(s)
- Ana Polo-López
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Department of Physiotherapy, University of Valencia, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Valencia, Spain
| | | | - Manuel Moya-Ramón
- Sports Research Centre (Department of Sport Sciences), Miguel Hernández University of Elche, Alicante, Spain; Department of Sport Sciences, Miguel Hernandez University, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Rubén López-Bueno
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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10
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Xu Z, Chen Y, Wang Y, Han W, Xu W, Liao X, Zhang T, Wang G. Matrix stiffness, endothelial dysfunction and atherosclerosis. Mol Biol Rep 2023; 50:7027-7041. [PMID: 37382775 DOI: 10.1007/s11033-023-08502-5] [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: 10/27/2022] [Accepted: 04/28/2023] [Indexed: 06/30/2023]
Abstract
Atherosclerosis (AS) is the leading cause of the human cardiovascular diseases (CVDs). Endothelial dysfunction promotes the monocytes infiltration and inflammation that participate fundamentally in atherogenesis. Endothelial cells (EC) have been recognized as mechanosensitive cells and have different responses to distinct mechanical stimuli. Emerging evidence shows matrix stiffness-mediated EC dysfunction plays a vital role in vascular disease, but the underlying mechanisms are not yet completely understood. This article aims to summarize the effect of matrix stiffness on the pro-atherosclerotic characteristics of EC including morphology, rigidity, biological behavior and function as well as the related mechanical signal. The review also discusses and compares the contribution of matrix stiffness-mediated phagocytosis of macrophages and EC to AS progression. These advances in our understanding of the relationship between matrix stiffness and EC dysfunction open the avenues to improve the prevention and treatment of now-ubiquitous atherosclerotic diseases.
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Affiliation(s)
- Zichen Xu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Yi Chen
- Chongqing Engineering Laboratory of Nano/Micro Biomedical Detection, Chongqing Key Laboratory of Nano/Micro Composite Material and Device, School of Metallurgy and Materials Engineering, Chongqing University of Science and Technology, Chongqing, 401331, China
| | - Yi Wang
- College of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China
| | - Wenbo Han
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Wenfeng Xu
- Chongqing Engineering Laboratory of Nano/Micro Biomedical Detection, Chongqing Key Laboratory of Nano/Micro Composite Material and Device, School of Metallurgy and Materials Engineering, Chongqing University of Science and Technology, Chongqing, 401331, China
| | - Xiaoling Liao
- Chongqing Engineering Laboratory of Nano/Micro Biomedical Detection, Chongqing Key Laboratory of Nano/Micro Composite Material and Device, School of Metallurgy and Materials Engineering, Chongqing University of Science and Technology, Chongqing, 401331, China
| | - Tao Zhang
- Chongqing Engineering Laboratory of Nano/Micro Biomedical Detection, Chongqing Key Laboratory of Nano/Micro Composite Material and Device, School of Metallurgy and Materials Engineering, Chongqing University of Science and Technology, Chongqing, 401331, China.
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China.
- Bioengineering College of Chongqing University, NO.174, Shazheng Street, Shapingba District, Chongqing, 400030, PR China.
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11
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Aguet C, Jorge J, Van Zaen J, Proença M, Bonnier G, Frossard P, Lemay M. Blood pressure monitoring during anesthesia induction using PPG morphology features and machine learning. PLoS One 2023; 18:e0279419. [PMID: 36735652 PMCID: PMC9897516 DOI: 10.1371/journal.pone.0279419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/06/2022] [Indexed: 02/04/2023] Open
Abstract
Blood pressure (BP) is a crucial biomarker giving valuable information regarding cardiovascular diseases but requires accurate continuous monitoring to maximize its value. In the effort of developing non-invasive, non-occlusive and continuous BP monitoring devices, photoplethysmography (PPG) has recently gained interest. Researchers have attempted to estimate BP based on the analysis of PPG waveform morphology, with promising results, yet often validated on a small number of subjects with moderate BP variations. This work presents an accurate BP estimator based on PPG morphology features. The method first uses a clinically-validated algorithm (oBPM®) to perform signal preprocessing and extraction of physiological features. A subset of features that best reflects BP changes is automatically identified by Lasso regression, and a feature relevance analysis is conducted. Three machine learning (ML) methods are then investigated to translate this subset of features into systolic BP (SBP) and diastolic BP (DBP) estimates; namely Lasso regression, support vector regression and Gaussian process regression. The accuracy of absolute BP estimates and trending ability are evaluated. Such an approach considerably improves the performance for SBP estimation over previous oBPM® technology, with a reduction in the standard deviation of the error of over 20%. Furthermore, rapid BP changes assessed by the PPG-based approach demonstrates concordance rate over 99% with the invasive reference. Altogether, the results confirm that PPG morphology features can be combined with ML methods to accurately track BP variations generated during anesthesia induction. They also reinforce the importance of adding a calibration measure to obtain an absolute BP estimate.
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Affiliation(s)
- Clémentine Aguet
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
- Signal Processing Laboratory (LTS4), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- * E-mail:
| | - João Jorge
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
| | - Jérôme Van Zaen
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
| | - Martin Proença
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
| | - Guillaume Bonnier
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
| | - Pascal Frossard
- Signal Processing Laboratory (LTS4), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Mathieu Lemay
- Signal Processing Group, Swiss Center for Electronics and Microtechnology (CSEM), Neuchâtel, Switzerland
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12
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Sutton NR, Malhotra R, Hilaire C, Aikawa E, Blumenthal RS, Gackenbach G, Goyal P, Johnson A, Nigwekar SU, Shanahan CM, Towler DA, Wolford BN, Chen Y. Molecular Mechanisms of Vascular Health: Insights From Vascular Aging and Calcification. Arterioscler Thromb Vasc Biol 2023; 43:15-29. [PMID: 36412195 PMCID: PMC9793888 DOI: 10.1161/atvbaha.122.317332] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/11/2022] [Indexed: 11/23/2022]
Abstract
Cardiovascular disease is the most common cause of death worldwide, especially beyond the age of 65 years, with the vast majority of morbidity and mortality due to myocardial infarction and stroke. Vascular pathology stems from a combination of genetic risk, environmental factors, and the biologic changes associated with aging. The pathogenesis underlying the development of vascular aging, and vascular calcification with aging, in particular, is still not fully understood. Accumulating data suggests that genetic risk, likely compounded by epigenetic modifications, environmental factors, including diabetes and chronic kidney disease, and the plasticity of vascular smooth muscle cells to acquire an osteogenic phenotype are major determinants of age-associated vascular calcification. Understanding the molecular mechanisms underlying genetic and modifiable risk factors in regulating age-associated vascular pathology may inspire strategies to promote healthy vascular aging. This article summarizes current knowledge of concepts and mechanisms of age-associated vascular disease, with an emphasis on vascular calcification.
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Affiliation(s)
- Nadia R. Sutton
- Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Rajeev Malhotra
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Cynthia Hilaire
- Division of Cardiology, Departments of Medicine and Bioengineering, Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, 1744 BSTWR, 200 Lothrop St, Pittsburgh, PA, 15260 USA
| | - Elena Aikawa
- Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease; Baltimore, MD
| | - Grace Gackenbach
- Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Adam Johnson
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Sagar U. Nigwekar
- Division of Nephrology, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Catherine M. Shanahan
- School of Cardiovascular and Metabolic Medicine and Sciences, King’s College London, London, UK
| | - Dwight A. Towler
- Department of Medicine | Endocrine Division and Pak Center for Mineral Metabolism Research, UT Southwestern Medical Center, Dallas, TX USA
| | - Brooke N. Wolford
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yabing Chen
- Department of Pathology, University of Alabama at Birmingham and Research Department, Veterans Affairs Birmingham Medical Center, Birmingham, AL, USA
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13
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Liu C, Pan H, Kong F, Yang S, Shubhra QTH, Li D, Chen S. Association of arterial stiffness with all-cause and cause-specific mortality in the diabetic population: A national cohort study. Front Endocrinol (Lausanne) 2023; 14:1145914. [PMID: 36967807 PMCID: PMC10031114 DOI: 10.3389/fendo.2023.1145914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Estimated pulse wave velocity (ePWV) has been proposed as a potential alternative to carotid-femoral pulse wave velocity to assess the degree of aortic stiffness, and may predict cardiovascular disease (CVD) outcomes and mortality in the general population. However, whether arterial stiffness estimated by ePWV predicts all-cause and cause-specific mortality in patients with diabetes mellitus (DM) has not been reported. METHODS This was a prospective cohort study with data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 and followed up until the end of December 2019. 5,235U.S. adults with DM (age≥20years) were included in the study. Arterial stiffness was estimated by ePWV. Survey-weighted Cox proportional hazards models were performed to assess the hazard ratios (HRs), and 95% confidence intervals (CIs) for the associations of ePWV with all-cause and cause-specific mortality. Meanwhile, the generalized additive model was used to visually assess the dose-dependent relationship between ePWV and mortality. As a complementary analysis, the relationship between mean blood pressure (MBP) and risk of mortality was also examined. Multiple imputations accounted for missing data. RESULTS For the 5,235 DM patients, the weighted mean age was 57.4 years, and 51.07% were male. During a median follow-up period of 115 months (interquartile range 81-155 months; 53,159 person-years), 1,604 all-cause deaths were recorded. In the fully adjusted Cox regression model, every 1 m/s increase in ePWV was associated with 56% (HR 1.56; 95% CI, 1.44 to 1.69) increase in the risk of all-cause. In addition, a nonlinear relationship between ePWV and all-cause mortality was observed (P for non-linear=0.033). Similar results were obtained after subgroup analysis and multiple imputations. Besides, the risk of most cause-specific mortality, except for accident and renal disease-specific mortality, increased from 53% to 102% for every 1 m/s increase in ePWV. CONCLUSIONS In the diabetic population, ePWV is independently associated with all-cause and most cause-specific mortality risks. ePWV may be a useful tool for assessing mortality risk.
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Affiliation(s)
- Cun Liu
- Department of Hypertension and Plateau Disease, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Qinghai, China
| | - Huachun Pan
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Fanliang Kong
- Department of Cardiology and Pneumology, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Shumin Yang
- State Key Laboratory of Agriculture Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Quazi T. H. Shubhra
- Stomatology Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
- Translational Medicine Engineering Research Center of Guangdong Province, Foshan First People’s Hospital, Foshan, China
| | - Dandan Li
- Department of Nursing, Zaozhuang Vocational College, Shandong, China
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Jiangxi, China
- *Correspondence: Siwei Chen,
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14
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Associations of cardiorespiratory fitness, body composition, and blood pressure with arterial stiffness in adolescent, young adult, and middle-aged women. Sci Rep 2022; 12:21378. [PMID: 36494498 PMCID: PMC9734157 DOI: 10.1038/s41598-022-25795-x] [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: 03/28/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Few studies have investigated whether higher cardiorespiratory fitness (CRF) or favourable body composition are related to lower arterial stiffness in women. We therefore investigated the associations of CRF, body fat percentage (BF%), fat free mass index (FFMI), and mean arterial pressure (MAP) with arterial stiffness in 146 women aged 16-58 years. CRF was assessed by a maximal exercise test with respiratory gas analysis either on a cycle ergometer or a treadmill. Aortic pulse wave velocity (PWVao), augmentation index (AIx%), and MAP were assessed by a non-invasive oscillometric device and BF% and FFMI by a bioelectrical impedance or DXA device. CRF was inversely associated with PWVao (β = - 0.004, 95% CI - 0.005 to - 0.002) and AIx% (β = - 0.075, 95% CI - 0.102 to - 0.048) and these associations remained similar after adjustment for BF% or MAP, but not after the adjustment for age. FFMI was inversely associated with PWVao (β = - 0.010, 95% CI - 0.019 to - 0.002) and MAP directly associated with PWVao (β = 0.005, 95% CI 0.003 to 0.006) and AIx% (β = 0.092, 95% CI 0.069 to 0.116) and the associations with PWVao also remained after further adjustments for BF% and age. In conclusion, a higher FFMI and a lower MAP were independently associated with lower arterial stiffness.
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15
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Abd El-Hakam FEZ, Abo Laban G, Badr El-Din S, Abd El-Hamid H, Farouk MH. Apitherapy combination improvement of blood pressure, cardiovascular protection, and antioxidant and anti-inflammatory responses in dexamethasone model hypertensive rats. Sci Rep 2022; 12:20765. [PMID: 36456799 PMCID: PMC9714403 DOI: 10.1038/s41598-022-24727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
Hypertension-induced ventricular and vascular remodeling causes myocardial infarction, heart failure, and sudden death. Most available pharmaceutical products used to treat hypertension lead to adverse effects on human health. Limited data is available on apitherapy (bee products) combinations for treatment of hypertension. This study aims to evaluate the antihypertensive effects of combinations of natural apitherapy compounds used in the medical sector to treat a variety of diseases. Rats were assigned into six groups consisting of one control group and five hypertensive groups where hypertension (blood pressure > 140/90) was induced with dexamethasone. One of these groups was used as a hypertension model, while the remaining four hypertensive groups were treated with a propolis, royal jelly, and bee venom combination (PRV) at daily oral doses of 0.5, 1.0, and 2.0 mg/kg, and with losartan 10 mg/kg. The PRV combination at all doses decreased arterial blood pressure below the suboptimal value (p < 0.001), and PRV combination treatment improved dexamethasone-induced-ECG changes. The same treatment decreased angiotensin-II, endothelin-1, and tumor growth factor β serum levels in hypertensive rats. Additionally, PRV combination improved histopathological structure, and decreased serum levels of NF-kB and oxidative stress biomarkers. We concluded that PRV combination therapy may be used as a potential treatment for a variety of cardiovascular diseases.
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Affiliation(s)
- Fatma El-Zahraa Abd El-Hakam
- grid.411303.40000 0001 2155 6022Pharmacology Department, Faculty of Medicine for Girls, Al-Azhar University, Nasr City, 11884 Cairo Egypt
| | - Gomaa Abo Laban
- grid.411303.40000 0001 2155 6022Plant Protection Department, Faculty of Agriculture, Al-Azhar University, Nasr City, 11884 Cairo Egypt
| | - Sahar Badr El-Din
- grid.411303.40000 0001 2155 6022Pharmacology Department, Faculty of Medicine for Girls, Al-Azhar University, Nasr City, 11884 Cairo Egypt
| | - Hala Abd El-Hamid
- grid.411303.40000 0001 2155 6022Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Nasr City, 11884 Cairo Egypt
| | - Mohammed Hamdy Farouk
- grid.411303.40000 0001 2155 6022Animal Production Department, Faculty of Agriculture, Al-Azhar University, Nasr City, 11884 Cairo Egypt
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16
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Chen W, Van Beusecum JP, Xiao L, Patrick DM, Ao M, Zhao S, Lopez MG, Billings FT, Cavinato C, Caulk AW, Humphrey JD, Harrison DG. Role of Axl in target organ inflammation and damage due to hypertensive aortic remodeling. Am J Physiol Heart Circ Physiol 2022; 323:H917-H933. [PMID: 36083796 PMCID: PMC9602715 DOI: 10.1152/ajpheart.00253.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
We have shown that excessive endothelial cell stretch causes release of growth arrest-specific 6 (GAS6), which activates the tyrosine kinase receptor Axl on monocytes and promotes immune activation and inflammation. We hypothesized that GAS6/Axl blockade would reduce renal and vascular inflammation and lessen renal dysfunction in the setting of chronic aortic remodeling. We characterized a model of aortic remodeling in mice following a 2-wk infusion of angiotensin II (ANG II). These mice had chronically increased pulse wave velocity, and their aortas demonstrated increased mural collagen. Mechanical testing revealed a marked loss of Windkessel function that persisted for 6 mo following ANG II infusion. Renal function studies showed a reduced ability to excrete a volume load, a progressive increase in albuminuria, and tubular damage as estimated by periodic acid Schiff staining. Treatment with the Axl inhibitor R428 beginning 2 mo after ANG II infusion had a minimal effect on aortic remodeling 2 mo later but reduced the infiltration of T cells, γ/δ T cells, and macrophages into the aorta and kidney and improved renal excretory capacity, reduced albuminuria, and reduced evidence of renal tubular damage. In humans, circulating Axl+/Siglec6+ dendritic cells and phospho-Axl+ cells correlated with pulse wave velocity and aortic compliance measured by transesophageal echo, confirming chronic activation of the GAS6/Axl pathway. We conclude that brief episodes of hypertension induce chronic aortic remodeling, which is associated with persistent low-grade inflammation of the aorta and kidneys and evidence of renal dysfunction. These events are mediated at least in part by GAS6/Axl signaling and are improved with Axl blockade.NEW & NOTEWORTHY In this study, a brief, 2-wk period of hypertension in mice led to progressive aortic remodeling, an increase in pulse wave velocity, and evidence of renal injury, dysfunction, and albuminuria. This end-organ damage was associated with persistent renal and aortic infiltration of CD8+ and γ/δ T cells. We show that this inflammatory response is likely due to GAS6/Axl signaling and can be ameliorated by blocking this pathway. We propose that the altered microvascular mechanical forces caused by increased pulse wave velocity enhance GAS6 release from the endothelium, which in turn activates Axl on myeloid cells, promoting the end-organ damage associated with aortic stiffening.
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Affiliation(s)
- Wei Chen
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Justin P Van Beusecum
- Ralph H. Johnson Veteran Affairs Medical Center, Charleston, South Carolina
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Liang Xiao
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - David M Patrick
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Veterans Affairs Medical Center, Nashville, Tennessee
| | - Mingfang Ao
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shilin Zhao
- Vanderbilt Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marcos G Lopez
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Frederic T Billings
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Cristina Cavinato
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Alexander W Caulk
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Jay D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
- Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, Connecticut
| | - David G Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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17
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Wang N, Guo Y, Dong Y, Li X, Liu Q, Liu Q, Wang G, Qin M, Zhang Z, Song J, Liang L, Zhong J. Association of plasma bone morphogenetic protein‐4 levels with arterial stiffness in hypertensive patients. J Clin Lab Anal 2022; 36:e24746. [DOI: 10.1002/jcla.24746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ning Wang
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Ying Guo
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Ying Dong
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Department of Cardiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Xueting Li
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Qian Liu
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Qi Liu
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Guohong Wang
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Mingzhao Qin
- Department of Geriatrics Beijing Tongren Hospital, Capital Medical University Beijing China
| | - Zhenzhou Zhang
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Department of Cardiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Jiawei Song
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Lirong Liang
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University Beijing China
| | - Jiuchang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University Beijing China
- Department of Cardiology Beijing Chaoyang Hospital, Capital Medical University Beijing China
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18
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Relative Handgrip Strength and Incidence of Hypertension: A Case-Cohort Study From Ravansar Non-Communicable Diseases Cohort. J Phys Act Health 2022; 19:666-672. [PMID: 36070859 DOI: 10.1123/jpah.2021-0774] [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: 12/06/2021] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The present study assessed the association between relative handgrip strength (RHGS) and hypertension incidence in healthy adults. METHODS We performed a case-cohort study on 3784 participants from Ravansar Non-Communicable Diseases cohort study. The absolute HGS was measured using a digital dynamometer. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mm Hg and/or use of antihypertensive medications. Cox regression analysis was utilized to estimate hazard ratios of incident hypertension events with RHGS. RESULTS Physical activity was significantly higher in the participants with hypertension compared with nonhypertensive participants (P < .001). High-level physical activity in the subjects with lower, middle, and upper RHGS was 19.6%, 33.1%, and 47.3%, respectively (P < .001). RHGS was significantly higher in individuals with greater skeletal muscle mass (P < .001). The men and women with the upper RHGS, had an 80% (hazard ratio: 0.2; 95% confidence interval, 0.1-0.3) and 70% (hazard ratio: 0.3; 95% confidence interval, 0.1-1.2), were lower risk of hypertension compared with those with the lower RHGS, respectively. This association remains significant after adjustment for confounding factors in men. CONCLUSION The study demonstrated that middle and upper levels of RHGS were associated with a lower risk of hypertension incidence. RHGS may be a protective factor for hypertension. We suggested muscle strengthening exercises.
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19
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Tonhajzerova I, Visnovcova Z, Ondrejka I, Funakova D, Hrtanek I, Ferencova N. Major depressive disorder at adolescent age is associated with impaired cardiovascular autonomic regulation and vasculature functioning. Int J Psychophysiol 2022; 181:14-22. [PMID: 36029918 DOI: 10.1016/j.ijpsycho.2022.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
Cardiovascular adverse complications represent a risk factor for increased cardiovascular morbidity and mortality in patients with major depressive disorder (MDD). However, there is little knowledge of adolescent MDD. We aimed to study complex cardiovascular autonomic regulation and early atherosclerotic damage with a focus on an analysis of heart rate variability (HRV), blood pressure variability (BPV), systolic time intervals, and measures of early atherosclerotic changes in adolescent MDD. Ninety depressive adolescents (34 boys, age 15.8 ± 1.3 yrs.) and 90 age-/gender-matched controls were examined. Evaluated parameters: HRV - time and spectral parameters, BPV - mean, systolic, and diastolic blood pressure, spectral systolic parameters; haemodynamic indices - stroke volume, cardiac output, total peripheral resistance, systolic time intervals - left ventricular ejection time, pre-ejection period; atherosclerotic indices - ankle-brachial index (ABI), pulse wave velocity, brachial-ankle pulse wave velocity, cardio-ankle vascular index; growth factors - epidermal growth factor (EGF), vascular endothelial growth factor associated with monocyte chemoattractant protein-1. Our results showed that the MDD group had significantly reduced HRV and higher BPV measures, shortened systolic time intervals, lower ABI, and higher EGF compared to controls. Concluding, our study revealed that adolescent MDD is associated with cardiovascular dysregulation and early vasculature dysfunction as preclinical markers of higher risk for cardiovascular morbidity, thus adolescence seems to represent an important age period for early diagnosis and prevention of later MDD-linked cardiovascular diseases manifesting in adulthood.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Dana Funakova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
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20
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Mizrak I, Asserhøj LL, Lund MAV, Greisen GO, Clausen TD, Main KM, Vejlstrup NG, Jensen RB, Pinborg A, Madsen PL. Aortic distensibility is equal in prepubertal girls and boys and increases with puberty in girls. Am J Physiol Heart Circ Physiol 2022; 323:H312-H321. [PMID: 35687504 DOI: 10.1152/ajpheart.00097.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Windkessel function is governed by conductance artery compliance that is associated with cardiovascular disease in adults independently of other risk factors. Sex-related differences in conductance artery compliance partly explain the sex-related differences in risk of cardiovascular disease. Studies on sex-related differences in conductance artery function in prepubertal children are few and inconclusive. This study determined conductance artery compliance and cardiac function by magnetic resonance imaging in 150 healthy children (75 girls) aged 7-10 years. Any sex-related difference in conductance artery function was determined with correction for other potential predictors in multivariable linear regression models. Our data showed that ascending (crude mean difference 1.11 95% CI (0.22; 2.01)) and descending (crude mean difference 1.10 95% CI (0.09; 1.91)) aortic distensibility were higher in girls, but differences disappeared after adjustment for pubertal status and other identified potential predictors. Systolic and diastolic blood pressure, cardiac output, left ventricle (LV) systolic function, and total peripheral resistance did not differ between the sexes. In girls, heart rate was 7 bpm higher, whereas pulse pressure (by 2 mmHg), and LV end-diastolic volume index (by 7 mL) and stroke volume (by 5 mL) were lower. LV peak filling rate indexed to LV end-diastolic volume was 0.5 s-1 higher in girls. In conclusion, prepubertal girls and boys have equal conductance artery function. Thus, the well-known sex difference in adult conductance artery function seems to develop after the onset of puberty with girls initially increasing aortic distensibility.
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Affiliation(s)
- Ikram Mizrak
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise L Asserhøj
- Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten A V Lund
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gorm O Greisen
- Department of Neonatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tine D Clausen
- Department of Gynecology and Obstetrics, North Zealand Hospital, Copenhagen University Hospital, Hilleroed, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels G Vejlstrup
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rikke B Jensen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per L Madsen
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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21
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Liu WL, Lin YY, Mündel T, Chou CC, Liao YH. Effects of Acute Interval Exercise on Arterial Stiffness and Cardiovascular Autonomic Regulatory Responses: A Narrative Review of Potential Impacts of Aging. Front Cardiovasc Med 2022; 9:864173. [PMID: 35620510 PMCID: PMC9127236 DOI: 10.3389/fcvm.2022.864173] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
The physiological changes associated with aging deleteriously impact cardiovascular function and regulation and therefore increase the risk of developing cardiovascular disease. There is substantial evidence that changes in the autonomic nervous system and arterial stiffness play an important role in the development of cardiovascular disease during the aging process. Exercise is known to be effective in improving autonomic regulation and arterial vascular compliance, but differences in the type and intensity of exercise can have varying degrees of impact on vascular regulatory responses and autonomic function. There is still little evidence on whether there are differences in the response of exercise interventions to cardiovascular modulatory effects across the lifespan. In addition, acute interval exercise challenges can improve autonomic modulation, although the results of interval exercise on autonomic physiological parameters vary. Therefore, this narrative review focuses on evaluating the effects of acute interval exercise on blood pressure regulation and autonomic responses and also incorporates studies investigating different age groups to evaluate the effects of acute interval exercise on the autonomic nervous system. Herein we also summarize existing literature examining the acute cardiovascular responses to varied modes of interval exercise, as well as to further compare the benefits of interval exercise with other types of exercise on autonomic regulation and arterial stiffness. After reviewing the existing literature, it has been shown that with advancing age, changes in the autonomic nervous activity of interval exercise result in significant impacts on the cardiovascular system. We document that with advancing age, changes in the autonomic nerves lead to aging of the nervous system, thereby affecting the regulation of blood pressure. According to the limited literature, interval exercise is more effective in attenuating arterial stiffness than continuous exercise, but the difference in exercise benefits may depend on the training mode, intensity, duration of exercise, and the age of participants. Therefore, the benefits of interval exercise on autonomic and arterial stiffness improvement still warrant investigation, particularly the impact of age, in future research.
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Affiliation(s)
- Wei-Long Liu
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yi-Yuan Lin
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Chun-Chung Chou
- Physical Education Office, National Taipei University of Technology, Taipei, Taiwan
- *Correspondence: Chun-Chung Chou
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Yi-Hung Liao
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22
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The Mighty Mitochondria Are Unifying Organelles and Metabolic Hubs in Multiple Organs of Obesity, Insulin Resistance, Metabolic Syndrome, and Type 2 Diabetes: An Observational Ultrastructure Study. Int J Mol Sci 2022; 23:ijms23094820. [PMID: 35563211 PMCID: PMC9101653 DOI: 10.3390/ijms23094820] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/25/2022] Open
Abstract
Mitochondria (Mt) are essential cellular organelles for the production of energy and thermogenesis. Mt also serve a host of functions in addition to energy production, which include cell signaling, metabolism, cell death, and aging. Due to the central role of Mt in metabolism as metabolic hubs, there has been renewed interest in how Mt impact metabolic pathways and multiple pathologies. This review shares multiple observational ultrastructural findings in multiple cells and organs to depict aberrant mitochondrial (aMt) remodeling in pre-clinical rodent models. Further, it is intended to show how remodeling of Mt are associated with obesity, insulin resistance, metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM). Specifically, Mt remodeling in hypertensive and insulin-resistant lean models (Ren2 rat models), lean mice with streptozotocin-induced diabetes, obesity models including diet-induced obesity, genetic leptin-deficient ob/ob, and leptin receptor-deficient db/db diabetic mice are examined. Indeed, aMt dysfunction and damage have been implicated in multiple pathogenic diseases. Manipulation of Mt such as the induction of Mt biogenesis coupled with improvement of mitophagy machinery may be helpful to remove leaky damaged aMt in order to prevent the complications associated with the generation of superoxide-derived reactive oxygen species and the subsequent reactive species interactome. A better understanding of Mt remodeling may help to unlock many of the mysteries in obesity, insulin resistance, MetS, T2DM, and the associated complications of diabetic end-organ disease.
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23
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Lee MH, Leda M, Buchan T, Malik A, Rigobon A, Liu H, Daza JF, O'Brien K, Stein M, Hing NNF, Siemeiniuk R, Sekercioglu N, Evaniew N, Foroutan F, Ross H, Alba AC. Prognostic value of blood pressure in ambulatory heart failure: a meta-analysis and systematic review. Ambulatory blood pressure predicts heart failure prognosis. Heart Fail Rev 2022; 27:455-464. [PMID: 33682033 DOI: 10.1007/s10741-021-10086-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 01/14/2023]
Abstract
Previous primary studies have explored the association between blood pressure (BP) and mortality in ambulatory heart failure (HF) patients reporting varying and contrasting associations. The aim is to determine the pooled BP prognostic value and explore potential reasons for between-study inconsistency. We searched Medline, Cochrane, EMBASE and CINAHL from January 2005 to October 2018 for studies with ≥ 50 events (mortality and/or hospitalization) and included BP in a multivariable model in ambulatory HF patients. We pooled hazard ratios (random effects model) for systolic BP (SBP) or diastolic BP (DBP) effect on mortality and/or hospitalization risk. We used a priori defined sub-group analyses to explore heterogeneity and GRADE approach to assess the certainty of the evidence. Seventy-one eligible articles (239,467 screened) at low to moderate risk of bias included 235,752 participants. Higher SBP was associated with reduced all-cause mortality (HR 0.93, 95%CI 0.91-0.95, I2 = 87.13%, moderate certainty), all-cause hospitalization events (HR 0.91, 95%CI 0.88-0.93, I2 = 44.4%, high certainty) and their composite endpoint (HR 0.93 per 10 mmHg, 95%CI 0.91-0.94, I2 = 86.3%, high certainty). DBP did not demonstrate a statistically significant effect for all outcomes. The association strength was significantly weaker in studies following patients with either LVEF > 40%, higher average SBP (> 130 mmHg), increasing age and diabetes. All other a priori subgroup hypotheses did not explain between study differences. Higher ambulatory SBP is associated with reduced risk of all-cause mortality and hospitalization. Patients with lower BP and reduced LVEF are in a high-risk group of developing adverse events with moderate certainty of evidence.
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Affiliation(s)
- Michael H Lee
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
| | - Mariela Leda
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
- McMaster University, Hamilton, ON, Canada
| | - Tayler Buchan
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
| | - Abdullah Malik
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
| | - Alanna Rigobon
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
| | - Helen Liu
- University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | | | - Nathan Evaniew
- Section of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada
| | - Farid Foroutan
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
- McMaster University, Hamilton, ON, Canada
| | - Heather Ross
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Ana Carolina Alba
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada.
- University of Toronto, Toronto, ON, Canada.
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24
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Mizrak I, Asserhøj LL, Lund MAV, Kielstrup LR, Greisen G, Clausen TD, Main KM, Jensen RB, Vejlstrup NG, Madsen PL, Pinborg A. Cardiovascular function in 8- to 9-year-old singletons born after ART with frozen and fresh embryo transfer. Hum Reprod 2022; 37:600-611. [PMID: 35015837 DOI: 10.1093/humrep/deab284] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/16/2021] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION Do 8- to 9-year-old singletons conceived after frozen embryo transfer (FET) or fresh embryo transfer (Fresh-ET) have increased arterial stiffness compared to naturally conceived (NC) children? SUMMARY ANSWER The process of FET or Fresh-ET is not associated with altered cardiovascular function in 8- to 9-year-old singletons, including arterial stiffness, as compared to NC children. WHAT IS KNOWN ALREADY ART has been suggested to influence cardiovascular risk factors (i.e. endothelial dysfunction, increased arterial blood pressure and insulin resistance). It is not known if ART procedures alter arterial stiffness in singletons. STUDY DESIGN, SIZE, DURATION A cohort study was carried out, including 8- to 9-year-old singletons conceived after FET, Fresh-ET and NC children (50 children in each group). This study was conducted between November 2018 and August 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 150 singletons were identified through the Danish IVF Registry and the Medical Birth Registry. They underwent cardiac magnetic resonance imaging (CMR) and anthropometric measurements. Parental data were collected using questionnaires. NC children were matched by sex and birth year with FET/Fresh-ET children. Exclusion criteria were congenital heart disease, maternal gestational diabetes or maternal diabetes mellitus. Our primary outcome was arterial stiffness, which is assessed from noninvasive arterial blood pressure and aortic ascendens distensibility. The secondary outcome was the pulse wave velocity of total aorta and exploratory outcomes were left ventricular ejection fraction, mean arterial pressure, cardiac output and total peripheral resistance. Measurements and analyses were performed blinded to the child group. MAIN RESULTS AND THE ROLE OF CHANCE Aortic ascendens distensibility of children conceived after FET and Fresh-ET did not differ from NC children (mean (SD): FET 11.1 (3.6) 10-3 mmHg-1, Fresh-ET 11.8 (3.0) 10-3 mmHg-1, NC 11.4 (2.8) 10-3 mmHg-1, P > 0.05). Multivariate linear regression was performed to adjust for potential confounders (i.e. child sex and age, maternal BMI at early pregnancy and maternal educational level). Data showed no statistically significant differences between study groups and aortic ascendens distensibility. However, the fully adjusted model showed a non-significant tendency of lowered aortic ascendens distensibility in children born after FET compared to Fresh-ET (β estimate (95% CI): -0.99 10-3 mmHg-1 (-2.20; 0.21)) and NC children (β estimate (95% CI): -0.77 10-3 mmHg-1 (-1.98; 0.44)). Lastly, secondary and exploratory outcomes did not differ between the groups. Primary and secondary outcomes showed good intra-rater reliability. LIMITATIONS, REASONS FOR CAUTION This study is possibly limited by potential selection bias as the participation rate was higher in the ART compared to the NC group. Also, in some variables, the study groups differed slightly from the non-participant population. The non-participant population (n = 1770) included those who were excluded, not invited to CMR scan, or declined to participate in this study. WIDER IMPLICATIONS OF THE FINDINGS Our findings indicate that children born after FET or Fresh-ET do not have altered cardiovascular function, including arterial stiffness. This is reassuring for the future use of ART. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Novo Nordisk Foundation (grant reference number: NNF19OC0054340) and The Research Foundation of Rigshospitalet. All authors declared no conflict of interests. TRIAL REGISTRATION NUMBER ClinicalTrials.gov identifier: NCT03719703.
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Affiliation(s)
- I Mizrak
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Herlev, Denmark.,Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen
| | - L L Asserhøj
- Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen.,Department of Growth and Reproduction and EDMaRC, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M A V Lund
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen
| | - L R Kielstrup
- Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen
| | - G Greisen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - T D Clausen
- Department of Obstetrics and Gynecology, North Zealand Hospital, Hillerød, Denmark
| | - K M Main
- Department of Growth and Reproduction and EDMaRC, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - R B Jensen
- Department of Growth and Reproduction and EDMaRC, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - N G Vejlstrup
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen
| | - P L Madsen
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - A Pinborg
- Fertility Department, Copenhagen University Hospital, Rigshospitalet, Denmark, Copenhagen
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25
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Goncharova M, Brink I. Influence made by industrial climbing safety equipment on the cardiovascular system performance and thermophysical parameters of limbs in an industrial climber at low ambient temperatures. CARDIOMETRY 2021. [DOI: 10.18137/cardiometry.2021.20.167174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The task of the article is to assess the effect made by an industrialclimbing safety system used by an industrial climber, performinghis work to provide a harness-based suspended accessat low ambient temperatures, on his physiological parameters.The article presents some studies on changes recorded in bodysurface temperatures, pulse rates, and blood pressure value inan industrial climber depending on the duration of his performanceusing a harness-based suspended access under ambientair low temperature conditions. The tests have been carriedout for various types of thermal protection of the human hiparea and the width of the belts of the safety system. The scientificnovelty of the study is that it is the first time when such astudy has been conducted for a combination of industrial factors,like prolonged suspended condition due to the utilizationof the climbing safety system and a low ambient temperature.As a result, it has been found that the physiological parametersare influenced by the width of the safety belts of the safetyequipment system and the method of the temperature protectionof the hip zone in a climber.
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26
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Zhang X, Wang L, Guo R, Xiao J, Liu X, Dong M, Luan X, Ji X, Lu H. Ginsenoside Rb1 Ameliorates Diabetic Arterial Stiffening via AMPK Pathway. Front Pharmacol 2021; 12:753881. [PMID: 34712140 PMCID: PMC8546248 DOI: 10.3389/fphar.2021.753881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose: Macrovascular complication of diabetes mellitus, characterized by increased aortic stiffness, is a major cause leading to many adverse clinical outcomes. It has been reported that ginsenoside Rb1 (Rb1) can improve glucose tolerance, enhance insulin activity, and restore the impaired endothelial functions in animal models. The aim of this study was to explore whether Rb1 could alleviate the pathophysiological process of arterial stiffening in diabetes and its potential mechanisms. Experimental Approach: Diabetes was induced in male C57BL/6 mice by administration of streptozotocin. These mice were randomly selected for treatment with Rb1 (10-60 mg/kg, i. p.) once daily for 8 weeks. Aortic stiffness was assessed using ultrasound and measurement of blood pressure and relaxant responses in the aortic rings. Mechanisms of Rb1 treatment were studied in MOVAS-1 VSMCs cultured in a high-glucose medium. Key Results: Rb1 improved DM-induced arterial stiffening and the impaired aortic compliance and endothelium-dependent vasodilation. Rb1 ameliorated DM-induced aortic remodeling characterized by collagen deposition and elastic fibers disorder. MMP2, MMP9, and TGFβ1/Smad2/3 pathways were involved in this process. In addition, Rb1-mediated improvement of arterial stiffness was partly achieved via inhibiting oxidative stress in DM mice, involving regulating NADPH oxidase. Finally, Rb1 could blunt the inhibition effects of DM on AMPK phosphorylation. Conclusion and Implications: Rb1 may represent a novel prevention strategy to alleviate collagen deposition and degradation to prevent diabetic macroangiopathy and diabetes-related complications.
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Affiliation(s)
- Xinyu Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Rong Guo
- Department of Cardiology, Ji'an Municipal Center People's Hospital, Ji'an, China
| | - Jie Xiao
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaoling Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mei Dong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaorong Luan
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaoping Ji
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huixia Lu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Dr. Gilbert Hung Ginseng Laboratory, Department of Biology, Faculty of Science, Hong Kong Baptist University, Hong Kong, Hong Kong, SAR China
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27
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Wu C, Ma D, Chen Y. Association of Pulse Pressure Difference and Diabetes Mellitus in Chinese People: A Cohort Study. Int J Gen Med 2021; 14:6601-6608. [PMID: 34703280 PMCID: PMC8523515 DOI: 10.2147/ijgm.s327841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Here, we sought to determine the association between pulse pressure difference and the incidence of type 2 diabetes mellitus (T2DM) in Chinese people. Methods This study involved 211,814 participants among whom 4156 had been diagnosed with T2DM. The correlation between pulse pressure difference and T2DM incidence in Chinese people was determined by multivariate analysis. A smooth curve fitting diagram was then used to explore correlation between pulse pressure difference and T2DM incidence. Finally, the inflection point in the correlation between pulse pressure difference and the T2DM incidence was located by piecewise linear regression. Results To understand the relationship, adjustments were made for sex, age, total serum cholesterol (TC), fasting blood glucose (FPG), triglyceride (TG), alanine aminotransferase (ALT), family history of diabetes, body mass index (BMI), blood urea nitrogen (BUN), drinking status, and smoking status. Diabetes incidence increased by 0.3% [HR 1.003 (1.001, 1.005), p = <0.05] for every 1mmHg increase in pulse pressure difference. Smooth curve analysis showed that, when pulse pressure difference was ≤35mmHg, diabetes incidence negatively correlated to pulse pressure difference [HR 0.972 (0.953, 0.972) p = 0.053]. However, when pulse pressure difference was >35mmHg, diabetes incidence increased with increasing pulse pressure difference [HR 1.044 (1.042, 1.047) p = <0.001]. And between pulse pressure difference and fasting blood glucose in the final visit, the blood glucose level increased with the elevation of pulse pressure. Conclusion The risk of diabetes was lowest at about 35mmHg pulse pressure difference.
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Affiliation(s)
- Chunlei Wu
- Department of Cardiac Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, People's Republic of China
| | - Denhua Ma
- Department of Cardiac Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, People's Republic of China
| | - Yu Chen
- Department of Cardiac Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, People's Republic of China
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Stamatelopoulos K, Georgiopoulos G, Baker KF, Tiseo G, Delialis D, Lazaridis C, Barbieri G, Masi S, Vlachogiannis NI, Sopova K, Mengozzi A, Ghiadoni L, van der Loeff IS, Hanrath AT, Ajdini B, Vlachopoulos C, Dimopoulos MA, Duncan CJA, Falcone M, Stellos K. Estimated pulse wave velocity improves risk stratification for all-cause mortality in patients with COVID-19. Sci Rep 2021; 11:20239. [PMID: 34642385 PMCID: PMC8511157 DOI: 10.1038/s41598-021-99050-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022] Open
Abstract
Accurate risk stratification in COVID-19 patients consists a major clinical need to guide therapeutic strategies. We sought to evaluate the prognostic role of estimated pulse wave velocity (ePWV), a marker of arterial stiffness which reflects overall arterial integrity and aging, in risk stratification of hospitalized patients with COVID-19. This retrospective, longitudinal cohort study, analyzed a total population of 1671 subjects consisting of 737 hospitalized COVID-19 patients consecutively recruited from two tertiary centers (Newcastle cohort: n = 471 and Pisa cohort: n = 266) and a non-COVID control cohort (n = 934). Arterial stiffness was calculated using validated formulae for ePWV. ePWV progressively increased across the control group, COVID-19 survivors and deceased patients (adjusted mean increase per group 1.89 m/s, P < 0.001). Using a machine learning approach, ePWV provided incremental prognostic value and improved reclassification for mortality over the core model including age, sex and comorbidities [AUC (core model + ePWV vs. core model) = 0.864 vs. 0.755]. ePWV provided similar prognostic value when pulse pressure or hs-Troponin were added to the core model or over its components including age and mean blood pressure (p < 0.05 for all). The optimal prognostic ePWV value was 13.0 m/s. ePWV conferred additive discrimination (AUC: 0.817 versus 0.779, P < 0.001) and reclassification value (NRI = 0.381, P < 0.001) over the 4C Mortality score, a validated score for predicting mortality in COVID-19 and the Charlson comorbidity index. We suggest that calculation of ePWV, a readily applicable estimation of arterial stiffness, may serve as an additional clinical tool to refine risk stratification of hospitalized patients with COVID-19 beyond established risk factors and scores.
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Affiliation(s)
- Kimon Stamatelopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece. .,Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.,School of Biomedical Engineering and Imaging Sciences, King's College, London, UK
| | - Kenneth F Baker
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Giusy Tiseo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dimitrios Delialis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Charalampos Lazaridis
- Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.,RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Greta Barbieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nikolaos I Vlachogiannis
- Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - Kateryna Sopova
- Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.,RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ina Schim van der Loeff
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Aidan T Hanrath
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Bajram Ajdini
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Charalambos Vlachopoulos
- First Department of Cardiology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Christopher J A Duncan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Marco Falcone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Konstantinos Stellos
- Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK. .,RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Lechner I, Reindl M, Tiller C, Holzknecht M, Niederreiter S, Mayr A, Klug G, Brenner C, Bauer A, Metzler B, Reinstadler SJ. Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction. Int J Cardiovasc Imaging 2021; 38:237-247. [PMID: 34476665 PMCID: PMC8818631 DOI: 10.1007/s10554-021-02383-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022]
Abstract
The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), the most widely used measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 [interquartile range (IQR) 12–31] months. Cox regression- and logistic regression analysis were performed to explore predictors of aortic stiffness and MACCE. Median aortic PWV was 6.6 m/s (IQR 5.6–8.3 m/s). In multivariable analysis, age [odds ratio (OR) 1.10, 95% confidence interval (CI), 1.08–1.14, p < 0.001] and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis [hazard ratio (HR) 2.45, 95% CI 1.19–5.04, p = 0.014]. In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. Trial (NCT04113356).
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Affiliation(s)
- Ivan Lechner
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christina Tiller
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Magdalena Holzknecht
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Sarah Niederreiter
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Agnes Mayr
- Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Gert Klug
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christoph Brenner
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Axel Bauer
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Sebastian Johannes Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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30
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Miyoshi T, Ito H. Arterial stiffness in health and disease: The role of cardio-ankle vascular index. J Cardiol 2021; 78:493-501. [PMID: 34393004 DOI: 10.1016/j.jjcc.2021.07.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022]
Abstract
Arterial stiffness increases with age, as well as in various pathological states, including obesity, diabetes mellitus, smoking, and dyslipidemia, and it has important consequences for cardiovascular health. Arterial stiffness plays a central role in hemodynamic dysfunction characterized by excess pulsatility; specifically, it leads to heart failure, cerebrovascular disease, and renal failure. Among measures of arterial stiffness, carotid-femoral pulse wave velocity is considered as the reference standard; however, it has not been incorporated into routine clinical practice. Cardio-ankle vascular index (CAVI), which is a marker of arterial stiffness measured from the origin of the aorta to the ankle, was developed in 2004. CAVI is based on stiffness parameter β, which is theoretically independent of blood pressure at the time of measurement. CAVI applies stiffness parameter β to arterial segments between the heart and ankle. The measurement of CAVI is simple and well-standardized, and its reproducibility and accuracy are acceptable. Several studies have demonstrated that CAVI is high in patients with various atherosclerotic risk factors, and treatment of cardiovascular risk factors and lifestyle modifications improve CAVI. Several prospective studies have investigated the association between CAVI and future cardiovascular events in the general population and in patients with cardiovascular risk factors. A cut-off value of 9.0 is proposed for predicting patients at a high risk of cardiovascular events. From this review, it is clear that CAVI may be useful in the prevention of cardiovascular disease.
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Affiliation(s)
- Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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31
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Zuo J, Chao H, Tang B, Avolio AP, Schlaich MP, Nolde JM, Adji A, Carnagarin R. Female Gender Is Associated with Higher Susceptibility of Weight Induced Arterial Stiffening and Rise in Blood Pressure. J Clin Med 2021; 10:jcm10163479. [PMID: 34441775 PMCID: PMC8396951 DOI: 10.3390/jcm10163479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 01/13/2023] Open
Abstract
Arterial stiffness is an important predictor of cardiovascular events, independent of traditional risk factors. Stiffening of arteries, though an adaptive process to hemodynamic load, results in substantial increase in the pulsatile hemodynamic forces that detrimentally affects the microcirculation perfusing the vital organs such as the brain, heart and kidneys. Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity. Our study sought to determine the gender-based effects on arterial stiffening in obesity which may predispose to the development of hypertension. We found female sex is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure in obesity. Women had significantly higher carotid-femoral pulse wave velocity (CF-PWV) with higher body mass index (BMI) status (normal: 7.9 ± 2 m/s; overweight: 9.1 ± 2 m/s; obese: 9 ± 2 m/s, p < 0.001), whereas it was similar in males across all BMI categories. The linear association between arterial stiffness and BMI following adjustment for age and brachial systolic and diastolic blood pressure (BP), remained significant in females (β = 0.06; 95% CI 0.01 to 0.1; p < 0.05) but not in males (β = 0.04; 95% CI -0.01 to 0.1; p > 0.05). The mean CF-PWV values increased by 0.1 m/s for every 1 kg/m2 increase in BMI in the female subjects in the age adjusted linear model, while such effect was not seen in the male subjects. In line with arterial stiffening, the overweight and obese females demonstrated significantly higher systolic brachial BP. (BP difference: ΔBP 9-11 mmHg, p < 0.01) and central systolic pressure (ΔBP 8-10 mmHg, p < 0.05) compared to their lean counterparts, unlike the male subjects. Our results suggest that female gender is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure.
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Affiliation(s)
- Junli Zuo
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Huijuan Chao
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
| | - Biwen Tang
- Department of Geriatrics and Geriatrics Centre, Ruijin Hospital/Jiaotong University School of Medicine, Shanghai 200240, China; (J.Z.); (H.C.); (B.T.)
| | - Alberto P. Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Markus P. Schlaich
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, WA 6000, Australia
- Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Janis Marc Nolde
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
| | - Audrey Adji
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia;
- St Vincent’s Hospital and Clinical School UNSW, Sydney, NSW 2000, Australia
- Victor Chang Cardiac Research Institute, Sydney, NSW 2010, Australia
- Correspondence: (A.A.); (R.C.); Tel.: +61-2-8382-1111 (A.A.); +61-8-9224-0316 (R.C.)
| | - Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine—Royal Perth Hospital Research Foundation, University of Western Australia, Perth, WA 6000, Australia; (M.P.S.); (J.M.N.)
- Correspondence: (A.A.); (R.C.); Tel.: +61-2-8382-1111 (A.A.); +61-8-9224-0316 (R.C.)
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Antza C, Doundoulakis I, Akrivos E, Stabouli S, Chrysaidou K, Gidaris D, Kotsis V. Estimated Arterial Stiffness and Prediction of Vascular Aging: The Rising of a New Era. Curr Pharm Des 2021; 27:1871-1877. [PMID: 32723254 DOI: 10.2174/1381612826666200728150637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022]
Abstract
Arterial stiffness has been associated with cardiovascular events and correlated with cardiovascular risk factors. In the new guidelines of the European Society of Hypertension, the evaluation of arterial stiffness, and specifically carotid-femoral pulse wave velocity (c-f PWV), was taken into account for the detailed screening of the hypertensive population. Despite the importance of arterial stiffness as a target organ damage, the measurement is time-consuming, not practical, needs expensive equipment and experienced staff. For all these reasons, c-f PWV is not recommended for the everyday clinical practice and its current use is restricted for research purposes. The importance of arterial properties in clinical practice and cardiovascular prevention is well known. Hence, the estimation of arterial stiffness and vascular health based on parameters that affect arterial stiffness, but without the use of a machine, is a new promising field. Furthermore, the relationship between age-related MRI abnormalities as well as ultrafast ultrasound with vascular effect gives a new promise for future vascular aging assessment.
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Affiliation(s)
- Christina Antza
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Doundoulakis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Akrivos
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Stabouli
- 1st Department of Pediatrics, Aristotle University Thessaloniki, Hippokration Hospital, Thessaloniki, Thessaloniki, Greece
| | - Katerina Chrysaidou
- 1st Department of Pediatrics, Aristotle University Thessaloniki, Hippokration Hospital, Thessaloniki, Thessaloniki, Greece
| | - Dimos Gidaris
- 1st Department of Pediatrics, Aristotle University Thessaloniki, Hippokration Hospital, Thessaloniki, Thessaloniki, Greece
| | - Vasilios Kotsis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Nabati M, Namazi S, Yazdani J. Aortic wall elasticity and left ventricular function in hypertensive patients with nonsignificant coronary artery disease. ULTRASOUND (LEEDS, ENGLAND) 2021; 29:162-171. [PMID: 34567228 PMCID: PMC8366218 DOI: 10.1177/1742271x20963346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Hypertension is an important cause of nonischemic heart failure. It is important to identify subclinical left ventricular dysfunction in patients with hypertension in an early stage to lower the risk of progression to more severe illness. The aim of our study was to assess the correlation between indices of left ventricular function and aortic stiffness in patients with hypertension. METHODS Our study was a case control study of 42 hypertensive and 40 normotensive patients with nonsignificant coronary artery disease. All the patients underwent echocardiography and left ventricular ejection fraction, global longitudinal strain, post systolic index, pulsed Doppler early transmitral peak flow velocity, early diastolic mitral annular velocity (e'), and aortic elasticity measurements were calculated. RESULTS The hypertensive patients were older (58.47 ± 9.57 vs. 52.94 ± 10.38 years, p = 0.018) and had a higher body mass index (30.09 ± 5.08 vs. 27.48 ± 4.17 kg/m2, p = 0.013) and E/e' ratio (8.16 ± 1.81 vs. 6.56 ± 1.71, p < 0.001) and a lower e' velocity (8.25 ± 2.28 vs. 9.52 ± 2.34 cm/s, p = 0.015) than normotensives. They also had a lower aortic distensibility (p = 0.008) and a higher aortic stiffness index (p = 0.039) compared with the normotensive group. The hypertensive patients did not show any association between aortic elasticity and stiffness with age or e' velocity despite significant association in normotensives. CONCLUSION Hypertension is associated with a high prevalence of diastolic dysfunction, elevated left ventricular filling pressure, and increased arterial stiffness, all of which have significant association with adverse outcomes. The measurements found in the hypertensive patients compared with the normotensive group may be due to several age-independent mechanisms.
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Affiliation(s)
- Maryam Nabati
- Department of cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shojaoddin Namazi
- Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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34
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Is there any relation between arterial stiffness and insomnia? A challenging question. Sleep Breath 2021; 26:333-338. [PMID: 34302608 DOI: 10.1007/s11325-021-02445-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Insomnia is a common sleep disorder which has high comorbidity with a number of cardiovascular diseases (CVD). As a possible risk factor for the CVDs, arterial stiffness may be assessed non-invasively by pulse wave velocity (PWV) and augmentation index (AI). The aim of this study was to evaluate any relation between insomnia and arterial stiffness. METHODS Patients with insomnia were included in the study after the exclusion of other sleep disorders by polysomnography. Sleep quality and the degree of insomnia symptoms were evaluated by the Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI), respectively. PWV and AI were assessed by Mobil-O-Graph arteriograph system. RESULTS Consecutive patients with insomnia (n = 72, 56 women, mean age 55.8 ± 9.1 years) were included. Patients were grouped as those with severe ISI scores (22-28) and those with mild to moderate ISI scores (8-21). Despite no significant difference in characteristics and clinical data, patients with severe ISI scores had significantly higher total PSQI scores and NREM-2 with significantly lower REM duration. They also had significantly higher systolic blood pressure, mean blood pressure, pulse pressure, PWV, and AI compared to patients with mild and moderate ISI scores. Correlation analysis revealed that PWV and AI were significantly correlated with the ISI score and PSQI score. CONCLUSION There is a close relation between arterial stiffness and insomnia suggesting a risk for CVD in patients with insomnia.
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35
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Wang Y, Müller J, Myers J. Association between cardiorespiratory fitness and health care costs in hypertensive men. Atherosclerosis 2021; 331:1-5. [PMID: 34252836 DOI: 10.1016/j.atherosclerosis.2021.06.914] [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: 01/24/2021] [Revised: 05/30/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Hypertension increases healthcare costs, but the impact of cardiorespiratory fitness (CRF) on these costs is unknown. This study explored the association between healthcare costs and CRF among hypertensive and normotensive men. METHODS We studied 9794 male subjects aged 58.5 ± 11.3 years from the Palo Alto Veterans Affairs Medical Center, including 6413 with and 3381 without hypertension. CRF was classified into four age-stratified categories according to metabolic equivalents (METs) derived from exercise testing: low fit (4.6 ± 1.2 METs; n = 2481), moderate fit (6.6 ± 1.2 METs; n = 2412), fit (8.0 ± 1.3 METs; n = 2505), and high fit (10.8 ± 2.1 METs; n = 2396). Annual costs per subject were quantified over eight years. RESULTS Total annual healthcare costs were higher in subjects with hypertension ($34,794, 95% CI, 32,828 to 36,761) in comparison to non-hypertensive subjects ($30,221, 95% CI, 26,104 to 32,450) (p < 0.01). In hypertensive subjects, a graded reduction in annual healthcare costs was observed as CRF was higher; costs were $40,346 for low fit, $35,939 for moderate fit, $32,312 for fit, and $29,277 for high fit subjects (p < 0.001). For each 1-MET increase in CRF, annual costs per subject (USD) were $1752 (95% CI, -2476 to -1,027, p < 0.001) lower among those with hypertension and $1025 (95% CI, -2047 to -2, p < 0.05) lower in those without hypertension. CONCLUSIONS Higher CRF is associated with lower healthcare costs in men with and without hypertension. The impact of CRF on healthcare costs is more striking in those with hypertension.
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Affiliation(s)
- Yi Wang
- Institute of Preventive Pediatrics, Technische Universtaet Muenchen, Germany; Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA, USA; Stanford University School of Medicine, Stanford, CA, USA.
| | - Jan Müller
- Institute of Preventive Pediatrics, Technische Universtaet Muenchen, Germany
| | - Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA, USA; Stanford University School of Medicine, Stanford, CA, USA
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Toribio M, Awadalla M, Cetlin M, Fulda ES, Stanley TL, Drobni ZD, Szczepaniak LS, Nelson MD, Jerosch-Herold M, Burdo TH, Neilan TG, Zanni MV. Brief Report: Vascular Dysfunction and Monocyte Activation Among Women With HIV. J Acquir Immune Defic Syndr 2021; 85:233-238. [PMID: 32541385 DOI: 10.1097/qai.0000000000002419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Women with HIV (WHIV) on antiretroviral therapy (ART) face an increased risk of cardiovascular disease (CVD) in the context of heightened systemic immune activation. Aortic stiffness, a measure of vascular dysfunction and a robust predictor of CVD outcomes, is highly influenced by immune activation. We compared aortic stiffness among women with and without HIV and examined interrelationships between aortic stiffness and key indices of systemic immune activation. METHODS Twenty WHIV on ART and 14 women without HIV group-matched on age and body mass index (BMI) were prospectively recruited and underwent cardiovascular magnetic resonance imaging, as well as metabolic and immune phenotyping. RESULTS Age and BMI did not differ significantly across groups (age: 52 ± 4 vs. 53 ± 6 years; BMI: 32 ± 7 vs. 32 ± 7 kg/m). Aortic pulse wave velocity (aPWV) was higher among WHIV (8.6 ± 1.3 vs. 6.5 ± 1.3 m/s, P < 0.0001), reflecting increased aortic stiffness. Among the whole group and among WHIV, aPWV related to sCD163 levels (whole group: R = 0.65, P < 0.0001; WHIV: R = 0.73, P = 0.0003) and to myocardial fibrosis (extracellular volume; whole group: R = 0.54, P = 0.001; WHIV: R = 0.47, P = 0.04). Both HIV status and sCD163 levels independently predicted aPWV, controlling for age, BMI, cigarette smoking status, and systolic blood pressure (HIV status: β-estimate = 0.69, 95% CI [0.1 to 1.3], P = 0.02; sCD163: β-estimate = 0.002, 95% CI [0.0006 to 0.004], P = 0.01). Among WHIV, sCD163 levels independently predicted aPWV, controlling for duration of HIV, CD4 count, and HIV viral load (sCD163: β-estimate = 0.004, 95% CI [0.002 to 0.005], P = 0.0005). CONCLUSIONS Asymptomatic WHIV on ART have increased aortic stiffness as compared to matched control subjects. Among WHIV, aPWV related to heightened monocyte activation (sCD163) and to downstream CVD pathology (myocardial fibrosis). CLINICALTRIALS. GOV REGISTRATION NCT02874703.
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Affiliation(s)
- Mabel Toribio
- Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Magid Awadalla
- Department of Radiology and Division of Cardiology, Cardiovascular Imaging Research Center (CIRC), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Madeline Cetlin
- Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Evelynne S Fulda
- Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Takara L Stanley
- Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Zsofia D Drobni
- Department of Radiology and Division of Cardiology, Cardiovascular Imaging Research Center (CIRC), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Michael D Nelson
- Department of Kinesiology, Applied Physiology and Advanced Imaging Laboratory, University of Texas at Arlington, Arlington, TX
| | - Michael Jerosch-Herold
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and
| | - Tricia H Burdo
- Department of Neuroscience, Temple University Lewis Katz School of Medicine, Philadelphia, PA
| | - Tomas G Neilan
- Department of Radiology and Division of Cardiology, Cardiovascular Imaging Research Center (CIRC), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Markella V Zanni
- Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Dong H, Jin N, Kannengiesser S, Raterman B, White RD, Kolipaka A. Magnetic resonance elastography for estimating in vivo stiffness of the abdominal aorta using cardiac-gated spin-echo echo-planar imaging: a feasibility study. NMR IN BIOMEDICINE 2021; 34:e4420. [PMID: 33021342 DOI: 10.1002/nbm.4420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Magnetic resonance elastography (MRE)-derived aortic stiffness is a potential biomarker for multiple cardiovascular diseases. Currently, gradient-recalled echo (GRE) MRE is a widely accepted technique to estimate aortic stiffness. However, multi-slice GRE MRE requires multiple breath-holds (BHs), which can be challenging for patients who cannot consistently hold their breath. The aim of this study was to investigate the feasibility of a multi-slice spin-echo echo-planar imaging (SE-EPI) MRE sequence for quantifying in vivo aortic stiffness using a free-breathing (FB) protocol and a single-BH protocol. METHOD On Scanner 1, 25 healthy subjects participated in the validation of FB SE-EPI against FB GRE. On Scanner 2, another 15 healthy subjects were recruited to compare FB SE-EPI with single-BH SE-EPI. Among all volunteers, five participants were studied on both scanners to investigate the inter-scanner reproducibility of FB SE-EPI aortic MRE. Bland-Altman analysis, Lin's concordance correlation coefficient (LCCC) and coefficient of variation (COV) were evaluated. The phase-difference signal-to-noise ratios (PD SNR) were compared. RESULTS Aortic MRE using FB SE-EPI and FB GRE yielded similar stiffnesses (paired t-test, P = 0.19), with LCCC = 0.97. The FB SE-EPI measurements were reproducible (intra-scanner LCCC = 0.96) and highly repeatable (LCCC = 0.99). The FB SE-EPI MRE was also reproducible across different scanners (inter-scanner LCCC = 0.96). Single-BH SE-EPI scans yielded similar stiffness to FB SE-EPI scans (LCCC = 0.99) and demonstrated a low COV of 2.67% across five repeated measurements. CONCLUSION Multi-slice SE-EPI aortic MRE using an FB protocol or a single-BH protocol is reproducible and repeatable with advantage over multi-slice FB GRE in reducing acquisition time. Additionally, FB SE-EPI MRE provides a potential alternative to BH scans for patients who have challenges in holding their breath.
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Affiliation(s)
- Huiming Dong
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Ning Jin
- Siemens Medical Solution, Columbus, Ohio, USA
| | | | - Brian Raterman
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Richard D White
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
- Department of Internal Medicine-Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Suzuki K, Claggett B, Minamisawa M, Nochioka K, Mitchell GF, Anand IS, Zannad F, Shah SJ, Lefkowitz M, Shi V, Pfeffer MA, McMurray JJV, Solomon SD. Pulse Pressure, Prognosis, and Influence of Sacubitril/Valsartan in Heart Failure With Preserved Ejection Fraction. Hypertension 2020; 77:546-556. [PMID: 33356401 DOI: 10.1161/hypertensionaha.120.16277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Arterial stiffness is increased with increasing age, and pulse pressure (PP), a marker of arterial stiffness, is a predictor of incident cardiovascular disease and mortality. However, the prognostic relevance of PP in heart failure (HF) with preserved ejection fraction has not been fully understood. We studied 4796 patients with HF with preserved ejection fraction from the PARAGON-HF trial. All patients underwent sequential run-in phases of valsartan and sacubitril/valsartan before randomization. We categorized patients by PP quartile and evaluated the influence of baseline PP on the PARAGON-HF primary end point (total HF hospitalizations and cardiovascular death). At screening, the median PP was 58 mm Hg (interquartile range, 50-69 mm Hg). There was a nonlinear, J-shaped association between PP and outcomes. Multivariable Cox proportional hazards models showed that patients in the highest PP quartile had a higher risk of the primary end point (adjusted hazard ratio, 1.39 [95% CI, 1.14-1.69]; P=0.001), total HF hospitalizations (adjusted hazard ratio, 1.43 [95% CI, 1.15-1.79]; P=0.001), and myocardial infarction (adjusted hazard ratio, 1.54 [95% CI, 1.06-2.23]; P=0.022) compared with those in the second (lowest risk) PP quartile. Reductions in PP during sacubitril/valsartan run-in were associated with a decreased risk of the primary end point and total HF hospitalizations. One year after randomization, PP was significantly lower in the sacubitril/valsartan group compared with the valsartan group (3.0 mm Hg decrease [95% CI, 2.4-3.5]; P<0.001). In conclusion, PP was an independent predictor of cardiovascular events in patients with HF with preserved ejection fraction enrolled in PARAGON-HF. Sacubitril/valsartan lowered PP compared with valsartan.
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Affiliation(s)
- Kota Suzuki
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (K.S., B.C., M.M., M.A.P., S.D.S.)
| | - Brian Claggett
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (K.S., B.C., M.M., M.A.P., S.D.S.)
| | - Masatoshi Minamisawa
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (K.S., B.C., M.M., M.A.P., S.D.S.).,Department of Cardiovascular Medicine, Shinshu University Hospital, Matsumoto, Nagano, Japan (M.M.)
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Miyagi, Japan (K.N.)
| | | | - Inder S Anand
- Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN (I.S.A.)
| | - Faiez Zannad
- INSERM Centre d'Investigation Clinic 1433 and Universite de Lorraine, Centre Hospitalier Regional et Universitaire, Nancy, France (F.Z.)
| | | | | | | | - Marc A Pfeffer
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (K.S., B.C., M.M., M.A.P., S.D.S.)
| | | | - Scott D Solomon
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (K.S., B.C., M.M., M.A.P., S.D.S.)
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Pan FF, Xu CC, Hu TJ, Fu GX, Zhong Y. Carotid plague formation is associated with ankle-brachial index in elderly people. Aging Clin Exp Res 2020; 32:2217-2223. [PMID: 31760610 DOI: 10.1007/s40520-019-01415-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
AIMS This study aimed at examining whether ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were independently associated with carotid Intima-media thickness (CIMT) or carotid artery plaque (CAP) in elderly people. METHODS A cross-sectional analysis was performed in 155 individuals aged over 75 years who underwent the measurements of ABI and baPWV. Low ABI was defined as ABI ≤ 1.0. High baPWV was defined as baPWV > 2000 cm/s. The CIMT and CAP were measured with a B-mode tomographic ultrasound system. RESULTS Neither ABI nor baPWV was associated with CIMT in this elderly population. The group with low ABI (≤ 1.0) was significantly associated with a higher prevalence of carotid plaque (P = 0.001), while the relationship between baPWV and prevalence of carotid plaque was not found. Linear regression analysis showed that the value of ABI was significantly associated with the thickness of carotid plaque. Even in the full adjusted model, each 0.01unit ABI decreasing still increased 0.1663 mm of carotid plaque thickness (P = 0.004). Logistic Regression Analysis demonstrated that ABI lower than 1.0 had predictive value in the formation of carotid plaque with top quartile thickness (OR 2.834, 95% CI 1.131-7.099, P = 0.026). Furthermore, individuals with low ABI (≤ 1.0) were more likely to form hypoechoic carotid plaques according to ultrasonography. CONCLUSION Low ABI but not high baPWV was associated with the formation of carotid plaque. Furthermore, ABI was significantly associated with the thickness and morphology of carotid plaque in elderly people.
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Bogatu LI, Turco S, Mischi M, Woerlee P, Bouwman A, Korsten EHHM, Muehlsteff J. A modelling framework for assessment of arterial compliance by fusion of oscillometry and pulse wave velocity information. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105492. [PMID: 32603986 DOI: 10.1016/j.cmpb.2020.105492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/29/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Measurement of arterial compliance is recognized as important for clinical use and for enabling better understanding of circulatory system regulation mechanisms. Estimation of arterial compliance involves either a direct measure of the ratio between arterial volume and pressure changes or an inference from the pulse wave velocity (PWV). In this study we demonstrate an approach to assess arterial compliance by fusion of these two information sources. The approach is based on combining oscillometry as used for blood pressure inference and PWV measurements based on ECG/PPG. Enabling reliable arterial compliance measurements will contribute to the understanding of regulation mechanisms of the arterial tree, possibly establishing arterial compliance as a key measure relevant in hemodynamic monitoring. METHODS A measurement strategy, a physiological model, and a framework based on Bayesian principles are developed for measuring changes in arterial compliance based on combining oscillometry and PWV data. A simulation framework is used to study and validate the algorithm and measurement principle in detail, motivated by previous experimental findings. RESULTS Simulations demonstrate the possibility of inferring arterial compliance via fusion of simultaneously acquired volume/pressure relationships and PWV data. In addition, the simulation framework demonstrates how Bayesian principles can be used to handle low signal - to - noise ratio and partial information loss. CONCLUSIONS The developed simulation framework shows the feasibility of the proposed approach for assessment of arterial compliance by combining multiple data sources. This represents a first step towards integration of arterial compliance measurements in hemodynamic monitoring using existing clinical technology. The Bayesian approach is of particular relevance for such patient monitoring settings, where measurements are repeated frequently, context is relevant, and data is affected by artefacts. In addition, the simulation framework is necessary for future clinical-study design, in order to determine device specifications and the extent to which noise affects the inference process.
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Affiliation(s)
- Laura I Bogatu
- Patient Care and Measurements, Philips Research, Eindhoven, 5656 AE, Netherlands; Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
| | - Simona Turco
- Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
| | - Massimo Mischi
- Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
| | - Pierre Woerlee
- Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
| | | | | | - Jens Muehlsteff
- Patient Care and Measurements, Philips Research, Eindhoven, 5656 AE, Netherlands.
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DILLON KN, SHARIFFI B, THOMPSON B, STEELE R, KIM JK. Effects of Acute Grape Seed Extract Supplementation on Hemodynamics in Normal Body Weight and Obese Males. J Nutr Sci Vitaminol (Tokyo) 2020; 66:427-431. [DOI: 10.3177/jnsv.66.427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Brian SHARIFFI
- Department of Kinesiology, California Baptist University
| | | | - Richard STEELE
- Department of Kinesiology, California Baptist University
| | - Jong-Kyung KIM
- Department of Kinesiology, California Baptist University
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Kroker-Lobos MF, Ford ND, Gonzalez-Casanova I, Martorell R, Ramirez-Zea M, Stein AD. Improved nutrition in early life and pulse wave velocity and augmentation index in mid-adulthood: Follow-up of the INCAP Nutrition Supplementation Trial Longitudinal Study. PLoS One 2020; 15:e0239921. [PMID: 33108379 PMCID: PMC7591084 DOI: 10.1371/journal.pone.0239921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
Nutrition in pregnancy and early childhood affects later blood pressure and precursors of atherosclerosis, but its influence on arterial stiffness is unexplored. This study determines whether exposure to improved nutrition during early life influences Augmentation index (AI) and pulse wave velocity (PWV) in mid-adulthood. We included 1221 adults (37-54y) who participated in a cluster-randomized nutritional supplementation trial of a protein-energy beverage (Atole), conducted between 1969–1977 in Guatemala. The comparison group received Fresco, a low-calorie protein-free beverage. In 2015–17, we measured anthropometry (weight, height, and waist-to-height ratio); AI and PWV (using carotid—femoral tonometry); blood pressure; fasting plasma glucose and serum lipids; and sociodemographic characteristics. Based on patterns of exposure, we characterized participants as fully, partially or unexposed to the intervention from conception to their second birthday (the ‘first 1000 days’). We fit pooled and sex-specific models using intention-to-treat, difference-in-difference regression analysis to test whether exposure to the supplement in the first 1000 days was associated with AI and PWV in adulthood adjusting for basal and current sociodemographic variables and current life-style and cardio-metabolic risk factors. Prevalence of obesity in men and women was 39.6% and 19.6%, and prevalence of hypertension was 44.0% and 36.0%, respectively. Women had higher AI (34.4±9.6%) compared to men (23.0± 9.8%), but had similar PWV (7.60±1.13 m/s and 7.60±1.31, respectively). AI did not differ significantly across intervention groups. PWV was lower in individuals with full exposure to the supplement during the first 1000 days (-0.39m/s, 95% CI -0.87, 0.09; p = 0.1) compared to unexposed individuals. This difference was similar after adjusting for cardio-metabolic risk factors (-0.45m/s; 95%C-0.93, 0.01; p = 0.06). Exposure to improved nutrition during the first 1000 days was marginally associated with lower PWV, but not with AI.
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Affiliation(s)
- Maria F. Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Nicole D. Ford
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
- * E-mail:
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Aykan AÇ, Çetin M, Kalaycıoğlu E, Menteşe Ü. Assessment of cardio-ankle vascular index in patients with abdominal aortic aneurysm: An observational study. Vascular 2020; 29:190-195. [PMID: 32757746 DOI: 10.1177/1708538120946549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Arterial stiffness is associated with major adverse cardiovascular events. The aim of this study is to investigate arterial stiffness by cardio-ankle vascular index (CAVI) in patients with abdominal aortic aneurysm (AAA). METHODS This observational and cross-sectional study involved 59 subjects with AAA and 32 healthy subjects. All subjects underwent ultrasonography examination. CAVI was measured by VaSera-1000 CAVI instrument. RESULTS Mean abdominal aortic diameter of AAA patients and controls were 43.88 ± 9.28 mm and 20.43 ± 3.14 mm, consecutively. Baseline clinical characteristics of the patients and controls were similar for age, presence of hypertension, diabetes, dyslipidemia, coronary artery disease and smoking. Left ventricle ejection fraction and Left ventricle mass index (LVMI) were similar between groups. CAVI was significantly higher in patients with AAA than controls (9.74 ± 1.50 vs. 7.60 ± 1.07, p < 0.001). CAVI was positively correlated with AAA diameter (r = 0.461, p < 0.001) and negatively correlated with left ventricle ejection fraction (r= -0.254, p = 0.015). CAVI >8.3 had a sensitivity 89.8% and a specificity of 78.1% for predicting the presence of AAA in ROC analysis (area under curve = 0.897, 95%CI = 0.816-0.951, p < 0.001). CONCLUSION CAVI is increased in patients with AAA. Increased arterial stiffness may be a mechanical link between AAA, coronary artery disease and peripheral artery disease or a common mechanism effects the arterial stiffness, coronary artery disease, peripheral artery disease and AAA. Therefore, CAVI may be used as a valuable marker for risk stratification for the development of AAA in susceptible patients.
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Affiliation(s)
- Ahmet Çağrı Aykan
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.,Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Mustafa Çetin
- Department of Cardiology, Faculty of Medicine, Rize Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ezgi Kalaycıoğlu
- Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Ümit Menteşe
- Department of Cardiovascular Surgery, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
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Kim HL, Joo HJ, Lim WH, Seo JB, Kim SH, Zo JH, Lim DS, Kim MA. Association Between Metabolic Syndrome and Parameters of Subclinical Target Organ Damage in Urban Subjects Without Documented Cardiovascular Disease. Metab Syndr Relat Disord 2020; 18:373-380. [PMID: 32721264 DOI: 10.1089/met.2020.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Identification of subclinical target organ damage (TOD) at early stage is important for the reduction in cardiovascular risk. This study was performed to assess the association between metabolic syndrome (MetS) and several types of TOD in urban people. Methods: Data from 958 Korean subjects without cardiovascular disease, living in Seoul city (mean age, 55.2 years, 47.6% males), were extracted from the prospective cohort database. All participants underwent extensive evaluation of TOD parameters, including left ventricular mass index (LVMI), E/e', brachial-ankle pulse wave velocity (baPWV), estimated glomerular filtration rate (eGFR), ankle-brachial index (ABI), carotid intima-media thickness (IMT), and obstructive coronary artery disease. Results: MetS and ≥1 TOD were detected in 494 (51.5%) and 329 (34.3%) subjects, respectively. There were no significant differences in the prevalence of ≥1 TOD according to the presence of MetS (P > 0.05). Among MetS components, only high blood pressure was associated with ≥1 TOD (69.6% vs. 59.9%, P = 0.004). There was a positive association between ≥1 TOD and the number of MetS traits (P = 0.034). There were significant linear correlations of Z-score of MetS with baPWV (r = 0.241, P < 0.001) and eGFR (r = -0.173, P < 0.001) but not with LVMI, E/e', ABI, and carotid IMT (P > 0.05 for each). Conclusions: In urban Korean population without cardiovascular disease, TOD is more closely related to the number of risk factors meeting MetS criteria and high blood pressure than the presence of MetS itself.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Hyung Joon Joo
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Do-Sun Lim
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea
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An LN, Rong N, Ning M, Feng LL, Chen ZH, Liu WQ, Ouyang XC, Diao FR, Han ZG, Hong J. High serum uric acid is associated with increased arterial stiffness in hypertension. Aging (Albany NY) 2020; 12:14569-14581. [PMID: 32701484 PMCID: PMC7425441 DOI: 10.18632/aging.103506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022]
Abstract
Serum uric acid level has been found to be associated with cerebrovascular diseases. However, whether serum uric acid level is a risk factor for arterial stiffness in the hypertension population is unclear. This study was designed to determine the relationship between serum uric acid level and arterial stiffness in the hypertension population. A total of 10450 participants were evaluated for the risk of arterial stiffness. Brachial-ankle pulse wave velocity (baPWV) was assessed, and high baPWV was determined as the highest quartile of baPWV values in a sex-specific manner. We evaluated the association between serum uric acid level and baPWV through multivariate-adjusted linear and logistic regression analyses. There was a significant difference on high baPWV between patients with quartiles of serum uric acid level in females and males (p<0.01), respectively. The odds ratios (95% CI) of the highest baPWV quartile across the sex-specific serum uric acid level were 1.0, 1.71 (1.35, 2.17), 1.75 (1.38, 2.23), and 1.95 (1.51, 2.51) in female, and 1.0, 1.33 (1.09, 1.64), 1.36 (1.11, 1.67), and 1.67 (1.36, 2.04) in male after adjusting for potential confounders. In conclusion, serum uric acid level could be considered as an important risk factor for arterial stiffness in Chinese hypertension population.
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Affiliation(s)
- Li-Na An
- Department of Geriatrics, Shanghai First People’s Hospital Affiliated to Nanjing Medical University, Shanghai 200080, China
- Department of Cardiology, Shidong Hospital of Shanghai Yangpu, Shanghai 200433, China
| | - Ning Rong
- Department of Neurology, School of Clinical Medicine, Dali University, YunNan 671000, China
| | - Min Ning
- Department of Geriatrics, Shanghai First People’s Hospital Affiliated to Nanjing Medical University, Shanghai 200080, China
| | - Liu-Liu Feng
- Department of Cardiology, Shidong Hospital of Shanghai Yangpu, Shanghai 200433, China
| | - Zhen-Han Chen
- Community Health Service Center, Shanghai 200435, China
| | - Wei-Qing Liu
- Community Health Service Center, Shanghai 201914, China
| | - Xiao-Chun Ouyang
- Department of Neurology, No.908 Hospital of the People's Liberation Army Joint Logistics Support Force, JiangXi 330000, China
| | - Fan-Rong Diao
- Department of Cardiology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
| | - Zhi-Gang Han
- Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Jiang Hong
- Department of Emergency, Shanghai First People's Hospital Affiliated to Nanjing Medical University, Shanghai 200080, China
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Steady-State Multifrequency Magnetic Resonance Elastography of the Thoracic and Abdominal Human Aorta-Validation and Reference Values. Invest Radiol 2020; 55:451-456. [PMID: 32520515 DOI: 10.1097/rli.0000000000000654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the potential of stroboscopic-wavefield-sampling-based multifrequency magnetic resonance elastography (sMRE) for quantifying the stiffness of the human thoracic and abdominal aorta in vivo. MATERIALS AND METHODS The sMRE of the thoracic and abdominal aorta was performed at 1.5 T field strength in 20 healthy volunteers aged 27 to 77 years (3 women; median age, 33 years; interquartile range [IQR], 16 years). Compound maps of shear wave speed (SWS) were reconstructed and evaluated during the diastolic phase in 3 anatomical regions: ascending thoracic aorta (AA), descending thoracic aorta (AD), and abdominal aorta (AAb). The SWS maps were read by 2 readers. Blood pressure and pulse wave velocity were determined noninvasively before sMRE. Data are given as median (IQR) and were compared using the Kruskal-Wallis and Wilcoxon rank sum tests. Intraclass correlation was used to determine interobserver and intraobserver agreement, as well as reproducibility. Multiple linear regression analysis was performed to evaluate effects of age, sex, vessel diameter, blood pressure, pulse wave velocity, and aortic segment on measured SWS. RESULTS All 20 participants underwent successful sMRE, resulting in a total of 60 aortic segments. The median SWS (IQR) of AA, AD, and AAb was 1.62 (0.16) m/s, 2.40 (0.24) m/s, and 2.48 (0.58) m/s, respectively. The SWS in AA was significantly lower (P < 0.001), and no differences in SWS (P = 0.67) were found between AD and AAb. Interobserver and intraobserver agreement, as well as reproducibility, was excellent, with intraclass correlation coefficients ranging between 0.957 and 0.998. A significant but weak influence of age on measured SWS was found, which increased from AA to AD and AAb (R = 0.229, 0.275, 0.377, respectively; P = 0.001-0.005). CONCLUSIONS Quantification of aortic stiffness in different segments of the human aorta is possible with sMRE. Our results correlate well with known aortic stiffness differences in different anatomical locations and demonstrate the potential of sMRE for clinical stiffness measurement of the thoracoabdominal aorta, which may allow detection of physiological variation and cardiovascular diseases.
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Liberale L, Camici GG. The Role of Vascular Aging in Atherosclerotic Plaque Development and Vulnerability. Curr Pharm Des 2020; 25:3098-3111. [PMID: 31470777 DOI: 10.2174/1381612825666190830175424] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 08/24/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND The ongoing demographical shift is leading to an unprecedented aging of the population. As a consequence, the prevalence of age-related diseases, such as atherosclerosis and its thrombotic complications is set to increase in the near future. Endothelial dysfunction and vascular stiffening characterize arterial aging and set the stage for the development of cardiovascular diseases. Atherosclerotic plaques evolve over time, the extent to which these changes might affect their stability and predispose to sudden complications remains to be determined. Recent advances in imaging technology will allow for longitudinal prospective studies following the progression of plaque burden aimed at better characterizing changes over time associated with plaque stability or rupture. Oxidative stress and inflammation, firmly established driving forces of age-related CV dysfunction, also play an important role in atherosclerotic plaque destabilization and rupture. Several genes involved in lifespan determination are known regulator of redox cellular balance and pre-clinical evidence underlines their pathophysiological roles in age-related cardiovascular dysfunction and atherosclerosis. OBJECTIVE The aim of this narrative review is to examine the impact of aging on arterial function and atherosclerotic plaque development. Furthermore, we report how molecular mechanisms of vascular aging might regulate age-related plaque modifications and how this may help to identify novel therapeutic targets to attenuate the increased risk of CV disease in elderly people.
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Affiliation(s)
- Luca Liberale
- Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, CH-8952 Schlieren, Switzerland
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, CH-8952 Schlieren, Switzerland.,University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland.,Department of Research and Education, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland
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Maimaitiaili R, Teliewubai J, Zhao S, Tang J, Chi C, Zhang Y, Xu Y. Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study. Clin Interv Aging 2020; 15:853-863. [PMID: 32606625 PMCID: PMC7283487 DOI: 10.2147/cia.s248816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/05/2020] [Indexed: 01/19/2023] Open
Abstract
Purpose There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship. Materials and Methods In this study, 3363 older participants (43.6% male, aged 71.1±5.9 years; 56.4% female, aged 71.1±6.1 years) derived from the Northern Shanghai Study were enrolled. Vascular aging criteria included arteriosclerosis, defined as carotid-femoral pulse wave velocity >10 m/s or brachial-ankle pulse wave velocity >1800 cm/s, and peripheral atherosclerosis, defined as ankle-brachial index <0.9, carotid artery intima-media thickness (cIMT) greater than 0.9 mm, or carotid plaque indicating carotid artery abnormality. Micro-albuminuria was defined as urinary albumin-to-creatinine ratio >30 mg/g. Decreased estimated glomerular filtration rate (eGFR) was defined as eGFR <60 mL/min/1.73 m2. Results When vascular aging parameters were respectively adjusted for age and sex, arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis were significantly associated with concentric remodeling, eccentric LV hypertrophy (LVH), and concentric LVH (P<0.045) but not with decreased eGFR or abnormal cIMT and presence of plaque. Peripheral atherosclerosis was strongly associated with LV concentric geometry (LVCG) when considering other covariates (risk factors, diseases, and treatments) (P<0.012). Conclusion Vascular aging parameters such as arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis are significantly and independently associated with LVCG in community-dwelling older Chinese population, suggesting the importance of vascular aging during early clinical assessment of abnormal LV geometry change and serious cardiovascular events.
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Affiliation(s)
- Rusitanmujiang Maimaitiaili
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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Abstract
PURPOSE To review the recent developments on the effect of chronic high mean arterial blood pressure (MAP) on cerebral blood flow (CBF) autoregulation and supporting the notion that CBF autoregulation impairment has connection with chronic cerebral diseases. Method: A narrative review of all the relevant papers known to the authors was conducted. Results: Our understanding of the connection between cerebral perfusion impairment and chronic high MAP and cerebral disease is rapidly evolving, from cerebral perfusion impairment being the result of cerebral diseases to being the cause of cerebral diseases. We now better understand the intertwined impact of hypertension and Alzheimer's disease (AD) on cerebrovascular sensory elements and recognize cerebrovascular elements that are more vulnerable to these diseases. Conclusion: We conclude with the suggestion that the sensory elements pathology plays important roles in intertwined mechanisms of chronic high MAP and AD that impact cerebral perfusion.
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Affiliation(s)
- Noushin Yazdani
- College of Public Health, University of South Florida , Tampa, FL, USA
| | - Mark S Kindy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida , Tampa, FL, USA.,Biomedical Research, James A. Haley VA Medical Center , Tampa, FL, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida , Tampa, FL, USA.,Byrd Neuroscience Institute, University of South Florida , Tampa, FL, USA
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Large-Artery Stiffness in Health and Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 74:1237-1263. [PMID: 31466622 DOI: 10.1016/j.jacc.2019.07.012] [Citation(s) in RCA: 478] [Impact Index Per Article: 119.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 12/27/2022]
Abstract
A healthy aorta exerts a powerful cushioning function, which limits arterial pulsatility and protects the microvasculature from potentially harmful fluctuations in pressure and blood flow. Large-artery (aortic) stiffening, which occurs with aging and various pathologic states, impairs this cushioning function, and has important consequences on cardiovascular health, including isolated systolic hypertension, excessive penetration of pulsatile energy into the microvasculature of target organs that operate at low vascular resistance, and abnormal ventricular-arterial interactions that promote left ventricular remodeling, dysfunction, and failure. Large-artery stiffness independently predicts cardiovascular risk and represents a high-priority therapeutic target to ameliorate the global burden of cardiovascular disease. This paper provides an overview of key physiologic and biophysical principles related to arterial stiffness, the impact of aortic stiffening on target organs, noninvasive methods for the measurement of arterial stiffness, mechanisms leading to aortic stiffening, therapeutic approaches to reduce it, and clinical applications of arterial stiffness measurements.
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