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Kim TI, Kostiuk V, Olson SL, Curci JA, Matsumura JS, Baxter BT, Blackwelder WC, Terrin ML, Guzman RJ. Effect of Doxycycline on Progression of Arterial Calcification in the Noninvasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA(3)CT). Ann Vasc Surg 2024; 104:1-9. [PMID: 37356652 PMCID: PMC10748791 DOI: 10.1016/j.avsg.2023.06.019] [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: 04/16/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Doxycycline has been shown to prevent arterial calcification via attenuation of matrix metalloproteinases (MMP) in preclinical models. We assessed the effects of doxycycline on progression of arterial calcification in patients enrolled in the Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA3CT). METHODS Two hundred and sixty-one patients were randomized to 100 mg doxycycline twice daily or placebo. Arterial calcification was measured in abdominal vessels on noncontrast computed tomography scans. Patients with baseline computed tomography scan and 1 or more follow-up scans within the 2-year study were included for analysis. For individual arteries, mean change in iliofemoral artery calcification over time was calculated via linear regression. Serum MMP-3 and MMP-9 levels were measured at baseline and 6 months. RESULTS Sixty-five patients in the doxycycline and 66 in the placebo arm were included in this analysis. Baseline characteristics between the groups were similar. The unadjusted mean change in iliofemoral calcium score per year trended toward higher values in patients treated with doxycycline compared with placebo (322 ± 399 units/year vs. 217 ± 307 units/year, P = 0.09). After 6 months, changes in serum MMP-3 and MMP-9 levels were not significantly different between study arms. CONCLUSIONS In patients with small aortic aneurysm, treatment with doxycycline 100 mg twice daily did not decrease circulating levels of the matrix degrading enzymes MMP-3 and 9 or alter the progression of arterial calcification.
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Affiliation(s)
- Tanner I Kim
- Department of Surgery, John A Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Valentyna Kostiuk
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Sydney L Olson
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - John A Curci
- Department of Vascular Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Jon S Matsumura
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Bernard T Baxter
- Division of Vascular Surgery, University of Nebraska School of Medicine, Omaha, NE
| | - William C Blackwelder
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - Michael L Terrin
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - Raul J Guzman
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT.
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Vargas AI, Tarraf SA, Jennings T, Bellini C, Amini R. Vascular Remodeling During Late-Gestation Pregnancy: An In-Vitro Assessment of the Murine Ascending Thoracic Aorta. J Biomech Eng 2024; 146:071004. [PMID: 38345599 DOI: 10.1115/1.4064744] [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: 10/24/2023] [Indexed: 03/20/2024]
Abstract
Maternal mortality due to cardiovascular disease is a rising concern in the U.S. Pregnancy triggers changes in the circulatory system, potentially influencing the structure of the central vasculature. Evidence suggests a link between a woman's pregnancy history and future cardiovascular health, but our understanding remains limited. To fill this gap, we examined the passive mechanics of the murine ascending thoracic aorta during late gestation. By performing biaxial mechanical testing on the ascending aorta, we were able to characterize the mechanical properties of both control and late-gestation tissues. By examining mechanical, structural, and geometric properties, we confirmed that remodeling of the aortic wall occurred. Morphological and mechanical properties of the tissue indicated an outward expansion of the tissue, as reflected in changes in wall thickness (∼12% increase) and luminal diameter (∼6% increase) at its physiologically loaded state in the pregnant group. With these geometric adaptations and despite increased hemodynamic loads, pregnancy did not induce significant changes in the tensile wall stress at the similar physiological pressure levels of the pregnant and control tissues. The alterations also included reduced intrinsic stiffness in the circumferential direction (∼18%) and reduced structural stiffness (∼26%) in the pregnant group. The observed vascular remodeling maintained the elastic stored energy of the aortic wall under systolic loads, indicating preservation of vascular function. Data from our study of pregnancy-related vascular remodeling will provide valuable insights for future investigations of maternal cardiovascular health.
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Affiliation(s)
- Ana I Vargas
- Department of Bioengineering, Northeastern University, Boston, MA 02115
| | - Samar A Tarraf
- Department of Bioengineering, Northeastern University, Boston, MA 02115
- Northeastern University
| | - Turner Jennings
- Department of Mechanical and Industrial Engineering, Department of Bioengineering, Northeastern University, Boston, MA 02115
- Northeastern University
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, Boston, MA 02115
| | - Rouzbeh Amini
- Department of Mechanical and Industrial Engineering, Department of Bioengineering, Northeastern University, Boston, MA 02115
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3
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Suriani I, Bouwman RA, Mischi M, Lau KD. An in silico study of the effects of cardiovascular aging on carotid flow waveforms and indexes in a virtual population. Am J Physiol Heart Circ Physiol 2024; 326:H877-H899. [PMID: 38214900 DOI: 10.1152/ajpheart.00304.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
Cardiovascular aging is strongly associated with increased risk of cardiovascular disease and mortality. Moreover, health and lifestyle factors may accelerate age-induced alterations, such as increased arterial stiffness and wall dilation, beyond chronological age, making the clinical assessment of cardiovascular aging an important prompt for preventative action. Carotid flow waveforms contain information about age-dependent cardiovascular properties, and their ease of measurement via noninvasive Doppler ultrasound (US) makes their analysis a promising tool for the routine assessment of cardiovascular aging. In this work, the impact of different aging processes on carotid waveform morphology and derived indexes is studied in silico, with the aim of establishing the clinical potential of a carotid US-based assessment of cardiovascular aging. One-dimensional (1-D) hemodynamic modeling was employed to generate an age-specific virtual population (VP) of N = 5,160 realistic carotid hemodynamic waveforms. The resulting VP was statistically validated against in vivo aging trends in waveforms and indexes from the literature, and simulated waveforms were studied in relation to age and underlying cardiovascular parameters. In our study, the carotid flow augmentation index (FAI) significantly increased with age (with a median increase of 50% from the youngest to the oldest age group) and was strongly correlated to local arterial stiffening (r = 0.94). The carotid pulsatility index (PI), which showed less pronounced age variation, was inversely correlated with the reflection coefficient at the carotid branching (r = -0.88) and directly correlated with carotid net forward wave energy (r = 0.90), corroborating previous literature where it was linked to increased risk of cerebrovascular damage in the elderly. There was a high correlation between corrected carotid flow time (ccFT) and cardiac output (CO) (r = 0.99), which was not affected by vascular age. This study highlights the potential of carotid waveforms as a valuable tool for the assessment of cardiovascular aging.NEW & NOTEWORTHY An age-specific virtual population was generated based on a 1-D model of the arterial circulation, including newly defined literature-based specific age variations in carotid vessel properties. Simulated carotid flow/velocity waveforms, indexes, and age trends were statistically validated against in vivo data from the literature. A comprehensive study of the impact of aging on carotid flow waveform morphology was performed, and the mechanisms influencing different carotid indexes were elucidated. Notably, flow augmentation index (FAI) was found to be a strong indicator of local carotid stiffness.
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Affiliation(s)
- Irene Suriani
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R Arthur Bouwman
- Eindhoven University of Technology, Eindhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Massimo Mischi
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Kevin D Lau
- Philips Research, Eindhoven, The Netherlands
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4
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Schellinger IN, Dannert A, Hoffmann A, Chodisetti G, Mattern K, Petzold A, Klöting N, Schuster A, Wagenhäuser MU, Emrich F, Stumvoll M, Hasenfuß G, Raaz U. Angiotensin Receptor-Neprilysin Inhibition (Sacubitril/Valsartan) Reduces Structural Arterial Stiffness in Middle-Aged Mice. J Am Heart Assoc 2024; 13:e032641. [PMID: 38348796 PMCID: PMC11010079 DOI: 10.1161/jaha.123.032641] [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: 10/18/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Increasing arterial stiffness is a prominent feature of the aging cardiovascular system. Arterial stiffening leads to fundamental alterations in central hemodynamics with widespread detrimental implications for organ function resulting in significant morbidity and death, and specific therapies to address the underlying age-related structural arterial remodeling remain elusive. The present study investigates the potential of the recently clinically available dual angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan (LCZ696) to counteract age-related arterial fibrotic remodeling and stiffening in 1-year-old mice. METHODS AND RESULTS Treatment of in 1-year-old mice with ARNI (sacubitril/valsartan), in contrast to angiotensin receptor blocker monotherapy (valsartan) and vehicle treatment (controls), significantly decreases structural aortic stiffness (as measured by in vivo pulse-wave velocity and ex vivo aortic pressure myography). This phenomenon appears, at least partly, independent of (indirect) blood pressure effects and may be related to a direct antifibrotic interference with aortic smooth muscle cell collagen production. Furthermore, we find aortic remodeling and destiffening due to ARNI treatment to be associated with improved parameters of cardiac diastolic function in aged mice. CONCLUSIONS This study provides preclinical mechanistic evidence indicating that ARNI-based interventions may counteract age-related arterial stiffening and may therefore be further investigated as a promising strategy to improve cardiovascular outcomes in the elderly.
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Affiliation(s)
- Isabel N. Schellinger
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Angelika Dannert
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Annet Hoffmann
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Giriprakash Chodisetti
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Karin Mattern
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Anne Petzold
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
| | - Nora Klöting
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Andreas Schuster
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
| | - Markus U. Wagenhäuser
- Department of Vascular and Endovascular SurgeryUniversity Hospital Düsseldorf, Heinrich‐Heine‐UniversityDüsseldorfGermany
| | - Fabian Emrich
- Department of Cardiothoracic and Vascular SurgeryGoethe University Hospital FrankfurtFrankfurtGermany
| | - Michael Stumvoll
- Department for Endocrinology, Nephrology and RheumatologyUniversity Medical Center Leipzig, University of LeipzigLeipzigGermany
| | - Gerd Hasenfuß
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
| | - Uwe Raaz
- Department of Cardiology and PneumologyHeart Center at the University Medical Center GöttingenGöttingenGermany
- German Center for Cardiovascular Research (DZHK) e.V. Partner site GöttingenGöttingenGermany
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Dua HS, Freitas R, Mohammed I, Ting DSJ, Said DG. The pre-Descemet's layer (Dua's layer, also known as the Dua-Fine layer and the pre-posterior limiting lamina layer): Discovery, characterisation, clinical and surgical applications, and the controversy. Prog Retin Eye Res 2023; 97:101161. [PMID: 36642673 DOI: 10.1016/j.preteyeres.2022.101161] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023]
Abstract
The pre-Descemet's layer/Dua's layer, also termed the Dua-Fine layer and the pre-posterior limiting lamina layer, lies anterior to the Descemet's membrane in the cornea, is 10 μm (range 6-16) thick, made predominantly of type I and some type VI collagen with abundant elastin, more than any other layer of the cornea. It has high tensile strength (bursting pressure up to 700 mm of Hg), is impervious to air and almost acellular. At the periphery it demonstrates fenestrations and ramifies to become the core of the trabecular meshwork, with implications for intraocular pressure and glaucoma. It has been demonstrated in some species of animals. The layer has assumed considerable importance in anterior and posterior lamellar corneal transplant surgery by improving our understanding of the behaviour of corneal tissue during these procedures, improved techniques and made the surgery safer with better outcomes. It has led to the innovation of new surgical procedures namely, pre-Descemet's endothelial keratoplasty, suture management of acute hydrops, DALK-triple and Fogla's mini DALK. The discovery and knowledge of the layer has introduced paradigm shifts in our age old concepts of Descemet's membrane detachment, acute corneal hydrops in keratoconus and Descemetoceles, with impact on management approaches. It has been shown to contribute to the pathology and clinical signs observed in corneal infections and some corneal dystrophies. Early evidence suggests that it may have a role in the pathogenesis of keratoconus in relation to its elastin content. Its contribution to corneal biomechanics and glaucoma are subjects of current investigations.
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Affiliation(s)
- Harminder S Dua
- Larry A Donoso Laboratory for Eye Research, Academic Unit of Ophthalmology and Visual Sciences, University of Nottingham, The Queens Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, England, UK.
| | - Rui Freitas
- Larry A Donoso Laboratory for Eye Research, Academic Unit of Ophthalmology and Visual Sciences, University of Nottingham, The Queens Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, England, UK; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal.
| | - Imran Mohammed
- Larry A Donoso Laboratory for Eye Research, Academic Unit of Ophthalmology and Visual Sciences, University of Nottingham, The Queens Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, England, UK.
| | - Darren S J Ting
- Larry A Donoso Laboratory for Eye Research, Academic Unit of Ophthalmology and Visual Sciences, University of Nottingham, The Queens Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, England, UK.
| | - Dalia G Said
- Larry A Donoso Laboratory for Eye Research, Academic Unit of Ophthalmology and Visual Sciences, University of Nottingham, The Queens Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, England, UK; Research Institute of Ophthalmology, Cairo, Egypt.
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Choi HZ, Kim SU, Huh J, Lee HG, Kim MK, Kim DS, Huh CW. Comparison of treatment outcomes and complications of coil embolization in elderly and very elderly patients with cerebral aneurysms: a propensity score matching analysis. Acta Neurochir (Wien) 2023; 165:3361-3369. [PMID: 37728829 DOI: 10.1007/s00701-023-05793-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE This single center study aims to compare the treatment outcomes and procedure-related complications of coil embolization in elderly patients (60-79 years) and very elderly patients (aged 80 years or older) with cerebral aneurysms. METHODS Data was collected from 504 elderly patients aged 60 years or older who underwent coil embolization for intracranial aneurysms from 2018 to 2021. The study evaluated patient-related and anatomical factors and assessed various outcomes, comparing results between groups using statistical analysis and propensity score matching. RESULTS A total of 503 cerebral aneurysms were analyzed from individuals aged 60-79 years (n = 472) and those aged 80 years or older (n = 31). The majority of the aneurysms were unruptured with an average size of 3.5 mm in height and 3.4 mm in width. The patients were compared using 1:1 propensity score matching, and no significant differences were found in factors other than age and aortic elongation. Logistic analysis revealed that being over 80 years old and having a severe aortic arch elongation were identified as risk factors for procedure-related events in both total and unruptured cases. CONCLUSIONS The study compared coil embolization treatment for cerebral aneurysms in patients aged 60-79 and over 80, finding no significant difference in treatment outcomes except for procedure-related events. Procedure-related events were associated with severe aortic arch elongation and being over 80 years old. Coil embolization can be considered safe and effective for patients over 80, but further trials are needed for accurate conclusions.
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Affiliation(s)
- Han-Zo Choi
- Department of emergency medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Sang-Uk Kim
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea.
| | - Joon Huh
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea
| | - Hyun-Goo Lee
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea
| | - Mi-Kyung Kim
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea
| | - Dal-Soo Kim
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea
| | - Choon-Woong Huh
- Department of Neurosurgery, Myong-Ji St. Mary's Hospital, 156, Dorimro, Youngdungpo-gu, Seoul, 07417, Republic of Korea
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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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Tarraf SA, Kramer B, Vianna E, Gillespie C, Germano E, Emerton KB, Amini R, Colbrunn R, Hargrave J, Roselli EE, Bellini C. Lengthwise regional mechanics of the human aneurysmal ascending thoracic aorta. Acta Biomater 2023; 162:266-277. [PMID: 36944405 PMCID: PMC10148908 DOI: 10.1016/j.actbio.2023.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 03/23/2023]
Abstract
The prognosis of patients undergoing emergency endovascular repair of ascending thoracic aortic aneurysm (ATAA) depends on defect location, with root disease bearing worse outcomes than proximal or distal aortopathy. We speculate that a spatial gradient in aneurysmal tissue mechanics through the length of the ascending thoracic aorta may fuel noted survival discrepancies. To this end, we performed planar biaxial testing on 153 root, proximal, and distal segments of ATAA samples collected from 80 patients receiving elective open surgical repair. Following data averaging via surface fitting-based interpolation of strain-controlled protocols, we combined in-vitro and in-vivo measurements of loads and geometry to resolve inflation-extension kinematics and evaluate mechanical metrics of stress, stiffness, and energy at consistent deformation levels. Representative (averaged) experimental data and simulated in-vivo conditions revealed significantly larger biaxial stiffness at the root compared to either proximal or distal tissues, which persisted as the entire aorta stiffened during aging. Advancing age further reduced biaxial stretch and energy storage, a measure of aortic function, across all ATAA segments. Importantly, age emerged as a stronger predictor of tissue mechanics in ATAA disease than either bicuspid aortic valve or connective tissue disorders. Besides strengthening the general understanding of aneurysmal disease, our findings provide specifications to customize the design of stent-grafts for the treatment of ATAA disease. Optimization of deployment and interaction of novel endovascular devices with the local native environment is expected to carry significant potential for improving clinical outcomes. STATEMENT OF SIGNIFICANCE: Elucidating the lengthwise regional mechanics of ascending thoracic aortic aneurysms (ATAAs) is critical for the design of endovascular devices tailored to the ascending aorta. Stent-grafts provide a less invasive alternative to support the long-term survival of ATAA patients ineligible for open surgical repair. In this study, we developed a numerical framework that combines semi-inverse constitutive and forward modeling with in-vitro and in-vivo data to extract mechanical descriptors of ATAA tissue behavior at physiologically meaningful deformation. Moving distally from the aortic root to the first ascending aortic branch, we observed a progressive decline in biaxial stiffness. Furthermore, we showed that aging leads to reduced aortic function and is a stronger predictor of mechanics than either valve morphology or underlying syndromic disorder.
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Affiliation(s)
- Samar A Tarraf
- Department of Bioengineering, Northeastern University, 360 Huntington Ave., Boston, MA, 02125 USA
| | - Benjamin Kramer
- Aortic Center, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Emily Vianna
- Aortic Center, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Callan Gillespie
- Department of Biomedical Engineering, BioRobotics and Mechanical Testing Core, Cleveland Clinic, Cleveland, OH, USA
| | - Emídio Germano
- Aortic Center, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Kelly B Emerton
- Aortic Center, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Rouzbeh Amini
- Department of Bioengineering, Northeastern University, 360 Huntington Ave., Boston, MA, 02125 USA; Department of Mechanical and Industrial Engineering, Northeastern University, 360 Huntington Ave., Boston, MA, 02125 USA
| | - Robb Colbrunn
- Department of Biomedical Engineering, BioRobotics and Mechanical Testing Core, Cleveland Clinic, Cleveland, OH, USA
| | - Jennifer Hargrave
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, OH, USA
| | - Eric E Roselli
- Aortic Center, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, BioRobotics and Mechanical Testing Core, Cleveland Clinic, Cleveland, OH, USA
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, 360 Huntington Ave., Boston, MA, 02125 USA.
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Huang YQ, He GD, Feng YQ. The association of lead exposure with blood pressure and hypertension: a mediation analyses of estimated glomerular filtration rate. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:59689-59700. [PMID: 37014600 DOI: 10.1007/s11356-023-26734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
The link between lead and blood pressure was debatable, and whether it was mediated by renal function was unknown. The purpose was to investigate the relationship between blood lead concentrations and blood pressure and hypertension, as well as the mediating role of estimated glomerular filtration rate (eGFR) in this relationship. Participants aged 18 were recruited from the National Health and Nutrition Examination Survey (1999-2014) and provided with lead and blood pressure data. Multivariate linear and logistic regression, stratification, interaction tests, and a restricted cubic spline curve were used to assess the association of blood lead with systolic/diastolic blood pressure (SBP/DBP) and hypertension, and mediation effect analysis was used to investigate the role of eGFR in this relationship. A total of 20,073 subjects were enrolled, and among them, 9837 (49.01%) were male and 7800 (38.86%) were hypertensive patients. Multivariate linear and logistic regression analysis showed that blood lead levels were significantly associated with SBP (β = 3.14, 95%CI: 2.03, 4.25; P < 0.001), DBP (β = 3.50, 95%CI: 2.69, 4.30; P < 0.001), and hypertension (OR = 1.29, 95%CI: 1.09, 1.52; P = 0.0026). In comparison to the lowest blood lead quartile, the highest lead group was significantly associated with SBP (= 2.55, 95%CI: 1.66, 3.44; P = 0.0001), DBP (= 2.60, 95%CI: 1.95, 3.24; P = 0.0001), and hypertension (OR = 1.26, 95%CI: 1.10, 1.45; P = 0.0007). Mediation analysis showed that the proportion of blood lead mediated for SBP, DBP, and hypertension was 3.56% (95%CI: 0.42%, 7.96%; P = 0.0320), 6.21% (95%CI: 4.02%, 9.32%; P < 0.0001), and 17.39% (95%CI: 9.34%, 42.71%; P < 0.0001), respectively. Adjusted restricted cubic spline curves presented a non-linear correlation of blood lead levels with DBP (P-non-linearity < 0.001), linear with SBP (P-non-linearity = 0.203), and hypertension (P-non-linearity = 0.763). Our findings demonstrated that blood lead levels were non-linear with DBP, but linear with SBP and hypertension, and this relationship was mediated by eGFR.
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Affiliation(s)
- Yu-Qing Huang
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guo-Dong He
- Research Department of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying-Qing Feng
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China.
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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10
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Eden MJ, Matz J, Garg P, Gonzalez MP, McElderry K, Wang S, Gollner MJ, Oakes JM, Bellini C. Prolonged smoldering Douglas fir smoke inhalation augments respiratory resistances, stiffens the aorta, and curbs ejection fraction in hypercholesterolemic mice. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 861:160609. [PMID: 36470384 PMCID: PMC10699119 DOI: 10.1016/j.scitotenv.2022.160609] [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: 06/09/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
While mounting evidence suggests that wildland fire smoke (WFS) inhalation may increase the burden of cardiopulmonary disease, the occupational risk of repeated exposure during wildland firefighting remains unknown. To address this concern, we evaluated the cardiopulmonary function in mice following a cumulative exposure to lab-scale WFS equivalent to a mid-length wildland firefighter (WLFF) career. Dosimetry analysis indicated that 80 exposure hours at a particulate concentration of 22 mg/m3 yield in mice the same cumulative deposited mass per unit of lung surface area as 3600 h of wildland firefighting. To satisfy this condition, male Apoe-/- mice were whole-body exposed to either air or smoldering Douglas fir smoke (DFS) for 2 h/day, 5 days/week, over 8 consecutive weeks. Particulate size in DFS fell within the respirable range for both mice and humans, with a count median diameter of 110 ± 20 nm. Expiratory breath hold in mice exposed to DFS significantly reduced their minute volume (DFS: 27 ± 4; Air: 122 ± 8 mL/min). By the end of the exposure time frame, mice in the DFS group exhibited a thicker (DFS: 109 ± 3; Air: 98 ± 3 μm) and less distensible (DFS: 23 ± 1; Air: 28 ± 1 MPa-1) aorta with reduced diastolic blood augmentation capacity (DFS: 53 ± 2; Air: 63 ± 2 kPa). Cardiac magnetic resonance imaging further revealed larger end-systolic volume (DFS: 14.6 ± 1.1; Air: 9.9 ± 0.9 μL) and reduced ejection-fraction (DFS: 64.7 ± 1.0; Air: 75.3 ± 0.9 %) in mice exposed to DFS. Consistent with increased airway epithelium thickness (DFS: 10.4 ± 0.8; Air: 7.6 ± 0.3 μm), airway Newtonian resistance was larger following DFS exposure (DFS: 0.23 ± 0.03; Air: 0.20 ± 0.03 cmH2O-s/mL). Furthermore, parenchyma mean linear intercept (DFS: 36.3 ± 0.8; Air: 33.3 ± 0.8 μm) and tissue thickness (DFS: 10.1 ± 0.5; Air: 7.4 ± 0.7 μm) were larger in DFS mice. Collectively, mice exposed to DFS manifested early signs of cardiopulmonary dysfunction aligned with self-reported events in mid-career WLFFs.
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Affiliation(s)
- Matthew J Eden
- Department of Bioengineering, Northeastern University, MA, USA
| | - Jacqueline Matz
- Department of Bioengineering, Northeastern University, MA, USA
| | - Priya Garg
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | | | | | - Siyan Wang
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - Michael J Gollner
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - Jessica M Oakes
- Department of Bioengineering, Northeastern University, MA, USA
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, MA, USA.
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11
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Aerobic exercise improves central blood pressure and blood pressure variability among patients with resistant hypertension: results of the EnRicH trial. Hypertens Res 2023:10.1038/s41440-023-01229-7. [PMID: 36813985 DOI: 10.1038/s41440-023-01229-7] [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: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
Central blood pressure (BP) and BP variability are associated with cardiovascular disease risk. However, the influence of exercise on these hemodynamic parameters is unknown among patients with resistant hypertension. The EnRicH (The Exercise Training in the Treatment of Resistant Hypertension) was a prospective, single-blinded randomized clinical trial (NCT03090529). Sixty patients were randomized to a 12-week aerobic exercise program or usual care. The outcome measures include central BP, BP variability, heart rate variability, carotid-femoral pulse wave velocity, and circulating cardiovascular disease risk biomarkers including high-sensitivity C-reactive protein, angiotensin II, superoxide dismutase, interferon gamma, nitric oxide, and endothelial progenitor cells. Central systolic BP decreased by 12.22 mm Hg (95% CI, -1.88 to -22.57, P = 0.022) as did BP variability by 2.85 mm Hg (95% CI, -4.91 to -0.78, P = 0.008), in the exercise (n = 26) compared to the control group (n = 27). Interferon gamma -4.3 pg/mL (95%CI, -7.1 to -1.5, P = 0.003), angiotensin II -157.0 pg/mL (95%CI, -288.1 to -25.9, P = 0.020), and superoxide dismutase 0.4 pg/mL (95%CI, 0.1-0.6, P = 0.009) improved in the exercise compared to the control group. Carotid-femoral pulse wave velocity, heart rate variability, high-sensitivity C-reactive protein, nitric oxide, and endothelial progenitor cells were not different between groups (P > 0.05). In conclusion, a 12-week exercise training program improved central BP and BP variability, and cardiovascular disease risk biomarkers in patients with resistant hypertension. These markers are clinically relevant as they are associated with target organ damage and increased cardiovascular disease risk and mortality.
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12
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Grewal N, Dolmaci O, Jansen E, Klautz R, Driessen A, Lindeman J, Poelmann RE. Are acute type A aortic dissections atherosclerotic? Front Cardiovasc Med 2023; 9:1032755. [PMID: 36698948 PMCID: PMC9868270 DOI: 10.3389/fcvm.2022.1032755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Type A aortic dissections (TAAD) are devastating aortic complications. Patients with Marfan syndrome, a bicuspid aortic valve or a thoracic aortic aneurysm have an increased risk to develop a TAAD. These predisposing conditions are characterized by a histologically thin intimal layer and hardly any atherosclerosis. Little is known about the susceptibility for atherosclerosis in patients with a type A aortic dissection. Objective We aim to systematically describe atherosclerotic lesions in TAAD patients. Materials and methods A total of 51 patients with a TAAD (mean age 62.5 ± 10.8 years, 49% females) and 17 control patients (mean age 63 ± 5.5 years, 53% females) were included in this study. Cardiovascular risk factors were assessed clinically. All sections were stained with Movat pentachrome and hematoxylin eosin. Plaque morphology was classified according to the modified AHA classification scheme proposed by Virmani et al. Results In the TAAD group thirty-seven percent were overweight (BMI > 25). Diabetes and peripheral arterial disease were not present in any of the patients. Fifty-nine percent of the patients had a history of hypertension. The intima in TAAD patients was significantly thinner as compared to the control group (mean thickness 143 ± 126.5 μm versus 193 ± 132 μm, p < 0.023). Seven TAAD patients had a normal intima without any form of adaptive or pathological thickening. Twenty-three TAAD patients demonstrated adaptive intimal thickening. Fourteen had an intimal xanthoma, also known as fatty streaks. A minority of 7 TAAD patients had progressive atherosclerotic lesions, 4 of which demonstrated pathological intimal thickening, 3 patients showed early fibroatheroma, late fibroatheroma and thin cap fibroatheroma. In the control group the majority of the patients exhibited progressive atherosclerotic lesions: three pathologic intimal thickening, two early fibroatheroma, six late fibroatheroma, one healed rupture and two fibrotic calcified plaque. Discussion This study shows that TAAD patients hardly exhibit any form of progressive atherosclerosis. The majority of TAAD patients showcase non-progressive intimal lesions, whereas the control group mostly demonstrated progressive intimal atherosclerotic lesions. Findings are independent of age, sex, or the presence of (a history of) hypertension.
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Affiliation(s)
- Nimrat Grewal
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands,Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands,*Correspondence: Nimrat Grewal,
| | - Onur Dolmaci
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Evert Jansen
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Robert Klautz
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands,Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Antoine Driessen
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Jan Lindeman
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Robert E. Poelmann
- Institute of Biology, Animal Sciences and Health, Leiden University, Leiden, Netherlands,Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
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13
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Oliveira AC, Cunha PMGM, Vitorino PVDO, Souza ALL, Deus GD, Feitosa A, Barbosa ECD, Gomes MM, Jardim PCBV, Barroso WKS. Vascular Aging and Arterial Stiffness. Arq Bras Cardiol 2022; 119:604-615. [PMID: 36287415 PMCID: PMC9563886 DOI: 10.36660/abc.20210708] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
O envelhecimento biológico é reflexo da interação entre genética, idade cronológica e fatores externos; é a base para novos conceitos em envelhecimento vascular, cuja progressão é determinada pela diferença entre idade biológica e cronológica. Do ponto de vista estrutural, os efeitos do envelhecimento vascular são mais evidentes na camada média das grandes artérias elásticas e resultam em aumento da rigidez arterial, da dilatação do lúmen e da espessura da parede. Esses efeitos são descritos no continuum de envelhecimento cardiovascular (proposto por Dzau em 2010) em que as etapas progressivas de lesões da microvasculatura de coração, rins e cérebro, têm início a partir do processo de envelhecimento. O aumento da rigidez arterial pode ser verificado de forma não invasiva por vários métodos. Os eventos cardiovasculares têm sido tradicionalmente previstos utilizando escores que combinam fatores de risco convencionais para aterosclerose. No continuum cardiovascular clássico (Dzau, 2006), é desafiador avaliar o peso exato da contribuição de cada fator de risco; entretanto, por refletir o dano precoce e cumulativo desses fatores de riscos cardiovascular, a rigidez arterial reflete o verdadeiro dano à parede arterial. Este artigo fornece uma visão geral dos mecanismos da fisiopatogenia, alterações estruturais das artérias e consequências hemodinâmicas do envelhecimento arterial; métodos não invasivos para a avaliação da rigidez arterial e da medida central da pressão arterial; o continuum de envelhecimento cardiovascular, e aplicação do conceito de rigidez arterial na estratificação de risco cardiovascular.
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Affiliation(s)
| | | | | | - Ana Luiza Lima Souza
- Universidade Federal de Goiás , Liga de Hipertensão , Goiânia , GO - Brasil.,Universidade Federal de Goiás - Programa de Pós-Graduação em Ciências da Saúde , Goiânia , GO - Brasil
| | - Gilcimar Divino Deus
- Pontifícia Universidade Católica de Goiás - Escola de Ciências Exatas e da Computação , Goiânia , GO - Brasil
| | - Audes Feitosa
- Universidade de Pernambuco , Recife , PE - Brasil.,Universidade Católica de Pernambuco , Recife , PE - Brasil
| | | | - Marco Mota Gomes
- Centro Universitario CESMAC - Hospital do Coração , Maceió , AL - Brasil
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14
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van Asten JGM, Ristori T, Nolan DR, Lally C, Baaijens FPT, Sahlgren CM, Loerakker S. Computational analysis of the role of mechanosensitive Notch signaling in arterial adaptation to hypertension. J Mech Behav Biomed Mater 2022; 133:105325. [PMID: 35839633 PMCID: PMC7613661 DOI: 10.1016/j.jmbbm.2022.105325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/03/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022]
Abstract
Arteries grow and remodel in response to mechanical stimuli. Hypertension, for example, results in arterial wall thickening. Cell-cell Notch signaling between vascular smooth muscle cells (VSMCs) is known to be involved in this process, but the underlying mechanisms are still unclear. Here, we investigated whether Notch mechanosensitivity to strain may regulate arterial thickening in hypertension. We developed a multiscale computational framework by coupling a finite element model of arterial mechanics, including residual stress, to an agent-based model of mechanosensitive Notch signaling, to predict VSMC phenotypes as an indicator of growth and remodeling. Our simulations revealed that the sensitivity of Notch to strain at mean blood pressure may be a key mediator of arterial thickening in hypertensive arteries. Further simulations showed that loss of residual stress can have synergistic effects with hypertension, and that changes in the expression of Notch receptors, but not Jagged ligands, may be used to control arterial growth and remodeling and to intensify or counteract hypertensive thickening. Overall, we identify Notch mechanosensitivity as a potential mediator of vascular adaptation, and we present a computational framework that can facilitate the testing of new therapeutic and regenerative strategies.
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Affiliation(s)
- Jordy G M van Asten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Tommaso Ristori
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - David R Nolan
- School of Engineering and Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
| | - Caitríona Lally
- School of Engineering and Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
| | - Frank P T Baaijens
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Cecilia M Sahlgren
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands; Faculty of Science and Engineering, Biosciences, Åbo Akademi, Turku, Finland
| | - Sandra Loerakker
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
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15
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Wang Y, Hou Y, Song S, Zuo Y, Yu Y, Chi Y, Zhang T. Harm of circadian misalignment to the hearts of the adolescent wistar rats. J Transl Med 2022; 20:352. [PMID: 35933342 PMCID: PMC9356460 DOI: 10.1186/s12967-022-03546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/17/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of this study was to observe the harm of circadian misalignment (CM), caused by an inverted photoperiod (IP), on the hearts of the adolescent Wistar rats, and to explore the mechanisms leading to harm. METHODS An IP was used to create a CM model. A total of 174 Wistar rats were randomly divided into circadian alignment (CA) and CM groups (87 rats per group). The different activity rhythms of the two groups of rats were adjusted through different light/dark cycles for 90 days. We recorded the rhythmic activity trajectory and sleep time of the rats. After 90 days of modeling, we performed various analyses (i.e., blood pressure, weight, cardiac ultrasound tests, serological tests, cardiac tissue immunofluorescence, immunohistochemistry, transmission electron microscopy on myocardial mitochondria, western blotting, and quantitative polymerase chain reactions). RESULTS (1) The IP protocol caused CM in rats. (2) CM rats showed significantly higher blood pressure during the day (resting phase). They also showed significantly higher serum levels of angiotensin II and epinephrine during the day compared to the CA rats. (3) CM caused up-regulation of gene expression of adrenergic receptors α1 (α1-AR) and β1 (β1-AR) and down-regulation of the glucocorticoid receptor (Gr) gene expression in rat hearts. It also caused downregulation of Bmal1 expression. In addition, the changes in Bmal1 and Per2 correlated with the changes in β1-AR and α1-AR. (4) CM had adverse effects on multiple molecular proteins of the heart. (5) CM increased the collagen fibers in the rat heart and increased the destruction of mitochondria. (6) Eventually, CM caused a decrease in the pumping function of the heart and decreased the coronary blood flow rate. CONCLUSIONS (1) CM significantly affected the cardiac structure and function in the adolescent rats through a variety of mechanisms. (2) CM can regulate the expression of myocardial clock genes, and it is likely to have an impact on the heart through this pathway.
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Affiliation(s)
- YunLei Wang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China.,Beijing Bo'ai Hospital, China Rehabilitation Research Center, No.10 JiaoMen North Road, Fengtai District, Beijing, 100068, China.,Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, 100068, China
| | - YuanYuan Hou
- School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China.,Beijing Bo'ai Hospital, China Rehabilitation Research Center, No.10 JiaoMen North Road, Fengtai District, Beijing, 100068, China.,Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, 100068, China
| | - ShaoFei Song
- School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China.,Beijing Bo'ai Hospital, China Rehabilitation Research Center, No.10 JiaoMen North Road, Fengtai District, Beijing, 100068, China.,Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, 100068, China
| | - Yao Zuo
- Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.,University of Health and Rehabilitation Sciences, Qingdao, 266071, Shandong, China
| | - Yan Yu
- China Rehabilitation Science Institute, Beijing, 100068, China
| | - YaFei Chi
- Capital Medical University, Beijing, 100069, China
| | - Tong Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China. .,Beijing Bo'ai Hospital, China Rehabilitation Research Center, No.10 JiaoMen North Road, Fengtai District, Beijing, 100068, China. .,Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, 100068, China.
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16
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Marlevi D, Mariscal-Harana J, Burris NS, Sotelo J, Ruijsink B, Hadjicharalambous M, Asner L, Sammut E, Chabiniok R, Uribe S, Winter R, Lamata P, Alastruey J, Nordsletten D. Altered Aortic Hemodynamics and Relative Pressure in Patients with Dilated Cardiomyopathy. J Cardiovasc Transl Res 2022; 15:692-707. [PMID: 34882286 PMCID: PMC9622552 DOI: 10.1007/s12265-021-10181-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/20/2021] [Indexed: 12/05/2022]
Abstract
Ventricular-vascular interaction is central in the adaptation to cardiovascular disease. However, cardiomyopathy patients are predominantly monitored using cardiac biomarkers. The aim of this study is therefore to explore aortic function in dilated cardiomyopathy (DCM). Fourteen idiopathic DCM patients and 16 controls underwent cardiac magnetic resonance imaging, with aortic relative pressure derived using physics-based image processing and a virtual cohort utilized to assess the impact of cardiovascular properties on aortic behaviour. Subjects with reduced left ventricular systolic function had significantly reduced aortic relative pressure, increased aortic stiffness, and significantly delayed time-to-pressure peak duration. From the virtual cohort, aortic stiffness and aortic volumetric size were identified as key determinants of aortic relative pressure. As such, this study shows how advanced flow imaging and aortic hemodynamic evaluation could provide novel insights into the manifestation of DCM, with signs of both altered aortic structure and function derived in DCM using our proposed imaging protocol.
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Affiliation(s)
- David Marlevi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Sweden
- Department of Clinical Sciences, Karolinska Institutet, Danderyd, Sweden
| | - Jorge Mariscal-Harana
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | | | - Julio Sotelo
- School of Biomedical Engineering, Universidad de Valparaíso, Valparaíso, Chile
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Cardio MR, Chile
| | - Bram Ruijsink
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Myrianthi Hadjicharalambous
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Liya Asner
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Eva Sammut
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Faculty of Health Science, Bristol Heart Institute and Translational Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Radomir Chabiniok
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Inria, Palaiseau, France
- LMS, Ecole Polytechnique, CNRS, Institut Polytechnique de Paris, Paris, France
- Department of Mathematics, Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, , Prague, Czech Republic
| | - Sergio Uribe
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Cardio MR, Chile
- Department of Radiology, School of Medicine, Pontifica Universidad Católica de Chile, Santiago, Chile
| | - Reidar Winter
- Department of Clinical Sciences, Karolinska Institutet, Danderyd, Sweden
| | - Pablo Lamata
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Jordi Alastruey
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- World-Class Research Center "Digital Biodesign and Personlized Healthcare", Sechenov University, Moscow, Russia
| | - David Nordsletten
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
- Department of Cardiac Surgery and Biomedical Engineering, University of Michigan, Plymouth Rd, Ann Arbor, MI, 48109, USA.
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17
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Ryffel CP, Eser P, Marcin T, Herrsche D, Brugger N, Trachsel LD, Wilhelm M. Young endurance training starting age in non-elite athletes is associated with higher proximal aortic distensibility. Open Heart 2022; 9:openhrt-2021-001771. [PMID: 35264414 PMCID: PMC8915284 DOI: 10.1136/openhrt-2021-001771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/09/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Decreased proximal aortic distensibility (AD) is known to significantly predict all-cause mortality and cardiovascular events among individuals without overt cardiovascular disease. This cross-sectional study investigated the association of endurance training (ET) parameters, namely, ET starting age, ET years and yearly ET volume with AD in non-elite endurance athletes. Methods Healthy, normotensive, male Caucasian participants of a 10-mile race were assessed with a 2D echocardiogram and comprehensive interview. Ascending aortic diameters were measured simultaneously with pulse pressure. Aortic strain, AD and aortic stiffness index were calculated. Predictors of AD were investigated among training parameters by linear regression models corrected for age, resting heart rate, stroke volume index and mean blood pressure. Results Ninety-two of 121 athletes (aged 42±8 years) had sufficient echocardiogram quality and were used for analysis. ET starting age (range 6–52 years) and years of ET (range 2–46 years) were highly collinear and used in two separate models for AD. Significant factors for AD were ET starting age, 10-mile race time and resting heart rate in model I, and age, years of ET, 10-mile race time and heart rate in model II (all p<0.01). Conclusions In our cohort of healthy, non-elite, middle-aged runners, AD was significantly higher in athletes with younger ET starting age or more years of ET (in the model adjusted for confounders). In the model with years of ET, age had a negative contribution to AD, suggesting that with older age, the benefit of more years of ET on AD decreased. Future studies assessing the effect of exercise training on arterial properties should include training starting age.
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Affiliation(s)
- Christoph P Ryffel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Prisca Eser
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thimo Marcin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Herrsche
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas D Trachsel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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18
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Gahide G, Banine A, Cossette M, Budimir M, Chen L, Lefebvre J, Phaneuf SC, Haddad I, Vendrell JF, Beland M, Despatis MA, Maghsoudloo K. Reporting Peripheral Artery Disease in Claudicants: Lessons Learned From the TASC-Ability Study. J Endovasc Ther 2022; 30:259-268. [PMID: 35236151 DOI: 10.1177/15266028221081093] [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: 11/16/2022]
Abstract
BACKGROUND The Trans-Atlantic Inter-Society Consensus Document (TASC II) aims to comprehensively describe the case scenarios of aortoiliac and femoropopliteal lesions to suggest an endovascular or a surgical approach. Over time, it has become a guide for describing the gravity of arterial lesions. PURPOSE To assess the revised TASC II system for classifying arterial lesions in a large database of patients presenting with claudication. MATERIALS AND METHODS This study was a retrospective review of the arteriograms of patients with intermittent claudication. Aortoiliac and femoropopliteal lesions were classified according to the TASC II. When no consensus was reached, the lesion was rated as unTASCable. RESULTS In total, 1454 patients were included (male: 62.1%, 66.8±9.3 years). There were 39% aortoiliac lesions (n=960/2462) and 61% femoropopliteal lesions (n=1502/2462); 33.6% of the patients (n=489/1454) were associated with aortoiliac and femoropopliteal lesions. In addition, 20% of the lesions (n=493/2462) were unTASCable, and 26.7% of the patients (n=388/1454) had at least 1 unTASCable lesion. There were 4 categories of unTASCable lesions: (1) association with a common femoral artery lesion in 53.1% (n=262/493); (2) iliac artery lesions in 23.1% (n=114/493); (3) femoropopliteal lesions whose lengths did not fit into any category in 16.6% (n=82/493); and (4) association with an aortic lesion in 7.1% (n=35/493). The interobserver agreement was 0.97 for anatomically describing the infrarenal arterial tree and 0.85 for TASCing, with the lesions lowering to 0.69 for aortoiliac lesions. CONCLUSION Using the revised TASC II case scenario, 26.7% of the patients had at least 1 unTASCable lesion. Reporting peripheral artery disease using a comprehensive anatomical description of the infrarenal arterial tree showed better interobserver reproducibility.
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Affiliation(s)
- Gérald Gahide
- Service d'Angioradiologie, Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,Centre de Recherche du CHUS, Etienne Le Bel, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Amine Banine
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Lois Chen
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Samuel C Phaneuf
- Service d'Angioradiologie, Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Iskandar Haddad
- Service d'Angioradiologie, Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Francois Vendrell
- Service d'Angioradiologie, Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mathieu Beland
- Département de Radiologie, Centre Hospitalier Universitaire de Québec, Quebec City, Canada
| | - Marc-Antoine Despatis
- Centre de Recherche du CHUS, Etienne Le Bel, Université de Sherbrooke, Sherbrooke, QC, Canada.,Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
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19
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Beulens JWJ, Canto ED, Stehouwer CDA, Rennenberg RJMW, Elders PJM, van Ballegooijen AJ. High vitamin K status is prospectively associated with decreased left ventricular mass in women: the Hoorn Study. Nutr J 2021; 20:85. [PMID: 34666769 PMCID: PMC8524956 DOI: 10.1186/s12937-021-00742-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022] Open
Abstract
Background Vitamin K is associated with reduced cardiovascular disease risk such as heart failure, possibly by carboxylation of matrix-gla protein (MGP), a potent inhibitor of vascular calcification. The relationship of vitamin K intake or status with cardiac structure and function is largely unknown. Therefore this study aims to investigate the prospective association of vitamin K status and intake with echocardiographic measures. Methods This study included 427 participants from the Hoorn Study, a population-based cohort. Vitamin K status was assessed at baseline by plasma desphospho-uncarboxylated MGP (dp-ucMGP) with higher concentrations reflecting lower vitamin K status. Vitamin K intake was assessed at baseline with a validated food-frequency questionnaire. Echocardiography was performed at baseline and after a mean follow-up time of 7.6, SD=±0.7 years. We used linear regression for the association of vitamin K status and intake with left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and left ventricular mass index (LVMI), adjusted for potential confounders. Results The mean age was 66.8, SD=±6.1 years (51% were male). A high vitamin K status was prospectively associated with decreased LVMI (change from baseline to follow-up: -5.0, 95% CI: -10.5;0.4 g/m2.7) for the highest quartile compared to the lowest in women (P-interaction sex=0.07). No association was found in men. Vitamin K status was not associated with LVEF or LAVI. Vitamin K intake was not associated with any of the echocardiographic measures. Conclusions This study showed a high vitamin K status being associated with decreased LVMI only in women, while intakes of vitamin K were not associated with any cardiac structure or function measures. These results extend previous findings for a role of vitamin K status to decrease heart failure risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00742-0.
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Affiliation(s)
- Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. .,Medical Faculty, Amsterdam UMC, location VUmc, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Elisa Dal Canto
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands.,Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Roger J M W Rennenberg
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Petra J M Elders
- Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands
| | - Adriana Johanne van Ballegooijen
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands.,Department of Nephrology, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC-location VUmc, Amsterdam, The Netherlands
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20
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The Causal Relationship between Endothelin-1 and Hypertension: Focusing on Endothelial Dysfunction, Arterial Stiffness, Vascular Remodeling, and Blood Pressure Regulation. Life (Basel) 2021; 11:life11090986. [PMID: 34575135 PMCID: PMC8472034 DOI: 10.3390/life11090986] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/13/2021] [Accepted: 09/17/2021] [Indexed: 12/01/2022] Open
Abstract
Hypertension (HTN) is one of the most prevalent diseases worldwide and is among the most important risk factors for cardiovascular and cerebrovascular complications. It is currently thought to be the result of disturbances in a number of neural, renal, hormonal, and vascular mechanisms regulating blood pressure (BP), so crucial importance is given to the imbalance of a number of vasoactive factors produced by the endothelium. Decreased nitric oxide production and increased production of endothelin-1 (ET-1) in the vascular wall may promote oxidative stress and low-grade inflammation, with the development of endothelial dysfunction (ED) and increased vasoconstrictor activity. Increased ET-1 production can contribute to arterial aging and the development of atherosclerotic changes, which are associated with increased arterial stiffness and manifestation of isolated systolic HTN. In addition, ET-1 is involved in the complex regulation of BP through synergistic interactions with angiotensin II, regulates the production of catecholamines and sympathetic activity, affects renal hemodynamics and water–salt balance, and regulates baroreceptor activity and myocardial contractility. This review focuses on the relationship between ET-1 and HTN and in particular on the key role of ET-1 in the pathogenesis of ED, arterial structural changes, and impaired vascular regulation of BP. The information presented includes basic concepts on the role of ET-1 in the pathogenesis of HTN without going into detailed analyses, which allows it to be used by a wide range of specialists. Also, the main pathological processes and mechanisms are richly illustrated for better understanding.
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21
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Zhu QY, Tai S, Tang L, Xiao YC, Tang JJ, Chen YQ, Shen L, He J, Ouyang MQ, Zhou SH. N-acetyl cysteine ameliorates aortic fibrosis by promoting M2 macrophage polarization in aging mice. Redox Rep 2021; 26:170-175. [PMID: 34530696 PMCID: PMC8451627 DOI: 10.1080/13510002.2021.1976568] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Vascular fibrosis is a universal phenomenon associated with aging, and oxidative stress plays an important role in the genesis of vascular damage in line with the aging process. However, whether antioxidants can ameliorate vascular fibrosis remains unclear. Objectives: The present study was to determine antioxidant N-acetylcysteine (NAC) could ameliorates aortic fibrosis in aging wild-type C57BL/6 mice. Methods: The aortas were harvested from both 12-week and 60-week wild-type mice. The 60-week mice were treated with and without the NAC for 12 weeks starting at the age of 48 weeks. Hematoxylin and eosin (H&E) staining and Masson's trichrome staining of aortic samples were performed, and the levels of reactive oxygen species (ROS), RNA expression of GAPDH, TNF-α, MCP-1, IL-6, IL-10, IL-4, SIRT-1, SIRT-3, FOXO-1, and macrophage polarization were determined. Results: There is a positive relationship between collagen deposition and the M1/M2 macrophage ratio in the aortic wall of aged wild-type C57BL/6 mice. The higher collagen area percentage in the aortas of 60-week-old mice than in 12-week-old mice was reversed by NAC. NAC could not impact the total number of macrophages, but partly promoted M2 macrophage polarization. By performing qRT-PCR using aortic samples from these mice, we identified that SIRT-1, SIRT-3, FOXO-1 could be somehow responsible for aging-related fibrosis. Conclusions: NAC ameliorates aortic fibrosis in aging wild type mice partly by promoting M2 macrophage polarization.
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Affiliation(s)
- Qing-Yi Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Shi Tai
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Liang Tang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yi-Chao Xiao
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jian-Jun Tang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Ya-Qin Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Li Shen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jia He
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Ming-Qi Ouyang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Sheng-Hua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
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22
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Kotiso KS, Degemu N, Gebremedhin S, Taye M, Petros A, Belayneh F, Wolde D, Hailu D. Determinants of hypertension among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa: A case-control study. PLoS One 2021; 16:e0256399. [PMID: 34424924 PMCID: PMC8382175 DOI: 10.1371/journal.pone.0256399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Hypertension (HTN) in patients with diabetes mellitus (DM) is a common problem that increases the risk of mortality and morbidity, and lowers the quality of life. Despite the disproportionately high burden of HTN in DM patients, determinants for the comorbidity have not been sufficiently explored. Therefore, this study aimed to identify the determinants of HTN among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital. METHODS AND MATERIALS We conducted a hospital-based unmatched case-control study at Tikur Anbessa Specialized Hospital on 386 randomly selected patients with type 2 diabetes on follow-up (200 cases and 186 controls). We collected data by using a structured interviewer-administered questionnaire and data extraction form. To identify determinants of hypertension, a multivariable binary logistic regression was fitted, and the findings are presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). RESULTS The mean reported age (±SD) of the cases and the controls was 60.3 (±9.9) and 55.3 (±11.3) years, respectively. The eight identified independent determinants of hypertension with AOR [95% CI] were obesity: 2.82 [1.43, 5.57], sedentary activity of ≥4hrs/day: 1.75 [1.10, 2.79], higher stress score: 1.05 [1.01, 1.10], serum creatinine above 1.1 mg/dl: 2.35 [1.13, 4.91], age: 1.05 [1.02, 1.08], being government employee as compared to private workers: 2.18 [1.06, 4.50] and family history of hypertension: 2.11 [1.26, 3.54]. Further, interaction of diabetes duration with insulin use: 1.03 [1.01, 1.07] was also a significant predictor of HTN among DM patients. CONCLUSION The finding calls for interventions for mitigating these determinants. Further research is needed to examine the interaction between diabetes duration and insulin use.
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Affiliation(s)
- Kehabtimer Shiferaw Kotiso
- Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Nabiha Degemu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Samson Gebremedhin
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melaku Taye
- School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Petros
- School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fanuel Belayneh
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Deneke Wolde
- Department of Medical Laboratory, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Dejene Hailu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Elastin-Derived Peptides in the Central Nervous System: Friend or Foe. Cell Mol Neurobiol 2021; 42:2473-2487. [PMID: 34374904 PMCID: PMC9560920 DOI: 10.1007/s10571-021-01140-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022]
Abstract
Elastin is one of the main structural matrix proteins of the arteries, lung, cartilage, elastic ligaments, brain vessels, and skin. These elastin fibers display incredible resilience and structural stability with long half-life. However, during some physiological and pathophysiological conditions, elastin is prone to proteolytic degradation and, due to the extremely low turnover rate, its degradation is practically an irreversible and irreparable phenomenon. As a result of elastin degradation, new peptides called elastin-derived peptides (EDPs) are formed. A growing body of evidence suggests that these peptides play an important role in the development of age-related vascular disease. They are also detected in the cerebrospinal fluid of healthy people, and their amount increases in patients after ischemic stroke. Recently, elastin-like polypeptides have been reported to induce overproduction of beta-amyloid in a model of Alzheimer's disease. Nevertheless, the role and mechanism of action of EDPs in the nervous system is largely unknown and limited to only a few studies. The article summarizes the current state of knowledge on the role of EDPs in the nervous system.
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Abstract
An aging-related reduction in the brain's functional reserve may explain why delirium is more frequent in the elderly than in younger people insofar as the reserve becomes inadequate to cover the metabolic requirements that are critically increased by stressors. The aim of this paper is to review the normal aging-related changes that theoretically compromise complex mental activities, neuronal and synaptic densities, and the neurocomputational flexibility of the functional reserve. A pivotal factor is diminished connectivity, which is substantially due to the loss of synapses and should specifically affect association systems and cholinergic fibres in delirious patients. However, micro-angiopathy with impaired blood flow autoregulation, increased blood/brain barrier permeability, changes in cerebrospinal fluid dynamics, weakened mitochondrial performance, and a pro-inflammatory involution of the immune system may also jointly affect neurons and their synaptic assets, and even cause the progression of delirium to dementia regardless of the presence of co-existing plaques, tangles, or other pathological markers. On the other hand, the developmental growth in functional reserve during childhood and adolescence makes the brain increasingly resistant to delirium, and residual reserve can allow the elderly to recover. These data support the view that functional reserve is the variable that confronts stressors and governs the risk and intensity of and recovery from delirium. Although people of any age are at risk of delirium, the elderly are at greater risk because aging and age-dependent structural changes inevitably affect the brain's functional reserve.
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Cortical thinning is associated with brain pulsatility in older adults: An MRI and NIRS study. Neurobiol Aging 2021; 106:103-118. [PMID: 34274697 DOI: 10.1016/j.neurobiolaging.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022]
Abstract
Aging is accompanied by global brain atrophy occurring unequally across the brain. Cortical thinning is seen with aging with a larger loss in the frontal and temporal subregions. We explored the link between regional cortical thickness and regional cerebral pulsatility. Sixty healthy individuals were divided into two age groups, young (aged 19-31) and older (aged 65-75) adults. Each participant underwent a near-infrared spectroscopy (NIRS) scan to index regional brain pulsatility from cerebral pulse-transit-time-to-the peak-of-the-pulse (PTTp), an anatomical magnetic resonance imaging (MRI) and a phase-contrast MRI (PC-MRI) scan to measure arterial and cerebrospinal fluid (CSF) pulsatility. In older adults, the greatest association between cerebral pulsatility and cortical thickness was found in superior and middle temporal and superior, middle and inferior frontal areas, which are the regions perfused first by the internal carotid arteries. This association dropped in the postcentral and superior parietal regions. These findings suggest higher brain pulsatility as a potential risk factor contributing to cortical thinning for some brain regions more than others.
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Bahloul MA, Laleg Kirati TM. Fractional-order model representations of apparent vascular compliance as an alternative in the analysis of arterial stiffness: an in-silicostudy. Physiol Meas 2021; 42. [PMID: 33761470 DOI: 10.1088/1361-6579/abf1b1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/24/2021] [Indexed: 11/11/2022]
Abstract
Objective. Recent studies have demonstrated the advantages of fractional-order calculus tools for probing the viscoelastic properties of collagenous tissue, characterizing the arterial blood flow and red cell membrane mechanics, and modeling the aortic valve cusp. In this article, we present novel lumped-parameter equivalent circuit models for apparent arterial compliance using a fractional-order capacitor (FOC). FOCs, which generalize capacitors and resistors, display a fractional-order behavior that can capture both elastic and viscous properties through a power-law formulation.Approach. The proposed framework describes the dynamic relationship between the blood-pressure input and the blood volume, using linear fractional-order differential equations.Main results. The results show that the proposed models present a reasonable fit with thein-silicodata of more than 4000 subjects. Additionally, strong correlations have been identified between the fractional-order parameter estimates and the central hemodynamic determinants as well as the pulse-wave velocity indexes.Significance. Therefore, the fractional-order-based paradigm for arterial compliance shows notable potential as an alternative tool in the analysis of arterial stiffness.
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Affiliation(s)
- Mohamed A Bahloul
- Electrical, and Mathematical Sciences, and Engineering Division (CEMSE), King Abdullah University of Science, and Technology (KAUST), Thuwal 23955- 6900, Makkah Province, Saudi Arabia
| | - Taous-Meriem Laleg Kirati
- Electrical, and Mathematical Sciences, and Engineering Division (CEMSE), King Abdullah University of Science, and Technology (KAUST), Thuwal 23955- 6900, Makkah Province, Saudi Arabia
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27
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Heinz A. Elastic fibers during aging and disease. Ageing Res Rev 2021; 66:101255. [PMID: 33434682 DOI: 10.1016/j.arr.2021.101255] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/29/2020] [Accepted: 12/30/2020] [Indexed: 02/08/2023]
Abstract
Elastic fibers are essential constituents of the extracellular matrix of higher vertebrates and endow several tissues and organs including lungs, skin and blood vessels with elasticity and resilience. During the human lifespan, elastic fibers are exposed to a variety of enzymatic, chemical and biophysical influences, and accumulate damage due to their low turnover. Aging of elastin and elastic fibers involves enzymatic degradation, oxidative damage, glycation, calcification, aspartic acid racemization, binding of lipids and lipid peroxidation products, carbamylation and mechanical fatigue. These processes can trigger an impairment or loss of elastic fiber function and are associated with severe pathologies. There are different inherited or acquired pathological conditions, which influence the structure and function of elastic fibers and microfibrils predominantly in the cardiorespiratory system and skin. Inherited elastic-fiber pathologies have a direct or indirect impact on elastic-fiber formation due to mutations in the fibrillin genes (fibrillinopathies), in the elastin gene (elastinopathies) or in genes encoding proteins that are associated with microfibrils or elastic fibers. Acquired elastic-fiber pathologies appear age-related or as a result of multiple factors impairing tissue homeostasis. This review gives an overview on the fate of elastic fibers over the human lifespan in health and disease.
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Karamanos NK, Theocharis AD, Piperigkou Z, Manou D, Passi A, Skandalis SS, Vynios DH, Orian-Rousseau V, Ricard-Blum S, Schmelzer CEH, Duca L, Durbeej M, Afratis NA, Troeberg L, Franchi M, Masola V, Onisto M. A guide to the composition and functions of the extracellular matrix. FEBS J 2021; 288:6850-6912. [PMID: 33605520 DOI: 10.1111/febs.15776] [Citation(s) in RCA: 334] [Impact Index Per Article: 111.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
Extracellular matrix (ECM) is a dynamic 3-dimensional network of macromolecules that provides structural support for the cells and tissues. Accumulated knowledge clearly demonstrated over the last decade that ECM plays key regulatory roles since it orchestrates cell signaling, functions, properties and morphology. Extracellularly secreted as well as cell-bound factors are among the major members of the ECM family. Proteins/glycoproteins, such as collagens, elastin, laminins and tenascins, proteoglycans and glycosaminoglycans, hyaluronan, and their cell receptors such as CD44 and integrins, responsible for cell adhesion, comprise a well-organized functional network with significant roles in health and disease. On the other hand, enzymes such as matrix metalloproteinases and specific glycosidases including heparanase and hyaluronidases contribute to matrix remodeling and affect human health. Several cell processes and functions, among them cell proliferation and survival, migration, differentiation, autophagy, angiogenesis, and immunity regulation are affected by certain matrix components. Structural alterations have been also well associated with disease progression. This guide on the composition and functions of the ECM gives a broad overview of the matrisome, the major ECM macromolecules, and their interaction networks within the ECM and with the cell surface, summarizes their main structural features and their roles in tissue organization and cell functions, and emphasizes the importance of specific ECM constituents in disease development and progression as well as the advances in molecular targeting of ECM to design new therapeutic strategies.
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Affiliation(s)
- Nikos K Karamanos
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece.,Foundation for Research and Technology-Hellas (FORTH)/Institute of Chemical Engineering Sciences (ICE-HT), Patras, Greece
| | - Achilleas D Theocharis
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece
| | - Zoi Piperigkou
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece.,Foundation for Research and Technology-Hellas (FORTH)/Institute of Chemical Engineering Sciences (ICE-HT), Patras, Greece
| | - Dimitra Manou
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece
| | - Alberto Passi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Spyros S Skandalis
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece
| | - Demitrios H Vynios
- Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Greece
| | - Véronique Orian-Rousseau
- Karlsruhe Institute of Technology, Institute of Biological and Chemical Systems- Functional Molecular Systems, Eggenstein-Leopoldshafen, Germany
| | - Sylvie Ricard-Blum
- University of Lyon, UMR 5246, ICBMS, Université Lyon 1, CNRS, Villeurbanne Cedex, France
| | - Christian E H Schmelzer
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany.,Institute of Pharmacy, Faculty of Natural Sciences I, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Laurent Duca
- UMR CNRS 7369 Matrice Extracellulaire et Dynamique Cellulaire (MEDyC), Team 2: Matrix Aging and Vascular Remodelling, Université de Reims Champagne Ardenne (URCA), UFR Sciences Exactes et Naturelles, Reims, France
| | - Madeleine Durbeej
- Department of Experimental Medical Science, Unit of Muscle Biology, Lund University, Sweden
| | - Nikolaos A Afratis
- Department Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Linda Troeberg
- Norwich Medical School, University of East Anglia, Bob Champion Research and Education Building, Norwich, UK
| | - Marco Franchi
- Department for Life Quality Study, University of Bologna, Rimini, Italy
| | | | - Maurizio Onisto
- Department of Biomedical Sciences, University of Padova, Italy
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Prevel R, Roubaud-Baudron C, Tellier E, Le Besnerais M, Kaplanski G, Veyradier A, Benhamou Y, Coppo P. [Endothelial dysfunction in thrombotic thrombocytopenic purpura: therapeutic perspectives]. Rev Med Interne 2021; 42:202-209. [PMID: 33455838 DOI: 10.1016/j.revmed.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/19/2020] [Accepted: 12/26/2020] [Indexed: 01/05/2023]
Abstract
Immune Thrombotic Thrombocytopenic Purpura (iTTP) is a rare but severe disease with a mortality rate of almost 100 % in the absence of adequate treatment. iTTP is caused by a severe deficiency in ADAMTS13 activity due to the production of inhibitory antibodies. Age has been shown to be a major prognostic factor. iTTP patients in the elderly (60yo and over) have more frequent organ involvement, especially heart and kidney failures compared with younger patients. They also have non-specific neurologic symptoms leading to a delayed diagnosis. Factors influencing this impaired survival among older patients remain unknown so far. Alteration of the functional capacity of involved organs could be part of the explanation as could be the consequences of vascular aging. In fact, severe ADAMTS13 deficiency is necessary but likely not sufficient for iTTP physiopathology. A second hit leading to endothelial activation is thought to play a central role in iTTP. Interestingly, the mechanisms involved in endothelial activation may share common features with those involved in vascular aging, potentially leading to endothelial dysfunction. It could thus be interesting to better investigate the causes of mid- and long-term mortality among older iTTP patients to confirm whether inflammation and endothelial activation really impact vascular aging and long-term mortality in those patients, in addition to their presumed role at iTTP acute phase. If so, further insights into the mechanisms involved could lead to new therapeutic targets.
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Affiliation(s)
- R Prevel
- CHU Bordeaux, Pôle de Gérontologie Clinique, 33000 Bordeaux, France; CHU Bordeaux, FHU Acronim 33000 Bordeaux, France; University Bordeaux, INSERM 1045 CRCTB 33000 Bordeaux, France
| | - C Roubaud-Baudron
- CHU Bordeaux, Pôle de Gérontologie Clinique, 33000 Bordeaux, France; University Bordeaux, INSERM UMR 1053 Bariton 33000 Bordeaux, France
| | - E Tellier
- Vascular Research Center of Marseille, Inserm, UMRS_1076, Aix-Marseille Université, Marseille, France
| | - M Le Besnerais
- Service de Médecine Interne, CHU Charles Nicolle, Rouen, France; INSERM U1096, UFR médecine pharmacie Rouen, Rouen, France
| | - G Kaplanski
- Vascular Research Center of Marseille, Inserm, UMRS_1076, Aix-Marseille Université, Marseille, France; Aix-Marseille université, 13284, Service de médecine interne, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13385 Marseille cedex 05, France; Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France
| | - A Veyradier
- Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France; Hématologie biologique, Hôpital Lariboisière, AP-HP, Université Paris Diderot, Paris, France
| | - Y Benhamou
- Service de Médecine Interne, CHU Charles Nicolle, Rouen, France; INSERM U1096, UFR médecine pharmacie Rouen, Rouen, France; Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France
| | - P Coppo
- Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), Paris, France; Service d'Hématologie, Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT, www.cnr-mat.fr), AP-HP.6, Paris, France.
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Berquand A, Wahart A, Henry A, Gorisse L, Maurice P, Blaise S, Romier-Crouzet B, Pietrement C, Bennasroune A, Sartelet H, Jaisson S, Gillery P, Martiny L, Touré F, Duca L, Molinari M. Revealing the elasticity of an individual aortic fiber during ageing at nanoscale by in situ atomic force microscopy. NANOSCALE 2021; 13:1124-1133. [PMID: 33399602 DOI: 10.1039/d0nr06753a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Arterial stiffness is a complex process affecting the aortic tree that significantly contributes to cardiovascular diseases (systolic hypertension, coronary artery disease, heart failure or stroke). This process involves a large extracellular matrix remodeling mainly associated with elastin content decrease and collagen content increase. Additionally, various chemical modifications that accumulate with ageing have been shown to affect long-lived assemblies, such as elastic fibers, that could affect their elasticity. To precisely characterize the fiber changes and the evolution of its elasticity with ageing, high resolution and multimodal techniques are needed for precise insight into the behavior of a single fiber and its surrounding medium. In this study, the latest developments in atomic force microscopy and the related nanomechanical modes are used to investigate the evolution and in a near-physiological environment, the morphology and elasticity of aorta cross sections obtained from mice of different ages with an unprecedented resolution. In correlation with more classical approaches such as pulse wave velocity and fluorescence imaging, we demonstrate that the relative Young's moduli of elastic fibers, as well as those of the surrounding areas, significantly increase with ageing. This nanoscale characterization presents a new view on the stiffness process, showing that, besides the elastin and collagen content changes, elasticity is impaired at the molecular level, allowing a deeper understanding of the ageing process. Such nanomechanical AFM measurements of mouse tissue could easily be applied to studies of diseases in which elastic fibers suffer pathologies such as atherosclerosis and diabetes, where the precise quantification of fiber elasticity could better follow the fiber remodeling and predict plaque rupture.
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Affiliation(s)
- Alexandre Berquand
- Laboratoire de Recherche en Nanosciences, LRN EA4682, University of Reims Champagne-Ardenne, 51685 Reims, France
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Tortuosity of the Descending Thoracic Aorta in Patients with Aneurysm and Type B Dissection. World J Surg 2020; 44:1323-1330. [PMID: 31873803 DOI: 10.1007/s00268-019-05328-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Tortuosity in the descending thoracic aorta (DTA) comes with aging and increases the risk of endoleaks after TEVAR. With this report, we would like to define and classify tortuosity in the DTA of patients with thoracic aortic disease. METHODS Retrospective case-control study of two hundred seven patients, comparing sixty-nine controls without aortic disease (CG), to sixty-nine patients with descending thoracic aortic aneurysm (AG) and sixty-nine patients with type B aortic dissection (DG). 3Mensio Vascular software was used to analyze CTA scans and collect the following measurements; tortuosity index, curvature ratio and the maximum tortuosity of the DTA. The DTA was divided into four equal zones. The maximum tortuosity was divided into three groups: low (<30°), moderate (30°-60°) and high tortuosity (>60°). RESULTS Compared to the CG, tortuosity was more pronounced in the DG, and even more in the AG, evidenced by the tortuosity index (1.11 vs. 1.20 vs. 1.31; p < 0.001), curvature ratio (1.00 vs. 1.01 vs. 1.03; p < 0.001), maximum tortuosity in degrees (28.17 vs. 33.29 vs. 43.83; p < 0.001) and group of tortuosity (p < 0.001). The maximum tortuosity was further distal for the DG and AG, evidenced by the zone of maximum tortuosity (4A vs. 4B vs. 4B; p < 0.001). CONCLUSION This study shows that tortuosity in the DTA is more prominent in diseased aortas, especially in aneurysmal disease. This phenomenon needs to be taken into account during planning of TEVAR to prevent stent graft-related complications and to obtain positive long-term outcome.
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Luciano MG, Dombrowski SM, El-Khoury S, Yang J, Thyagaraj S, Qvarlander S, Khalid S, Suk I, Manbachi A, Loth F. Epidural Oscillating Cardiac-Gated Intracranial Implant Modulates Cerebral Blood Flow. Neurosurgery 2020; 87:1299-1310. [PMID: 32533835 PMCID: PMC7666905 DOI: 10.1093/neuros/nyaa188] [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: 06/25/2019] [Accepted: 03/16/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We have previously reported a method and device capable of manipulating ICP pulsatility while minimally effecting mean ICP. OBJECTIVE To test the hypothesis that different modulations of the intracranial pressure (ICP) pulse waveform will have a differential effect on cerebral blood flow (CBF). METHODS Using an epidural balloon catheter attached to a cardiac-gated oscillating pump, 13 canine subjects underwent ICP waveform manipulation comparing different sequences of oscillation in successive animals. The epidural balloon was implanted unilaterally superior to the Sylvian sulcus. Subjects underwent ICP pulse augmentation, reduction and inversion protocols, directly comparing time segments of system activation and deactivation. ICP and CBF were measured bilaterally along with systemic pressure and heart rate. CBF was measured using both thermal diffusion, and laser doppler probes. RESULTS The activation of the cardiac-gate balloon implant resulted in an ipsilateral/contralateral ICP pulse amplitude increase with augmentation (217%/202% respectively, P < .0005) and inversion (139%/120%, P < .0005). The observed changes associated with the ICP mean values were smaller, increasing with augmentation (23%/31%, P < .0001) while decreasing with inversion (7%/11%, P = .006/.0003) and reduction (4%/5%, P < .0005). CBF increase was observed for both inversion and reduction protocols (28%/7.4%, P < .0001/P = .006 and 2.4%/1.3%, P < .0001/P = .003), but not the augmentation protocol. The change in CBF was correlated with ICP pulse amplitude and systolic peak changes and not with change in mean ICP or systemic variables (heart rate, arterial blood pressure). CONCLUSION Cardiac-gated manipulation of ICP pulsatility allows the study of intracranial pulsatile dynamics and provides a potential means of altering CBF.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Amir Manbachi
- Correspondence: Mark G. Luciano, MD, PhD, Departments of Neurosurgery and Biomedical Engineering, Johns Hopkins University, 600 North Wolfe Street, Phipps 126, Baltimore, MD 20287, USA.
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Mariscal-Harana J, Charlton PH, Vennin S, Aramburu J, Florkow MC, van Engelen A, Schneider T, de Bliek H, Ruijsink B, Valverde I, Beerbaum P, Grotenhuis H, Charakida M, Chowienczyk P, Sherwin SJ, Alastruey J. Estimating central blood pressure from aortic flow: development and assessment of algorithms. Am J Physiol Heart Circ Physiol 2020; 320:H494-H510. [PMID: 33064563 PMCID: PMC7612539 DOI: 10.1152/ajpheart.00241.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Central blood pressure (cBP) is a highly prognostic cardiovascular (CV) risk factor whose accurate, invasive assessment is costly and carries risks to patients. We developed and assessed novel algorithms for estimating cBP from noninvasive aortic hemodynamic data and a peripheral blood pressure measurement. These algorithms were created using three blood flow models: the two- and three-element Windkessel (0-D) models and a one-dimensional (1-D) model of the thoracic aorta. We tested new and existing methods for estimating CV parameters (left ventricular ejection time, outflow BP, arterial resistance and compliance, pulse wave velocity, and characteristic impedance) required for the cBP algorithms, using virtual (simulated) subjects (n = 19,646) for which reference CV parameters were known exactly. We then tested the cBP algorithms using virtual subjects (n = 4,064), for which reference cBP were available free of measurement error, and clinical datasets containing invasive (n = 10) and noninvasive (n = 171) reference cBP waves across a wide range of CV conditions. The 1-D algorithm outperformed the 0-D algorithms when the aortic vascular geometry was available, achieving central systolic blood pressure (cSBP) errors≤2.1 ± 9.7mmHg and root-mean-square errors (RMSEs)≤6.4 ± 2.8mmHg against invasive reference cBP waves (n = 10). When the aortic geometry was unavailable, the three-element 0-D algorithm achieved cSBP errors ≤ 6.0 ± 4.7mmHg and RMSEs ≤ 5.9 ± 2.4mmHg against noninvasive reference cBP waves (n = 171), outperforming the two-element 0-D algorithm. All CV parameters were estimated with mean percentage errors ≤ 8.2%, except for the aortic characteristic impedance (≤13.4%), which affected the three-element 0-D algorithm’s performance. The freely available algorithms developed in this work enable fast and accurate calculation of the cBP wave and CV parameters in datasets containing noninvasive ultrasound or magnetic resonance imaging data.
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Affiliation(s)
- Jorge Mariscal-Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Department of Clinical Pharmacology, King's College London, King's Health Partners, London , United Kingdom
| | - Jorge Aramburu
- TECNUN Escuela de Ingenieros, Universidad de Navarra, Donostia-San Sebastián, Spain
| | - Mateusz Cezary Florkow
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Philips Research, Cambridge, United Kingdom
| | - Arna van Engelen
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Torben Schneider
- Philips Healthcare UK, Philips Centre, Guildford Business Park, Guildford, Surrey, United Kingdom
| | - Hubrecht de Bliek
- HSDP Clinical Platforms, Philips Healthcare, Eindhoven, The Netherlands
| | - Bram Ruijsink
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Israel Valverde
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Cardiovascular Pathophysiology, Institute of Biomedicine of Seville, University Hospital of Virgen del Rocío, University of Seville, CIBERCV, CSIC, Seville, Spain
| | - Philipp Beerbaum
- Department of Pediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany
| | - Heynric Grotenhuis
- Department of Pediatric Cardiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Marietta Charakida
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London , United Kingdom
| | - Spencer J Sherwin
- Department of Aeronautics, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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Effectiveness of yoga on arterial stiffness: A systematic review. Complement Ther Med 2020; 52:102484. [PMID: 32951734 DOI: 10.1016/j.ctim.2020.102484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Arterial stiffness is a major cardiovascular (CV) risk and an independent strong predictor of CV morbidity and mortality. The aim of this systematic review is to evaluate the clinical or interventional studies that assessed the effectiveness of yoga on arterial stiffness in participants of any age or sex, healthy or with any conditions. DESIGN Systematic review of clinical trials or interventional studies. DATA SOURCES Cochrane Library, Medline/PubMed, Scopus, and Google Scholar databases. REVIEW METHODS Databases were searched till July 2019 for clinical trials or interventional studies whether controlled or uncontrolled, randomized or non-randomized studies assessing the effects of yoga on arterial stiffness. Quality of the studies was assessed by using Physiotherapy Evidence Database (PEDro) Scale. RESULTS Seven full-text articles (total number of participants = 362) that evaluated the effect of yoga on arterial stiffness were included in this review. There were three randomized controlled studies and four were non-controlled studies (single group studies). Four studies have shown significant reduction in arterial stiffness, while three studies did not find any significant change in arterial stiffness. The beneficial effects of yoga intervention on arterial stiffness in young adults and elderly hypertensive patients are encouraging. Methodological quality was good for one study, moderate for two studies and poor for four studies. CONCLUSIONS This review shows that yoga practice is effective in preventing or reducing the arterial stiffness in young healthy and obese, and elderly hypertensive patients. As the methodology of many studies is of low quality and safety measures were not reported, there is a need of quality randomized controlled trials of yoga effects on arterial stiffness among high risk individuals.
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35
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Gong P, Heiss C, Sampson DM, Wang Q, Yuan Z, Sampson DD. Detection of localized pulsatile motion in cutaneous microcirculation by speckle decorrelation optical coherence tomography angiography. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200112R. [PMID: 32935499 PMCID: PMC7490763 DOI: 10.1117/1.jbo.25.9.095004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 05/21/2023]
Abstract
SIGNIFICANCE Pulsatility is a vital characteristic of the cardiovascular system. Characterization of the pulsatility pattern locally in the peripheral microvasculature is currently not readily available and would provide an additional source of information, which may prove important in understanding the pathophysiology of arterial stiffening, vascular ageing, and their linkage with cardiovascular disease development. AIM We aim to confirm the suitability of speckle decorrelation optical coherence tomography angiography (OCTA) under various noncontact/contact scanning protocols for the visualization of pulsatility patterns in vessel-free tissue and in the microvasculature of peripheral human skin. RESULTS Results from five healthy subjects show distinct pulsatile patterns both in vessel-free tissue with either noncontact or contact imaging and in individual microvessels with contact imaging. Respectively, these patterns are likely caused by the pulsatile pressure and pulsatile blood flow. The pulse rates show good agreement with those from pulse oximetry, confirming that the pulsatile signatures reflect pulsatile hemodynamics. CONCLUSIONS This study demonstrates the potential of speckle decorrelation OCTA for measuring localized peripheral cutaneous pulsatility and defines scanning protocols necessary to undertake such measurements. Noncontact imaging should be used for the study of pulsatility in vessel-free tissue and contact imaging with strong mechanical coupling in individual microvessels. Further studies of microcirculation based upon this method and protocols are warranted.
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Affiliation(s)
- Peijun Gong
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
- Address all correspondence to Peijun Gong, E-mail:
| | - Christian Heiss
- The University of Surrey, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, Guildford, Surrey, United Kingdom
- Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom
| | - Danuta M. Sampson
- The University of Surrey, Centre for Vision, Speech, and Signal Processing, Surrey Biophotonics, Guildford, Surrey, United Kingdom
- The University of Surrey, School of Biosciences and Medicine, Surrey Biophotonics, Guildford, Surrey, United Kingdom
| | - Qiang Wang
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
| | - Zhihong Yuan
- The University of Western Australia, Optical+Biomedical Engineering Laboratory, Department of Electrical, Electronic, and Computer Engineering, Perth, Western Australia, Australia
| | - David D. Sampson
- The University of Surrey, School of Biosciences and Medicine, Surrey Biophotonics, Guildford, Surrey, United Kingdom
- The University of Surrey, Advanced Technology Institute, School of Physics, Surrey Biophotonics, Guildford, Surrey, United Kingdom
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36
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Heinz A. Elastases and elastokines: elastin degradation and its significance in health and disease. Crit Rev Biochem Mol Biol 2020; 55:252-273. [PMID: 32530323 DOI: 10.1080/10409238.2020.1768208] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Elastin is an important protein of the extracellular matrix of higher vertebrates, which confers elasticity and resilience to various tissues and organs including lungs, skin, large blood vessels and ligaments. Owing to its unique structure, extensive cross-linking and durability, it does not undergo significant turnover in healthy tissues and has a half-life of more than 70 years. Elastin is not only a structural protein, influencing the architecture and biomechanical properties of the extracellular matrix, but also plays a vital role in various physiological processes. Bioactive elastin peptides termed elastokines - in particular those of the GXXPG motif - occur as a result of proteolytic degradation of elastin and its non-cross-linked precursor tropoelastin and display several biological activities. For instance, they promote angiogenesis or stimulate cell adhesion, chemotaxis, proliferation, protease activation and apoptosis. Elastin-degrading enzymes such as matrix metalloproteinases, serine proteases and cysteine proteases slowly damage elastin over the lifetime of an organism. The destruction of elastin and the biological processes triggered by elastokines favor the development and progression of various pathological conditions including emphysema, chronic obstructive pulmonary disease, atherosclerosis, metabolic syndrome and cancer. This review gives an overview on types of human elastases and their action on human elastin, including the formation, structure and biological activities of elastokines and their role in common biological processes and severe pathological conditions.
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Affiliation(s)
- Andrea Heinz
- Department of Pharmacy, LEO Foundation Center for Cutaneous Drug Delivery, University of Copenhagen, Copenhagen, Denmark
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37
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Immune thrombotic thrombocytopenic purpura in older patients: prognosis and long-term survival. Blood 2020; 134:2209-2217. [PMID: 31530564 DOI: 10.1182/blood.2019000748] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/10/2019] [Indexed: 12/30/2022] Open
Abstract
Older age is associated with increased mortality in immune thrombotic thrombocytopenic purpura (iTTP). Yet, data are scarce regarding iTTP occurring among older patients. To assess clinical features and long-term impact of iTTP on mortality in older patients (>60 years old), characteristics and prognoses of adult iTTP patients enrolled in the French Reference Center for Thrombotic Microangiopathies registry between 2000 and 2016 were described according to age (<60 years old or ≥60 years old). Long-term mortality of iTTP older survivors was compared with that of non-iTTP geriatric subjects. Comparing, respectively, older iTTP patients (N = 71) with younger patients (N = 340), time from hospital admission to diagnosis was longer (P < .0001); at diagnosis, delirium (P = .034), behavior impairment (P = .045), renal involvement (P < .0001), and elevated troponin level (P = .025) were more important whereas cytopenias were less profound (platelet count, 22 × 103/mm3 [9-57] vs 13 × 103/mm3 [9-21], respectively [P = .002]; hemoglobin level, 9 g/dL [8-11] vs 8 g/dL [7-10], respectively [P = .0007]). Short- and mid-term mortalities were higher (P < .0001) and increased for every 10 years of age range. Age ≥60 years, cardiac involvement, increased plasma creatinine level, and total plasma exchange volume were independently associated with 1-month mortality. Compared with a non-iTTP geriatric population, older survivors showed an increased long-term mortality (hazard ratio = 3.44; P < .001). In conclusion, older iTTP patients have atypical neurological presentation delaying the diagnosis. Age negatively impacts short-term but also long-term mortality.
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Eser P, Marcin T, Prescott E, Prins LF, Kolkman E, Bruins W, van der Velde AE, Peña-Gil C, Iliou MC, Ardissino D, Zeymer U, Meindersma EP, Van'tHof AWJ, de Kluiver EP, Laimer M, Wilhelm M. Clinical outcomes after cardiac rehabilitation in elderly patients with and without diabetes mellitus: The EU-CaRE multicenter cohort study. Cardiovasc Diabetol 2020; 19:37. [PMID: 32192524 PMCID: PMC7081600 DOI: 10.1186/s12933-020-01013-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background The prevalence of patients with concomitant cardiovascular disease and diabetes mellitus (DM) is increasing rapidly. We aimed to compare the effectiveness of current cardiac rehabilitation (CR) programs across seven European countries between elderly cardiac patients with and without DM. Methods 1633 acute and chronic coronary artery disease (CAD) patients and patients after valve intervention with an age 65 or above who participated in comprehensive CR (3 weeks to 3 months, depending on centre) were included. Peak oxygen uptake (VO2 peak), body mass index, resting systolic blood pressure, low-density lipoprotein-cholesterol (LDL-C), and glycated haemoglobin (HbA1c) were assessed before start of CR, at termination of CR (variable time point), and 12 months after start of CR, with no intervention after CR. Baseline values and changes from baseline to 12-month follow-up were compared between patients with and without DM using mixed models, and mortality and hospitalisation rates using logistic regression. Results 430 (26.3%) patients had DM. Patients with DM had more body fat, lower educational level, more comorbidities, cardiovascular risk factors, and more advanced CAD. Both groups increased their VO2 peak over the study period but with a significantly lower improvement from baseline to follow-up in patients with DM. In the DM group, change in HbA1c was associated with weight change but not with change in absolute VO2 peak. 12-month cardiac mortality was higher in patients with DM. Conclusions While immediate improvements in VO2 peak after CR in elderly patients with and without DM were similar, 12-month maintenance of this improvement was inferior in patients with DM, possibly related to disease progression. Glycemic control was less favourable in diabetic patients needing insulin in the short- and long-term. Since glycemic control was only related to weight loss but not to increase in exercise capacity, this highlights the importance of weight loss in obese DM patients during CR. Trial registration NTR5306 at trialregister.nl; trial registered 07/16/2015; https://www.trialregister.nl/trial/5166
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Affiliation(s)
- Prisca Eser
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thimo Marcin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eva Prescott
- Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark
| | | | | | | | | | - Carlos Peña-Gil
- Department of Cardiology, Hospital Clínico Universitario de Santiago, SERGAS, FIDIS, CIBER CV, University of Santiago de Compostela, Santiago, Spain
| | - Marie-Christine Iliou
- Department of Cardiac Rehabilitation, Assistance Publique Hopitaux de Paris, Paris, France
| | - Diego Ardissino
- Department of Cardiology, Parma University Hospital, Parma, Italy
| | - Uwe Zeymer
- Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
| | - Esther P Meindersma
- Isala Heart Centre, Zwolle, The Netherlands.,Department of Cardiology, Radboud University, Nijmegen, The Netherlands
| | - Arnoud W J Van'tHof
- Isala Heart Centre, Zwolle, The Netherlands.,Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Cardiology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | | | - Markus Laimer
- Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism (UDEM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Hypertension and Diabetes Are Associated With Clinical Characteristics in Patients Undergoing Microvascular Decompression for Hemifacial Spasm. J Craniofac Surg 2019; 31:468-471. [PMID: 31842083 DOI: 10.1097/scs.0000000000006049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of the present study is to investigate effect of hypertension and diabetes on neuroelectrophysiology, outcomes and complications in patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD). METHODS From June 2014 to December 2016, 476 consecutive HFS patients who had undergone MVD were divided into 2 groups according to the presence or absence of comorbidities: diabetic group (n = 26) versus non-diabetic group (n = 450), and hypertensive group (n = 141) versus normotensive group (n = 335). Relevant patient data, including preoperative and postoperative neuroelectrophysiology, operative findings, outcome of MVD and complications, were collected and analyzed retrospectively over the 2-year follow-up period. The impact of hypertension and diabetes on the clinical features of HFS patients was investigated by using logistic regression models. RESULTS Brainstem auditory evoked potential (BAEP), postoperative prognosis and abnormal muscle response (AMR) were not different between any of the 2 groups. Preoperative positive AMR occurred more frequently in the nondiabetic group than diabetic group [OR = 0.202, P = 0.004], whereas hypertension was not independently predictive for neuroelectrophysiology in patients with HFS. Adjusted multivariate analysis indicated that hypertension was the only clinical factor associated with MVD-related complications [OR = 0.482, P = 0.007] and hearing impairment [OR = 0.28, P = 0.004] after various potential confounders were taken into account, whereas diabetes was not predictive for postoperative complications. CONCLUSIONS Diabetes is associated with low positive rate of preoperative AMR, thus weakening the predictive role of AMR for successful MVD. Hypertension may be an independent risk factor for hearing impairment after MVD.
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Fossan FE, Mariscal-Harana J, Alastruey J, Hellevik LR. Optimization of topological complexity for one-dimensional arterial blood flow models. J R Soc Interface 2019; 15:20180546. [PMID: 30958234 PMCID: PMC6303799 DOI: 10.1098/rsif.2018.0546] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As computational models of the cardiovascular system are applied in modern personalized medicine, maximizing certainty of model input becomes crucial. A model with a high number of arterial segments results in a more realistic description of the system, but also requires a high number of parameters with associated uncertainties. In this paper, we present a method to optimize/reduce the number of arterial segments included in one-dimensional blood flow models, while preserving key features of flow and pressure waveforms. We quantify the preservation of key flow features for the optimal network with respect to the baseline networks (a 96-artery and a patient-specific coronary network) by various metrics and quantities like average relative error, pulse pressure and augmentation pressure. Furthermore, various physiological and pathological states are considered. For the aortic root and larger systemic artery pressure waveforms a network with minimal description of lower and upper limb arteries and no cerebral arteries, sufficiently captures important features such as pressure augmentation and pulse pressure. Discrepancies in carotid and middle cerebral artery flow waveforms that are introduced by describing the arterial system in a minimalistic manner are small compared with errors related to uncertainties in blood flow measurements obtained by ultrasound.
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Affiliation(s)
- Fredrik E Fossan
- 1 Norwegian University of Science and Technology , Trondheim , Norway
| | | | - Jordi Alastruey
- 2 Department of Biomedical Engineering, King's College , London , UK.,3 Institute of Personalized Medicine, Sechenov University , Moscow , Russia
| | - Leif R Hellevik
- 1 Norwegian University of Science and Technology , Trondheim , Norway
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Smith ER, Hewitson TD, Holt SG. Diagnostic Tests for Vascular Calcification. Adv Chronic Kidney Dis 2019; 26:445-463. [PMID: 31831123 DOI: 10.1053/j.ackd.2019.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/22/2019] [Accepted: 07/28/2019] [Indexed: 02/06/2023]
Abstract
Vascular calcification (VC) is the heterogeneous endpoint of multiple vascular insults, which varies by arterial bed, the layer of the arterial wall affected, and is propagated by diverse cellular and biochemical mechanisms. A variety of in vivo and ex vivo techniques have been applied to the analysis of VC in preclinical studies, but clinical examination has principally relied on a number of noninvasive and invasive imaging modalities for detection and quantitation. Most imaging methods suffer from suboptimal spatial resolution, leading to the inability to distinguish medial from intimal VC and insufficient sensitivity to detect microcalcifications that are indicative of active mineral deposition and of vulnerable plaques which may be prone to rupture. Serum biomarkers lack specificity for VC and cannot discriminate pathology. Overall, uncertainties surrounding the sensitivity and specificity of different VC testing modalities, the absence of a clear cause-effect relationship, and lack of any evidence-based diagnostic or therapeutic protocols in relation to VC testing in chronic kidney disease has yielded weak or ungraded recommendations for their use in clinical practice. While VC is recognized as a key manifestation of chronic kidney disease-mineral and bone disorder and those with an increasing burden of VC are considered to be at higher cardiovascular risk, routine screening is not currently recommended.
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Charlton PH, Mariscal Harana J, Vennin S, Li Y, Chowienczyk P, Alastruey J. Modeling arterial pulse waves in healthy aging: a database for in silico evaluation of hemodynamics and pulse wave indexes. Am J Physiol Heart Circ Physiol 2019; 317:H1062-H1085. [PMID: 31442381 PMCID: PMC6879924 DOI: 10.1152/ajpheart.00218.2019] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/09/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022]
Abstract
The arterial pulse wave (PW) is a rich source of information on cardiovascular (CV) health. It is widely measured by both consumer and clinical devices. However, the physical determinants of the PW are not yet fully understood, and the development of PW analysis algorithms is limited by a lack of PW data sets containing reference CV measurements. Our aim was to create a database of PWs simulated by a computer to span a range of CV conditions, representative of a sample of healthy adults. The typical CV properties of 25-75 yr olds were identified through a literature review. These were used as inputs to a computational model to simulate PWs for subjects of each age decade. Pressure, flow velocity, luminal area, and photoplethysmographic PWs were simulated at common measurement sites, and PW indexes were extracted. The database, containing PWs from 4,374 virtual subjects, was verified by comparing the simulated PWs and derived indexes with corresponding in vivo data. Good agreement was observed, with well-reproduced age-related changes in hemodynamic parameters and PW morphology. The utility of the database was demonstrated through case studies providing novel hemodynamic insights, in silico assessment of PW algorithms, and pilot data to inform the design of clinical PW algorithm assessments. In conclusion, the publicly available PW database is a valuable resource for understanding CV determinants of PWs and for the development and preclinical assessment of PW analysis algorithms. It is particularly useful because the exact CV properties that generated each PW are known.NEW & NOTEWORTHY First, a comprehensive literature review of changes in cardiovascular properties with age was performed. Second, an approach for simulating pulse waves (PWs) at different ages was designed and verified against in vivo data. Third, a PW database was created, and its utility was illustrated through three case studies investigating the determinants of PW indexes. Fourth, the database and tools for creating the database, analyzing PWs, and replicating the case studies are freely available.
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Affiliation(s)
- Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Jorge Mariscal Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Ye Li
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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Lim K, Halim A, Lu TS, Ashworth A, Chong I. Klotho: A Major Shareholder in Vascular Aging Enterprises. Int J Mol Sci 2019; 20:E4637. [PMID: 31546756 PMCID: PMC6770519 DOI: 10.3390/ijms20184637] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 01/08/2023] Open
Abstract
Accelerated vascular aging is a condition that occurs as a complication of several highly prevalent inflammatory conditions such as chronic kidney disease, cancer, HIV infection and diabetes. Age-associated vascular alterations underlie a continuum of expression toward clinically overt cardiovascular disease. This has contributed to the striking epidemiologic transition whereby such noncommunicable diseases have taken center stage as modern-day global epidemics and public health problems. The identification of α-Klotho, a remarkable protein that confers powerful anti-aging properties has stimulated significant interest. In fact, emerging data have provided fundamental rationale for Klotho-based therapeutic intervention for vascular diseases and multiple other potential indications. However, the application of such discoveries in Klotho research remains fragmented due to significant gaps in our molecular understanding of Klotho biology, as well as hurdles in clinical research and experimental barriers that must first be overcome. These advances will be critical to establish the scientific platform from which future Klotho-based interventional trials and therapeutic enterprises can be successfully launched.
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Affiliation(s)
- Kenneth Lim
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- MGH Renal Associates, 165 Cambridge Street, Suite 302, Boston, MA 02114, USA
| | - Arvin Halim
- Renal Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02114, USA; (A.H.)
| | - Tzong-shi Lu
- Renal Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02114, USA; (A.H.)
| | - Alan Ashworth
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), 1450 3rd St, San Francisco, CA 94158, USA;
| | - Irene Chong
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK;
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Stevens RRF, Donders WP, Quicken S, van de Vosse FN, Mess WH, Delhaas T, Huberts W. The Role of One-Dimensional Model-Generated Inter-Subject Variations in Systemic Properties on Wall Shear Stress Indices of Intracranial Aneurysms. IEEE Trans Biomed Eng 2019; 67:1030-1039. [PMID: 31329544 DOI: 10.1109/tbme.2019.2928416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Variations in systemic properties of the arterial tree, such as aging-induced vessel stiffness, can alter the shape of pressure and flow waveforms. As a consequence, the hemodynamics around a cerebral aneurysm change, and therefore, also the corresponding in- and outlet boundary conditions (BCs) used for three-dimensional (3D) calculations of hemodynamic indices. In this study, we investigate the effects of variations in systemic properties on wall shear stress (WSS) indices of a cerebral aneurysm. We created a virtual patient database by varying systemic properties within physiological ranges. BCs for 3D-CFD simulations were derived using a pulse wave propagation model for each realization of the virtual database. WSS indices were derived from the 3D simulations and their variabilities quantified. Variations in BCs, caused by changes in systemic properties, yielded variabilities in the WSS indices that were of the same order of magnitude as differences in these WSS indices between ruptured and unruptured aneurysms. Sensitivity analysis showed that the systemic properties impacted both in- and outlet BCs simultaneously and altered the WSS indices. We conclude that the influence of variations in patient-specific systemic properties on WSS indices should be evaluated when using WSS indices in multidisciplinary rupture prediction models.
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Kennedy G, Meyer D, Hardman RJ, Macpherson H, Scholey AB, Pipingas A. Physical Fitness and Aortic Stiffness Explain the Reduced Cognitive Performance Associated with Increasing Age in Older People. J Alzheimers Dis 2019; 63:1307-1316. [PMID: 29865082 DOI: 10.3233/jad-171107] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Greater physical fitness is associated with reduced rates of cognitive decline in older people; however, the mechanisms by which this occurs are still unclear. One potential mechanism is aortic stiffness, with increased stiffness resulting in higher pulsatile pressures reaching the brain and possibly causing progressive micro-damage. There is limited evidence that those who regularly exercise may have lower aortic stiffness. OBJECTIVE To investigate whether greater fitness and lower aortic stiffness predict better cognitive performance in older people and, if so, whether aortic stiffness mediates the relationship between fitness and cognition. METHODS Residents of independent living facilities, aged 60-90, participated in the study (N = 102). Primary measures included a computerized cognitive assessment battery, pulse wave velocity analysis to measure aortic stiffness, and the Six-Minute Walk test to assess fitness. Based on hierarchical regression analyses, structural equation modelling was used to test the mediation hypothesis. RESULTS Both fitness and aortic stiffness independently predicted Spatial Working Memory (SWM) performance, however no mediating relationship was found. Additionally, the derived structural equation model shows that, in conjunction with BMI and sex, fitness and aortic stiffness explain 33% of the overall variation in SWM, with age no longer directly predicting any variation. CONCLUSIONS Greater fitness and lower aortic stiffness both independently predict better SWM in older people. The strong effect of age on cognitive performance is totally mediated by fitness and aortic stiffness. This suggests that addressing both physical fitness and aortic stiffness may be important to reduce the rate of age associated cognitive decline.
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Affiliation(s)
- Greg Kennedy
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Denny Meyer
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Roy J Hardman
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Helen Macpherson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Andrew B Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
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Chronic administration of minoxidil protects elastic fibers and stimulates their neosynthesis with improvement of the aorta mechanics in mice. Cell Signal 2019; 62:109333. [PMID: 31176018 DOI: 10.1016/j.cellsig.2019.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 01/25/2023]
Abstract
Arterial wall elastic fibers, made of 90% elastin, are arranged into elastic lamellae which are responsible for the resilience and elastic properties of the large arteries (aorta and its proximal branches). Elastin is synthesized only in early life and adolescence mainly by the vascular smooth muscles cells (VSMC) through the cross-linking of its soluble precursor, tropoelastin. In normal aging, the elastic fibers become fragmented and the mechanical load is transferred to collagen fibers, which are 100-1000 times stiffer than elastic fibers. Minoxidil, an ATP-dependent K+ channel opener, has been shown to stimulate elastin expression in vitro, and in vivo in the aorta of male aged mice and young adult hypertensive rats. Here, we have studied the effect of a 3-month chronic oral treatment with minoxidil (120 mg/L in drinking water) on the abdominal aorta structure and function in adult (6-month-old) and aged (24-month-old) male and female mice. Our results show that minoxidil treatment preserves elastic lamellae integrity at both ages, which is accompanied by the formation of newly synthesized elastic fibers in aged mice. This leads to a generally decreased pulse pressure and a significant improvement of the arterial biomechanical properties in female mice, which present an increased distensibility and a decreased rigidity of the aorta. Our studies show that minoxidil treatment reversed some of the major adverse effects of arterial aging in mice and could be an interesting anti-arterial aging agent, also potentially usable for female-targeted therapies.
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Yu CG, Wei FF, Yang WY, Zhang ZY, Mujaj B, Thijs L, Feng YM, Boggia J, Nawrot TS, Struijker-Boudier HAJ, Staessen JA. Central hemodynamics in relation to blood lead in young men prior to chronic occupational exposure. Blood Press 2019; 28:279-290. [DOI: 10.1080/08037051.2019.1610654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Cai-Guo Yu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Department of Endocrinology, Beijing Luhe Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Blerim Mujaj
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Ying-Mei Feng
- Department of Endocrinology, Beijing Luhe Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China
| | - José Boggia
- Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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Belvroy VM, de Beaufort HW, van Herwaarden JA, Bismuth J, Moll FL, Trimarchi S. Tortuosity of the descending thoracic aorta: Normal values by age. PLoS One 2019; 14:e0215549. [PMID: 31013307 PMCID: PMC6478292 DOI: 10.1371/journal.pone.0215549] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/03/2019] [Indexed: 11/19/2022] Open
Abstract
Background Aging changes the aorta in length, tortuosity and diameter. This is relevant in thoracic endovascular aortic repair (TEVAR) and in the long term follow up. Methods and results Two groups of hundred patients < 65 years and hundred patients ≥ 65 years, with no vascular diseases were made. Thin cut CT scans were analyzed with 3Mensio Vascular software and the following measurements were collected; tortuosity index, curvature ratio, maximum tortuosity in degrees and the level of vertebrae of the maximum tortuosity. The descending thoracic aorta (DTA) was analyzed and was divided into four zones of equal length. Subjects were divided into three groups based on their maximum tortuosity value: low (< 30°), moderate (30° – 60°) and high (> 60°). A linear regression model was built to test the effect of age and gender on tortuosity. Tortuosity was more pronounced in the ≥ 65 compared to the < 65 group (tortuosity index: 1.05 vs. 1.14, respectively; p < 0.001), curvature ratio (1.00 vs. 1.01; p < 0.001), maximum tortuosity (22.24 vs. 27.26; p < 0.001), and group of angulation (low vs. low; p < 0.001). Additionally, the location of maximum tortuosity was further distal for the ≥ 65 group (level of vertebrae; 5.00 vs. 5.00; p < 0.001), and zone of maximum tortuosity (4A vs. 4A; p < 0.001). There was no significant difference between male and female subjects. Conclusion Normal DTA tortuosity increases with age. This is important to understand natural aging and for TEVAR planning and follow-up.
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Affiliation(s)
- Viony M. Belvroy
- Thoracic Aortic Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, United States of America
- * E-mail:
| | - Hector W.L. de Beaufort
- Thoracic Aortic Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jean Bismuth
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, United States of America
| | - Frans L. Moll
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Santi Trimarchi
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
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Rosenbaum D, Gallo A, Lethielleux G, Bruckert E, Levy BI, Tanguy ML, Dulon J, Dahmoune N, Salem JE, Bittar R, Leban M, Girerd X, Touraine P, Bachelot A. Early central blood pressure elevation in adult patients with 21-hydroxylase deficiency. J Hypertens 2019; 37:175-181. [PMID: 30036269 DOI: 10.1097/hjh.0000000000001850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONTEXT Controversial data exist on cardiovascular damages in patients with congenital adrenal hyperplasia (CAH). OBJECTIVE To assess blood pressure and early cardiovascular damages on a large cohort of adult CAH patients and control individuals. DESIGN Case-control study. SETTING Referral Center for Rare Disease, Pitié Salpêtrière Hospital, Paris, France. PATIENTS OR OTHER PARTICIPANTS Fifty-eight women and 26 men with CAH diagnosed in childhood and 85 controls matched-paired for sex, age and smoking status were prospectively included. INTERVENTION Measurement of large arteries and microcirculatory anatomical and functional indices as well as hormonal status and cardiovascular risk factors evaluation. MAIN OUTCOME MEASURE The primary objective was to compare carotid intima-media thickness (cIMT) in CAH patients and controls. The secondary objectives were to compare blood pressure (BP), radial augmentation index (rAI), central BP, carotid-femoral pulse wave velocity (PWV), skin microcirculation indices and inflammation parameters in CAH patients and controls. RESULTS Although PWV and cIMT were identical in patients and controls, higher rAI (64.6 ± 1.7 vs. 59.9 ± 1.6%, P = 0.02) and higher central SBP (101.8 ± 1.5 vs. 95.1 ± 1.5 mmHg, P < 0.001) were observed in CAH patients. Regarding microcirculatory indices, there was a higher functional resting capacity and a lower anatomical capillary density in CAH patients. In multivariate analysis, we found an independant association between CAH and central SBP elevation. CONCLUSION We found an early rise in central SBP in CAH patients whereas sublinical arterial damages markers were normal. Our study suggest that vascular damages and increased cardiovascular risk could be mainly BP-driven.
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Affiliation(s)
- David Rosenbaum
- AP-HP, Endocrinology - Metabolism and Prevention of Cardiovascular Diseases, Groupe Hospitalier Pitié-Salpêtrière - Université Pierre et Marie Curie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146 - CNRS 7371, Laboratoire d'imagerie Biomédicale, F-75013
- Imaging Core Lab, Institute of Cardiometabolism and Nutrition
| | - Antonio Gallo
- AP-HP, Endocrinology - Metabolism and Prevention of Cardiovascular Diseases, Groupe Hospitalier Pitié-Salpêtrière - Université Pierre et Marie Curie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146 - CNRS 7371, Laboratoire d'imagerie Biomédicale, F-75013
- Imaging Core Lab, Institute of Cardiometabolism and Nutrition
| | - Gaelle Lethielleux
- AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN
| | - Eric Bruckert
- AP-HP, Endocrinology - Metabolism and Prevention of Cardiovascular Diseases, Groupe Hospitalier Pitié-Salpêtrière - Université Pierre et Marie Curie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146 - CNRS 7371, Laboratoire d'imagerie Biomédicale, F-75013
- Imaging Core Lab, Institute of Cardiometabolism and Nutrition
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI)
| | - Bernard I Levy
- AP-HP, Physiologie clinique - Explorations fonctionnelles Lariboisière Hospital
| | | | - Jérôme Dulon
- AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN
| | - Nora Dahmoune
- AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN
| | - Joe Elie Salem
- AP-HP, Pitié-Salpêtrière Hospital, Department of Pharmacology and CIC-1421
- INSERM, CIC-1421 and UMR ICAN 1166
- Sorbonne Universités
- UPMC Univ Paris 06
| | - Randa Bittar
- AP-HP, Hôpital Pitié-Salpêtrière, Department of Hormonal Biochemistry, Paris, France
| | - Monique Leban
- AP-HP, Hôpital Pitié-Salpêtrière, Department of Hormonal Biochemistry, Paris, France
| | - Xavier Girerd
- AP-HP, Endocrinology - Metabolism and Prevention of Cardiovascular Diseases, Groupe Hospitalier Pitié-Salpêtrière - Université Pierre et Marie Curie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146 - CNRS 7371, Laboratoire d'imagerie Biomédicale, F-75013
- Imaging Core Lab, Institute of Cardiometabolism and Nutrition
- Dyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC - Paris VI)
| | - Philippe Touraine
- AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN
- Sorbonne Universités
- UPMC Univ Paris 06
| | - Anne Bachelot
- AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Centre de Référence des Pathologies Gynécologiques Rares, ICAN
- Sorbonne Universités
- UPMC Univ Paris 06
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