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Cunha LF, Santos RB, Giatti S, Parise BK, Aielo AN, Silva WA, Souza SP, Bortolotto LA, Lotufo PA, Bensenor IM, Drager LF. Gender Modulated the Association of Sleep Apnea and Sleep Duration with Arterial Stiffness: The ELSA-Brasil Study. Angiology 2024; 75:976-984. [PMID: 37688484 DOI: 10.1177/00033197231193618] [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] [Indexed: 09/11/2023]
Abstract
Increased arterial stiffness is independently associated with cardiovascular risk. Obstructive sleep apnea (OSA) and sleep duration (SDUR) may contribute to increased arterial stiffness, but it is unclear whether this association is modulated by gender. We aimed to evaluate the potential impact of gender in modulating the association of OSA and SDUR with arterial stiffness. Participants from the ELSA-Brasil study performed sleep assessments with portable polygraph to define OSA severity and SDUR by 1-week wrist actigraphy. Pulse wave velocity (PWV) was measured using a standard technique without access to the sleep data. We studied 1863 participants (42.2% male, age: 49±8 years, respiratory disturbance index (RDI): 9.9 (4.5-19.4) events/h, SDUR: 6.5 (5.9-7.1) hours, mean PWV: 7.3 ± 1.2 m/s). We found that men had higher PWV, higher frequency of diabetes, and higher blood pressure when compared to women. The regression analysis showed an independent association between increased RDI and PWV in men (ß: 0.007; 95% CI: 0.001-0.012), but not in women. In contrast, an independent association between SDUR and increased arterial stiffness was observed only in women (ß: 0.068; 95% CI: 0.002-0.134). In conclusion, the association of sleep disorders with arterial stiffness showed a distinct gender pattern depending on the sleep variable studied.
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Affiliation(s)
- Lorenna F Cunha
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ronaldo B Santos
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor) do Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Soraya Giatti
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Barbara K Parise
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Aline N Aielo
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Wagner A Silva
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor) do Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Silvana P Souza
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor) do Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Luiz A Bortolotto
- Unidade de Hipertensão, Instituto do Coração (InCor) do Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
| | - Luciano F Drager
- Center of Clinical and Epidemiologic Research (CPCE), University of Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor) do Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Khanmohammadi M, Danish H, Sekar NC, Suarez SA, Chheang C, Peter K, Khoshmanesh K, Baratchi S. Cyclic stretch enhances neutrophil extracellular trap formation. BMC Biol 2024; 22:209. [PMID: 39289752 PMCID: PMC11409804 DOI: 10.1186/s12915-024-02009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/05/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Neutrophils, the most abundant leukocytes circulating in blood, contribute to host defense and play a significant role in chronic inflammatory disorders. They can release their DNA in the form of extracellular traps (NETs), which serve as scaffolds for capturing bacteria and various blood cells. However, uncontrolled formation of NETs (NETosis) can lead to excessive activation of coagulation pathways and thrombosis. Once neutrophils are migrated to infected or injured tissues, they become exposed to mechanical forces from their surrounding environment. However, the impact of transient changes in tissue mechanics due to the natural process of aging, infection, tissue injury, and cancer on neutrophils remains unknown. To address this gap, we explored the interactive effects of changes in substrate stiffness and cyclic stretch on NETosis. Primary neutrophils were cultured on a silicon-based substrate with stiffness levels of 30 and 300 kPa for at least 3 h under static conditions or cyclic stretch levels of 5% and 10%, mirroring the biomechanics of aged and young arteries. RESULTS Using this approach, we found that neutrophils are sensitive to cyclic stretch and that increases in stretch intensity and substrate stiffness enhance nuclei decondensation and histone H3 citrullination (CitH3). In addition, stretch intensity and substrate stiffness promote the response of neutrophils to the NET-inducing agents phorbol 12-myristate 13-acetate (PMA), adenosine triphosphate (ATP), and lipopolysaccharides (LPS). Stretch-induced activation of neutrophils was dependent on calpain activity, the phosphatidylinositol 3-kinase (PI3K)/focal adhesion kinase (FAK) signalling and actin polymerization. CONCLUSIONS In summary, these results demonstrate that the mechanical forces originating from the surrounding tissue influence NETosis, an important neutrophil function, and thus identify a potential novel therapeutic target.
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Affiliation(s)
- Manijeh Khanmohammadi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Habiba Danish
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nadia Chandra Sekar
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | - Chanly Chheang
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Karlheinz Peter
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Khashayar Khoshmanesh
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- School of Engineering, RMIT University, Melbourne, VIC, Australia
| | - Sara Baratchi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia.
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3
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Triantafyllias K, Liverakos S, Muthuraman M, Cavagna L, Parodis I, Schwarting A. Cardiovascular Risk Evaluation in Psoriatic Arthritis by Aortic Stiffness and the Systemic Coronary Risk Evaluation (SCORE): Results of the Prospective PSOCARD Cohort Study. Rheumatol Ther 2024; 11:897-911. [PMID: 38819779 PMCID: PMC11265042 DOI: 10.1007/s40744-024-00676-z] [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: 02/08/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is associated with increased cardiovascular (CV) risk and mortality. Aortic stiffness measured by carotid-femoral pulse wave velocity (cfPWV) has been shown to predict CV risk in the general population. The present study aimed to examine cfPWV values of patients with PsA compared to healthy controls and to evaluate associations of cfPWV with patient- and disease-associated characteristics, as well as with an established traditional CV prediction score of the European Society of Cardiology (Systemic Coronary Risk Evaluation; SCORE), for the first time. METHODS cfPWV and SCORE were evaluated in patients with PsA and healthy controls, along with clinical and laboratory disease parameters. Differences in cfPWV measurements between the two groups and associations of cfPWV with patient- and disease-associated characteristics were statistically evaluated. RESULTS A total of 150 patients with PsA (PSOCARD cohort) and 88 control subjects were recruited. cfPWV was significantly higher in the PsA group compared to controls, even after adjustment for confounders (padj = 0.034). Moreover, cfPWV was independently associated with disease duration (r = 0.304, p = 0.001), age (rho = 0.688, p < 0.001), systolic arterial pressure (rho = 0.351, p < 0.001), glomerular filtration rate (inverse: rho = - 0.264, p = 0.001), and red cell distribution width, a marker of major adverse CV events (MACE) (rho = 0.190, p = 0.02). SCORE revealed an elevated CV risk in 8.73% of the patients, whereas cfPWV showed increased aortic stiffness and end-organ disease in 16.00% of the same cohort. CONCLUSIONS In the largest cfPWV/PsA cohort examined to date, patients with PsA exhibited increased aortic stiffness compared to healthy controls. PsA duration was the most important independent disease-associated predictor of increased aortic stiffness, next to traditional CV risk factors. cfPWV measurements may help identify subclinical end-organ disease and abnormal aortic stiffness and thus assist CV risk classification in PsA.
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Affiliation(s)
- Konstantinos Triantafyllias
- Rheumatology Center Rhineland-Palatinate, Bad Kreuznach, Germany
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | | | | | - Lorenzo Cavagna
- University and IRCCS Policlinic S. Matteo Foundation, Pavia, Italy
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Andreas Schwarting
- Rheumatology Center Rhineland-Palatinate, Bad Kreuznach, Germany.
- Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
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McNally RJ, Boguslavskyi A, Malek R, Floyd CN, Cecelja M, Douiri A, Bruno RM, Farukh B, Chowienczyk P, Faconti L. Influence of Blood Pressure Reduction on Pulse Wave Velocity in Primary Hypertension: A Meta-Analysis and Comparison With an Acute Modulation of Transmural Pressure. Hypertension 2024; 81:1619-1627. [PMID: 38721709 PMCID: PMC11177599 DOI: 10.1161/hypertensionaha.123.22436] [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: 11/20/2023] [Accepted: 03/15/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Increased arterial stiffness and pulse wave velocity (PWV) of the aorta and large arteries impose adverse hemodynamic effects on the heart and other organs. Antihypertensive treatment reduces PWV, but it is unknown whether this results from an unloading of stiffer elements in the arterial wall or is due to an alternate functional or structural change that might differ according to class of antihypertensive drug. METHODS We performed a systematic review and meta-analysis of the effects of different antihypertensive drug classes and duration of treatment on PWV with and without adjustment for change in mean arterial blood pressure (BP; study 1) and compared this to the change in PWV after an acute change in transmural pressure, simulating an acute change in BP (study 2). RESULTS A total of 83 studies involving 6200 subjects were identified. For all drug classes combined, the reduction of PWV was 0.65 (95% CI, 0.46-0.83) m/s per 10 mm Hg reduction in mean arterial BP, a change similar to that induced by an acute change in transmural pressure in a group of hypertensive subjects. When adjusted for change in mean arterial BP, the reduction in PWV after treatment with beta-blockers or diuretics was less than that after treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists or calcium channel antagonists. CONCLUSIONS Reduction in PWV after antihypertensive treatment is largely explained by the reduction in BP, but there are some BP-independent effects. These might increase over time and contribute to better outcomes over the long term, but this remains to be demonstrated in long-term clinical trials.
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Affiliation(s)
- Ryan J. McNally
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
| | - Andrii Boguslavskyi
- Cardiac Outpatient Department, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom (A.B.)
| | - Rayka Malek
- King’s College London, School of Life Course and Population Sciences, United Kingdom (R.M., A.D.)
| | - Christopher N. Floyd
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
| | - Marina Cecelja
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
| | - Abdel Douiri
- King’s College London, School of Life Course and Population Sciences, United Kingdom (R.M., A.D.)
| | - Rosa-Maria Bruno
- Université Paris Cité, INSERM U970 Team 7, Paris Cardiovascular Research Centre – PARCC, France (R.-M.B.)
| | - Bushra Farukh
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
| | - Phil Chowienczyk
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
| | - Luca Faconti
- King’s College London, Department of Vascular Risk and Surgery, British Heart Foundation Centre, United Kingdom (R.J.M., C.N.F., M.C., B.F., P.C., L.F.)
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Yoo TK, Lee SW, Lee MY, Choi H, Sung KC. Influence of MAFLD and NAFLD on arterial stiffness: A longitudinal cohort study. Nutr Metab Cardiovasc Dis 2024; 34:1769-1778. [PMID: 38644081 DOI: 10.1016/j.numecd.2024.03.008] [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: 01/01/2024] [Revised: 02/20/2024] [Accepted: 03/07/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND AIMS This cohort study investigated associations of nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) with risk of increase in arterial stiffness (AS), measured as brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS Participants who had health examinations between 2006 and 2019 were analyzed for fatty liver and increased baPWV using liver ultrasonography and automatic volume plethysmography device. Participants were classified based on presence of MAFLD or NAFLD and further divided into subgroups: no fatty liver disease (reference), NAFLD-only, MAFLD-only, and both NAFLD and MAFLD. Subgroups were additionally stratified by sex. Cox proportional hazard model was utilized to analyze the risk of developing baPWV ≥1400 cm/s in participants without baseline elevation of the baPWV. The NAFLD and MAFLD groups exhibited higher risks of increased baPWV (NAFLD: adjusted hazard ratio (aHR), 1.35 [95% CI, 1.29-1.42]; MAFLD: aHR, 1.37 [95% CI, 1.31-1.43]) compared to group without the conditions. Incidence of NAFLD or MAFLD were higher in men than in women but aHR of developing the increase in AS was higher in women. In subgroup analysis, the MAFLD-only group presented the strongest associations with increase in AS (aHR, 1.53 [95% CI, 1.43-1.64]), with the trend more pronounced in women than in men (Women, aHR, 1.63 [95% CI, 1.08-2.46]; Men, aHR 1.45 [95% CI, 1.35-1.56]). CONCLUSIONS Both NAFLD and MAFLD are significantly associated with elevated AS. These associations tended to be stronger in MAFLD than in NAFLD, in women than in men.
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Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center, Framingham, MA, USA
| | - Seung Wook Lee
- Department of Medicine, MetroWest Medical Center, Framingham, MA, USA
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hanna Choi
- Walgreens Pharmacy, #6072, Bonston, MA, USA
| | - Ki-Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Georgiopoulos G, Faconti L, Mohamed AT, Figliozzi S, Asher C, Keehn L, McNally R, Alfakih K, Vennin S, Chiribiri A, Lamata P, Chowienczyk P, Masci PG. Ethnicity differences in geometric remodelling and myocardial composition in hypertension unveiled by cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging 2024; 25:901-911. [PMID: 38597630 PMCID: PMC11210986 DOI: 10.1093/ehjci/jeae097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/11/2024] Open
Abstract
AIMS Hypertensive patients of African ancestry (Afr-a) have higher incidences of heart failure and worse clinical outcomes than hypertensive patients of European ancestry (Eu-a), yet the underlying mechanisms remain misunderstood. This study investigated right (RV) and left (LV) ventricular remodelling alongside myocardial tissue derangements between Afr-a and Eu-a hypertensives. METHODS AND RESULTS 63 Afr-a and 47 Eu-a hypertensives underwent multi-parametric cardiovascular magnetic resonance. Biventricular volumes, mass, function, mass/end-diastolic volume (M/V) ratios, T2 and pre-/post-contrast T1 relaxation times, synthetic extracellular volume, and myocardial fibrosis (MF) were measured. 3D shape modelling was implemented to delineate ventricular geometry. LV and RV mass (indexed to body-surface-area) and M/V ratio were significantly greater in Afr-a than Eu-a hypertensives (67.1 ± 21.7 vs. 58.3 ± 16.7 g/m2, 12.6 ± 3.48 vs. 10.7 ± 2.71 g/m2, 0.79 ± 0.21 vs. 0.70 ± 0.14 g/mL, and 0.16 ± 0.04 vs. 0.13 ± 0.03 g/mL, respectively; P < 0.03). Afr-a patients showed greater basal interventricular septum thickness than Eu-a patients, influencing LV hypertrophy and RV cavity changes. This biventricular remodelling was associated with prolonged T2 relaxation time (47.0 ± 2.2 vs. 45.7 ± 2.2 ms, P = 0.005) and higher prevalence (23% vs. 4%, P = 0.001) and extent of MF [2.3 (0.6-14.3) vs. 1.6 (0.9-2.5) % LV mass, P = 0.008] in Afr-a patients. Multivariable linear regression showed that modifiable cardiovascular risk factors and greater end-diastolic volume, but not ethnicity, were independently associated with greater LV mass. CONCLUSION Afr-a hypertensives had distinctive biventricular remodelling, including increased RV mass, septal thickening and myocardial tissue abnormalities compared with Eu-a hypertensives. From this study, modifiable cardiovascular risk factors and ventricular geometry, but not ethnicity, were independently associated with greater LV myocardial mass.
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Affiliation(s)
- Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Luca Faconti
- British Heart Foundation Centre, Department of Clinical Pharmacology, King’s College London, St Thomas’ Hospital, London, UK
| | - Aqeel T Mohamed
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
- GKT School of Medical Education, King’s College London, London, UK
| | - Stefano Figliozzi
- Cardio Center, Humanitas Research Hospital I.R.C.S.S., Rozzano, Milan, Italy
| | - Clint Asher
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
| | - Louise Keehn
- British Heart Foundation Centre, Department of Clinical Pharmacology, King’s College London, St Thomas’ Hospital, London, UK
| | - Ryan McNally
- British Heart Foundation Centre, Department of Clinical Pharmacology, King’s College London, St Thomas’ Hospital, London, UK
| | - Khaled Alfakih
- Department of Cardiology, Lewisham and Greenwich NHS Trust, London, UK
| | - Samuel Vennin
- British Heart Foundation Centre, Department of Clinical Pharmacology, King’s College London, St Thomas’ Hospital, London, UK
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
| | - Pablo Lamata
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
| | - Philip Chowienczyk
- British Heart Foundation Centre, Department of Clinical Pharmacology, King’s College London, St Thomas’ Hospital, London, UK
| | - Pier-Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, Room ST0404253 4th Floor Lambeth Wing, St Thomas’ Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
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Gasparotto M, Di Pierro G, Toffoli B, Grillo A, Bressan M, Fiorentin M, Di Luozzo L, Fischetti F, Zen M, Fabris B, Bernardi S, Tomietto P. Preliminary Study on Pulse Wave Changes in Patients with Inflammatory Arthropathies Treated with bDMARDs. J Clin Med 2024; 13:2684. [PMID: 38731213 PMCID: PMC11084438 DOI: 10.3390/jcm13092684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Patients with inflammatory arthropathies exhibit an increased cardiovascular disease (CVD) risk as compared to the general population, which is not fully quantified by the conventional CVD risk scores. Biotechnological disease-modifying drugs (bDMARDs) have proved beneficial to reduce the overall CVD risk in these patients, although CVD remains a major cause of increased mortality. Since it has been shown that pulse wave parameters and in particular carotid-femoral pulse wave velocity (cfPWV) are predictors of CVD risk, the aim of this study was to evaluate their changes in patients with inflammatory arthropathies before and after bDMARD therapy. Methods: Pulse wave parameters were evaluated with applanation tonometry in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and rheumatoid arthritis (RA), before and after two years of bDMARD therapy. Results: At baseline, cfPWV was significantly associated with age (p < 0.001) and, among pulse wave parameters, the subendocardial viability ratio was negatively associated with C-reactive protein (CRP) (p = 0.04) and the HAQ-disability index (p = 0.03). At baseline, PsA patients showed a higher percentage of male subjects, higher CRP, and the highest cfPWV values (p = 0.048). After two years, pulse wave parameters improved in the AS and RA groups, but not in the PsA group. Conclusions: Our data confirm that pulse wave parameters are potentially reversible after bDMARD therapy, as they improved in AS and RA patients. In PsA patients, there were no changes, which may be due to the higher percentage of male subjects and higher baseline cfPWV values.
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Affiliation(s)
- Michela Gasparotto
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medicine, Padua University Hospital, University of Padua, 35122 Padova, Italy;
| | - Giuliano Di Pierro
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Barbara Toffoli
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Andrea Grillo
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Marco Bressan
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Marco Fiorentin
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Lorenzo Di Luozzo
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Fabio Fischetti
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Margherita Zen
- Department of Medicine, Padua University Hospital, University of Padua, 35122 Padova, Italy;
| | - Bruno Fabris
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Stella Bernardi
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
- Department of Medical Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (G.D.P.); (B.T.); (M.B.); (M.F.); (L.D.L.)
| | - Paola Tomietto
- UCO Medicina Clinica, ASUGI, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy; (M.G.); (A.G.); (F.F.) (B.F.); (P.T.)
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Mu Y, Yang Y, Jiang S, Liu C, Han Y, Jiang J, Wang Y. Benefits of Puerarin on Metabolic Syndrome and Its Associated Cardiovascular Diseases in Rats Fed a High-Fat/High-Sucrose Diet. Nutrients 2024; 16:1273. [PMID: 38732519 PMCID: PMC11085683 DOI: 10.3390/nu16091273] [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: 03/11/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases (CVDs) that has become a global public health problem. Puerarin (PUE), the principal active compound of Pueraria lobata, has the effects of regulating glucose and lipid metabolism and protecting against cardiovascular damage. This study aimed to investigate whether dietary supplementation with PUE could ameliorate MetS and its associated cardiovascular damage. Rats were randomly divided into three groups: the normal diet group (NC), the high-fat/high-sucrose diet group (HFHS), and the HFHS plus PUE diet group (HFHS-PUE). The results showed that PUE-supplemented rats exhibited enhanced glucose tolerance, improved lipid parameters, and reduced blood pressure compared to those on the HFHS diet alone. Additionally, PUE reversed the HFHS-induced elevations in the atherogenic index (AI) and the activities of serum lactate dehydrogenase (LDH) and creatine kinase (CK). Ultrasonic evaluations indicated that PUE significantly ameliorated cardiac dysfunction and arterial stiffness. Histopathological assessments further confirmed that PUE significantly mitigated cardiac remodeling, arterial remodeling, and neuronal damage in the brain. Moreover, PUE lowered systemic inflammatory indices including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). In conclusion, dietary supplementation with PUE effectively moderated metabolic disorders, attenuated systemic inflammation, and minimized cardiovascular damage in rats with MetS induced by an HFHS diet. These results provide novel insights into the potential benefits of dietary PUE supplementation for the prevention and management of MetS and its related CVDs.
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Affiliation(s)
| | | | | | | | | | - Jiandong Jiang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yuhong Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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9
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Evangelatos G, Konstantonis G, Tentolouris N, Sfikakis PP, Tektonidou MG. Arterial stiffness tested by pulse wave velocity and augmentation index for cardiovascular risk stratification in antiphospholipid syndrome. Rheumatology (Oxford) 2024; 63:1030-1038. [PMID: 37294733 PMCID: PMC10986810 DOI: 10.1093/rheumatology/kead267] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/06/2023] [Accepted: 05/26/2023] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVES Cardiovascular disease is a major cause of morbidity and mortality in Antiphospholipid syndrome (APS). Arterial stiffness (ArS) has emerged as a predictor of future cardiovascular events in the general population. We aimed to assess ArS in patients with thrombotic APS versus diabetes mellitus (DM) and healthy controls (HC) and identify predictors of increased ArS in APS. METHODS ArS was evaluated by carotid-femoral pulse wave velocity (cfPWV) and augmentation index normalized to 75 beats/min (AIx@75) using the SphygmoCor device. Participants also underwent carotid/femoral ultrasound for atherosclerotic plaque detection. We used linear regression to compare ArS measures among groups and assess ArS determinants in the APS group. RESULTS We included 110 patients with APS (70.9% female, mean age 45.4 years), 110 DM patients and 110 HC, all age/sex matched. After adjustment for age, sex, cardiovascular risk factors and plaque presence, APS patients exhibited similar cfPWV [β = -0.142 (95% CI -0.514, 0.230), p = 0.454] but increased AIx@75 [β = 4.525 (95% CI 1.372, 7.677), p = 0.005] compared with HC and lower cfPWV (p < 0.001) but similar AIx@75 (p = 0.193) versus DM patients. In the APS group, cfPWV was independently associated with age [β = 0.056 (95% CI 0.034, 0.078), p < 0.001], mean arterial pressure (MAP) [β = 0.070 (95% CI 0.043, 0.097), p < 0.001], atherosclerotic femoral plaques [β = 0.732 (95% CI 0.053, 1.411), p = 0.035] and anti-β2-glycoprotein I IgM positivity [β = 0.696 (95% CI 0.201, 1.191), p = 0.006]. AIx@75 was associated with age [β = 0.334 (95% CI 0.117, 0.551), p = 0.003], female sex [β = 7.447 (95% CI 2.312, 12.581), p = 0.005] and MAP [β = 0.425 (95% CI 0.187, 0.663), p = 0.001]. CONCLUSION APS patients exhibit elevated AIx@75 vs HC and similar to DM patients, indicating enhanced arterial stiffening in APS. Given its prognostic value, ArS evaluation may help to improve cardiovascular risk stratification in APS.
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Affiliation(s)
- Gerasimos Evangelatos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Konstantonis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Tektonidou
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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10
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Li L, Zhang J, Zhang X, Huo Z, Jiang J, Wu Y, Zhu C, Chen S, Du X, Li H, Wei X, Ji C, Wu S, Huang Z. Association of Cumulative Exposure to Cardiovascular Health Behaviors and Factors with the Onset and Progression of Arterial Stiffness. J Atheroscler Thromb 2024; 31:368-381. [PMID: 37926522 PMCID: PMC10999723 DOI: 10.5551/jat.64469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/10/2023] [Indexed: 11/07/2023] Open
Abstract
AIM This study aims to explore the association of cumulative exposure to cardiovascular health behaviors and factors with the onset and progression of arterial stiffness. METHODS In this study, 24,110 participants were examined from the Kailuan cohort, of which 11,527 had undergone at least two brachial-ankle pulse wave velocity (baPWV) measurements. The cumulative exposure to cardiovascular health behaviors and factors (cumCVH) was calculated as the sum of the cumCVH scores between two consecutive physical examinations, multiplied by the time interval between the two. A logistic regression model was constructed to evaluate the association of cumCVH with arterial stiffness. Generalized linear regression models were used to analyze how cumCVH affects baPWV progression. Moreover, a Cox proportional hazards regression model was used to analyze the effect of cumCVH on the risk of arterial stiffness. RESULTS In this study, participants were divided into four groups, according to quartiles of cumCVH exposure levels, namely, quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Logistic regression analysis showed that compared with the Q1 group, the incidence of arterial stiffness in terms of cumCVH among Q2, Q3, and Q4 groups decreased by 16%, 30%, and 39%, respectively. The results of generalized linear regression showed that compared with the Q1 group, the incidence of arterial stiffness in the Q3 and Q4 groups increased by -25.54 and -29.83, respectively. The results of Cox proportional hazards regression showed that compared with the Q1 group, the incidence of arterial stiffness in cumCVH among Q2, Q3, and Q4 groups decreased by 11%, 19%, and 22%, respectively. Sensitivity analyses showed consistency with the main results. CONCLUSIONS High cumCVH can delay the progression of arterial stiffness and reduce the risk of developing arterial stiffness.
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Affiliation(s)
- Liuxin Li
- Department of Cardiology, Kailuan Hospital, Tangshan, China
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jingdi Zhang
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Xiaoxue Zhang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Zhenyu Huo
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jinguo Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Chenrui Zhu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xin Du
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Huiying Li
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiaoming Wei
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Chunpeng Ji
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Zhe Huang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
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11
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Miao R, Dong Q, Liu X, Chen Y, Wang J, Chen J. A cost-effective, machine learning-driven approach for screening arterial functional aging in a large-scale Chinese population. Front Public Health 2024; 12:1365479. [PMID: 38572001 PMCID: PMC10987946 DOI: 10.3389/fpubh.2024.1365479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/23/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction An easily accessible and cost-free machine learning model based on prior probabilities of vascular aging enables an application to pinpoint high-risk populations before physical checks and optimize healthcare investment. Methods A dataset containing questionnaire responses and physical measurement parameters from 77,134 adults was extracted from the electronic records of the Health Management Center at the Third Xiangya Hospital. The least absolute shrinkage and selection operator and recursive feature elimination-Lightweight Gradient Elevator were employed to select features from a pool of potential covariates. The participants were randomly divided into training (70%) and test cohorts (30%). Four machine learning algorithms were applied to build the screening models for elevated arterial stiffness (EAS), and the performance of models was evaluated by calculating the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Results Fourteen easily accessible features were selected to construct the model, including "systolic blood pressure" (SBP), "age," "waist circumference," "history of hypertension," "sex," "exercise," "awareness of normal blood pressure," "eat fruit," "work intensity," "drink milk," "eat bean products," "smoking," "alcohol consumption," and "Irritableness." The extreme gradient boosting (XGBoost) model outperformed the other three models, achieving AUC values of 0.8722 and 0.8710 in the training and test sets, respectively. The most important five features are SBP, age, waist, history of hypertension, and sex. Conclusion The XGBoost model ideally assesses the prior probability of the current EAS in the general population. The integration of the model into primary care facilities has the potential to lower medical expenses and enhance the management of arterial aging.
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Affiliation(s)
- Rujia Miao
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qian Dong
- School of Science, Hunan University of Technology and Business, Changsha, China
| | - Xuelian Liu
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yingying Chen
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiangang Wang
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianwen Chen
- School of Science, Hunan University of Technology and Business, Changsha, China
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12
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Katsuda SI, Horikoshi Y, Shiomi M, Kitajima S, Ito T, Hazama A, Shimizu T, Shirai K. Arterial stiffness of the aorta and iliofemoral artery and their responses to nitroglycerin administration in myocardial infarction-prone Watanabe heritable hyperlipidemic rabbits. J Hypertens 2024; 42:441-449. [PMID: 37937516 PMCID: PMC10842652 DOI: 10.1097/hjh.0000000000003608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES The role of hypercholesterolemia in arterial stiffness, which usually reflects the progression of atherosclerosis has not been fully investigated. To clarify the meaning of arterial stiffness in hypercholesterolemia, we evaluated arterial stiffness in myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits by using new arterial stiffness indices of the aorta and common iliac to femoral artery. The new arterial stiffness indices of both arteries were determined by the application of the theory of cardio-ankle vascular index (CAVI) to the aorta (aBeta) and ilio-femoral artery (ifBeta). Furthermore, the responses of both indices to nitroglycerin (NTG) administration were compared between WHHHMI and normal rabbits. DESIGN AND METHODS aBeta and ifBeta of WHHLMI and normal rabbits were measured under anesthesia. Pulse wave velocity in the whole aorta (aPWV) and ilio-femoral artery (ifPWV), blood pressure, and other parameters were measured before and after administration of NTG (50-120 μg/kg/min) every 1 for 5 min. RESULTS Atherosclerotic lesions were observed in the aorta, but a little in the ilio-femoral artery in WHHLMI rabbits. Compared with normal rabbits, aBeta was significantly higher, but ifBeta was lower in WHHLMI rabbits. When NTG was administered, ifBeta decreased significantly in both groups; however, aBeta increased in normal rabbits, but remained unchanged in WHHIMI rabbits. CONCLUSION These findings suggested that hereditary hypercholesterolemia in rabbits did not uniformly enhance arterial stiffness in elastic artery and muscular artery. The responses to NTG were also different between two arteries. The mechanism of these different responses needs further studies.
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Affiliation(s)
- Shin-ichiro Katsuda
- Department of Cellular and Integrative Physiology, Fukushima Medical University School of Medicine, 1 Hikari-ga-oka
| | - Yuko Horikoshi
- Division of Laboratory Medicine, Fukushima Medical University School of Health Sciences, Fukushima
| | - Masashi Shiomi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe
- Division of Biological Resources and Development, Analytical Research Center for Experimental Sciences, Saga University, Saga
| | - Shuji Kitajima
- Division of Biological Resources and Development, Analytical Research Center for Experimental Sciences, Saga University, Saga
| | - Toshiro Ito
- Department of Cellular and Integrative Physiology, Fukushima Medical University School of Medicine, 1 Hikari-ga-oka
| | - Akihiro Hazama
- Department of Cellular and Integrative Physiology, Fukushima Medical University School of Medicine, 1 Hikari-ga-oka
| | - Tsuyoshi Shimizu
- Shimizu Institute of Space Physiology, Suwa Maternity Clinic, Nagano
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13
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Petrova M, Li Y, Gholipour A, Kiat H, McLachlan CS. The influence of aortic stiffness on carotid stiffness: computational simulations using a human aorta carotid model. ROYAL SOCIETY OPEN SCIENCE 2024; 11:230264. [PMID: 38511082 PMCID: PMC10951721 DOI: 10.1098/rsos.230264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/11/2023] [Indexed: 03/22/2024]
Abstract
Increased aortic and carotid stiffness are independent predictors of adverse cardiovascular events. Arterial stiffness is not uniform across the arterial tree and its accurate assessment is challenging. The complex interactions and influence of aortic stiffness on carotid stiffness have not been investigated. The aim of this study was to evaluate the effect of aortic stiffness on carotid stiffness under physiological pressure conditions. A realistic patient-specific geometry was used based on magnetic resonance images obtained from the OsiriX library. The luminal aortic-carotid model was reconstructed from magnetic resonance images using 3D Slicer. A series of aortic stiffness simulations were performed at different regional aortic areas (levels). By applying variable Young's modulus to the aortic wall under two pulse pressure conditions, one could examine the deformation, compliance and von Mises stress between the aorta and carotid arteries. An increase of Young's modulus in an aortic area resulted in a notable difference in the mechanical properties of the aortic tree. Regional deformation, compliance and von Mises stress changes across the aorta and carotid arteries were noted with an increase of the aortic Young's modulus. Our results indicate that increased carotid stiffness may be associated with increased aortic stiffness. Large-scale clinical validation is warranted to examine the influence of aortic stiffness on carotid stiffness.
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Affiliation(s)
- Marjana Petrova
- Centre for Healthy Futures, Torrens University Australia Surrey Hills, New South Wales 2010, Australia
| | - Yujie Li
- Centre for Healthy Futures, Torrens University Australia Surrey Hills, New South Wales 2010, Australia
| | - Alireza Gholipour
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales 2006, Australia
| | - Hosen Kiat
- Centre for Healthy Futures, Torrens University Australia Surrey Hills, New South Wales 2010, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- School of Rural Medicine, University of New South Wales, New South Wales 2640, Australia
| | - Craig S. McLachlan
- Centre for Healthy Futures, Torrens University Australia Surrey Hills, New South Wales 2010, Australia
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14
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Hong S, Coté G. Arterial Pulse Wave Velocity Signal Reconstruction Using Low Sampling Rates. BIOSENSORS 2024; 14:92. [PMID: 38392011 PMCID: PMC10887207 DOI: 10.3390/bios14020092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/28/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Pulse Wave Velocity (PWV) analysis is valuable for assessing arterial stiffness and cardiovascular health and potentially for estimating blood pressure cufflessly. However, conventional PWV analysis from two transducers spaced closely poses challenges in data management, battery life, and developing the device for continuous real-time applications together along an artery, which typically need data to be recorded at high sampling rates. Specifically, although a pulse signal consists of low-frequency components when used for applications such as determining heart rate, the pulse transit time for transducers near each other along an artery takes place in the millisecond range, typically needing a high sampling rate. To overcome this issue, in this study, we present a novel approach that leverages the Nyquist-Shannon sampling theorem and reconstruction techniques for signals produced by bioimpedance transducers closely spaced along a radial artery. Specifically, we recorded bioimpedance artery pulse signals at a low sampling rate, reducing the data size and subsequently algorithmically reconstructing these signals at a higher sampling rate. We were able to retain vital transit time information and achieved enhanced precision that is comparable to the traditional high-rate sampling method. Our research demonstrates the viability of the algorithmic method for enabling PWV analysis from low-sampling-rate data, overcoming the constraints of conventional approaches. This technique has the potential to contribute to the development of cardiovascular health monitoring and diagnosis using closely spaced wearable devices for real-time and low-resource PWV assessment, enhancing patient care and cardiovascular disease management.
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Affiliation(s)
- Sungcheol Hong
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Gerard Coté
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
- Department of Electrical Engineering, Texas A&M University, College Station, TX 77843, USA
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experiment Station, Texas A&M University, College Station, TX 77843, USA
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15
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Takahashi T, Nakano H, Shiina K, Fujii M, Matsumoto C, Satomi K, Yamashina A, Tomiyama H, Chikamori T. Central Systolic Blood Pressure as a Risk Factor for Accelerated Progression of Arterial Stiffness. J Atheroscler Thromb 2024; 31:180-187. [PMID: 37612091 PMCID: PMC10857834 DOI: 10.5551/jat.64228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023] Open
Abstract
AIMS In the arterial tree, a pressure gradient of the systolic blood pressure (SBP) is observed from the center to the periphery, with the pressure being higher in the periphery because of pressure wave reflection. However, this gradient is attenuated, with elevation of the central SBP (cSBP), in cases with abnormal pressure wave reflection in the arterial tree. It remains unclear if increase of the cSBP might be an independent risk factor for accelerated progression of arterial stiffness. We conducted this prospective observational study using latent growth curve model (LGCM) analyses to examine if elevated cSBP might be an independent risk factor for accelerated progression of the arterial stiffness in middle-aged Japanese men. METHODS In this 9-year prospective observational study, we analyzed the data of 3862 middle-aged Japanese men (43±10years old) without cerebrocardiovascular disease at the study baseline who had undergone repeated annual measurements of the brachial-ankle pulse wave velocity (baPWV) and cSBP, as represented by the second peak of the radial pressure waveform (SBP2) in radial pressure waveform analysis. RESULTS During the follow-up period (6.3±2.5years), significant increases of both the baPWV and SBP2 were observed in all the subjects. Analysis using the LGCM confirmed that the SBP2, a marker of the cSBP (B=0.260, P<0.001), was a significant determinant of the slope of the annual changes of the baPWV during the study period. CONCLUSIONS Our finding may appear to confirm elevated cSBP as an independent risk factor for accelerated progression of the arterial stiffness in middle-aged Japanese men.
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Affiliation(s)
| | - Hiroki Nakano
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuki Shiina
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
- Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Tokyo, Japan
| | - Masatsune Fujii
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Chisa Matsumoto
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuhiro Satomi
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | | | - Hirofumi Tomiyama
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
- Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Tokyo, Japan
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16
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Can Y, Uçaroğlu Can N, Akçay Ç, Ulaş SB, Kocayiğit I, Kocayiğit H, Ağaç MT. Increased Cardio-ankle Vascular Index Values in Migraine Patients With Aura. Angiology 2024:33197241228043. [PMID: 38236077 DOI: 10.1177/00033197241228043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Patients with migraine with aura are at an increased risk of cardiovascular disease. There are limited data on arterial stiffness in migraine patients with aura. The present study evaluated arterial stiffness in these patients using the cardio-ankle vascular index (CAVI). This prospective study included 50 patients with migraine with aura (43 female, mean age 38.9 ± 9.9 years). The patient group was matched for age and gender with 50 healthy individuals with no history of migraine (43 female, mean age 39.3 ± 10.3 years). All patients and control subjects underwent a comprehensive clinical evaluation by an experienced neurologist and were interviewed about their headache histories. There was no significant difference in baseline demographic characteristics and echocardiographic parameters between migraine with aura patients and the control group. Both right and left CAVI values were significantly higher in the patients with migraine with aura (6.5 ± 1.2 vs 6.1 ± 0.7, P = .043 and 6.6 ± 1.2 vs 6.1 ± 0.7, P = .009, respectively). Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI, a novel marker of the arterial stiffness, is increased in patients with migraine with aura.
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Affiliation(s)
- Yusuf Can
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | - Nimet Uçaroğlu Can
- Department of Neurology, Training and Research Hospital, Sakarya University, Turkey
| | - Çağla Akçay
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | | | - Ibrahim Kocayiğit
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
| | - Havva Kocayiğit
- Department of Anaesthesiology and Reanimation, School of Medicine, Sakarya University, Turkey
| | - Mustafa Tarık Ağaç
- Department of Cardiology, School of Medicine, Sakarya University, Turkey
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17
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Aizawa K, Gates PE, Mawson DM, Casanova F, Gooding KM, Hope SV, Goncalves I, Nilsson J, Khan F, Colhoun HM, Natali A, Palombo C, Shore AC. Type 2 diabetes exacerbates changes in blood pressure-independent arterial stiffness: cross-sectional and longitudinal evidence from the SUMMIT study. J Appl Physiol (1985) 2024; 136:13-22. [PMID: 37969084 PMCID: PMC11208039 DOI: 10.1152/japplphysiol.00283.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 11/17/2023] Open
Abstract
Greater central artery stiffness is observed in people with type 2 diabetes (T2DM). Elevated blood pressure (BP) and altered arterial wall structure/composition in T2DM are generally considered as main drivers for this alteration. However, because conventional arterial stiffness measures are BP-dependent and as such an influence of BP remains in a measure, it is unclear if greater central artery stiffness is a function of greater BP, or due to changes in the structure and composition of the arterial wall. We aimed to measure BP-independent arterial stiffness (β0) cross-sectionally and longitudinally in T2DM. We studied 753 adults with T2DM (DM+) and 436 adults without (DM-) at baseline (Phase 1), and 310 DM+ and 210 DM- adults at 3-yr follow-up (Phase 2). We measured carotid-femoral pulse wave velocity and used it to calculate β0. In Phase 1, β0 was significantly greater in DM+ than DM- after adjusting for age and sex [27.5 (26.6-28.3) vs. 23.6 (22.4-24.8) au, P < 0.001]. Partial correlation analyses after controlling for age and sex showed that β0 was significantly associated with hemoglobin A1c (r = 0.15 P < 0.001) and heart rate [(HR): r = 0.23 P < 0.001)] in DM+. In Phase 2, percentage-change in β0 was significantly greater in DM+ than DM- [19.5 (14.9-24.0) vs. 5.0 (-0.6 to 10.6) %, P < 0.001] after adjusting for age, sex, and baseline β0. β0 was greater in DM+ than DM- and increased much more in DM+ than in DM- over 3 yr. This suggests that T2DM exacerbates BP-independent arterial stiffness and may have a complemental utility to existing arterial stiffness indices.NEW & NOTEWORTHY We demonstrate in this study a greater BP-independent arterial stiffness β0 in people with type 2 diabetes (T2DM) compared to those without, and also a greater change in β0 over 3 yr in people with T2DM than those without. These findings suggest that the intrinsic properties of the arterial wall may change in a different and more detrimental way in people with T2DM and likely represents accumulation of cardiovascular risk.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - David M Mawson
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Kim M Gooding
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Suzy V Hope
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
| | - Isabel Goncalves
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Faisel Khan
- Division of Systems Medicine, University of Dundee, Dundee, United Kingdom
| | - Helen M Colhoun
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Palombo
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
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18
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Sato S, Ito T, Tabata T, Ogawa A, Saiki A, Shimizu K. Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension. Front Cardiovasc Med 2023; 10:1325846. [PMID: 38107257 PMCID: PMC10722157 DOI: 10.3389/fcvm.2023.1325846] [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: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by organized pulmonary thrombi, and pulmonary endarterectomy is the only curative treatment. Since balloon pulmonary angioplasty (BPA) has become an established therapeutic option for inoperable CTEPH, prognosis has improved. Recent reports suggest that arterial stiffness evaluated using the cardio-ankle vascular index (CAVI) may play an important role in the cardio-vascular interaction in CTEPH; however, the details remain unclear. This study aimed to clarify the role of CAVI in CTEPH through hemodynamic changes and ventricular remodeling after BPA. Methods and results A total of 23 patients with CTEPH who had undergone BPA were enrolled in this study. The mean pulmonary artery pressure (mPAP) and CAVI significantly decreased after BPA [mPAP, 34 (26-45) mmHg to 20 (19-24) mmHg, p < 0.0001; CAVI, 9.4 (8.0-10.3) to 8.3 (7.5-9.6), p = 0.004]. The echocardiographic right ventricle was significantly decreased, and the left ventricular volume was significantly increased after BPA, indicating significant biventricular remodeling after BPA. Changes in CAVI (ΔCAVI) significantly correlated with changes in mPAP (r = 0.45, p = 0.03). Additionally, ΔCAVI was significantly correlated with changes in both right ventricular area and left ventricular volume. Conclusions Arterial stiffness, evaluated using the CAVI, improved after BPA. Changes in CAVI were significantly correlated with changes in pulmonary arterial pressure and biventricular remodeling. CAVI may play an important role in cardiovascular interactions in patients with CTEPH.
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Affiliation(s)
- Shuji Sato
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Takuro Ito
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Tsuyoshi Tabata
- Department of Clinical Functional Physiology, Toho University Sakura Medical Center, Chiba, Japan
| | - Akihiro Ogawa
- Department of Rehabilitation, Toho University Sakura Medical Center, Chiba, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan
| | - Kazuhiro Shimizu
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
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19
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Wang Q, Xu X, Geng X, Hu H, Cui W. Brachial-ankle pulse wave velocity increasing with heart rate accelerates. Front Cardiovasc Med 2023; 10:1280966. [PMID: 38028478 PMCID: PMC10652409 DOI: 10.3389/fcvm.2023.1280966] [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: 08/21/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Pulse wave velocity (PWV) indicates the degree of vascular stiffness. This study aimed to explore the association between heart rate (HR) and brachial-ankle (ba)-PWV in patients with pacemaker implantation. This retrospective observational study included patients who underwent permanent pacemaker implantation at the Second Hospital of Hebei Medical University between December 2018 and December 2021. All patients were pacemaker-dependent, and the ba-PWV values were collected during HR setted from 60 to 100 bpm. A total of 68 patients (34 males, aged 65.97 ± 9.90 years) were included in this study. There were significant difference of ba-PWV and diastolic blood pressure (DBP) among different HR (both P < 0.001). After adjusted systolic blood pressure (SBP), DBP, age, and sex, the generalized estimating equation showed ba-PWV was independently associated with HR, with increased HR showed higher coefficient: 70 bpm: β = 42.26 (95% CI: 15.34-69.18, P = 0.002), 80 bpm: β = 84.16 (95% CI: 52.48-115.84, P < 0.001), 90 bpm: β = 129.27 (95% CI: 52.48-115.84, P < 0.001), and 100 bpm: 186.31 (95% CI: 137.02-235.59, P < 0.001). The results demonstrate that changes in HR may affect the ba-PWV, the ba-PWV values tend to be higher when HR accelerates.
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Affiliation(s)
- Qian Wang
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinxin Xu
- Department of Cardiovascular Medicine, Cangzhou People’s Hospital, Cangzhou, China
| | - Xue Geng
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haijuan Hu
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Cui
- Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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20
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Lelis DDF, Cunha RS, Santos RD, Sposito AC, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Association Between Triglycerides, High-Density Lipoprotein Cholesterol, and Their Ratio With the Pulse Wave Velocity in Adults From the ELSA-Brasil Study. Angiology 2023; 74:822-831. [PMID: 35972851 DOI: 10.1177/00033197221121434] [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] [Indexed: 11/16/2022]
Abstract
Atherogenic dyslipidemia is a risk factor for cardiovascular diseases. The present study aimed to evaluate the association between triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the triglycerides to high-density lipoprotein (TG/HDL-C) ratio with carotid-femoral pulse wave velocity (cf-PWV), a marker of vascular stiffness. Anthropometric, biochemical, and clinical data from 13,732 adults were used to assess this association. Individuals within the third TG/HDL-C tertile presented worse anthropometric, biochemical, and clinical profiles as compared with the participants in the lower TG/HDL-C tertile. There was a linear association between TG, HDL-C, and TG/HDL-C ratio and cf-PWV in both men and women (stronger in women). After adjustment for confounders, lower levels of HDL-C were associated with increased cf-PWV in men (9.63 ± .02 m/s) and women (8.90 ± .03 m/s). However, TG was not significantly associated with cf-PWV after adjustment, regardless of sex. An increased TG/HDL-C ratio is associated with higher cf-PWV only in women (9.01 ± .03 m/s), but after adjustment for HDL-C levels, the association was non-significant (8.99 ± .03 m/s). These results highlight the stronger association of HDL-C with arterial stiffness, and that the association of TG/HDL-C with cf-PWV is dependent on HDL-C.
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Affiliation(s)
- Deborah de Farias Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Raul D Santos
- Lipid Clinic Heart Institute (Incor) University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | | | - Maria Inês Schmidt
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruce B Duncan
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
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21
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Chen S, Zhou K, Shang H, Du M, Wu L, Chen Y. Effects of concurrent aerobic and resistance training on vascular health in type 2 diabetes: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1216962. [PMID: 37780628 PMCID: PMC10534066 DOI: 10.3389/fendo.2023.1216962] [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: 05/04/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To determine the impacts of concurrent aerobic and resistance training on vascular structure (IMT) and function (PWV, FMD, NMD) in type 2 diabetes (T2D). Methods The electronic databases PubMed, Web of Science Core Collection, Cochrane Library, Embase, Scopus, CINAHL, and SPORTDiscus were systematically searched for articles on "type 2 diabetes" and "concurrent training" published from inception to August 2, 2022. We included randomized controlled trials that examined the effects of concurrent training versus passive controls on IMT, PWV, FMD and NMD in T2D. Results Ten studies were eligible, including a total of 361 participants. For IMT, concurrent training showed a slight decrease by 0.05 mm (95% CI -0.11 to 0.01, p > 0.05). concurrent training induced an overall significant improvement in FMD by 1.47% (95% CI 0.15 to 2.79, p < 0.05) and PWV by 0.66 m/s (95% CI -0.89 to -0.43, p < 0.01) in type 2 diabetics. However, concurrent training seemed to exaggerate the impaired NMD (WMD = -2.30%, 95% CI -4.02 to -0.58, p < 0.05). Conclusions Concurrent training is an effective method to improve endothelial function and artery stiffness in T2D. However, within 24 weeks concurrent training exacerbates vascular smooth muscle dysfunction. More research is needed to explore whether longer and/or higher-intensity concurrent training interventions could enhance the vascular structure and smooth muscle function in this population. Systematic review registration www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350604.
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Affiliation(s)
- Shengju Chen
- School of Physical Education, Liaoning Normal University, Dalian, China
| | - Kaixiang Zhou
- Sports Health College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huayu Shang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Mingyang Du
- College of Physical Education, Chongqing University, Chongqing, China
| | - Linfeng Wu
- College of Physical Education, Chongqing University, Chongqing, China
| | - Yu Chen
- College of Physical Education, Chongqing University, Chongqing, China
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22
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van der Sluijs KM, Thannhauser J, Visser IM, Nabeel PM, Raj KV, Malik AEF, Reesink KD, Eijsvogels TMH, Bakker EA, Kaur P, Joseph J, Thijssen DHJ. Central and local arterial stiffness in White Europeans compared to age-, sex-, and BMI-matched South Asians. PLoS One 2023; 18:e0290118. [PMID: 37616275 PMCID: PMC10449187 DOI: 10.1371/journal.pone.0290118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Ethnicity impacts cardiovascular disease (CVD) risk, and South Asians demonstrate a higher risk than White Europeans. Arterial stiffness is known to contribute to CVD, and differences in arterial stiffness between ethnicities could explain the disparity in CVD risk. We compared central and local arterial stiffness between White Europeans and South Asians and investigated which factors are associated with arterial stiffness. METHODS Data were collected from cohorts of White Europeans (the Netherlands) and South Asians (India). We matched cohorts on individual level using age, sex, and body mass index (BMI). Arterial stiffness was measured with ARTSENS® Plus. Central stiffness was expressed as carotid-femoral pulse wave velocity (cf-PWV, m/s), and local carotid stiffness was quantified using the carotid stiffness index (Beta) and pressure-strain elastic modulus (Epsilon, kPa). We compared arterial stiffness between cohorts and used multivariable linear regression to identify factors related to stiffness. RESULTS We included n = 121 participants per cohort (age 53±10 years, 55% male, BMI 24 kg/m2). Cf-PWV was lower in White Europeans compared to South Asians (6.8±1.9 vs. 8.2±1.8 m/s, p<0.001), but no differences were found for local stiffness parameters Beta (5.4±2.4 vs. 5.8±2.3, p = 0.17) and Epsilon (72±35 vs. 70±31 kPa, p = 0.56). Age (standardized β, 95% confidence interval: 0.28, 0.17-0.39), systolic blood pressure (0.32, 0.21-0.43), and South Asian ethnicity (0.46, 0.35-0.57) were associated with cf-PWV; associations were similar between cohorts (p>0.05 for interaction). Systolic blood pressure was associated with carotid stiffness in both cohorts, whereas age was associated to carotid stiffness only in South Asians and BMI only in White Europeans. CONCLUSION Ethnicity is associated with central but not local arterial stiffness. Conversely, ethnicity seems to modify associations between CVD risk factors and local but not central arterial stiffness. This suggests that ethnicity interacts with arterial stiffness measures and the association of these measures with CVD risk factors.
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Affiliation(s)
- Koen M. van der Sluijs
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
| | - Jos Thannhauser
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
- Faculty of Science and Technology, Department of Cardiovascular and Respiratory Physiology, University of Twente, Enschede, Overijssel, The Netherlands
| | - Iris M. Visser
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
- Technical Medicine, University of Twente, Enschede, Overijssel, The Netherlands
| | - P. M. Nabeel
- Healthcare Technology Innovation Centre, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
| | - Kiran V. Raj
- Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
| | - Afrah E. F. Malik
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Limburg, The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Limburg, The Netherlands
| | - Thijs M. H. Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
| | - Esmée A. Bakker
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
| | - Prabhdeep Kaur
- National Institute of Epidemiology, Indian Council of Medical Research, Chennai, Tamil Nadu, India
| | - Jayaraj Joseph
- Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
| | - Dick H. J. Thijssen
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
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23
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Climie RE, Alastruey J, Mayer CC, Schwarz A, Laucyte-Cibulskiene A, Voicehovska J, Bianchini E, Bruno RM, Charlton PH, Grillo A, Guala A, Hallab M, Hametner B, Jankowski P, Königstein K, Lebedeva A, Mozos I, Pucci G, Puzantian H, Terentes-Printzios D, Yetik-Anacak G, Park C, Nilsson PM, Weber T. Vascular ageing: moving from bench towards bedside. Eur J Prev Cardiol 2023; 30:1101-1117. [PMID: 36738307 PMCID: PMC7614971 DOI: 10.1093/eurjpc/zwad028] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
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Affiliation(s)
- Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, 7000 Hobart, Australia
- Sports Cardiology, Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne 3000, Australia
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, 249 Westminster Bridge Rd, London SE1 7EH, UK
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Achim Schwarz
- ALF Distribution GmbH, Stephanstrasse 19, 52064 Aachen, Germany
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
- Faculty of Medicine, Vilnius University, M. K. C iurlionio g. 21, 03101 Vilnius, Lithuania
| | - Julija Voicehovska
- Department of Internal Diseases, Riga Stradins University, Dzirciema str. 16, Riga, L-1007, Latvia
- Nephrology and Renal Replacement Therapy Clinics, Riga East University Hospital, Hipokrata str. 2, Riga, LV-1079, Latvia
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa (PI), Italy
| | - Rosa-Maria Bruno
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Andrea Grillo
- Medicina Clinica, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Paseo de la Vall d’Hebron, 129, 08035 Barcelona, Spain
| | - Magid Hallab
- Clinique Bizet, 23 Georges Bizet, 75116 Paris, France
| | - Bernhard Hametner
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 231 Czerniakowska St., 00-416 Warsaw, Poland
| | - Karsten Königstein
- Department of Sport, Exercise and Health (DSBG) University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Anna Lebedeva
- Department of Internal Medicine and Cardiology, Dresden Heart Centre, Dresden University of Technology, Fetscher str. 76, 01307 Dresden, Germany
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, T. Vladimirescu Street 14, 300173 Timisoara, Romania
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Houry Puzantian
- Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32 Atasehir, 34752 Istanbul, Turkey
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK; and
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600 Wels, Austria
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Li A, Yan J, Zhao Y, Yu Z, Tian S, Khan AH, Zhu Y, Wu A, Zhang C, Tian XL. Vascular Aging: Assessment and Intervention. Clin Interv Aging 2023; 18:1373-1395. [PMID: 37609042 PMCID: PMC10441648 DOI: 10.2147/cia.s423373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023] Open
Abstract
Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.
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Affiliation(s)
- Ao Li
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330031, People’s Republic of China
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Jinhua Yan
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ya Zhao
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Zhenping Yu
- Institute of Translational Medicine, School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Shane Tian
- Department of Biochemistry/Chemistry, Ohio State University, Columbus, OH, USA
| | - Abdul Haseeb Khan
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Yuanzheng Zhu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Andong Wu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Cuntai Zhang
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiao-Li Tian
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
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Murakami T. Atherosclerosis and arteriosclerosis. Hypertens Res 2023; 46:1810-1811. [PMID: 37072574 DOI: 10.1038/s41440-023-01284-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/02/2023] [Indexed: 04/20/2023]
Affiliation(s)
- Tomoaki Murakami
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan.
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Álvarez-Bustos A, Carnicero JA, Rodríguez-Sánchez B, El-Assar M, Rueda R, Pereira SL, Sepúlveda-Loyola W, Garcia-Garcia FJ, Sulo S, Rodríguez-Mañas L. Association Between Pulse Wave Velocity and Frailty, Disability, and Mortality in Community-Dwelling Older Adults. JACC. ADVANCES 2023; 2:100423. [PMID: 38939008 PMCID: PMC11198582 DOI: 10.1016/j.jacadv.2023.100423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/17/2023] [Accepted: 05/09/2023] [Indexed: 06/29/2024]
Abstract
Background Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the same population. Objectives The purpose of this study was to evaluate the role of arterial stiffness in the loss of functional ability (frailty and disability) and mortality. Methods Data were taken from community-dwelling aged 65 years participants without diabetes in the Toledo Study of Healthy Ageing cohort. Pulse wave velocity (PWV), assessed through SphygmoCor, was recorded at baseline. Median follow-up time were 2.99 years for frailty (frailty phenotype [FP] and Frailty Trait Scale-5 [FTS5]) and disability (Katz Index) and 6.2 for mortality. Logistic regressions models were built for disability and frailty and Cox proportional hazards model for death, adjusted by age and sex, comorbidity, cardiovascular risk factors, asymmetric dimethylarginine levels, and polypharmacy. Results Overall, 978 (mean age 74.5 ± 5.6 years, 56.7% female) participants were included. Different cut-off points were shown for each outcome. PWV >11.5 m/s was cross-sectionally associated with frailty (FP: OR fully-adjusted model: 1.69, 95% CI: 1.45-1.97; FTS5: OR: 1.51, 95% CI: 1.22-1.87) and disability (OR: 1.51, 95% CI: 1.26-1.79); PWV >10 m/s with incident frailty by FP (OR: 1.36, 95% CI: 1.10-1.68) and FTS5 (OR: 1.40, 95% CI: 1.12-1.75), and PWV >11 m/s with death (HR: 1.28, 95% CI: 1.09-1.50). For incident (OR: 1.28, 95% CI: 1.06-1.55) and worsening disability (OR: 1.21, 95% CI: 1.02-1.45) the threshold was 12.5 m/s. Below these cut-off points, age was the best predictor of adverse outcomes. Conclusions Arterial stiffness predicts frailty, disability, and mortality in older people, with different cut-off points, ie,severity degrees, for each of the assessed outcomes.
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Affiliation(s)
- Alejandro Álvarez-Bustos
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A. Carnicero
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Fundación de Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | - Beatriz Rodríguez-Sánchez
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Economía Aplicada, Economía Pública y Economía Política, Facultad de Derecho, Universidad Complutense de Madrid, Madrid, Spain
| | - Mariam El-Assar
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Fundación de Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | | | | | | | - Francisco J. Garcia-Garcia
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Geriatría, Hospital Virgen del Valle, Toledo, Spain
| | - Suela Sulo
- Abbott Nutrition, Chicago, Illinois, USA
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
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Fioretti V, Gerardi D, Giugliano G, Di Fazio A, Stabile E. Focus on Prevention: Peripheral Arterial Disease and the Central Role of the Cardiologist. J Clin Med 2023; 12:4338. [PMID: 37445373 PMCID: PMC10342387 DOI: 10.3390/jcm12134338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Peripheral artery disease (PAD) is a manifestation of systemic atherosclerotic disease. PAD patients have a poor prognosis with an increased risk of cardiovascular (CV) events, including myocardial infarction (MI), stroke, limb ischemia and CV death; therefore, it is important to detect and treat PAD early. PAD and coronary artery disease (CAD) share a common pathogenesis and risk factors for development; therefore, cardiologists are in a unique position to screen, diagnosis and treat PAD. Moreover, PAD and CAD also share some treatment goals, including an aggressive modification of risk factors to reduce the risk of CV events. However, PAD remains an underdiagnosed and undertreated disease with medico-legal implications. As the role of cardiologists is expanding, the purpose of this review was to awaken the clinicians to the significance of PAD.
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Affiliation(s)
- Vincenzo Fioretti
- Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", 85100 Potenza, Italy
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Donato Gerardi
- Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", 85100 Potenza, Italy
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Giuseppe Giugliano
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Aldo Di Fazio
- Regional Complex Intercompany Institute of Legal Medicine, Azienda Ospedaliera Regionale "San Carlo", 85100 Potenza, Italy
| | - Eugenio Stabile
- Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", 85100 Potenza, Italy
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Wu S, Tian X, Chen S, Zhang Y, Zhang X, Xu Q, Wang A. Arterial stiffness and blood pressure in treated hypertension: a longitudinal study. J Hypertens 2023; 41:768-774. [PMID: 36883462 DOI: 10.1097/hjh.0000000000003400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVES It has been reported that an increase in arterial stiffness precedes an increase in blood pressure (BP) in the general population. Whether BP lowering results from of reducing arterial wall or vice versa in antihypertensive treatment is unclear. This study aimed to investigate the association between arterial stiffness and BP in patients with treated hypertension. METHODS This study included 3277 participants who were treated with antihypertensive agents and with repeated measurements of branchial-ankle pulse wave velocity (baPWV) and BP during 2010-2016 from the Kailuan study. Temporal relation between baPWV and BP was assessed by cross-lagged path analyses. RESULTS After adjustment for potential confounders, the standard regression coefficient from baseline baPWV to follow-up SBP was 0.14 [95% confidence interval (95% CI), 0.10-0.18], which was significantly greater than that from baseline SBP to follow-up baPWV (0.05; 95% CI, 0.02-0.08) ( P < 0.0001 for difference). Similar results were observed for the cross-lagged analysis with changes of baPWV and mean arterial pressure. Further analysis showed that the yearly rate of change in SBP during the follow-up period significantly varied across increasing quartiles of baseline baPWV ( P < 0.0001), whereas the yearly rate of change in baPWV showed a nonsignificantly varied trend across quartiles of baseline SBP ( P = 0.2443). CONCLUSION These findings provided strong evidence that reduction in arterial stiffness through antihypertensive treatment could precede BP lowering.
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Affiliation(s)
- Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
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Deng X, Song Y, Han X, Chen X, Yang W, Wu S, Zhou Y. Brachial-ankle pulse wave velocity trajectories in a middle-aged population. Front Cardiovasc Med 2023; 10:1092525. [PMID: 37051065 PMCID: PMC10083284 DOI: 10.3389/fcvm.2023.1092525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/06/2023] [Indexed: 03/28/2023] Open
Abstract
ObjectiveThe “trajectory” phenotype was observed in several cardiovascular risk factors with aging. We aim to identify multiple brachial-ankle Pulse Wave Velocity (baPWV) trajectory phenotypes and assess their determinants.MethodsAmong 5,182 participants with baPWV measurements (2010–2016) at no less than three time points in Kailuan Study, we derived baPWV trajectory pattern using SAS Proc Traj program. We applied the lowest Bayesian information criterion to identify the best typing model, related the identified trajectory pattern to baseline and changes in characteristics.ResultsAmong 5.3 ± 1.7 years follow-up, four distinct baPWV trajectories were identified as low (1,961,37.8%), medium-low (1,846,35.6%), medium-high (1,024,19.8%), and high (351,6.8%) groups. In the stepwise models, mean arterial pressure and age were the main determinators of the trajectory patterns, with a Δpseudo-R2 of 0.335 and 0.164, respectively. With the low trajectory group as reference and multivariable adjustment, odd ratios of medium low, medium high and high associated with 1 mmHg increment of mean arterial pressure were 1.08(95%CI: 1.07–1.09), 1.13(1.12–1.14), and 1.16(1.15–1.18). The estimates for age were 1.08(1.07–1.10), 1.20(1.18–1.21) and 1.28(1.26–1.31). Additionally, baseline resting heart rate, low-density lipoprotein cholesterol, fasting blood glucose, hypersensitive C-reaction protein and uric acid, and changes in mean arterial pressure, resting heart rate, fasting blood glucose, and uric acid were positively associated with the trajectory, while BMI was negatively associated.ConclusionsThe changes in baPWV overtime followed a “trajectory” pattern, mainly determined by mean arterial pressure and age.
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Isaykina OY, Skripnikova IA, Kolchina MA, Kosmatova OV, Novikov VE, Tsoriev TT. Associations of Arterial Stiffness and Bone Mineral Density in Postmenopausal Women. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2023. [DOI: 10.20996/1819-6446-2023-02-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Aim. To study associations between arterial stiffness and bone mineral density in postmenopausal women.Material and methods. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (AP) were studied using duplex scanning. Pulse wave velocity (PWV), augmentation index (AI) were measured by applanation. The Bone mineral density (BMD) of the spine, hip neck (HN) and proximal hip (PH) was measured using double energy x-ray absorptiometry.Results. A significant correlation of PWV with age, duration of menopause was revealed, a more pronounced correlation was noted with blood pressure (BP), maximum IMT thickness. There was no significant correlation between PWV and BMD. AI showed a statistically significant but weak negative correlation with the HN (rs=0.12, p<0.05); a more pronounced negative correlation was obtained for BMD (rs=0.16, p<0.01). For indicators characterizing the degree of bone mass increased, there is a significant correlation with age (rs=-0.4, p<0.01), weight (rs=0.4, p<0.01), Quetelet index (rs=0.3, p<0.01) and the presence of AP (rs=-0.12, p<0.05). According to the results of multivariate regression analysis, the most significant predictors of arterial stiffness were indicators reflecting obesity and diastolic BP. The relationship between BMD and age-adjusted vascular stiffness was not statistically significant.Conclusion. In our study, postmenopausal women have increased arterial stiffness, suggesting a higher risk of cardiovascular disease. The relationship between bone mineral density and vascular wall stiffness was insignificant. To a greater extent, arterial stiffness depended on age, increased blood pressure, and the presence of atherosclerotic changes.
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Affiliation(s)
- O. Yu. Isaykina
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. A. Kolchina
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Kosmatova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. E. Novikov
- National Medical Research Center for Therapy and Preventive Medicine
| | - T. T. Tsoriev
- National Medical Research Center for Therapy and Preventive Medicine
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Ellström K, Abul-Kasim K, Siennicki-Lantz A, Elmståhl S. Associations of carotid artery flow parameters with MRI markers of cerebral small vessel disease and patterns of brain atrophy. J Stroke Cerebrovasc Dis 2023; 32:106981. [PMID: 36657270 DOI: 10.1016/j.jstrokecerebrovasdis.2023.106981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES A growing body of evidence links age related brain pathologies to systemic vascular processes. We aimed to study the prevalence and interrelations between magnetic resonance imaging (MRI) markers of cerebral small vessel disease and patterns of brain atrophy, and their association to carotid duplex ultrasound flow parameters. MATERIALS AND METHODS We investigated a population based randomised cohort of older adults (n=391) aged 70-87, part of the Swedish Good Aging in Skåne Study. Peak systolic and end diastolic velocities of the carotid arteries were measured by ultrasound, and resistivity- and pulsatility indexes were calculated. Subjects with increased peak systolic velocity indicating carotid stenosis were excluded from analysis. Nine MRI findings were rated by visual scales: white matter changes, pontine white matter changes, microbleeds, lacunar infarctions, medial temporal lobe atrophy, global cortical atrophy, parietal atrophy, precuneus atrophy and central atrophy. RESULTS MRI pathologies were found in 80% of subjects. Mean end diastolic velocity in common carotid arteries was inversely associated with white matter hyperintensities (OR=0.92; p=0.004), parietal lobe atrophy (OR=0.94; p=0.039), global cortical atrophy (OR=0.90; p=0.013), precuneus atrophy (OR=0.94; p=0.022), "number of CSV pathologies" (β=-0.07; p<0.001) and "MRI-burden score" (β=-0.11; p<0.001), after adjustment for age and sex. The latter three were also associated with pulsatility and resistivity indexes. CONCLUSIONS Low carotid end diastolic velocity, as well as increased carotid resistivity and pulsatility, were associated with signs of cerebral small vessel disease and patterns of brain atrophy, indicating a vascular component in the process of brain aging.
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Affiliation(s)
- Katarina Ellström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden.
| | - Kasim Abul-Kasim
- Department of Clinical Sciences Lund, Division of Diagnostic Radiology, Lund University, Sweden
| | - Arkadiusz Siennicki-Lantz
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
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Wright A, Stavres J, Galloway R, Donahue P, Sha Z, McCoy S. Aortic stiffness increases during prolonged sitting independent of intermittent standing or prior exercise. Eur J Appl Physiol 2023; 123:533-546. [PMID: 36334128 DOI: 10.1007/s00421-022-05079-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Adverse vascular responses can occur during prolonged sitting, including stiffening of the aortic artery which may contribute to cardiovascular disease. Few studies have investigated the impact of intermittent standing and/or prior exercise as strategies to attenuate these potentially deleterious vascular changes. PURPOSE To investigate central vascular health responses during prolonged sitting, with and without intermittent standing and/or prior exercise. METHODS Fifteen males aged 18 to 31 years were recruited. Subjects completed a control condition [Sitting Only (SO)], and three randomized strategy conditions [Sitting Plus Standing (SSt), Exercise Plus Sitting (ES), Exercise Plus Sitting Plus Standing (ESSt)]. For all conditions, measurements of carotid-femoral pulse wave velocity (cfPWV) were taken at pre- and post-intervention, and brachial and central blood pressure (BP) at pre-, 1-h, 2-h, and 3-h intervention. RESULTS cfPWV significantly increased from pre- to post-intervention for all conditions (all p ≤ 0.043), as did brachial mean arterial pressure (MAP) and diastolic BP, and central MAP and diastolic BP for the control condition (all p ≤ 0.022). Brachial and central systolic BP were significantly higher during SO compared to ESSt at 1 h, and compared to ES for central systolic BP (all p ≤ 0.036). CONCLUSIONS Strategies of intermittent standing and/or prior exercise may not prevent aortic stiffening during sitting but may attenuate BP elevations in the brachial and aortic arteries. Future research should investigate causal mechanistic links between sitting and aortic stiffening, and other attenuation strategies.
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Affiliation(s)
- Alexander Wright
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Jon Stavres
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Riley Galloway
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Paul Donahue
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Zhanxin Sha
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Stephanie McCoy
- School of Kinesiology and Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
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Keehn L, Mangino M, Spector T, Chowienczyk P, Cecelja M. Relation of Pulse Wave Velocity to Contemporaneous and Historical Blood Pressure in Female Twins. Hypertension 2023; 80:361-369. [PMID: 36408690 PMCID: PMC9847690 DOI: 10.1161/hypertensionaha.122.19311] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND An association between blood pressure and aortic stiffness is well known, but ambiguity remains as to whether one precedes the other. This study aimed to investigate the association of aortic stiffness with contemporaneous versus historic blood pressure and direction of causality between aortic stiffening and hypertension in female twins. METHODS Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), and mean arterial pressure (MAP) was recorded in 2037 female TwinsUK participants (mean age: 62.4±9.7 years) at a single time point. A subset of 947 participants had repeat PWV and MAP measures (mean interval 5.5±1.7 years) with additional historic MAP (mean interval 6.6±3.3 years before baseline). RESULTS Cross-sectional multivariable linear regression analysis confirmed PWV significantly associated with age and MAP. In longitudinal analysis, annual progression of PWV was not associated with historic MAP (standardized beta coefficient [β]=-0.02, P=0.698), weakly associated with baseline MAP (β=0.09, P=0.049) but strongly associated with progression (from baseline to most recent measurement) of MAP (β= 0.26, P<0.001). Progression of MAP associated with both baseline and progression of PWV (β=0.13, P=0.003 and β=0.24, P<0.001, respectively). CONCLUSIONS Progression of aortic stiffness associates more strongly with contemporaneous MAP compared with historic MAP. In contrast, progression of MAP is associated with prior arterial stiffness. These findings suggest a bidirectional relationship between arterial stiffness and blood pressure, and that lowering blood pressure may prevent a cycle of arterial stiffening and hypertension.
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Affiliation(s)
- Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Massimo Mangino
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, London (M.M.)
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
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Podrug M, Šunjić B, Bekavac A, Koren P, Đogaš V, Mudnić I, Boban M, Jerončić A. The effects of experimental, meteorological, and physiological factors on short-term repeated pulse wave velocity measurements, and measurement difficulties: A randomized crossover study with two devices. Front Cardiovasc Med 2023; 9:993971. [PMID: 36712242 PMCID: PMC9873998 DOI: 10.3389/fcvm.2022.993971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Background Large longitudinal studies with repeated pulse wave velocity (PWV) measurements, a direct measure of arterial stiffness, are required to realize the full potential of arterial stiffness in clinical practice. To facilitate such studies it is important to increase the power of a study by reducing within-subject variability of PWV, and to ease the use of a PWV device in clinical settings by minimizing PWV measurement difficulties. Methods We systematically investigated experimental setting and meteorological conditions, as well as physiological factors and participant characteristics, to determine whether and to what extent they affected: between- and within-subjects variability of PWV recordings, and measurement difficulties of a particular device. We conducted a 2-week longitudinal block-randomized cross-over study with two blinded observers and two commonly used devices: applanation tonometry SphygmoCor CvMS and oscillometric Arteriograph to assess carotid-femoral (cfPWV) or aortic (PWVao) PWV, respectively. Our sample had uniform and wide-spread distribution of age, blood pressures, hypertensive status and BMI. Each participant (N = 35) was recorded 12 times over 3 visiting days, 7 days apart. On each day, recordings were made twice in the morning (7-10 a.m.) and afternoon (16-18 p.m.). Data were analyzed using multilevel mixed-effects models, separately for each device. Results In addition to age and mean arterial pressure (MAP) that strongly affected both cfPWV and PWVao, other significant factors appeared to indicate a measurement approach. cfPWV as a more direct measure of arterial stiffness was additionally affected by hypertension status, outdoor temperature, interaction of MAP with outdoor temperature and the order of visit, with MAP within-subject variability contributing on average 0.27 m/s to difference in repeated measurements at 5°C and 0.004 m/s at 25°C. PWVao measurements derived at a single brachial site were more dependent on age than cfPWV and also depended on personal characteristics such as height and sex, and heart rate; with within-subject MAP variability adding on average 0.23 m/s to the difference in repeated measures. We also found that female sex significantly increased, and recording in afternoon vs. morning significantly decreased measurement difficulties of both devices. Conclusion We identified factors affecting PWV recordings and measurement-difficulties and propose how to improve PWV measuring protocols.
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Affiliation(s)
- Mario Podrug
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,University Department of Health Studies, University of Split, Split, Croatia
| | - Borna Šunjić
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,University Department of Health Studies, University of Split, Split, Croatia
| | - Anamarija Bekavac
- PhD Study Programme, University of Split School of Medicine, Split, Croatia
| | - Pjero Koren
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Varja Đogaš
- Department of Psychological Medicine, University of Split School of Medicine, Split, Croatia
| | - Ivana Mudnić
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, Split, Croatia
| | - Mladen Boban
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, Split, Croatia
| | - Ana Jerončić
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia,*Correspondence: Ana Jerončić,
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Hypertension and cardiomyopathy associated with chronic kidney disease: epidemiology, pathogenesis and treatment considerations. J Hum Hypertens 2023; 37:1-19. [PMID: 36138105 PMCID: PMC9831930 DOI: 10.1038/s41371-022-00751-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/09/2022] [Accepted: 08/31/2022] [Indexed: 01/31/2023]
Abstract
Chronic kidney disease (CKD) is a complex condition with a prevalence of 10-15% worldwide. An inverse-graded relationship exists between cardiovascular events and mortality with kidney function which is independent of age, sex, and other risk factors. The proportion of deaths due to heart failure and sudden cardiac death increase with progression of chronic kidney disease with relatively fewer deaths from atheromatous, vasculo-occlusive processes. This phenomenon can largely be explained by the increased prevalence of CKD-associated cardiomyopathy with worsening kidney function. The key features of CKD-associated cardiomyopathy are increased left ventricular mass and left ventricular hypertrophy, diastolic and systolic left ventricular dysfunction, and profound cardiac fibrosis on histology. While these features have predominantly been described in patients with advanced kidney disease on dialysis treatment, patients with only mild to moderate renal impairment already exhibit structural and functional changes consistent with CKD-associated cardiomyopathy. In this review we discuss the key drivers of CKD-associated cardiomyopathy and the key role of hypertension in its pathogenesis. We also evaluate existing, as well as developing therapies in the treatment of CKD-associated cardiomyopathy.
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Pilz N, Patzak A, Bothe TL. The pre-ejection period is a highly stress dependent parameter of paramount importance for pulse-wave-velocity based applications. Front Cardiovasc Med 2023; 10:1138356. [PMID: 36873391 PMCID: PMC9975268 DOI: 10.3389/fcvm.2023.1138356] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Purpose The pulse-wave-velocity, is used for indirect, cuff-less, continuous blood pressure estimation. It is commonly detected by measuring the time delay between a defined point in an ECG and the arrival of the peripheral pulse wave (e.g., oxygen saturation sensor). The period between electrical stimulation of the heart (ECG) and actual blood ejection from the heart is called the pre-ejection period (PEP). This study aims at characterizing the PEP under mental and physical stress with focus on its relations to other cardiovascular parameters such as heart rate and importance for blood pressure (BP) estimation. Methods We measured the PEP in 71 young adults at rest, under mental (TSST) and physical stress (ergometer) via impedance-cardiography. Results The PEP is highly dependent on mental and physical load. It is strongly correlated with indicators of sympathetic strain (p < 0.001). At rest (mean 104.5 ms), the PEP shows a high interindividual variability but small intraindividual variability. Mental stress decreases the PEP by 16% (mean 90.0 ms) while physical stress halves PEP (mean 53.9 ms). The PEP does correlate differently with heart rate under differing circumstances (rest: R 2 0.06, mental stress: R 2 0.29, physical stress: R 2 0.65). Subsequently, using PEP and heart rate enables the discrimination of rest, mental and physical strain with a positive predictive value of 93%. Conclusion The PEP is a cardiovascular parameter with large interindividual variability at rest and subject-depended dynamic under load which is of great importance for ECG-based pulse-wave-velocity (PWV) determination. Considering its variability and large impact on the pulse arrival time, PEP is a crucial factor in PWV based BP estimation.
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Affiliation(s)
- Niklas Pilz
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Patzak
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tomas L Bothe
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Jiang Y, Xing A, Hidru TH, Li J, Yang X, Chen S, Xia YL, Wu S. The association between arterial stiffness and cancer occurrence: Data from Kailuan cohort study. Front Cardiovasc Med 2023; 10:1112047. [PMID: 36937940 PMCID: PMC10014543 DOI: 10.3389/fcvm.2023.1112047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/02/2023] [Indexed: 03/05/2023] Open
Abstract
Background This study aimed to investigate whether increased arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV) is associated with cancer. Materials and methods A total of 45,627 Chinese adults underwent a baPWV examination. The participants were followed up from 1st January 2012 to 31st December 2018. Cox proportional hazards model was used to assess the association between the baPWV values and cancer. Results During a total follow-up duration of 172,775.69 person-years, there were 553 new cases of cancer. The subjects in the highest baPWV group showed an increased risk of cancer when compared with the lowest baPWV group as confirmed by multivariate-adjusted hazard ratios (HR = 1.51, 95% CI = 1.14∼2.00) in the entire cohort. Compared with participants in the lowest baPWV group, the HRs (95% CI) for digestive cancer in the second and third groups were 1.55 (1.00∼2.40) and 1.99 (1.19∼3.33), respectively. The Kaplan-Meier analysis demonstrated a significant increase in cancer in participants with a baPWV ≥ 18 m/s (P < 0.001). Compared with the lowest baPWV group, the highest baPWV group showed an increased risk of cancer in men (HR = 1.72, 95% CI = 1.22∼2.43) and those < 60 years (HR = 1.75, 95% CI = 1.20∼2.55), respectively. Conclusion Increased arterial stiffness measured by baPWV is associated with cancer occurrence, especially digestive cancer occurrence. Clinical trial registration ClinicalTrials.gov, identifier ChiCTR-TNRC-11001489.
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Affiliation(s)
- Yinong Jiang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, Hebei, China
| | - Tesfaldet Habtemariam Hidru
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jiatian Li
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Shuohua Chen
- Health Department of Kailuan Group, Tangshan, China
| | - Yun-Long Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- *Correspondence: Yun-Long Xia,
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, Hebei, China
- Shouling Wu,
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Sato S, Shimizu K, Takahashi M, Masai M, Nagakawa O, Uchino J, Suzuki T, Sato Y, Iwai N, Shirai K. Changes in blood pressure and arterial stiffness monitored using the cardio-ankle vascular index during hemodialysis. Front Physiol 2023; 14:1133037. [PMID: 36891139 PMCID: PMC9987587 DOI: 10.3389/fphys.2023.1133037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
During hemodialysis (HD), blood pressure (BP) changes are frequently observed. However, the mechanism of BP changes during HD has not been fully clarified. The cardio-ankle vascular index (CAVI) reflects the arterial stiffness of the arterial tree from the origin of the aorta to the ankle independent from BP during measurement. Additionally, CAVI reflects functional stiffness in addition to structural stiffness. We aimed to clarify the role of CAVI in regulating the BP system during HD. We included 10 patients undergoing 4-hour HD (total 57 HD sessions). Changes in the CAVI and various hemodynamic parameters were evaluated during each session. During HD, BP decreased and CAVI significantly increased (CAVI, median [interquartile range]; 9.1 [8.4-9.8] [0 min] to 9.6 [9.2-10.2] [240 min], p < 0.05). Changes in CAVI from 0 min to 240 min were significantly correlated with water removal rate (WRR) (r = -0.42, p = 0.002). Changes in CAVI at each measurement point were negatively correlated with ΔBP (Δsystolic BPeach MP, r = -0.23, p < 0.0001; Δdiastolic BPeach MP, r = -0.12, p = 0.029). Whereas one patient exhibited a simultaneous decrease in BP and CAVI during the initial 60 min of HD. Arterial stiffness monitored with CAVI generally increased during HD. CAVI elevation is associated with decreased WWR and BP. An increase in CAVI during HD may reflect the contraction of smooth muscle cells and play an important role in BP maintenance. Hence, measuring CAVI during HD may distinguish the cause of BP changes.
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Affiliation(s)
- Shuji Sato
- Department of Cardiology, Toho University Sakura Medical Center, Chiba, Japan
| | - Kazuhiro Shimizu
- Department of Cardiology, Toho University Sakura Medical Center, Chiba, Japan
| | - Mao Takahashi
- Department of Cardiology, Toho University Sakura Medical Center, Chiba, Japan
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Cecelja M, Ruijsink B, Puyol‐Antón E, Li Y, Godwin H, King AP, Razavi R, Chowienczyk P. Aortic Distensibility Measured by Automated Analysis of Magnetic Resonance Imaging Predicts Adverse Cardiovascular Events in UK Biobank. J Am Heart Assoc 2022; 11:e026361. [PMID: 36444831 PMCID: PMC9851433 DOI: 10.1161/jaha.122.026361] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022]
Abstract
Background Automated analysis of cardiovascular magnetic resonance images provides the potential to assess aortic distensibility in large populations. The aim of this study was to compare the prediction of cardiovascular events by automated cardiovascular magnetic resonance with those of other simple measures of aortic stiffness suitable for population screening. Methods and Results Aortic distensibility was measured from automated segmentation of aortic cine cardiovascular magnetic resonance using artificial intelligence in 8435 participants. The associations of distensibility, brachial pulse pressure, and stiffness index (obtained by finger photoplethysmography) with conventional risk factors was examined by multivariable regression and incident cardiovascular events by Cox proportional-hazards regression. Mean (±SD) distensibility values for men and women were 1.77±1.15 and 2.10±1.45 (P<0.0001) 10-3 mm Hg-1, respectively. There was a good correlation between automatically and manually obtained systolic and diastolic aortic areas (r=0.980 and r=0.985, respectively). In regression analysis, distensibility associated with age, mean arterial pressure, heart rate, weight, and plasma glucose but not male sex, cholesterol or current smoking. During an average follow-up of 2.8±1.3 years, 86 participants experienced cardiovascular events 6 of whom died. Higher distensibility was associated with reduced risk of cardiovascular events (adjusted hazard ratio [HR], 0.61 per log unit of distensibility; P=0.016). There was no evidence of an association between pulse pressure (adjusted HR 1.00; P=0.715) or stiffness index (adjusted HR, 1.02; P=0.535) and risk of cardiovascular events. Conclusions Automated cardiovascular magnetic resonance-derived aortic distensibility may be incorporated into routine clinical imaging. It shows a similar association to cardiovascular risk factors as other measures of arterial stiffness and predicts new-onset cardiovascular events, making it a useful tool for the measurement of vascular aging and associated cardiovascular risk.
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Affiliation(s)
- Marina Cecelja
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
| | - Bram Ruijsink
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Esther Puyol‐Antón
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Ye Li
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
| | - Harriet Godwin
- King’s College London British Heart Foundation CentreSchool of Cardiovascular Medicine & Sciences, Department of CardiologyLondonUnited Kingdom
| | - Andrew P. King
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Reza Razavi
- School of Bioengineering and Imaging SciencesKing’s College LondonLondonUnited Kingdom
| | - Phil Chowienczyk
- King’s College London British Heart Foundation Centre, Department of Clinical PharmacologySt Thomas’ HospitalLondonUnited Kingdom
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Ushida T, Cotechini T, Protopapas N, Atallah A, Collyer C, Toews AJ, Macdonald-Goodfellow SK, Tse MY, Winn LM, Pang SC, Adams MA, Othman M, Kotani T, Kajiyama H, Graham CH. Aberrant inflammation in rat pregnancy leads to cardiometabolic alterations in the offspring and intrauterine growth restriction in the F2 generation. J Dev Orig Health Dis 2022; 13:706-718. [PMID: 35593438 DOI: 10.1017/s2040174422000265] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Children of women with pre-eclampsia have increased risk of cardiovascular (CV) and metabolic disease in adult life. Furthermore, the risk of pregnancy complications is higher in daughters born to women affected by pre-eclampsia than in daughters born after uncomplicated pregnancies. While aberrant inflammation contributes to the pathophysiology of pregnancy complications, including pre-eclampsia, the contribution of maternal inflammation to subsequent risk of CV and metabolic disease as well as pregnancy complications in the offspring remains unclear. Here, we demonstrate that 24-week-old female rats (F1) born to dams (F0) exposed to lipopolysaccharide (LPS) during pregnancy (to induce inflammation) exhibited mild systolic dysfunction, increased cardiac growth-related gene expression, altered glucose tolerance, and coagulopathy; whereas male F1 offspring exhibited altered glucose tolerance and increased visceral fat accumulation compared with F1 sex-matched offspring born to saline-treated dams. Both male and female F1 offspring born to LPS-treated dams had evidence of anemia. Fetuses (F2) from F1 females born to LPS-treated dams were growth restricted, and this reduction in fetal growth was associated with increased CD68 positivity (indicative of macrophage presence) and decreased expression of glucose transporter-1 in their utero-placental units. These results indicate that abnormal maternal inflammation can contribute to increased risk of CV and metabolic disease in the offspring, and that the effects of inflammation may cross generations. Our findings provide evidence in support of early screening for CV and metabolic disease, as well as pregnancy complications in offspring affected by pre-eclampsia or other pregnancy complications associated with aberrant inflammation.
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Affiliation(s)
- Takafumi Ushida
- Department of Gynecology and Obstetrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tiziana Cotechini
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Nicole Protopapas
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Aline Atallah
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Charlotte Collyer
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Alexa J Toews
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - M Yat Tse
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Louise M Winn
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Stephen C Pang
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Michael A Adams
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Maha Othman
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
- School of Baccalaureate Nursing, St. Lawrence College, Kingston, Ontario, Canada
| | - Tomomi Kotani
- Department of Gynecology and Obstetrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroaki Kajiyama
- Department of Gynecology and Obstetrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Charles H Graham
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
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Shaulian SY, Makaryus AN, Zeltser R. Role of Vascular Receptors in the Development of Hypertension in the Elderly Population. Int J Angiol 2022; 31:260-266. [PMID: 36588863 PMCID: PMC9803552 DOI: 10.1055/s-0042-1759650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hypertension is a disease common in adults, with many risk factors and potentially life-threatening outcomes. Blood pressure is controlled by receptors that inform the brain about the amount of pressure inside the arteries, and the amount of oxygen and carbon dioxide in the blood, respectively. Research has revealed that baroreflex sensitivity (BRS) decreases with increasing age and that there is a high correlation between hypertension and low BRS. However, various studies with differing results have indicated that high blood pressure is what causes BRS to decline, and vice versa. Several studies have shown very conflicting results on the correlation between chemoreflex and age; there have been indications of chemoreflex having a positive, negative, and zero correlation with age. In several experiments, the surgical removal of the chemoreceptors of hypertensive rats was followed by a decrease in blood pressure. These animal experiments, and an additional noninvasive human experiment in which the chemoreceptors were temporarily "shut off," are reasons why more attention should be given to chemoreceptors as a route of alleviating hypertension.
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Affiliation(s)
| | - Amgad N. Makaryus
- Department of Cardiology, Nassau University Medical Center, East Meadow, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Roman Zeltser
- Department of Cardiology, Nassau University Medical Center, East Meadow, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Ollikainen E, Tervonen T, Suominen AL, Knuuttila M, Jula A, Saxlin T, Ylöstalo P. Periodontal condition and ultrasound-based measures of arterial stiffness: results of the Health 2000 Survey. BMC Oral Health 2022; 22:487. [DOI: 10.1186/s12903-022-02502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Periodontitis has been associated with inflammatory processes in arterial walls such as impairment in endothelial function and thickening of intima media. As inflammation plays a role also in arterial stiffening, an association between periodontal inflammation and arterial stiffness can be expected. So far, conflicting results of the association between periodontal disease and arterial stiffness have been reported. Many of the earlier studies were conducted in specific populations and heterogeneous measures of both arterial stiffness and periodontal status were used. In this population-based study we aimed to investigate whether periodontal pocketing and gingival bleeding are associated with ultrasound-based measures of arterial stiffness.
Methods
In this cross-sectional study, two sets of data based on the national Health 2000 Survey in Finland were formed. Data set I comprised never-smoking 45–64-year-old dentate (≥ 10 natural teeth), non-diabetic, non-rheumatic, non-obese (BMI ≤ 30 kg/m2), non-hypertensive subjects with no coronary artery disease or ongoing lipid-lowering medications (n = 157). Data set II was formed of an unrestricted 45–74-year-old dentate population (n = 536). Four arterial stiffness measures (carotid artery compliance, Peterson’s elastic modulus, Young’s elastic modulus and beta stiffness index) based on an ultrasound examination of the common carotid artery were used. Periodontal parameters included the number of teeth with ≥ 4 mm deep periodontal pockets and the number of sextants with gingival bleeding. β-estimates, confidence intervals, and p-values were obtained from linear regression models.
Results
In Data set I, the adjusted β-estimates for the association between the number of teeth with ≥ 4 mm deep periodontal pockets and Peterson’s elastic modulus and Young’s elastic modulus were 15.80 (p = 0.12) and 61.02 (p = 0.22), respectively. The respective β-estimates were 31.06 (p = 0.17) and 121.16 (p = 0.28) for the association between the number of bleeding sextants and these two stiffness measures. The results in Data set II were in line with the results in Data set I, with the exception that the adjusted β-estimates for the associations between Peterson’s elastic modulus and Young’s elastic modulus and periodontal parameters were closer to null.
Conclusions
This population-based study did not provide evidence of an association between periodontal condition and arterial stiffness.
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Li Y, Xu Y, Ma Z, Ye Y, Gao L, Sun Y. An XGBoost-based model for assessment of aortic stiffness from wrist photoplethysmogram. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107128. [PMID: 36150230 DOI: 10.1016/j.cmpb.2022.107128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/26/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Carotid-femoral pulse wave velocity (cf-PWV) is the gold standard for non-invasive assessment of aortic stiffness. Photoplethysmography used in wearable devices provides an indirect measurement method for cf-PWV. This study aimed to construct a cf-PWV prediction method based on the XGBoost algorithm and wrist photoplethysmogram (wPPG) for the early screening of arteriosclerosis in primary healthcare. METHODS Data from 210 subjects were used for modeling, and 100 subjects were used as an external validation set. The wPPG pulse waves were filtered by discrete wavelet transform, and various features were extracted from each waveform, including two original indexes. The extraction rate (ER) and Pearson P were calculated to evaluate the applicability of each feature for model training. The magnitude of cf-PWV was predicted by an XGBoost-based model using the selected features and basic physiological parameters (age, sex, height, weight and BMI). The level of aortic stiffness was classified by a 3-classification strategy according to the standard cf-PWV (measured by the Complior device). Bland-Altman plot, Pearson correlation analysis, and accuracy tested performance from two aspects: predicting the magnitude of cf-PWV and classifying the level of aortic stiffness. RESULTS In the external validation set (n = 100, age range 22-79), 97 subjects obtained features (ER = 97%). The predicted cf-PWV was significantly correlated with the standard cf-PWV (r = 0.927, P < 0.001). The accuracy (AC) of the 3-classification was 85.6%. The interrater agreement for assessing aortic stiffness was at least substantial (quadratically weighted Kappa = 0.833). CONCLUSIONS The multi-parameter fusion cf-PWV prediction method based on the XGBoost algorithm and wPPG pulse wave analysis proves the feasibility of atherosclerosis screening in wearable devices.
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Affiliation(s)
- Yunlong Li
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; University of Science and Technology of China, Hefei 230026, PR China
| | - Yang Xu
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China.
| | - Zuchang Ma
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Yuqi Ye
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; University of Science and Technology of China, Hefei 230026, PR China
| | - Lisheng Gao
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Yining Sun
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
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Haley JE, Woodly SA, Daniels SR, Falkner B, Ferguson MA, Flynn JT, Hanevold CD, Hooper SR, Ingelfinger JR, Khoury PR, Lande MB, Martin LJ, Meyers KE, Mitsnefes M, Becker RC, Rosner BA, Samuels J, Tran AH, Urbina EM. Association of Blood Pressure-Related Increase in Vascular Stiffness on Other Measures of Target Organ Damage in Youth. Hypertension 2022; 79:2042-2050. [PMID: 35762327 PMCID: PMC9378473 DOI: 10.1161/hypertensionaha.121.18765] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hypertension-related increased arterial stiffness predicts development of target organ damage (TOD) and cardiovascular disease. We hypothesized that blood pressure (BP)-related increased arterial stiffness is present in youth with elevated BP and is associated with TOD. METHODS Participants were stratified by systolic BP into low- (systolic BP <75th percentile, n=155), mid- (systolic BP ≥80th and <90th percentile, n=88), and high-risk BP categories (≥90th percentile, n=139), based on age-, sex- and height-specific pediatric BP cut points. Clinic BP, 24-hour ambulatory BP monitoring, anthropometrics, and laboratory data were obtained. Arterial stiffness measures included carotid-femoral pulse wave velocity and aortic stiffness. Left ventricular mass index, left ventricular systolic and diastolic function, and urine albumin/creatinine were collected. ANOVA with Bonferroni correction was used to evaluate differences in cardiovascular risk factors, pulse wave velocity, and cardiac function across groups. General linear models were used to examine factors associated with arterial stiffness and to determine whether arterial stiffness is associated with TOD after accounting for BP. RESULTS Pulse wave velocity increased across groups. Aortic distensibility, distensibility coefficient, and compliance were greater in low than in the mid or high group. Significant determinants of arterial stiffness were sex, age, adiposity, BP, and LDL (low-density lipoprotein) cholesterol. Pulse wave velocity and aortic compliance were significantly associated with TOD (systolic and diastolic cardiac function and urine albumin/creatinine ratio) after controlling for BP. CONCLUSIONS Higher arterial stiffness is associated with elevated BP and TOD in youth emphasizing the need for primary prevention of cardiovascular disease.
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Affiliation(s)
| | - Shalayna A Woodly
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | | | | | - Joseph T Flynn
- Department of Pediatrics, University of Washington, Seattle, WA (J.T.F., C.D.H.)
- Division of Nephrology, Seattle Children's Hospital, Seattle, WA (J.T.F., C.D.H.)
| | - Coral D Hanevold
- Department of Pediatrics, University of Washington, Seattle, WA (J.T.F., C.D.H.)
- Division of Nephrology, Seattle Children's Hospital, Seattle, WA (J.T.F., C.D.H.)
| | | | | | - Philip R Khoury
- Rady Children's Hospital San Diego, CA (J.E.H.)
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | - Marc B Lande
- University of Rochester Medical Center, Rochester, NY (M.B.L.)
| | - Lisa J Martin
- Rady Children's Hospital San Diego, CA (J.E.H.)
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | - Mark Mitsnefes
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
| | | | | | - Joshua Samuels
- University of Texas Health Sciences Center, Houston (J.S.)
| | - Andrew H Tran
- Nationwide Children's Hospital, Columbus, OH (A.H.T.)
| | - Elaine M Urbina
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (S.A.W., P.R.K., L.J.M., M.M., E.M.U.)
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Yazıcı R, Altıntepe L, Guney İ, Yazıcı M. Effect of Congenital or Acquired Renal Mass Reduction on Arterial Stiffness. Clin Physiol Funct Imaging 2022; 42:436-442. [PMID: 35979581 DOI: 10.1111/cpf.12783] [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: 06/08/2022] [Revised: 07/12/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The changes in kidney functions, adversely affect the cardiovascular system. The aim of this study was to investigate whether arterial stiffness (AS), an indicator of subclinical atherosclerosis, was affected in patients with congenital or acquired reduced renal mass. METHODS In this prospective study, a total 135 patients (mean age 43.4±8.5 years and 71.9% female) with congenital unilateral small/non-functioning kidney or unilateral agenesis or with unilateral nephrectomy were included. As control group, 44 healthy individuals with similar age and gender (mean age, 42.5±7.1 year and 61.4% female) were included. Estimated glomerular filtration rate (eGFR) was calculated by Modification of Diet in Renal Disease formula. Official blood pressures (BP) and 24-h ambulatory non-invasive BP of both groups were measured. AS was assessed with pulse wave velocity (PWV) by using Mobile-O-Graph NG arteriograph device using oscillometrical method. RESULTS There was no difference in terms of BP parameters and body mass index between groups. eGFR values of control group and study group were 93±19ml/min/1.73m² and 89±28ml/min/1.73m², respectively (p=0.379). Compared with control group, the study group had higher PWV values (6.72±1.11m/sec vs 6.29±0.75m/sec, p=0.018). In linear regression analysis, PWV was found to be correlated with age (β=0.752, p<0.001), and daytime ambulatory systolic BP (β=0.345, p<0.001). CONCLUSION Our study showed that AS was increased in patients with reduced renal mass and this increase in AS was related to age and systolic BP. No relation was determined between AS and eGFR. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Raziye Yazıcı
- Konya Beyhekim Education and Research Hospital, Nephrology Department, Konya, Turkey
| | | | - İbrahim Guney
- University of Health Sciences, Konya Research and Training Hospital, Nephrology Department, Konya, Turkey
| | - Mehmet Yazıcı
- Academia Meram Hospital, Cardiology Department, Konya, Turkey
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Fan B, Zhang T, Li S, Yan Y, Fan L, Bazzano L, He J, Chen W. Differential Roles of Life-Course Cumulative Burden of Cardiovascular Risk Factors in Arterial Stiffness and Thickness. Can J Cardiol 2022; 38:1253-1262. [PMID: 35314334 DOI: 10.1016/j.cjca.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Data are limited regarding differential and common effects of cardiovascular risk factors on subclinical changes in vascular structure and function. We aimed to examine the relationships of life-course cumulative burdens of cardiovascular risk factors with adult arterial pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) in a longitudinal cohort of the Bogalusa Heart Study. METHODS The cohort consisted of 900 subjects who had aortic-femoral PWV and CIMT measurements. These participants were examined 5-16 times for body mass index (BMI), blood pressure, atherogenic index of plasma (AIP), and low-density lipoprotein cholesterol (LDLC) from childhood to adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden of the risk factors. RESULTS Adjusting for covariates, adult PWV was associated with AUCs of BMI, systolic blood pressure (SBP) and AIP (standardized regression coefficient [β] = 0.191, 0.321, 0.153, respectively; P < 0.001 for all). Adult CIMT was associated with AUCs of BMI, SBP, AIP and LDLC (β = 0.115, 0.202, 0.141, 0.152, respectively; P < 0.001 for all). Moreover, childhood BMI was associated with adult PWV and CIMT (β = 0.088 and 0.075, respectively; false discovery rate q values < 0.05 for both), and childhood LDLC with adult CIMT (β = 0.079; false discovery rate q value < 0.05). These associations did not differ significantly among race and sex groups. CONCLUSIONS The life-course cumulative burden of BMI, SBP, and AIP has common effects on arterial wall stiffening and thickening, whereas LDLC is specifically associated with arterial wall thickness, and this effect starts in early life.
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Affiliation(s)
- Bingbing Fan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science, Shandong University, Jinan, Shandong, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science, Shandong University, Jinan, Shandong, China.
| | - Shengxu Li
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Yinkun Yan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lijun Fan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Institute for Iodine Deficiency Disorders Prevention and Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Disparities between determinants of impaired vascular structure and function in young people with primary hypertension: a systematic review. J Hypertens 2022; 40:1369-1379. [PMID: 35762477 DOI: 10.1097/hjh.0000000000003155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Early effects of primary hypertension on arterial structure and function in children and young people (CYP) and their determinants remain elusive. We aimed to review independent determinants of carotid intima-media thickness (cIMT), carotid wall cross-sectional area (WCSA) and carotid-femoral pulse wave velocity (cfPWV) in CYP with primary hypertension. METHODS We performed a systematic review of studies reporting multivariable analysis of cfPWV, cIMT and WCSA in CYP (up to 25 years of age) with primary hypertension. Literature search was performed in PubMed database and 13, 12 and two articles including 3860 (age range 4-25 years, 50% male individuals), 2038 children (5-25 years, 55% male individuals) and 136 children (5-17 years, 85% male individuals) were selected for final analysis of cfPWV, cIMT and WCSA, respectively. RESULTS Ninety and 86% of the studies reported higher cfPWV and cIMT in CYP with elevated blood pressure (BP) compared with normotensive controls. Different indices of BP were positively associated with cfPWV in 92% of studies, whereas BMI showed association in 31%. Carotid IMT associated with BP indices in 50% and with BMI in 25% of the studies. WCSA was studied longitudinally and its improvement associated with decrease in measures of central obesity. CONCLUSION We found a disparity between the determinants of structural and functional impairment of arterial tree in CYP with primary hypertension. In contrast to cIMT and WCSA, increase of cfPWV is almost exclusively determined by BP.
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Helleputte S, Van Bortel L, Verbeke F, Op 't Roodt J, Calders P, Lapauw B, De Backer T. Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools. Cardiovasc Diabetol 2022; 21:97. [PMID: 35681143 PMCID: PMC9185867 DOI: 10.1186/s12933-022-01537-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients free from known CVD, and compare it to other CV risk evaluation tools used in T1D. Methods Cross-sectional study in adults with a T1D duration of at least 10 years and without established CVD. Patients were categorized in CVD risk groups based on 2019 European Society of Cardiology (ESC) guidelines, and the STENO T1D risk engine was used to estimate 10-year risk for CV events. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Coronary artery calcium (CAC) score was assessed and carotid ultrasound was performed. Ambulatory 24-h blood pressure and central hemodynamic parameters were evaluated. Data on renal function and diabetic kidney disease was retrieved. Results 54 patients (age: 46 ± 9.5 years; T1D duration: 27 ± 8.8 years) were included. One-fourth of patients showed prematurely increased aortic stiffness based on cf-PWV (24%). Cf-PWV was significantly associated with CAC score, carotid intima-media thickness, central hemodynamic parameters and diabetic kidney disease. Based on STENO, 20 patients (37%) were at low, 20 patients (37%) at moderate, and 14 patients (26%) at high 10-year risk for CV event. Cf-PWV was strongly associated with the STENO score (rs = + 0.81; R2 = 0.566, p < 0.001), increasing with each higher STENO group (p < 0.01). However, cf-PWV was not significantly different between the two CV risk groups (high versus very high) based on ESC criteria, and ESC criteria compared to STENO classified 10 patients more as having > 10% 10-year risk for CV events (n = 44/54; 81.5% versus n = 34/54; 63%). Conclusions This study demonstrated that a substantial proportion of long-standing T1D patients free from known CVD show premature arterial stiffening. Cf-PWV strongly associates with the STENO risk score for future CV events and with cardiovascular imaging and function outcomes, thereby illustrating the clinical importance of arterial stiffness. The data, however, also show considerable heterogeneity in CV risk and differences in risk categorisation between the STENO tool and ESC criteria.There is a need for refinement of CV risk classification in T1D, and future studies should investigate if evaluation of arterial stiffness should be implemented in T1D clinical practice and which patients benefit the most from its assessment.
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Affiliation(s)
- Simon Helleputte
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Fonds Wetenschappelijk Onderzoek (FWO) Vlaanderen, Ghent, Belgium.
| | - Luc Van Bortel
- Unit of Clinical Pharmacology, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Francis Verbeke
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Jos Op 't Roodt
- Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Patrick Calders
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Bruno Lapauw
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Tine De Backer
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Unit of Clinical Pharmacology, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium.,Department of Cardiology, Ghent University Hospital, Ghent, Belgium
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Tsai CH, Liao CW, Wu XM, Chen ZW, Pan CT, Chang YY, Lee BC, Shun CT, Wen WF, Chou CH, Wu VC, Hung CS, Lin YH. Autonomous cortisol secretion is associated with worse arterial stiffness and vascular fibrosis in primary aldosteronism: a cross-sectional study with follow-up data. Eur J Endocrinol 2022; 187:197-208. [PMID: 35551115 DOI: 10.1530/eje-21-1157] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 05/12/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The presence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) is common and potentially associated with poor outcomes. The aim of this study was to investigate the association between ACS and vascular remodeling in PA patients. DESIGN AND METHODS We prospectively enrolled 436 PA patients from October 2006 to November 2019. ACS (defined as a cortisol level >1.8 μg/dL after a 1 mg dexamethasone suppression test) was detected in 23% of the PA patients. Propensity score matching (PSM) with age, sex, systolic and diastolic blood pressure was performed. The brachial-ankle pulse wave velocity (baPWV) was examined at baseline and 1 year after targeted treatment. Small arteries of periadrenal fat in 46 patients were stained with Picro Sirus red to quantify the severity of vascular fibrosis. RESULTS After PSM, the PA patients with ACS had a significantly higher prevalence of diabetes mellitus, higher plasma aldosterone concentration and higher aldosterone-to-renin ratio. The baseline mean baPWV was also significantly higher in the PA patients with ACS. After multivariable regression analysis, the presence of ACS was a significant predictor of worse baseline mean baPWV (β: 235.745, 95% CI: 59.602-411.888, P = 0.010). In addition, the PA patients with ACS had worse vascular fibrosis (fibrosis area: 25.6 ± 8.4%) compared to those without ACS (fibrosis area: 19.8 ± 7.7%, P = 0.020). After 1 year of PA treatment, baPWV significantly improved in both groups. CONCLUSION The presence of ACS in PA patients is associated with worse arterial stiffness and vascular remodeling.
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Affiliation(s)
- Cheng-Hsuan Tsai
- National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Che-Wei Liao
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Xue-Ming Wu
- Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Zheng-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Chien-Ting Pan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Yi-Yao Chang
- Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Bo-Ching Lee
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Forensic Medicine and Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Fen Wen
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Chou
- Department of Obstetrics and Gynecology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Sheng Hung
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
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Camelo LV, Machado AV, Chor D, Griep RH, Mill JG, Brant LCC, Barreto SM. Racial discrimination is associated with greater arterial stiffness and carotid intima-media thickness: The ELSA-Brasil study. Ann Epidemiol 2022; 72:40-47. [DOI: 10.1016/j.annepidem.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/01/2022]
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