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Noskova VV, Khrabrikov AN. [Endothelial dysfunction as a pathogenetic factor of sensorineural hearing loss]. Vestn Otorinolaringol 2024; 89:21-27. [PMID: 38506021 DOI: 10.17116/otorino20248901121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Chronic sensorineural hearing loss (SNHL) is a common disease that leads to disability of the population. Despite the many reports devoted to SNHL, the question of the pathogenesis of the disease is still open. Many researchers consider the development of SNHL as a manifestation of microangiopathy. The mechanism of development of microangiopathy in SNHL is multifactorial, but most researchers agree that endothelial dysfunction (ED) triggers a complex of pathological changes in the vessels of the inner ear. OBJECTIVE Review of the results of scientific research in recent years on the problem of etiopathogenesis of sensorineural hearing loss from the perspective of endothelial dysfunction in the formation of auditory disorders.
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Affiliation(s)
- V V Noskova
- Kirov State Medical University, Kirov, Russia
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Ahn J, Baik JW, Kim D, Choi K, Lee S, Park SM, Kim JY, Nam SH, Kim C. In vivo photoacoustic monitoring of vasoconstriction induced by acute hyperglycemia. PHOTOACOUSTICS 2023; 30:100485. [PMID: 37082618 PMCID: PMC10112177 DOI: 10.1016/j.pacs.2023.100485] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Postprandial hyperglycemia, blood glucose spikes, induces endothelial dysfunction, increasing cardiovascular risks. Endothelial dysfunction leads to vasoconstriction, and observation of this phenomenon is important for understanding acute hyperglycemia. However, high-resolution imaging of microvessels during acute hyperglycemia has not been fully developed. Here, we demonstrate that photoacoustic microscopy can noninvasively monitor morphological changes in blood vessels of live animals' extremities when blood glucose rises rapidly. As blood glucose level rose from 100 to 400 mg/dL following intraperitoneal glucose injection, heart/breath rate, and body temperature remained constant, but arterioles constricted by approximately -5.7 ± 1.1% within 20 min, and gradually recovered for another 40 min. In contrast, venular diameters remained within about 0.6 ± 1.5% during arteriolar constriction. Our results experimentally and statistically demonstrate that acute hyperglycemia produces transitory vasoconstriction in arterioles, with an opposite trend of change in blood glucose. These findings could help understanding vascular glucose homeostasis and the relationship between diabetes and cardiovascular diseases.
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Affiliation(s)
- Joongho Ahn
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Jin Woo Baik
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Donggyu Kim
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Karam Choi
- Samsung Advanced Institute of Technology, Samsung Electronics Co. Ltd., Suwon 16678, Republic of Korea
| | - Seunghyun Lee
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Sung-Min Park
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Jin Young Kim
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Sung Hyun Nam
- Samsung Advanced Institute of Technology, Samsung Electronics Co. Ltd., Suwon 16678, Republic of Korea
- Corresponding authors.
| | - Chulhong Kim
- Departments of Electrical Engineering, Convergence IT Engineering, Mechanical Engineering, and Medical Science and Engineering, and Medical Device Innovation Center, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
- Corresponding authors.
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3
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Poonia K, Bhalla M, Dogar K, Malhotra A, Aggarwal K. Brachial artery flow-mediated dilation in patients with systemic sclerosis: an experience from tertiary care center from North India. Clin Rheumatol 2023:10.1007/s10067-023-06562-3. [PMID: 36897457 DOI: 10.1007/s10067-023-06562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/11/2023]
Abstract
Role of flow-mediated dilatation (FMD) testing in the assessment of the macrovascular dysfunction in systemic sclerosis (SS) and correlation of FMD values with disease severity. Twenty-five patients of SS and 25 healthy age-matched controls were recruited. Modified Rodnan skin thickness score (MRSS) was used for skin thickness assessment. FMD values were measured in the brachial artery. FMD values done at baseline before the initiation of treatment were lower in SSc patients (4.044 ± 2.742) compared to the healthy controls (11.076 ± 5.896) (P < 0.05). Comparison of FMD values between patients with limited cutaneous systemic sclerosis (LSSc) and diffuse cutaneous systemic sclerosis (DSSc) showed a trend toward lower in LSSc (3.182 ± 2.482) as compared to DSSc patients (5.111 ± 2.711); however, the difference was not statistically significant. Patients with lung manifestations on high-resolution CT chest showed lower FMD values (2.66 ± 2.23) compared to those without HRCT changes (6.45 ± 2.56) (P < 0.05). We demonstrate that FMD values in SSc patients were lower when compared to healthy controls. Patients with SS having pulmonary manifestations showed a lower value of FMD. Key Points • FMD is a simple non-invasive tool to assess the endothelial function in patients with systemic sclerosis. • Lower values of FMD in systemic sclerosis suggest that the endothelial dysfunction and values can also be correlated with other organ involvement such as lung and skin involvement. So, lower FMD values might be a useful marker for disease severity.
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Affiliation(s)
- Kavita Poonia
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Chandigarh, India.
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Science, Bathinda, India.
| | - Mala Bhalla
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Chandigarh, India
| | - Kanika Dogar
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Chandigarh, India
| | - Anita Malhotra
- Department of Physiology, Government Medical College and Hospital, Chandigarh, India
| | - Kajal Aggarwal
- Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Chandigarh, India
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Bapir M, Untracht GR, Hunt JEA, McVey JH, Harris J, Skene SS, Campagnolo P, Dikaios N, Rodriguez-Mateos A, Sampson DD, Sampson DM, Heiss C. Age-Dependent Decline in Common Femoral Artery Flow-Mediated Dilation and Wall Shear Stress in Healthy Subjects. Life (Basel) 2022; 12:life12122023. [PMID: 36556388 PMCID: PMC9787166 DOI: 10.3390/life12122023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Femoral artery (FA) endothelial function is a promising biomarker of lower extremity vascular health for peripheral artery disease (PAD) prevention and treatment; however, the impact of age on FA endothelial function has not been reported in healthy adults. Therefore, we evaluated the reproducibility and acceptability of flow-mediated dilation (FMD) in the FA and brachial artery (BA) (n = 20) and performed cross-sectional FA- and BA-FMD measurements in healthy non-smokers aged 22−76 years (n = 50). FMD protocols demonstrated similar good reproducibility. Leg occlusion was deemed more uncomfortable than arm occlusion; thigh occlusion was less tolerated than forearm and calf occlusion. FA-FMD with calf occlusion was lower than BA-FMD (6.0 ± 1.1% vs 6.4 ± 1.3%, p = 0.030). Multivariate linear regression analysis indicated that age (−0.4%/decade) was a significant independent predictor of FA-FMD (R2 = 0.35, p = 0.002). The age-dependent decline in FMD did not significantly differ between FA and BA (pinteraction agexlocation = 0.388). In older participants, 40% of baseline FA wall shear stress (WSS) values were <5 dyne/cm2, which is regarded as pro-atherogenic. In conclusion, endothelial function declines similarly with age in the FA and the BA in healthy adults. The age-dependent FA enlargement results in a critical decrease in WSS that may explain part of the age-dependent predisposition for PAD.
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Affiliation(s)
- Mariam Bapir
- Department of Clinical and Experimental Medicine, School of Biosciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Gavrielle R. Untracht
- Optical + Biomedical Engineering Laboratory, School of Electrical, Electronic and Computer Engineering, The University of Western Australia, Perth 6009, Australia
- Surrey Biophotonics, Advanced Technology Institute, School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Julie E. A. Hunt
- School of Biosciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - John H. McVey
- Department of Biochemical Sciences, School of Biosciences, University of Surrey, Guildford GU2 7XH, UK
| | - Jenny Harris
- School of Health Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Simon S. Skene
- Department of Clinical and Experimental Medicine, School of Biosciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Paola Campagnolo
- Department of Biochemical Sciences, School of Biosciences, University of Surrey, Guildford GU2 7XH, UK
| | - Nikolaos Dikaios
- Mathematics Research Center, Academy of Athens, 11855 Athens, Greece
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King’s College London, London SE1 9NH, UK
| | - David D. Sampson
- Surrey Biophotonics, Advanced Technology Institute, School of Physics and School of Biosciences and Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Danuta M. Sampson
- Department of Clinical and Experimental Medicine, School of Biosciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
- Surrey Biophotonics, Centre for Vision, Speech and Signal Processing and School of Biosciences and Medicine, University of Surrey, Guildford GU2 7XH, UK
- Institute of Ophthalmology, University College London, London SE5 9RS, UK
| | - Christian Heiss
- Department of Clinical and Experimental Medicine, School of Biosciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
- Surrey and Sussex NHS Healthcare Trust, Redhill RH1 5RH, UK
- Correspondence:
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Solano MM, Richer E, Cheriet F, Lesk MR, Costantino S. Mapping Pulsatile Optic Nerve Head Deformation Using OCT. OPHTHALMOLOGY SCIENCE 2022; 2:100205. [PMID: 36531582 PMCID: PMC9754981 DOI: 10.1016/j.xops.2022.100205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To develop a noninvasive technique to quantitatively assess the pulsatile deformation due to cardiac contractions of the optic nerve head (ONH). DESIGN Evaluation of a diagnostic test or technology. PARTICIPANTS Healthy subjects with no history of refractive surgery, divided into 2 cohorts on the basis of their axial length (AL). METHODS We present a noninvasive technique to quantitatively assess the pulsatile deformation of the ONH tissue by combining high-frequency OCT imaging and widely available image processing algorithms. We performed a thorough validation of the approach, numerically and experimentally, evaluating the sensitivity of the method to artificially induced deformation and its robustness to different noise levels. We performed deformation measurements in cohorts of healthy (n = 9) and myopic (n = 5) subjects in different physiological strain conditions by calculating the amplitude of tissue displacement in both the primary position and abduction. The head rotation was measured using a goniometer. During imaging in abduction, the head was rotated 40° ± 3°, and subjects were instructed to direct their gaze toward the OCT visual target. MAIN OUTCOME MEASURES Pulsatile tissue displacement maps. RESULTS The robustness of the method was assessed using artificial deformations and increasing noise levels. The results show acceptable absolute errors before the noise simulations grossly exaggerate image degradation. For the group of subjects with AL of < 25 mm (n = 9), the median pulsatile displacement of the ONH was 7.8 ± 1.3 μm in the primary position and 8.9 ± 1.2 μm in abduction. The Wilcoxon test showed a significant difference (P ≤ 0.005) between the 2 paired measures. Reproducibility was tested in 2 different sessions in 5 different subjects with the same intraocular pressure, and an intraclass correlation coefficient of 0.99 was obtained (P < 0.005). CONCLUSIONS The computational pipeline demonstrated good reproducibility and had the capacity to accurately map the pulsatile deformation of the optic nerve. In a clinical setting, we detected physiological changes in normal subjects supporting its translation potential as a novel biomarker for the diagnosis and progression of optic nerve diseases.
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Affiliation(s)
- Marissé Masís Solano
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
| | - Emmanuelle Richer
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Farida Cheriet
- Department of Computer Engineering and Software Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Mark R. Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
- Department of Ophthalmology. Université de Montréal, Montreal, Quebec, Canada
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Bojic L, Rogosic V, Markovic D, Rogosic LV, Glavas D. Brachial flow-mediated dilation and carotid intima-media thickness in glaucoma patients. BMC Ophthalmol 2022; 22:275. [PMID: 35739540 PMCID: PMC9229099 DOI: 10.1186/s12886-022-02498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of the study was to assess the ultrasound measurements of the brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) and their relationship in glaucoma patients. Methods Thirty-seven patients with glaucoma and thirty-one healthy controls were included in the study. All glaucoma patients and controls underwent ultrasound measurement of FMD of the brachial artery and ultrasound measurement of IMT of the carotid artery. Results The mean values of brachial FMD were significantly lower among the glaucoma compared with controls (16.4 ± 10.6% vs 20.3 ± 8.5%, p = 0.034). No significant difference was found in carotid IMT (1.2 ± 0.4 vs. 1.1 ± 0.4, p = 0.3), and brachial artery diameter at rest (4.7 ± 0.6 vs. 4.9 ± 0.3, p = 0.2) between the glaucoma patients and controls. The significant difference in brachial artery diameter in hyperemia between the glaucoma patients and controls (5.5 ± 0.6 vs. 5.9 ± 0.4 p = 0.002) was found. A negative correlation among brachial FMD and carotid IMT as well as among brachial FMD and brachial artery diameter at rest was found. Conclusions Impaired brachial FMD indicates presence of systemic vascular endothelial dysfunction in glaucoma; glaucoma patients with lower values of the brachial FMD are at increased risk of having thickened carotid IMT.
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Affiliation(s)
| | - Veljko Rogosic
- Department of Ophthalmology, University Hospital Split, Split, Croatia
| | - Domagoj Markovic
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia.
| | | | - Duska Glavas
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia
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7
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Koep JL, Weston ME, Barker AR, Bailey TG, Coombes JS, Lester A, Bond B. The within- and between-day reliability of cerebrovascular reactivity using traditional and novel analytical approaches. Exp Physiol 2021; 107:29-41. [PMID: 34806238 DOI: 10.1113/ep090031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the central question of the study? What is the reliability of middle cerebral artery velocity cerebrovascular reactivity (CVR) when using traditional and novel outcomes, as measured by transcranial Doppler? What is the main finding and its importance? Traditional CVR approaches presented acceptable reproducibility but should be expressed as an absolute CVR. Large within- and between-individual differences in the middle cerebral artery velocity response profile support using a dynamic peak, rather than a set time point, for the most reliable interpretation. The study highlights the utility of novel kinetic CVR outcomes, but due to increased variability in time-based metrics, this analysis requires larger sample sizes than traditional methods. ABSTRACT Cerebrovascular reactivity (CVR) of middle cerebral artery velocity (MCAv) to CO2 is a common method to assess cerebrovascular function. Yet, the approaches used to calculate CVR outcomes vary. The aim of this study was to explore the within- and between-day reliability of traditional CVR outcomes. The second aim was to explore the reliability of novel kinetic-based analyses. Healthy adults (n = 10, 22.3 ± 3.4 years) completed assessments of CVR over 4 min using a fixed fraction of inspired CO2 (6%). This was repeated across four separate visits (between-day), and on one visit measures were repeated 2.5 h later (within-day). No mean biases were present between assessments for traditional CVR metrics, expressed as absolute (cm/s/mmHg) or relative (%/mmHg) outcomes (minute 3, minute 4, peak 1 s, peak 30 s) (between-day: P > 0.14, ηp 2 < 0.20; within-day: P > 0.22, d > 0.27). Absolute, rather than relative, CVR yielded the most reproducible parameters (coefficient of variation: 8.1-13.2% vs. 14-83%, respectively). There were significant differences between CVR outcomes (P < 0.001, ηp 2 > 0.89) dependent on the time point used to determine CVR, as a steady state MCAv response was rarely observed. Furthermore, the MCAv response was not reproducible within an individual (κ = 0.15, P = 0.09). No mean differences were present for novel kinetic outcomes (amplitude, time-delay, time constant) (between-day: P > 0.05, d < 0.33; within-day: P > 0.38, d < 0.25). The results support the need for standardisation and indicate CVR should be defined as a dynamic peak, rather than a set time point for increased reliability. For novel kinetic outcomes variability was greater (CV: 8.7-120.9%) due to the nature of time-based metrics.
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Affiliation(s)
- Jodie L Koep
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Max E Weston
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,School of Nursing Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alice Lester
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Troy AM, Cheng HM. Human microvascular reactivity: a review of vasomodulating stimuli and non-invasive imaging assessment. Physiol Meas 2021; 42. [PMID: 34325417 DOI: 10.1088/1361-6579/ac18fd] [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: 03/31/2021] [Accepted: 07/29/2021] [Indexed: 11/11/2022]
Abstract
The microvasculature serves an imperative function in regulating perfusion and nutrient exchange throughout the body, adaptively altering blood flow to preserve hemodynamic and metabolic homeostasis. Its normal functioning is vital to tissue health, whereas its dysfunction is present in many chronic conditions, including diabetes, heart disease, and cognitive decline. As microvascular dysfunction often appears early in disease progression, its detection can offer early diagnostic information. To detect microvascular dysfunction, one uses imaging to probe the microvasculature's ability to react to a stimulus, also known as microvascular reactivity (MVR). An assessment of MVR requires an integrated understanding of vascular physiology, techniques for stimulating reactivity, and available imaging methods to capture the dynamic response. Practical considerations, including compatibility between the selected stimulus and imaging approach, likewise require attention. In this review, we provide a comprehensive foundation necessary for informed imaging of MVR, with a particular focus on the challenging endeavor of assessing microvascular function in deep tissues.
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Affiliation(s)
- Aaron M Troy
- Institute of Biomedical Engineering, University of Toronto, Toronto, CANADA
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9
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Schick V, Boensch M, van Edig M, Alfitian J, Pola T, Ecker H, Lindacher F, Shah-Hosseini K, Wetsch WA, Riedel B, Schier R. Impaired vascular endothelial function as a perioperative risk predictor - a prospective observational trial. BMC Anesthesiol 2021; 21:190. [PMID: 34266384 PMCID: PMC8281450 DOI: 10.1186/s12871-021-01400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Background In the recent years, an increasing number of patients with multiple comorbidities (e.g. coronary artery disease, diabetes, hypertension) presents to the operating room. The clinical risk factors are accompanied by underlying vascular-endothelial dysfunction, which impairs microcirculation and may predispose to end-organ dysfunction and impaired postoperative outcome. Whether preoperative endothelial dysfunction identifies patients at risk of postoperative complications remains unclear. In this prospective observational study, we tested the hypothesis that impaired flow-mediated dilation (FMD), a non-invasive surrogate marker of endothelial function, correlates with Days at Home within 30 days after surgery (DAH30). DAH30 is a patient-centric metric that captures postoperative complications and importantly also hospital re-admissions. Methods Seventy-one patients scheduled for major abdominal surgery were enrolled. FMD was performed pre-operatively prior to major abdominal surgery and patients were dichotomised at a threshold value of 10%. FMD was then correlated with DAH30 (primary endpoint) and postoperative complications (secondary endpoints). Results DAH30 did not differ between patients with reduced FMD and normal FMD (14 (4) (median (IQR)) vs. 15 (8), P = 0.8). Similary, no differences between both groups were found for CCI (normal FMD: 21 (30) (median (IQR)), reduced FMD: 26 (38), P = 0.4) or frequency of major complications (normal FMD: 7 (19%) (n (%)), reduced FMD: 12 (35%), P = 0.12). The regression analyses revealed that FMD in combination with ASA status and surgery duration had no additional significant predictive effect for DAH30, CCI or Clavien-Dindo score. Conclusion FMD does not add predictive value with regards to DAH30, CCI or Clavien-Dindo score within our study cohort of patients undergoing abdominal surgery. Trial registration The study was registered in the German Clinical Trials Register (DRKS00005472), prospectively registered on 25/11/2013.
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Affiliation(s)
- Volker Schick
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Marc Boensch
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Milan van Edig
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Jonas Alfitian
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Tülay Pola
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Hannes Ecker
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Falko Lindacher
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Kija Shah-Hosseini
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Wolfgang A Wetsch
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Bernhard Riedel
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre and The University of Melbourne, Melbourne, Australia
| | - Robert Schier
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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10
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Trinity JD, Craig JC, Fermoyle CC, McKenzie AI, Lewis MT, Park SH, Rondina MT, Richardson RS. Impact of presymptomatic COVID-19 on vascular and skeletal muscle function: a case study. J Appl Physiol (1985) 2021; 130:1961-1970. [PMID: 34002634 PMCID: PMC8213510 DOI: 10.1152/japplphysiol.00236.2021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The impact of COVID-19 has been largely described after symptom development. Although the SARS-CoV-2 virus elevates heart rate (HR) prior to symptom onset, whether this virus evokes other presymptomatic alterations is unknown. This case study details the presymptomatic impact of COVID-19 on vascular and skeletal muscle function in a young woman [24 yr, 173.5 cm, 89 kg, body mass index (BMI): 29.6 kg·m-2]. Vascular and skeletal muscle function were assessed as part of a separate study with the first and second visits separated by 2 wk. On the evening following the second visit, the participant developed a fever and a rapid antigen test confirmed a positive COVID-19 diagnosis. Compared with the first visit, the participant presented with a markedly elevated HR (∼30 beats/min) and a lower mean blood pressure (∼8 mmHg) at the second visit. Vascular function measured by brachial artery flow-mediated dilation, reactive hyperemia, and passive leg movement were all noticeably attenuated (25%-65%) as was leg blood flow during knee extension exercise. Muscle strength was diminished as was ADP-stimulated respiration (30%), assessed in vitro, whereas there was a 25% increase in the apparent Km. Lastly, an elevation in IL-10 was observed prior to symptom onset. Notably, 2.5 mo after diagnosis symptoms of fatigue and cough were still present. Together, these findings provide unique insight into the physiological responses immediately prior to onset of COVID-19 symptoms; they suggest that SARS-CoV-2 negatively impacts vascular and skeletal muscle function prior to the onset of common symptoms and may set the stage for the widespread sequelae observed following COVID-19 diagnosis.NEW & NOTEWORTHY This unique case study details the impact of SARS-CoV-2 infection on vascular and skeletal muscle function in a young predominantly presymptomatic woman. Prior to COVID-19 diagnosis, substantial reductions in vascular, skeletal muscle, and mitochondrial function were observed along with an elevation in IL-10. This integrative case study indicates that the presymptomatic impact of COVID-19 is widespread and may help elucidate the acute and long-term sequelae of this disease.
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Affiliation(s)
- Joel D. Trinity
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah,3Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jesse C. Craig
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah
| | - Caitlin C. Fermoyle
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah
| | - Alec I. McKenzie
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah
| | - Matthew T. Lewis
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah
| | - Soung Hun Park
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,3Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Matthew T. Rondina
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah,4Molecular Medicine Program, Division of General Internal Medicine, Departments of Internal Medicine and Pathology, University of Utah, Salt Lake City, Utah
| | - Russell S. Richardson
- 1Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah,2Division of Geriatrics, Department of Internal Medicine, grid.223827.eUniversity of Utah, Salt Lake City, Utah,3Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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11
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Falz R, Thieme R, Tegtbur U, Bischoff C, Leps C, Hillemanns P, Kohlhaw K, Klempnauer J, Lordick F, Stolzenburg JU, Aktas B, Weitz J, Bork U, Wimberger P, Thomas C, Biemann R, Jansen-Winkeln B, Schulze A, Gockel I, Busse M. CRBP-TS - evaluation of a home-based training and health care program for colorectal, breast, and prostate cancer using telemonitoring and self-management: study protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:15. [PMID: 33622370 PMCID: PMC7901214 DOI: 10.1186/s13102-021-00244-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/07/2021] [Indexed: 01/19/2023]
Abstract
Background Physical training is recommended in various national and international guidelines for patients with cancer. Observational studies have shown that physical activity leads to reduced recurrence and mortality rates by 20–40% in colorectal, breast, and prostate cancer. Despite existing evidence, a systematic care structure is still lacking. The primary aim of this study is to implement and evaluate an online training platform to strengthen physical performance and patient empowerment after cancer surgery. Methods The evaluation will be conducted as a prospective multicenter randomized controlled trial with three subgroups (colorectal-, breast-, and prostate cancer). Each group will include 100 patients (total 300 patients including dropouts; clinical stages T1–3 and/or N+; M0 after surgery intervention) and the primary endpoint (13% increase in the maximal oxygen consumption during exercise) will be examined. The intervention group will receive a 6-month home-based online training (2–3 times per week strength-endurance training using video presentations), bidirectional activity feedback information, online communication, and online counseling. The control group (usual care) will be advised lifestyle improvement. In-hospital testing will be performed before, during, and after the intervention. In addition to cardiopulmonary capacity, tumor specific diagnostics (liquid biopsy, depression and fatigue assessment, metabolic and endothelial screening) will be applied. Discussion Due to the increasing incidence of cancer, associated with considerable mortality, morbidity and impaired quality of life, there is an imperative requirement for improved cancer care, of which structured physical training may become an integral component. Trial registration DRKS-ID: DRKS00020499; Registered 17 March 2020.
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Institute of Sport Medicine, Hannover Medical School, Hannover, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Christian Leps
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Kay Kohlhaw
- Department of Surgery, Sana Hospitals "Leipziger Land", Borna, Germany
| | - Jürgen Klempnauer
- Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Florian Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology and Infectious Diseases, University Hospital Leipzig, Leipzig, Germany.,University Cancer Center Leipzig, University Hospital Leipzig, Leipzig, Germany
| | | | - Bahriye Aktas
- Department of Gynaecology, University Hospital Leipzig, Leipzig, Germany
| | - Jürgen Weitz
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Ulrich Bork
- Department of Visceral-, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Pauline Wimberger
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Thomas
- National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.,Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Boris Jansen-Winkeln
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
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12
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Altilix ® Supplement Containing Chlorogenic Acid and Luteolin Improved Hepatic and Cardiometabolic Parameters in Subjects with Metabolic Syndrome: A 6 Month Randomized, Double-Blind, Placebo-Controlled Study. Nutrients 2019; 11:nu11112580. [PMID: 31731527 PMCID: PMC6893885 DOI: 10.3390/nu11112580] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 02/06/2023] Open
Abstract
The objective was to evaluate the effects of 6 months of supplementation with Altilix®, containing chlorogenic acid and its derivatives, and luteolin and its derivatives, on cardiovascular risk and hepatic markers in subjects with metabolic syndrome (MetS). A randomized, double-blind, placebo-controlled study was performed in 100 subjects with MetS with a follow-up period of 6 months; 50 subjects were randomized to Altilix® (26 men and 24 women, mean age 63 ± 8 years) and the other 50 to placebo (28 men and 22 women, mean age 63 ± 11 years). Anthropometric, cardiometabolic, and hepatic parameters were assessed at baseline and at the end of follow-up. Carotid intima-media thickness and endothelial function were assessed by doppler ultrasound and by flow-mediated dilation of the brachial artery, respectively. The presence and degree of non-alcoholic fatty liver disease (NAFLD) was assessed by the fatty liver index (FLI), and subjects were divided into three subgroups: (1) without NAFLD; (2) with borderline NAFLD; and (3) with NAFLD. After 6 months of Altilix® supplementation, we found a significant improvement vs. placebo in most of the evaluated parameters, including body weight (−2.40% (95% CI −3.79, −1.01); p < 0.001), waist circumference (−2.76% (95% CI −4.55, −0.96); p = 0.003), HbA1c (−0.95% (95% CI −1.22, −0.67); p < 0.001), plasma lipids, FLI (−21.83% (95% CI −27.39, −16.27); p < 0.001), hepatic transaminases, flow-mediated dilation (10.56% (95% CI 5.00, 16.12); p < 0.001), and carotid intima-media thickness (−39.48% (95% CI −47.98, −30.97); p < 0.001). Further, the improvement in cardiometabolic variables was independent of the degree of hepatic steatosis. Altilix® supplementation improved hepatic and cardio-metabolic parameters in MetS subjects. Altilix® supplementation was a beneficial approach in the management of hepatic and cardiometabolic alterations in MetS subjects.
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13
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Gilbertson NM, Miller SL, Eichner NZ, Malin SK. Endothelial function following interval exercise plus low-calorie diet treatment in obese females. Physiol Rep 2019; 7:e14239. [PMID: 31552710 PMCID: PMC6759506 DOI: 10.14814/phy2.14239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/30/2019] [Indexed: 12/30/2022] Open
Abstract
We determined if interval exercise plus a low-calorie diet (LCD + INT) increases endothelial function more than an energy-matched LCD. Obese women (47.2 ± 2.6y, 37.5 ± 1.3kg/m2 ) were randomized to 13 days of a LCD (n = 12; mixed meals of ~ 1200kcal/d) or LCD + INT (n = 13; 12 supervised 60-min INT bouts of 3 min at 90% and 50% HRpeak ). LCD + INT subjects received 350kcal postexercise to equate energy availability with LCD. Fitness (VO2 peak) and body composition (BodPod) were determined and a 120 min, 75 g oral glucose tolerance test was performed to examine fasting and postprandial flow-mediated dilation (FMD, endothelial function), respiratory exchange ratio (RER) via indirect calorimetry as well as glucose and insulin incremental area under the curve (iAUC120min ). LCD + INT increased VO2 peak (P = 0.02) compared with LCD, and both treatments decreased fat mass (P < 0.001) and insulin iAUC120min (P = 0.03). There was no overall treatment effect on fasting or iAUC120min FMD. However, in participants who increased fasting endothelial function after each treatment (Δ > 50%; LCD n = 5, LCD + INT n = 7), LCD + INT increased fasted (P = 0.005) and decreased iAUC120min (P = 0.003) FMD compared with LCD. Enhanced fitness correlated with increased fasting FMD (r = 0.43, P = 0.03) and diminished FMD iAUC120min (r = -0.44, P = 0.03). Decreased FMD iAUC120min correlated with reduced glucose iAUC120min (r = 0.64, P = 0.001) as well as increased 60-min RER (r = -0.42, P = 0.04). Low baseline fasting and iAUC120min FMD was also linked to enhanced fasting and iAUC120min FMD post-treatment (r = -0.71, P < 0.001; r = -0.89, P < 0.001, respectively). In conclusion, increasing fitness via INT may increase the effect of LCD on lowering cardiovascular disease risk in obese women.
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Affiliation(s)
| | | | | | - Steven K. Malin
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginia
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of VirginiaCharlottesvilleVirginia
- Robert M. Berne Cardiovascular Research CenterUniversity of VirginiaCharlottesvilleVirginia
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14
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Detterich JA, Kato R, Bush A, Chalacheva P, Ponce D, De Zoysa M, Shah P, Khoo MC, Meiselman HJ, Coates TD, Wood JC. Sickle cell microvascular paradox-oxygen supply-demand mismatch. Am J Hematol 2019; 94:678-688. [PMID: 30916797 DOI: 10.1002/ajh.25476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 12/13/2022]
Abstract
We have previously demonstrated that sickle cell disease (SCD) patients maintain normal global systemic and cerebral oxygen delivery by increasing cardiac output. However, ischemic end-organ injury remains common suggesting that tissue oxygen delivery may be impaired by microvascular dysregulation or damage. To test this hypothesis, we performed fingertip laser Doppler flowmetry measurements at the base of the nailbed and regional oxygen saturation (rSO2 ) on the dorsal surface of the same hand. This was done during flow mediated dilation (FMD) studies in 26 chronically transfused SCD, 75 non-transfused SCD, and 18 control subjects. Chronically transfused SCD patients were studied prior to and following a single transfusion and there was no acute change in rSO2 or perfusion. Laser Doppler estimates of resting perfusion were 76% higher in non-transfused and 110% higher in transfused SCD patients, compared to control subjects. In contrast, rSO2 was 12 saturation points lower in non-transfused SCD patients, but normal in the transfused SCD patients. During cuff occlusion, rSO2 declined at the same rate in all subjects suggesting similar intrinsic oxygen consumption rates. Upon cuff release, laser doppler post occlusive hyperemia was blunted in SCD patients in proportion to their resting perfusion values. Transfusion therapy did not improve the hyperemia response. FMD was impaired in SCD subjects but partially ameliorated in transfused SCD subjects. Taken together, non-transfused SCD subjects demonstrate impaired conduit artery FMD, impaired microcirculatory post-occlusive hyperemia, and resting hypoxia in the hand despite compensated oxygen delivery, suggesting impaired oxygen supply-demand matching. Transfusion improves FMD and oxygen supply-demand matching but not microcirculation hyperemic response.
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Affiliation(s)
- Jon A. Detterich
- Division of Cardiology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
- Department of Physiology and NeuroscienceUniversity of Southern California Keck School of Medicine Los Angeles California
| | - Roberta Kato
- Division of Pediatric PulmonologyChildren's Hospital Los Angeles Los Angeles California
| | - Adam Bush
- Department of Biomedical EngineeringUniversity of Southern California Viterbi School of Engineering
| | - Patjanaporn Chalacheva
- Department of Biomedical EngineeringUniversity of Southern California Viterbi School of Engineering
| | - Derek Ponce
- Division of Cardiology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
| | - Madushka De Zoysa
- Division of Cardiology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
| | - Payal Shah
- Division of Hematology Oncology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
| | - Michael C. Khoo
- Department of Biomedical EngineeringUniversity of Southern California Viterbi School of Engineering
| | - Herbert J. Meiselman
- Department of Physiology and NeuroscienceUniversity of Southern California Keck School of Medicine Los Angeles California
| | - Thomas D. Coates
- Division of Hematology Oncology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
| | - John C. Wood
- Division of Cardiology, Children's Hospital Los AngelesUniversity of Southern California Keck School of Medicine Los Angeles California
- Department of Biomedical EngineeringUniversity of Southern California Viterbi School of Engineering
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15
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Patti AM, Nikolic D, Magan-Fernandez A, Giglio RV, Castellino G, Chianetta R, Citarrella R, Corrado E, Provenzano F, Provenzano V, Montalto G, Rizvi AA, Rizzo M. Exenatide once-weekly improves metabolic parameters, endothelial dysfunction and carotid intima-media thickness in patients with type-2 diabetes: An 8-month prospective study. Diabetes Res Clin Pract 2019; 149:163-169. [PMID: 30759365 DOI: 10.1016/j.diabres.2019.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/02/2019] [Accepted: 02/06/2019] [Indexed: 02/07/2023]
Abstract
AIM To evaluate the effect of exenatide long acting release (LAR) on carotid intima-media thickness (IMT) and endothelial function in patients with type 2 diabetes mellitus. METHODS Sixty subjects with type 2 diabetes mellitus were treated with exenatide LAR as add-on to stable doses of metformin for 8 months in an open label study. Anthropometric variables, lipid profile and glycemic parameters were assessed by routine analysis. Carotid IMT by Doppler ultrasound and endothelial function by flow-mediated dilation of the brachial artery were also assessed. RESULTS Exenatide significantly improved fasting glycaemia (from 8.8 ± 2.8 to 7.3 ± 2.2 mmol/L, p < 0.0001), HbA1c (from 8.0 ± 0.4 to 6.9 ± 1.1%, p < 0.0001), body mass index (from 33 ± 9 to 31 ± 6 kg/m2, p = 0.0348) and waist circumference (from 109 ± 13 to 106 ± 13 cm, p = 0.0105). There was a significant improvement of the lipid profile, except in triglyceride level where no changes were observed. Carotid IMT and flow-mediated dilation were also improved (from 0.98 ± 0.14 to 0.87 ± 0.15 mm and from 5.8 ± 1.3 to 6.8 ± 1.7%, respectively; p < 0.0001 for both). CONCLUSIONS Treatment with exenatide LAR led to improved cardio-metabolic parameters, including carotid IMT and flow-mediated dilation, independently of glucometabolic control. These results may help to explain, at least in part, the cardiovascular safety of exenatide LAR, as recently reported in cardiovascular outcome trials.
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Affiliation(s)
| | | | | | | | | | | | | | - Egle Corrado
- PROMISE Department, University of Palermo, Italy
| | | | | | | | - Ali A Rizvi
- Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Manfredi Rizzo
- PROMISE Department, University of Palermo, Italy; Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
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16
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Maranna S, Hill A, Fairlie-Jones L, Osborne B, Davison K. Reliability of sonographic measurements of endothelial function: Flow-mediated dilation, blood flow velocity, resistive and pulsatility indices. SONOGRAPHY 2018. [DOI: 10.1002/sono.12138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sandhya Maranna
- School of Health Sciences; University of South Australia; South Australia Australia
| | - Alison Hill
- School of Pharmacy and Medical Sciences; University of South Australia; South Australia Australia
| | - Lucy Fairlie-Jones
- School of Pharmacy and Medical Sciences; University of South Australia; South Australia Australia
| | - Brooke Osborne
- School of Health Sciences; University of South Australia; South Australia Australia
| | - Kade Davison
- School of Health Sciences; University of South Australia; South Australia Australia
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17
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Ghiorghe S, Dragomir A, Bartos D. ENDOTHELIAL DYSFUNCTION IN ACROMEGALIC PATIENTS: A CASE-CONTROL STUDY. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2018; 14:384-388. [PMID: 31149287 PMCID: PMC6525771 DOI: 10.4183/aeb.2018.384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Assessing cardiovascular risk in patients with acromegaly using traditional cardiovascular risk factors is inadequate. Endothelial dysfunction seems to be a much better indicator for assessing cardiovascular risk in acromegaly. The study aims to compare from this point of view two groups of patients, with hypertension and with acromegaly. METHODS The first group consists of 54 patients with acromegaly and the second group of 64 hypertensive patients. Endothelial dysfunction was evaluated by the FMD method. The relationship between endothelial dysfunction, specific humoral markers of acromegaly and traditional cardiovascular risk factors was analysed in both groups. RESULTS Although the presence of cardiovascular risk factors was statistically significantly higher in the group of hypertensives (the most important were age, blood pressure, glycemia, hypertriglyceridemia and SCORE), the presence of endothelial dysfunction was higher in the acromegaly group (61.10% vs. 32.10%, p=0.02). The best correlation with endothelial dysfunction in acromegaly group was the level of GH (28.9±28 vs. 11.7±10.3, p=0.003). CONCLUSIONS The presence of endothelial dysfunction in patients with acromegaly is highly dependent on the level of GH and traditional cardiovascular risk factors are less important. In these patients the cardiovascular risk should not be evaluated in the same way as in normal population.
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Affiliation(s)
- S. Ghiorghe
- “Policlinico di Monza” Medical Center, Dept. of Cardiology, Bucharest, Romania
| | - A. Dragomir
- “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania
| | - D. Bartos
- Clinical Emergency Hospital, Dept. of Internal Medicine, Bucharest, Romania
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Irace C, De Rosa S, Tripolino C, Ambrosio G, Covello C, Abramo E, Carallo C, Mongiardo A, Spaccarotella C, Torella D, Gnasso A, Indolfi C. Delayed flow-mediated vasodilation and critical coronary stenosis. J Investig Med 2018; 66:1-7. [PMID: 29550752 DOI: 10.1136/jim-2017-000644] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 11/04/2022]
Abstract
Endothelial dysfunction, wall thickening and plaque are progressive manifestations of atherosclerosis. Delayed or absent brachial artery dilation after ischemic stimulus has been associated with severity of extracoronary and coronary atherosclerosis. In the current study, we aimed to verify if delayed or absent dilation associates with critical coronary stenosis. We also evaluated the association between coronary stenosis, carotid artery wall thickness and peripheral artery disease. Endothelial function was investigated by flow-mediated dilation of the brachial artery up to 3 min after ischemia, and patients classified as early, late or no dilators. Coronary angiography was performed through transradial or femoral artery approach. Computerized quantitative angiography was used to obtain percent stenosis of all lesions, while the Gensini score was used to evaluate the severity of coronary atherosclerosis. Seventy-four patients were enrolled. Carotid wall thickness and plaque, and peripheral artery disease were detected by ultrasound. Subjects with critical coronary stenosis showed a higher prevalence of delayed or absent dilation (coronary stenosis ≥70 per cent: late dilators 50 per cent, no dilators 35 per cent; coronary stenosis ≤70 per cent : late dilators 27 per cent, no dilators 6 per cent). The Gensini score was progressively higher in late dilators and no dilators compared with early dilators (early: 4.5±13.5; late 17.5±27.1; no 39.7±55.0; P<0.02). Carotid atherosclerosis and peripheral artery disease were more prevalent in subjects with critical coronary stenosis. Delayed or absent dilation associates with coronary stenosis and different degree of coronary atherosclerosis. The kinetic of arterial dilation seems to be relevant as the magnitude of dilation.
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Affiliation(s)
- Concetta Irace
- Department of Health Science, Magna Graecia University, Catanzaro, Italy
| | - Salvatore De Rosa
- Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
| | - Cesare Tripolino
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | | | - Caterina Covello
- Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
| | - Ennio Abramo
- Azienda Ospedaliero-universitaria Mater Domini, Catanzaro, Italy
| | - Claudio Carallo
- Azienda Ospedaliero-universitaria Mater Domini, Catanzaro, Italy
| | | | | | - Daniele Torella
- Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
| | - Agostino Gnasso
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
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19
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Giles LV, Tebbutt SJ, Carlsten C, Koehle MS. The effect of low and high-intensity cycling in diesel exhaust on flow-mediated dilation, circulating NOx, endothelin-1 and blood pressure. PLoS One 2018; 13:e0192419. [PMID: 29466393 PMCID: PMC5821322 DOI: 10.1371/journal.pone.0192419] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 01/11/2018] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Exposure to air pollution impairs aspects of endothelial function such as flow-mediated dilation (FMD). Outdoor exercisers are frequently exposed to air pollution, but how exercising in air pollution affects endothelial function and how these effects are modified by exercise intensity are poorly understood. OBJECTIVES Therefore, the purpose of this study was to determine the effects of low-intensity and high-intensity cycling with diesel exhaust (DE) exposure on FMD, blood pressure, plasma nitrite and nitrate (NOx) and endothelin-1. METHODS Eighteen males performed 30-minute trials of low or high-intensity cycling (30% and 60% of power at VO2peak) or a resting control condition. For each subject, each trial was performed once while breathing filtered air (FA) and once while breathing DE (300ug/m3 of PM2.5, six trials in total). Preceding exposure, immediately post-exposure, 1 hour and 2 hours post-exposure, FMD, blood pressure and plasma endothelin-1 and NOx concentrations were measured. Data were analyzed using repeated-measures ANOVA and linear mixed model. RESULTS Following exercise in DE, plasma NOx significantly increased and was significantly greater than FA (p<0.05). Two hours following DE exposure, endothelin-1 was significantly less than FA (p = 0.037) but exercise intensity did not modify this response. DE exposure did not affect FMD or blood pressure. CONCLUSION Our results suggest that exercising in DE did not adversely affect plasma NOX, endothelin-1, FMD and blood pressure. Therefore, recommendations for healthy individuals to moderate or avoid exercise during bouts of high pollution appear to have no acute protective effect.
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Affiliation(s)
- Luisa V. Giles
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott J. Tebbutt
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Christopher Carlsten
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S. Koehle
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Sports Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Siu SP, Leung WK, Wan PS, Liu EK, Lai CW. Association between sonographically measured mesenteric fat thickness and brachial artery flow-mediated dilation in Chinese young male adults. J Int Med Res 2017; 45:1930-1938. [PMID: 29239246 PMCID: PMC5805196 DOI: 10.1177/0300060516688407] [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] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the potential correlation between sonographically measured mesenteric fat thickness (MFT) and brachial artery flow-mediated dilation (FMD) in a sample of healthy Chinese male young adults. Methods Healthy male participants were recruited from Hong Kong Polytechnic University for this prospective observational study. The physical activity readiness questionnaire and ultrasound measurements of carotid intima media thickness were used to screen for clinically healthy subjects. MFT and brachial artery FMD were measured by ultrasound, and body mass index (BMI) was recorded. Results A total of 34 healthy male subjects, aged 19-26 years (mean ± SD BMI, 21.7 ± 3.2 kg/m2) were included. Pearson's correlation coefficient test showed that brachial artery FMD had a statistically significant inverse relationship with BMI and with Log (MFT). Further stepwise multiple linear regression analysis showed that Log (MFT), and not BMI, was an independent predictor of impaired brachial artery FMD. Conclusions Sonographic measurements of MFT were an independent predictor of brachial artery FMD in Chinese male young adults.
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Affiliation(s)
- Stanley Py Siu
- 1 Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Wilson Kc Leung
- 1 Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Polly Sc Wan
- 1 Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Eric Kh Liu
- 2 Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Christopher Wk Lai
- 1 Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
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A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations. Sci Rep 2017; 7:12893. [PMID: 29018246 PMCID: PMC5635024 DOI: 10.1038/s41598-017-12775-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/15/2017] [Indexed: 02/07/2023] Open
Abstract
Blood pressure (BP) measurement is a central element in clinical practice. According to international recommendations 3 to 5 minutes of resting is needed before blood pressure measurement. Surprisingly, no study has modelled the time course of BP decrease and the minimum resting-time before BP measurement. A cross-sectional bicentric observational study was performed including outpatients addressed for vascular examination. Using two automatic BP monitors we recorded the blood pressure every minute during 11 consecutive minutes. The data was analyzed by non-linear mixed effect regression. Systolic (SBP) and diastolic BPs were studied and we tested the effect of covariates on its evolution through log-likelihood ratio tests. We included 199 patients (66+/−13years old). SBP was found to decrease exponentially. Simulations based on the final model show that only half the population reaches a stabilized SBP (defined as SBP + 5 mmHg) after 5 min of resting-time while it takes 25 min to ensure 90% of the population has a stabilized SBP. In conclusion, our results and simulations suggest that 5 minutes are not enough to achieve a stabilized SBP in most patients and at least 25 minutes are required. This questions whether the diagnosis of hypertension can be reliably made during routine visits in general practitioners’ offices.
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Karlas A, Reber J, Diot G, Bozhko D, Anastasopoulou M, Ibrahim T, Schwaiger M, Hyafil F, Ntziachristos V. Flow-mediated dilatation test using optoacoustic imaging: a proof-of-concept. BIOMEDICAL OPTICS EXPRESS 2017; 8:3395-3403. [PMID: 28717575 PMCID: PMC5508836 DOI: 10.1364/boe.8.003395] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/30/2017] [Accepted: 05/12/2017] [Indexed: 05/18/2023]
Abstract
Label-free multispectral optoacoustic tomography (MSOT) has recently shown superior performance in visualizing the morphology of human vasculature, especially of smaller vessels, compared to ultrasonography. Herein, we extend these observations towards MSOT interrogation of macrovascular endothelial function. We employed a real-time handheld MSOT scanner to assess flow-mediated dilatation (FMD), a technique used to characterize endothelial function. A data processing scheme was developed to quantify the dimensions and diameter changes of arteries in humans and determine wall distensibility parameters. By enabling high-resolution delineation of the blood-vessel wall in a cross-sectional fashion, the findings suggest MSOT as a capable alternative to ultrasonography for clinical FMD measurements.
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Affiliation(s)
- Angelos Karlas
- HelmholtzZentrum München, Institute for Biological and Medical Imaging, 85764 Neuherberg, Germany
- Munich School of Bioengineering, Technische Universität München (TUM), 81675 Munich, Germany
- Klinikum Rechts der Isar, Department of Cardiology, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Josefine Reber
- HelmholtzZentrum München, Institute for Biological and Medical Imaging, 85764 Neuherberg, Germany
| | - Gael Diot
- Munich School of Bioengineering, Technische Universität München (TUM), 81675 Munich, Germany
| | - Dmitry Bozhko
- HelmholtzZentrum München, Institute for Biological and Medical Imaging, 85764 Neuherberg, Germany
| | - Maria Anastasopoulou
- HelmholtzZentrum München, Institute for Biological and Medical Imaging, 85764 Neuherberg, Germany
| | - Tareq Ibrahim
- Klinikum Rechts der Isar, Department of Cardiology, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Markus Schwaiger
- Klinikum Rechts der Isar, Department of Nuclear Medicine, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Fabien Hyafil
- Klinikum Rechts der Isar, Department of Nuclear Medicine, Ismaningerstrasse 22, 81675 Munich, Germany
- Bichat University Hospital, Department of Nuclear Medicine, Inserm 1148, University Diderot, Paris, France
| | - Vasilis Ntziachristos
- HelmholtzZentrum München, Institute for Biological and Medical Imaging, 85764 Neuherberg, Germany
- Munich School of Bioengineering, Technische Universität München (TUM), 81675 Munich, Germany
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Bellamkonda K, Williams M, Handa A, Lee R. Flow Mediated Dilatation as a Biomarker in Vascular Surgery Research. J Atheroscler Thromb 2017; 24:779-787. [PMID: 28674324 PMCID: PMC5556184 DOI: 10.5551/jat.40964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Endothelial dysfunction is one of the hallmarks of atherogenesis, and correlates with many cardiovascular risk factors. One of the features of endothelial dysfunction is the loss of nitric oxide (NO) bioavailability, resulting in derangements in the vasodilatory response of the vessel wall. Flow mediated dilatation (FMD) of the brachial artery is an accepted method for non-invasive assessment of systemic endothelial function. FMD is examined extensively in the context of cardiovascular research, and has been utilised as a routine assessment in large cohorts such as the Framingham Heart Study, Young Finns Study, and Gutenberg Heart Study. However, FMD is less known in the context of vascular surgery research, despite the similarities between the underpinning disease mechanisms. This review will provide a summary of FMD in terms of its history of development and the conduct of the test in research settings. It will further highlight the key literature of FMD as a biomarker for vascular surgeons, particularly in the context of abdominal aortic aneurysms and lower limb peripheral arterial disease.
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Affiliation(s)
| | | | - Ashok Handa
- Nuffield Department of Surgical Sciences, University of Oxford
| | - Regent Lee
- Nuffield Department of Surgical Sciences, University of Oxford
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Moroni L, Selmi C, Angelini C, Meroni PL. Evaluation of Endothelial Function by Flow-Mediated Dilation: a Comprehensive Review in Rheumatic Disease. Arch Immunol Ther Exp (Warsz) 2017; 65:463-475. [DOI: 10.1007/s00005-017-0465-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/03/2017] [Indexed: 12/18/2022]
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Gupta N, Giri S, Rathi V, Ranga GS. Flow Mediated Dilatation, Carotid Intima Media Thickness, Ankle Brachial Pressure Index and Pulse Pressure in Young Male Post Myocardial Infarction Patients in India. J Clin Diagn Res 2016; 10:OC35-OC39. [PMID: 27891375 DOI: 10.7860/jcdr/2016/20872.8751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification. AIM To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls. MATERIALS AND METHODS Eighty male patients of MI aged ≤45 years, who presented to the Cardiac Care Unit and Department of Medicine of Guru Teg Bahadur Hospital, Delhi, India, from November 2010 to April 2012 were recruited consecutively for this case control study and same number of age and sex matched healthy controls were also analyzed. Six weeks after MI, FMD of the brachial artery, intima media thickness of carotid artery, ABPI and PP were measured in the cases and compared with healthy controls. RESULTS The FMD was lower among young patients of MI than controls (p<0.001). CIMT was higher among cases than controls (p=0.001). ABI was lower among cases than controls (p<0.001). Compared to controls, PP was higher among cases (p=0.001). In all subjects, a negative correlation between FMD and CIMT (r=-0.220, p=0.005) and a positive correlation between FMD and ABPI (r=0.304, p<0.001) was found. A statistically significant negative correlation was found between endothelial dependent FMD and PP among cases and control groups (r=-0.209, p=0.007). CONCLUSION Biophysical parameters were deranged in young post MI patients. Majority of our young male patients fell in low risk Framingham risk score but still they manifested with CAD. Despite six weeks of treatment among young male patients of MI, various biophysical parameters were still deranged.
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Affiliation(s)
- Nikhil Gupta
- Senior Resident, Department of Rheumatology, CMC , Vellore, Tamilnadu, India
| | - Subhash Giri
- Professor, Department of Medicine, University College of Medical Sciences , Dilshad Garden, Delhi, India
| | - Vinita Rathi
- Professor, Department of Radio-Diagnosis, University College of Medical Sciences , Dilshad Garden, Delhi, India
| | - Gajender Singh Ranga
- Professor, Department of Medicine, University College of Medical Sciences , Dilshad Garden, Delhi, India
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McLay KM, Nederveen JP, Pogliaghi S, Paterson DH, Murias JM. Repeatability of vascular responsiveness measures derived from near-infrared spectroscopy. Physiol Rep 2016; 4:4/9/e12772. [PMID: 27147496 PMCID: PMC4873629 DOI: 10.14814/phy2.12772] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/31/2016] [Indexed: 12/30/2022] Open
Abstract
Near‐infrared spectroscopy (NIRS)‐derived measures of tissue oxygen saturation (StO2) have been recently shown to significantly correlate with the widely used method for noninvasively assessing vascular endothelial function, flow‐mediated dilation (FMD). The purpose of this study was to examine the intraday and interday reliability of the reperfusion slope of StO2 (slope 2 StO2) and compare it to FMD. Ultrasound‐derived FMD was quantified following 5 min of distal cuff occlusion of the popliteal artery in nine healthy young men (26 ± 3 years). An FMD test was performed each of 4 days, with a fifth involving three tests. FMD was calculated as the greatest percent change in diameter from baseline (%FMD). StO2 was measured using NIRS throughout each test, with slope 2 StO2 being calculated as the upslope of 10‐sec following cuff release. Reliability was determined using repeatability, intraclass correlation coefficients (ICC), and coefficient of variation (CV). Repeatability of slope 2 StO2 was better than %FMD for both intraday (0.43 and 5.65, respectively) and interday (0.48 and 4.82, respectively) comparisons; approximately 30% of mean values for slope 2 StO2 could be attributed to measurement error, whereas 100% of mean FMD could be for both intraday and interday comparisons. Similarly, ICC and CV values indicated stronger reliability of slope 2 StO2 compared to %FMD for both intraday (ICC 0.92 and 0.36, respectively; CV 9 ± 4% and 44 ± 24%, respectively) and interday (ICC 0.94 and 0.25, respectively; CV 14 ± 5% and 40 ± 22%, respectively) comparisons. In conclusion, NIRS‐derived slope 2 StO2 can be used as a reliable measure of vascular reactivity.
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Affiliation(s)
- Kaitlin M McLay
- Canadian Centre for Activity and Aging, The University of Western Ontario, London, Ontario, Canada School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Josh P Nederveen
- Canadian Centre for Activity and Aging, The University of Western Ontario, London, Ontario, Canada School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Silvia Pogliaghi
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Donald H Paterson
- Canadian Centre for Activity and Aging, The University of Western Ontario, London, Ontario, Canada School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Juan M Murias
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Skaug EA, Nes B, Aspenes ST, Ellingsen Ø. Non-Smoking Tobacco Affects Endothelial Function in Healthy Men in One of the Largest Health Studies Ever Performed; The Nord-Trøndelag Health Study in Norway; HUNT3. PLoS One 2016; 11:e0160205. [PMID: 27490361 PMCID: PMC4974005 DOI: 10.1371/journal.pone.0160205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 07/17/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Oral tobacco (snuff) is taking a large market share in Scandinavia, especially with young users. However, long-term health effects are unknown. Small studies show association between snuff and reduced endothelial function, representing an early stage of vascular injury that often precedes manifest cardiovascular disease by several years. We therefore determined the associations between snuff and endothelial function in a large sample of healthy Norwegian men. METHODS AND DESIGN In the Fitness substudy of the Nord-Trøndelag Health Study (HUNT3), endothelial function was measured by flow-mediated dilation (FMD). Aerobic fitness was measured by peak oxygen uptake (VO2peak). A cross-sectional design including 1 592 self-reported healthy men compared these observations with records of present tobacco use, standard cardiovascular risk factors, and socioeconomic status, using general linear models. RESULTS FMD was lower in snuff users (FMD: 4.12%, 3.63, 4.61) compared to non-users (FMD: 4.52%, 4.27, 4.78) after adjustment for age (difference: -0.57%, -1.12, -0.01). After further adjustment for potential confounders, FMD still tended to be lower in snuff users than in non-users (difference: -0.53%, -1.09, 0.02). This difference was even more pronounced in the inactive snuff users (-0.83%, -1.59, -0.06) and in the low fit snuff users (-0.74%, CI -0.55, 0.079). CONCLUSIONS Oral tobacco is associated with a tendency towards reduced endothelial function, indicating vascular changes that precede cardiovascular disease. The strongest associations were found in men with low physical activity or reduced aerobic fitness.
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Affiliation(s)
- Eli-Anne Skaug
- K. G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Bjarne Nes
- K. G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Thoresen Aspenes
- K. G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Ellingsen
- K. G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Cardiology, St. Olav’s Hospital, Trondheim, Norway
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Hackl G, Jud P, Avian A, Gary T, Deutschmann H, Seinost G, Brodmann M, Hafner F. COPART Risk Score, Endothelial Dysfunction, and Arterial Hypertension are Independent Risk Factors for Mortality in Claudicants. Eur J Vasc Endovasc Surg 2016; 52:211-7. [PMID: 27369292 DOI: 10.1016/j.ejvs.2016.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 05/17/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The COPART risk score consists of six variables to assess the prognosis of PAOD patients. The flow mediated dilation (FMD) quantifies endothelial function. The aim of this study was to evaluate the mortality prediction of these two variables in a long-term observation of claudicants. METHODS 184 consecutive claudicants were included in a prospective observational study over a median observation period of 7.9 (IQR 7.2-8.7) years. The endothelial function was assessed on the day of study inclusion using brachial FMD. RESULTS Three groups were assigned according to the COPART risk score: low risk (LR), n = 72 (39%); medium risk (MR), n = 59 (32%); and high risk (HR), n = 53 (29%). Overall survival rates differed among COPART risk score groups (p < .001, 5 year survival: LR group 83% [95% CI 74-92%]; MR group 73% [95% CI 62-84%]; HR group 57% [95% CI 43-70%]). Survivors had a significantly better median FMD than non-survivors (4.1% [IQR 1.2-6.4] vs. 1.3% [IQR 0.0-4.2]; p < .001). Also the FMD differed significantly among the three COPART risk groups (LR 4.0% [IQR 1.2-6.3], MR 2.3% [IQR 0.0-6.3], HR 1.7% [IQR 0.0-3.6]; p = .033). Finally, independent predictors for disease specific survival were COPART risk score (p = .033; MR group [HR 1.6], 95% CI 0.7-3.6; HR group [HR 2.7], 95% CI 1.2-5.8), FMD (p = .004; FMD ≤2.5 vs. >2.5, HR 2.6, 95% CI 1.4-4.9), and arterial hypertension (p = .039; HR 3.5, 95% CI 1.1-11.3). CONCLUSIONS COPART risk score, FMD, and arterial hypertension are independent long-term mortality predictors in this group of claudicants. The best mortality assessment is provided by including all three predictors.
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Affiliation(s)
- G Hackl
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria.
| | - P Jud
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria
| | - A Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Austria
| | - T Gary
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria
| | - H Deutschmann
- Department of Radiology, Division of Vascular and Interventional Radiology, Medical University Graz, Austria
| | - G Seinost
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria
| | - M Brodmann
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria
| | - F Hafner
- Department of Internal Medicine, Division of Angiology, Medical University Graz, Austria
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Sack CS, Jansen KL, Cosselman KE, Trenga CA, Stapleton PL, Allen J, Peretz A, Olives C, Kaufman JD. Pretreatment with Antioxidants Augments the Acute Arterial Vasoconstriction Caused by Diesel Exhaust Inhalation. Am J Respir Crit Care Med 2016; 193:1000-7. [PMID: 26599707 PMCID: PMC4872652 DOI: 10.1164/rccm.201506-1247oc] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/24/2015] [Indexed: 01/12/2023] Open
Abstract
RATIONALE Diesel exhaust inhalation, which is the model traffic-related air pollutant exposure, is associated with vascular dysfunction. OBJECTIVES To determine whether healthy subjects exposed to diesel exhaust exhibit acute vasoconstriction and whether this effect could be modified by the use of antioxidants or by common variants in the angiotensin II type 1 receptor (AGTR1) and other candidate genes. METHODS In a genotype-stratified, double-blind, four-way crossover study, 21 healthy adult subjects were exposed at rest in a randomized, balanced order to diesel exhaust (200 μg/m(3) particulate matter with an aerodynamic diameter ≤ 2.5 μm [PM2.5]) and filtered air, and to pretreatment with antioxidants (N-acetylcysteine and ascorbate) and placebo. Before and after each exposure, brachial artery diameter (BAd) was assessed using ultrasound. Changes in BAd were compared across pretreatment and exposure sessions. Gene-exposure interactions were evaluated in the AGTR1 A1166C polymorphism, on which recruitment was stratified, and other candidate genes, including TRPV1 and GSTM1. MEASUREMENTS AND MAIN RESULTS Compared with filtered air, exposure to diesel exhaust resulted in a significant reduction in BAd (mean, -0.09 mm, 95% confidence interval [CI], -0.01 to -0.17; P = 0.03). Pretreatment with antioxidants augmented diesel exhaust-related vasoconstriction with a mean change in BAd of -0.18 mm (95% CI, -0.28 to -0.07 mm; P = 0.001). Diesel exhaust-related vasoconstriction was primarily observed in the variant alleles of AGTR1 and TRPV1. No association was found between diesel exhaust inhalation and flow-mediated dilation. CONCLUSIONS We confirmed that short-term exposure to diesel exhaust in healthy subjects is associated with acute vasoconstriction in a conductance artery and found suggestive evidence of involvement of nociception and renin-angiotensin systems in this effect. Pretreatment with an antioxidant regimen increased vasoconstriction.
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Affiliation(s)
- Cora S. Sack
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Karen L. Jansen
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Kristen E. Cosselman
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Carol A. Trenga
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Pat L. Stapleton
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Jason Allen
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Alon Peretz
- Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Casey Olives
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health, University of Washington, Seattle, Washington; and
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Rodriguez-Miguelez P, Seigler N, Harris RA. Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test. J Vis Exp 2016:54011. [PMID: 27167596 PMCID: PMC4942014 DOI: 10.3791/54011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies. Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events. Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.
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Affiliation(s)
- Paula Rodriguez-Miguelez
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University
| | - Nichole Seigler
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University
| | - Ryan A Harris
- Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University; Sport and Exercise Science Research Institute, University of Ulster;
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Sapmaz F, Uzman M, Basyigit S, Ozkan S, Yavuz B, Yeniova A, Kefeli A, Asilturk Z, Nazligül Y. Steatosis Grade is the Most Important Risk Factor for Development of Endothelial Dysfunction in NAFLD. Medicine (Baltimore) 2016; 95:e3280. [PMID: 27057890 PMCID: PMC4998806 DOI: 10.1097/md.0000000000003280] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/05/2016] [Accepted: 03/09/2016] [Indexed: 12/13/2022] Open
Abstract
It is shown that there are strong associations between nonalcoholic fatty liver disease (NAFLD) and endothelial dysfunction. The aim of our study was to reveal whether steatosis or fibrosis score is more important in the development of endothelial dysfunction in patients with NAFLD in a prospective manner.This cross-sectional study included 266 subjects. These subjects were divided into 2 groups depending on presence of hepatosteatosis sonographically. Patients with hepatosteatosis were also divided into 3 subgroups depending on degree of steatosis: grade 1, 2, and 3. In all patients, Aspartate aminotransferase-to-Platelet Ratio Index and Fibrosis-4 (FIB4) scores were calculated. In addition, flow-mediated dilatation (FMD) measurements were recorded.There was NAFLD in 176 (66.2%) of 266 patients included. There were no significant differences in sex and age distributions between patients with NAFLD (group 1) and controls without NAFLD (group 2) (P = 0.05). Mean Aspartate aminotransferase-to-Platelet Ratio Index score was significantly higher in group 1 compared with the control group (P = 0.001), whereas no significant difference was detected regarding FIB4 scores between groups (P = 0.4). Mean FMD value was found to be significantly lower in group 1 (P = 0.008). Patients with grade 3 hepatosteatosis had significantly lower FMD values than those with grade 1 steatosis and controls (P = 0.001). In univariate and multivariate analyses in group 1, no significant difference was detected regarding mean FMD measurements (P = 0.03). Again, no significant difference was detected in mean FMD measurement between FIB4 subgroups among patients with NAFLD and the whole study group (P = 0.09).The endothelial dysfunction is associated with steatosis in patients with NAFLD.
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Affiliation(s)
- Ferdane Sapmaz
- From the Keçiören Education and Training Hospital (FS, MU, SB, AY, AK, ZA, YN), Gastroenterology Department; and Keçiören Education and Training Hospital (SO, BY), Cardiology Department, Ankara, Turkey
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Merashli M, Ster IC, Ames PRJ. Subclinical atherosclerosis in Behcet’s disease: A systematic review and meta-analysis. Semin Arthritis Rheum 2016; 45:502-10. [DOI: 10.1016/j.semarthrit.2015.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/23/2015] [Accepted: 06/30/2015] [Indexed: 12/17/2022]
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Kamen DL, Oates J. A Pilot Study to Determine if Vitamin D Repletion Improves Endothelial Function in Lupus Patients. Am J Med Sci 2015; 350:302-7. [PMID: 26351776 PMCID: PMC4589474 DOI: 10.1097/maj.0000000000000556] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The endothelium is important not only in regulating vascular tone but also in modulating inflammation. Patients with systemic lupus erythematosus (SLE) have deficits in these endothelial functions. Vitamin D is a nuclear hormone that regulates vascular endothelial nitric oxide synthase activity and expression. Many SLE patients have insufficient levels of vitamin D. The effect of this hormone on vascular endothelial function in SLE patients is not known. This study was designed to determine the effect size of repleting vitamin D levels on endothelial function in patients with SLE and vitamin D deficiency. METHODS SLE patients with 25(OH) vitamin D (25(OH)D) levels <20 ng/mL were randomized to oral vitamin D3 (D3) doses that did or did not raise 25(OH)D levels to ≥32 ng/mL. Endothelial function was measured with flow-mediated dilation (FMD) before and after 16 weeks of vitamin D3 supplementation. RESULTS Half of those who achieved 25(OH)D levels of ≥32 ng/mL experienced increases in FMD, whereas none of those with continued low 25(OH)D levels did. Those with increases in FMD had significantly higher final 25(OH)D levels. Using the effect size from this study, future studies designed to test the effect of repleting 25(OH)D on FMD in vitamin D-deficient SLE patients will require 35 patients in each group. CONCLUSIONS These results suggest a potential role for vitamin D in SLE-related endothelial dysfunction and that an adaptive, multi-arm, treat-to-target, serum-level trial design may increase the efficiency and likelihood of success of such a study.
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Affiliation(s)
- Diane L Kamen
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Jim Oates
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC
- Rheumatology Section, Medical Service, Ralph H. Johnson VA Medical Center, Charleston, SC
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Barry DR, Utzschneider KM, Tong J, Gaba K, Leotta DF, Brunzell JD, Easterling TR. Intraabdominal fat, insulin sensitivity, and cardiovascular risk factors in postpartum women with a history of preeclampsia. Am J Obstet Gynecol 2015; 213:104.e1-104.e11. [PMID: 26003058 PMCID: PMC5181653 DOI: 10.1016/j.ajog.2015.05.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/03/2015] [Accepted: 05/18/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Women who develop preeclampsia have a higher risk of future cardiovascular disease and diabetes compared to women who have uncomplicated pregnancies. We hypothesized that women with prior preeclampsia would have increased visceral adiposity that would be a major determinant of their metabolic and cardiovascular risk factors. STUDY DESIGN We compared intraabdominal fat (IAF) area, insulin sensitivity index (SI), fasting lipids, low-density lipoprotein relative flotation rate, and brachial artery flow-mediated dilatation in 49 women with prior preeclampsia and 22 controls who were at least 8 months postpartum and matched for age, parity, body mass index, and months postpartum. Women were eligible if they did not smoke tobacco, use hormonal contraception, have chronic hypertension, or have a history of gestational diabetes. RESULTS The groups were similar for age (mean ± SD: prior preeclampsia 33.4 ± 6.6 vs control 34.6 ± 4.3 years), parity (median: 1 for both), body mass index (26.7 ± 5.9 vs 24.0 ± 7.3 kg/m(2)), and months postpartum (median [25th-75th percentile]: 16 [13-38] vs 16.5 [13-25]). There were no significant differences in IAF area and SI. Despite this, women with preeclampsia had lower high-density lipoprotein (46.0 ± 10.7 vs 51.3 ± 9.3 mg/dL; P < .05), smaller/denser low-density lipoprotein relative flotation rate (0.276 ± 0.022 vs 0.289 ± 0.016; P = .02), higher systolic (114.6 ± 10.9 vs 102.3 ± 7.5 mm Hg) and diastolic (67.6 ± 7.5 vs 60.9 ± 3.6 mm Hg; P < .001) blood pressures, and impaired flow-mediated dilatation (4.5 [2-6.7] vs 8.8 [4.5-9.1] percent change, P < .05) compared to controls. In a subgroup analysis, women with nonsevere preeclampsia (n = 17) had increased IAF (98.3 [60.1-122.2]) vs 63.1 [40.1-70.7] cm(2); P = .02) and decreased SI (4.18 [2.43-5.25] vs 5.5 [3.9-8.3] × 10(-5) min(-1)/pmol/L; P = .035) compared to the controls, whereas women with severe preeclampsia (n = 32) were not different for IAF and SI. IAF was negatively associated with SI and positively associated with cardiovascular risk factors even after adjusting for the matching variables and total body fat. CONCLUSION Women with prior preeclampsia have an atherogenic lipid profile and endothelial dysfunction compared to matched control subjects despite having similar adiposity and insulin sensitivity, suggesting that there are mechanisms separate from obesity and insulin resistance that lead to their cardiovascular risk factors. Visceral adiposity may have a role in contributing to these risk factors in the subgroup of women who have preeclampsia without severe features.
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Affiliation(s)
- Darcy R Barry
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA.
| | - Kristina M Utzschneider
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, Department of Veterans Affairs Puget Sound Health Care System, and University of Washington, University of Washington, Seattle, WA
| | - Jenny Tong
- Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University, Durham, NC
| | - Kersten Gaba
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
| | - Daniel F Leotta
- Applied Physics Laboratory, University of Washington, Seattle, WA
| | - John D Brunzell
- Division of Metabolism, Endocrinology, and Nutrition, Seattle, WA
| | - Thomas R Easterling
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
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Kachamakova-Trojanowska N, Bukowska-Strakova K, Zukowska M, Dulak J, Jozkowicz A. The real face of endothelial progenitor cells - Circulating angiogenic cells as endothelial prognostic marker? Pharmacol Rep 2015; 67:793-802. [PMID: 26321283 DOI: 10.1016/j.pharep.2015.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 02/08/2023]
Abstract
Endothelial progenitor cells (EPCs) have been extensively studied for almost 19 years now and were considered as a potential marker for endothelial regeneration ability. On the other hand, circulating endothelial cells (CEC) were studied as biomarker for endothelial injury. Yet, in the literature, there is also huge incoherency in regards to terminology and protocols used. This results in misleading conclusions on the role of so called "EPCs", especially in the clinical field. The discrepancies are mainly due to strong phenotypic overlap between EPCs and circulating angiogenic cells (CAC), therefore changes in "EPC" terminology have been suggested. Other factors leading to inconsistent results are varied definitions of the studied populations and the lack of universal data reporting, which could strongly affect data interpretation. The current review is focused on controversies concerning the use of "EPCs"/CAC and CEC as putative endothelial diagnostic markers.
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Affiliation(s)
- Neli Kachamakova-Trojanowska
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Karolina Bukowska-Strakova
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Monika Zukowska
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Jozef Dulak
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Alicja Jozkowicz
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.
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Chronic transfusion therapy improves but does not normalize systemic and pulmonary vasculopathy in sickle cell disease. Blood 2015; 126:703-10. [PMID: 26036801 DOI: 10.1182/blood-2014-12-614370] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/11/2015] [Indexed: 02/07/2023] Open
Abstract
Tricuspid regurgitant (TR) jet velocity and its relationship to pulmonary hypertension has been controversial in sickle cell disease (SCD). Plasma free hemoglobin is elevated in SCD patients and acutely impairs systemic vascular reactivity. We postulated that plasma free hemoglobin would be negatively associated with both systemic and pulmonary endothelial function, assessed by flow-mediated dilation (FMD) of the brachial artery and TR jet velocity, respectively. Whole blood viscosity, plasma free hemoglobin, TR jet, and FMD were measured in chronically transfused SCD pre- and posttransfusion (N = 25), in nontransfused SCD (N = 26), and in ethnicity-matched control subjects (N = 10). We found increased TR jet velocity and decreased FMD in nontransfused SCD patients compared with the other 2 groups. TR jet velocity was inversely correlated with FMD. There was a striking nonlinear relationship between plasma free hemoglobin and both TR jet velocity and FMD. A single transfusion in the chronically transfused cohort improved FMD. In our patient sample, TR jet velocity and FMD were most strongly associated with plasma free hemoglobin and transfusion status (transfusions being protective), and thus consistent with the hypothesis that intravascular hemolysis and increased endogenous erythropoiesis damage vascular endothelia.
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Skaug EA, Madssen E, Aspenes ST, Wisløff U, Ellingsen Ø. Cardiovascular risk factors have larger impact on endothelial function in self-reported healthy women than men in the HUNT3 Fitness study. PLoS One 2014; 9:e101371. [PMID: 24991924 PMCID: PMC4081583 DOI: 10.1371/journal.pone.0101371] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 06/05/2014] [Indexed: 01/10/2023] Open
Abstract
Background Several studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men. Methods and Results Associations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men. Conclusion Endothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.
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Affiliation(s)
- Eli-Anne Skaug
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik Madssen
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olavs Hospital, Trondheim, Norway
| | - Stian Thoresen Aspenes
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Ellingsen
- Department of Circulation and Medical Imaging and KG Jebsen Center for Exercise in Medicine Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olavs Hospital, Trondheim, Norway
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de Matthaeis A, Greco A, Dagostino MP, Paroni G, Fontana A, Vinciguerra M, Mazzoccoli G, Seripa D, Vendemiale G. Effects of hypercapnia on peripheral vascular reactivity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease. Clin Interv Aging 2014; 9:871-8. [PMID: 24904207 PMCID: PMC4043425 DOI: 10.2147/cia.s57548] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Blood acid-base imbalance has important effects on vascular reactivity, which can be related to nitric oxide (NO) concentration and increased during hypercapnia. Release of NO seems to be linked to H+ and CO2 concentration and to exacerbation of chronic obstructive pulmonary disease (COPD), a common medical condition in the elderly. Flow-mediated dilation (FMD), a valuable cardiovascular risk indicator, allows assessment of endothelial-dependent vasodilation, which is to a certain extent mediated by NO. We investigated the effects of hypercapnia and acid-base imbalance on endothelial-dependent vasodilation by measurement of FMD in 96 elderly patients with acute exacerbation of COPD. Patients underwent complete arterial blood gas analysis and FMD measurement before (phase 1) and after (phase 2) standard therapy for acute exacerbation of COPD and recovery. Significant differences between phase 1 and phase 2 were observed in the mean values of pH (7.38±0.03 versus 7.40±0.02, P<0.001), pO2 (59.6±4.9 mmHg versus 59.7±3.6 mmHg, P<0.001), pCO2 (59.3±8.63 mmHg versus 46.7±5.82 mmHg, P<0.001), FMD (10.0%±2.8% versus 8.28%±2.01%, P<0.001) and blood flow rate (1.5±0.3 m/s versus 1.5±0.3 m/s, P=0.001). FMD values were positively correlated with pCO2 values (r=0.294, P=0.004) at baseline. A significant correlation was also found between relative changes in FMD and pCO2 levels, passing from phase 1 to phase 2 (r=0.23, P=0.023). Patients with higher baseline endothelium-dependent vasodilation as evaluated by FMD showed greater modification with regard to pCO2 changes (2.6±1.39 versus 1.59±1.4, P=0.012). In conclusion, endothelium-dependent vasodilation as evaluated by FMD was elevated during hypercapnia, and varied significantly according to pCO2 changes in patients with higher baseline levels, suggesting that vascular reactivity in acute COPD exacerbations in the elderly depends on integrity of the vascular endothelium.
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Affiliation(s)
| | - Antonio Greco
- Geriatrics Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, Foggia, Italy
| | - Mariangela Pia Dagostino
- Geriatrics Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, Foggia, Italy
| | - Giulia Paroni
- Geriatrics Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, Foggia, Italy
| | - Andrea Fontana
- Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Manlio Vinciguerra
- Division of Internal Medicine and Chronobiology Unit, Foggia, Italy ; Euro-Mediterranean Institute of Sciences and Technology, Palermo, Italy ; University College London, Institute for Liver and Digestive Health, Division of Medicine, Royal Free Campus, London, UK
| | | | - Davide Seripa
- Geriatrics Unit and Gerontology, Geriatrics Research Laboratory, Department of Medical Sciences, Foggia, Italy
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Ostrem JD, Dengel DR, Marlatt KL, Steinberger J. Comparison of baseline brachial artery measurements and effect on peak flow‐mediated dilation. Clin Physiol Funct Imaging 2014; 35:34-40. [PMID: 24438447 DOI: 10.1111/cpf.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/11/2013] [Indexed: 01/21/2023]
Affiliation(s)
- Joseph D. Ostrem
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
| | - Donald R. Dengel
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
- Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA
| | - Kara L. Marlatt
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
| | - Julia Steinberger
- Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA
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Stuckey MI, Shapiro S, Gill DP, Petrella RJ. A lifestyle intervention supported by mobile health technologies to improve the cardiometabolic risk profile of individuals at risk for cardiovascular disease and type 2 diabetes: study rationale and protocol. BMC Public Health 2013; 13:1051. [PMID: 24199747 PMCID: PMC3922899 DOI: 10.1186/1471-2458-13-1051] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 11/01/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of cardiovascular risk factors that greatly increase the risk of developing cardiovascular disease and type 2 diabetes. Regular exercise improves the risk profile, but most people do not successfully change their exercise habits to beneficially reduce risk. Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce cardiometabolic risk, but optimal implementation practices remain unknown. Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes. These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities is not well understood. This study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes. METHODS/DESIGN Adults (n = 149) with at least two metabolic syndrome risk factors were recruited from rural communities and randomized to either: 1) an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or 2) an active control group receiving only an exercise prescription. All participants reported to the research centre at baseline, and at 12-, 24- and 52-week follow-up visits for measurement of anthropometrics and blood pressure and for a blood draw to test blood-borne markers of cardiometabolic health. Vascular and autonomic function were examined. Fitness was assessed and exercise prescribed according to the Step Test and Exercise Prescription protocol. DISCUSSION This study tested the effects of a prescriptive exercise intervention alone, versus one supported by mobile health technology on cardiometabolic risk factors. The intervention was designed to be translated into clinical or community-based programming. Results will contribute to the current literature by investigating the utility of mobile health technology support for exercise prescription interventions to improve cardiometabolic risk status and maintain improvements over time; particularly in rural communities. TRIAL REGISTRATION CLINICAL TRIALS REGISTRATION NCT01944124.
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Affiliation(s)
- Melanie I Stuckey
- Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Rd E, Ste B 3002, London, Ontario N6C 5J1, Canada
- Faculty of Health Sciences, University of Western Ontario, London Ontario, Canada
| | - Sheree Shapiro
- Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Rd E, Ste B 3002, London, Ontario N6C 5J1, Canada
| | - Dawn P Gill
- Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Rd E, Ste B 3002, London, Ontario N6C 5J1, Canada
- Faculty of Health Sciences, University of Western Ontario, London Ontario, Canada
- School of Public Health, University of Washington, Seattle WA, USA
| | - Robert J Petrella
- Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Rd E, Ste B 3002, London, Ontario N6C 5J1, Canada
- Faculty of Health Sciences, University of Western Ontario, London Ontario, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London Ontario, Canada
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Takase B, Hattori H, Tanaka Y, Uehata A, Nagata M, Ishihara M, Fujita M. Acute Effect of Whole-Body Periodic Acceleration on Brachial Flow-Mediated Vasodilatation Assessed by a Novel Semi-Automatic Vessel Chasing UNEXEF18G System. J Cardiovasc Ultrasound 2013; 21:130-6. [PMID: 24198919 PMCID: PMC3816163 DOI: 10.4250/jcu.2013.21.3.130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 07/31/2013] [Accepted: 08/12/2013] [Indexed: 11/30/2022] Open
Abstract
Background Repeated application of whole-body periodic acceleration (WBPA) upregulates endothelial nitric oxide synthase and improves brachial artery endothelial function (BAEF) as assessed by measurement of flow-mediated vasodilatation (FMD). However, the acute effect of a single application of WBPA on BAEF has not been fully characterized. In addition, although a novel semi-automatic vessel chasing system (UNEXEF18G) has now been developed in Japan, the direct comparison of UNEXEF18G with a conventional method for FMD measures has not been conducted even if UNEXEF18G has already been utilized in a relatively large scale study. Methods We have developed a novel semi-automatic vessel chasing system (UNEXEF18G) that can measure FMD on-line, identify time to peak vasodilatation (TPV), and determine the area under the vasodilatation curve (AUC). Thus, 45 min of WBPA was applied in 20 healthy volunteers (age, 34 ± 13 years), and BAEF was measured by UNEXEF18G before and after WBPA. Also, UNEXEF18G measured FMD was compared with those of a conventional FMD measurement method at rest in order to validate a novel UNEXEF18G measured FMD. Results Single WBPA resulted in a significant increase in FMD (from 6.4 ± 3.4 to 10.7 ± 4.3%, p < 0.01), a significant decrease in TPV and a significant increase in AUC. In the validation study for UNEXEF18G, Bland and Altman analysis showed that UNEXEF18G measured FMD was almost identical to those of the conventional method at rest. Conclusion These data suggest the usefulness of a new UNEXEF18G and that single application of WBPA results in acute improvement in BAEF in humans.
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Affiliation(s)
- Bonpei Takase
- Department of Intensive Care Medicine, National Defense Medical College, National Defense Medical College Research Institute, Saitama, Japan
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Catov JM, Dodge R, Barinas-Mitchell E, Sutton-Tyrrell K, Yamal JM, Piller LB, Ness RB. Prior preterm birth and maternal subclinical cardiovascular disease 4 to 12 years after pregnancy. J Womens Health (Larchmt) 2013; 22:835-43. [PMID: 24033091 DOI: 10.1089/jwh.2013.4248] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We considered that women with prior preterm birth (PTB) would have evidence of subclinical atherosclerosis, endothelial dysfunction, and arterial stiffness. METHODS Four to 12 years after pregnancy, blood pressure and fasting lipids were analyzed, and women underwent evaluation, following standardized protocols, of carotid intima-media thickness (IMT), brachial flow-mediated dilation (FMD), and pulse wave velocity (PWV). Women with prior preterm (<37 weeks, n=181) or term births (>= 37 weeks, n=306) were compared. Those with preeclampsia or term small-for-gestational-age (SGA) births were excluded. RESULTS Women with a prior preterm vs. term birth had higher blood pressure, on average, and a more atherogenic lipid profile. They also had marginally higher IMT (0.579 standard error [SE] 0.005-vs. 0.567 [0.004] mm, p=0.06), adjusted for body size, demographics, and smoking. IMT differences were greater among those with non-preeclamptic-indicated PTB (0.034 mm, p=0.05) and PTB<34 weeks (0.024 mm, p=0.04) compared to those with term births. These differences appeared to be explained in part by the atherogenic lipid elevations in women with preterm birth. Women with prior PTB<34 weeks tended to have lower FMD, but results were not statistically significant. PWV did not differ according to PTB. CONCLUSIONS In the decade following pregnancy, women with non-preeclamptic-indicated PTB or PTB delivered before 34 weeks had higher blood pressure, atherogenic lipids, and IMT compared to women with term births. There may be subgroups of women with a prior PTB with excess cardiovascular risk that is detectable before overt clinical disease.
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Affiliation(s)
- Janet M Catov
- 1 Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yıldız A, Yüksel M, Polat N, Acet H, Işık F, Ülgen MS. Relation of epicardial fat thickness and brachial flow-mediated vasodilation with coronary artery disease. J Cardiol 2013; 62:343-7. [PMID: 23810068 DOI: 10.1016/j.jjcc.2013.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/09/2013] [Accepted: 05/11/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the presence of a statistical association between epicardial fat thickness (EFT) and coronary artery disease (CAD) and between flow-mediated vasodilation (FMD) and CAD. METHODS We measured the EFT and FMD in 64 subjects with suspected stable angina pectoris. The patients were separated into two groups according to their coronary angiography results: 34 patients with CAD and 30 patients with normal coronary arteries (NCA). RESULTS EFT was significantly higher in the patients with CAD than the NCA group (6.43 ± 0.90 mm vs. 5.35 ± 0.75 mm, p<0.001) while FMD was significantly lower in the patients with CAD than those in the NCA group (6.41 ± 2.51% vs. 8.33 ± 3.45%, p=0.015). No significant correlation was found between EFT and FMD. After adjustment for EFT, FMD, age, sex, ejection fraction, glucose, and low-density lipoprotein cholesterol through multivariate logistic regression analysis, EFT (odds ratio: 6.325, 95% confidence interval 2.289-17.476, p<0.001) and age (odds ratio: 1.093, 95% confidence interval 1.008-1.185, p=0.032) remained significant predictors of CAD. A cut-off value of EFT≥5.8mm predicted the presence of CAD with 77% sensitivity and 70% specificity. CONCLUSION An echocardiographic EFT assessment is independently associated with the presence of CAD. Thus, EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.
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Affiliation(s)
- Hasan Kaya
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
| | - Faruk Ertaş
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Zihni Bilik
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Abdulkadir Yıldız
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Murat Yüksel
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Nihat Polat
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Ferhat Işık
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Sıddık Ülgen
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
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Vuckovic KM, Piano MR, Phillips SA. Effects of exercise interventions on peripheral vascular endothelial vasoreactivity in patients with heart failure with reduced ejection fraction. Heart Lung Circ 2013; 22:328-40. [PMID: 23340198 PMCID: PMC3679497 DOI: 10.1016/j.hlc.2012.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/28/2012] [Accepted: 12/11/2012] [Indexed: 01/22/2023]
Abstract
Changes in vascular function, such as endothelial dysfunction are linked to the progression of heart failure (HF) and poorer outcomes, such as increased hospitalisations. Exercise training may positively influence endothelial function in HF patients with reduced ejection fraction. The aim of this manuscript is to summarise HF studies evaluating the influence of exercise training on endothelial function as measured by flow mediated vasodilation as a primary outcome and to provide recommendations for future research studies designed to improve peripheral vascular function in HF. Databases were searched for studies published between 1995 and December 2011. Two reviewers determined eligibility and extracted information on study characteristics and quality, exercise interventions, and endothelial function. Eleven articles (N=318 HF participants with an ejection fraction <40%) were eligible for full review. Aerobic, resistance, or combined exercise training improved endothelium-dependent vasodilation as measured by ultrasound or plethysmography. There is less evidence supporting improvement in endothelium-independent function with exercise training. Sample sizes were small and predominantly male. Future research is needed to address the best mode and optimal dose of exercise for all patients with HF including women and subgroups with specific co-morbidities.
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Affiliation(s)
- Karen M Vuckovic
- College of Nursing, Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL 60612, United States.
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Wang L, Guo L, Zhang L, Zhou Y, He Q, Zhang Z, Wang M. Effects of glucose load and nateglinide intervention on endothelial function and oxidative stress. J Diabetes Res 2013; 2013:849295. [PMID: 23691521 PMCID: PMC3647564 DOI: 10.1155/2013/849295] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 02/17/2013] [Accepted: 02/18/2013] [Indexed: 11/18/2022] Open
Abstract
We analysed endothelial function and oxidative stress in patients with abnormal glucose metabolism, the effect of glucose load, and the impact of nateglinide. 109 participants were grouped into newly diagnosed diabetes, prediabetes, and control. Fasting plasma glucose (FPG), postprandial plasma glucose (PPG), glycosylated haemoglobin (HbA1c), and glycated albumin (GA) varied significantly among the study groups (P < 0.01). Nitric oxide (NO) and insulin resistance index (HOMA-IRI) levels were markedly different between the newly diagnosed diabetes and the control (P < 0.01). Glucose loading lowered flow-mediated endothelium-dependent dilation (FMEDD), NO, and superoxide dismutase (SOD) (P < 0.01). Fasting and glucose loading FMEDD, FPG, PPG, HbA1c, and GA were negatively correlated (r = -0.4573, -0.4602, -0.3895, -0.3897, and r = -0.4594, -0.4803, -0.4494, -0.3885; P < 0.01), whereas NO, SOD, and HOMA- β were positively correlated (r = 0.2983, 0.3211, 0.311, and r = 0.1954, 0.361, 0.2569; P < 0.05). After the treatment with nateglinide, significant decreases in FPG, PPG, GA, HbA1C, endothelin-1(ET-1), malondialdehyde (MDA), and HOMA-IRI were observed, whereas FMEDD, NO, and SOD increased (P < 0.01). Thus, the study demonstrated the adverse effect of glucose load on endothelial function and oxidative stress. Nateglinide lowers blood glucose, reduces insulin resistance and oxidative stress, and improves endothelial function in newly diagnosed diabetes.
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Affiliation(s)
- Leilei Wang
- VIP Department, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
| | - Lixin Guo
- Endocrinology and Metabolism Department, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
- *Lixin Guo:
| | - Lina Zhang
- Endocrinology and Metabolism Department, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
| | - Yan Zhou
- Endocrinology and Metabolism Department, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
| | - Qinghua He
- Endocrinology and Metabolism Department, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
| | - Zheng Zhang
- Ultrasound Division, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
| | - Meng Wang
- Laboratory Division, Beijing Hospital of the Ministry of Health, Dongdan Dahua, Road Number One, Beijing 100730, China
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Strand LB, Laugsand LE, Skaug EA, Ellingsen Ø, Madssen E, Wisløff U, Vatten L, Janszky I. Insomnia and endothelial function - the HUNT 3 fitness study. PLoS One 2012; 7:e50933. [PMID: 23236412 PMCID: PMC3516514 DOI: 10.1371/journal.pone.0050933] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 10/26/2012] [Indexed: 01/20/2023] Open
Abstract
Background Insomnia is associated with increased risk of coronary heart disease (CHD), but the underlying mechanisms are not understood. To our knowledge, no previous studies have examined insomnia in relation to endothelial function, an indicator of preclinical atherosclerosis. Our aim was to assess the association of insomnia with endothelial function in a large population based study of healthy individuals. Methods A total of 4 739 participants free from known cardiovascular or pulmonary diseases, cancer, and sarcoidosis, and who were not using antihypertensive medication were included in the study. They reported how often they had experienced difficulties falling asleep at night, repeated awakenings during the night, early awakenings without being able to go back to sleep, and daytime sleepiness. Endothelial function was measured by flow mediated dilation (FMD) derived from the brachial artery. Results We found no consistent association between the insomnia symptoms and endothelial function in multiadjusted models, but individual insomnia symptoms may be related to endothelial function. Among women who reported early awakenings, endothelial function may be lower than in women without this symptom (p = 0.03). Conclusions This study provided no evidence that endothelial function, an early indicator of atherosclerosis, is an important linking factor between insomnia and CHD. Further studies are needed to explore the complex interrelation between sleep and cardiovascular pathology.
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Affiliation(s)
- Linn B Strand
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Ukawa T, Takayanagi T, Morimoto H, Higashi Y, Idei N, Yoshizumi M, Tsuji T. Novel non-invasive method of measurement of endothelial function: enclosed-zone flow-mediated dilatation (ezFMD). Med Biol Eng Comput 2012; 50:1239-47. [PMID: 23054376 DOI: 10.1007/s11517-012-0955-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 09/13/2012] [Indexed: 01/22/2023]
Abstract
Measurement of flow-mediated dilatation (FMD) is the conventional non-invasive method for assessment of endothelial function; however, it requires an expensive ultrasound system and high levels of technical skill. Therefore, we developed a novel method for measurement of endothelial function, namely, measurement of ezFMD. ezFMD estimates the degree of vasodilatation from the oscillation signals transmitted to a sphygmomanometer cuff attached to the upper arm. The objective of this study was to validate the principle underlying the measurement of ezFMD, and to evaluate the repeatability of the ezFMD measurements. We observed the blood vessel behavior and oscillometric pattern in ten subjects. When the cuff was inflated to the level of the mean blood pressure, the oscillation amplitude increased with increasing degree of vasodilatation. In experiment to evaluate the repeatability of the ezFMD measurement, the average difference between the paired measurements was 3.7 %, the standard deviation was 11.5 %, and the average coefficient of variation value for the 11 paired measurements was 23.7 %. These results suggest the validity of the principle underlying the measurement of the ezFMD for the assessment of endothelial function. And, this study suggests that the repeatability of the ezFMD measurements is superior to that of the conventional measurement of FMD.
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Affiliation(s)
- Teiji Ukawa
- Nihon Kohden Corporation, Tokyo 161-8560, Japan.
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Mazzoccoli G, Fontana A, Grilli M, Dagostino MP, Copetti M, Pellegrini F, Vendemiale G. Idiopathic deep venous thrombosis and arterial endothelial dysfunction in the elderly. AGE (DORDRECHT, NETHERLANDS) 2012; 34:751-760. [PMID: 21598017 PMCID: PMC3337930 DOI: 10.1007/s11357-011-9265-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Accepted: 05/05/2011] [Indexed: 05/30/2023]
Abstract
Arterial and venous thrombosis have always been regarded as different pathologies and epidemiological studies have examined the association between venous thrombosis and indicators of atherosclerosis and/or arterial thromboembolic events. We measured the flow-mediated dilation (FMD), a well-known marker of arterial endothelial dysfunction, in young-middle-aged and old-aged patients with and without unprovoked deep venous thrombosis (DVT). The aim of this study was to investigate whether DVT was a significant predictor for impaired FMD, considering all the patients and young-middle-aged (age < 65 years) and old-aged (age ≥ 65 years) patients separately. FMD was measured in the brachial artery on a population of 120 subjects with the same atherosclerosis risk factors, 68 male and 52 female, 70 young-middle-aged subjects (mean age ± SD 49.5 ± 10.5 years) and 50 old-aged subjects (76.2 ± 7.7 years). Patients with DVT showed a significant decrease of FMD compared to patients without DVT (6.8 ± 5.5% vs. 10.9 ± 3.5%, p < 0.001). Moreover, old-aged patients showed a significant decrease of FMD compared to the young-middle-aged subjects (7.4 ± 4.1% vs. 9.8 ± 5.3%, p = 0.005). In the whole study population, DVT was strongly associated with FMD (risk factors adjusted β = -4.14, p < 0.001). A significant interaction between age and the presence of DVT on predicting FMD was found (p = 0.003) suggesting a differential behavior of DVT as predictor of FMD. In young-middle-aged group, multivariate model confirmed that DVT was the most significant predictor of continuous FMD (β = -6.06, p < 0.001). On the contrary, DVT was no more a predictor of FMD in the old age group (β = -0.73, p = 0.556). Furthermore, old-aged patients without DVT showed a statistically significant decrease of FMD compared to the young-middle-aged subjects without DVT (8.2 ± 2.1% vs. 12.6 ± 2.7%, p<0.001) and old-aged patients with DVT showed a not statistically significant decrease of the FMD compared to the young-middle-aged patients with DVT (6.7 ± 5.3% vs. 6.8 ± 5.7%, p = 0.932). In conclusion, young-middle-aged patients with spontaneous DVT show an impaired FMD, whereas this impairment in old-aged subjects is evident independently from the presence or absence of DVT. Aging per se may be associated with physiologic abnormalities in the systemic arteries and with endothelial dysfunction.
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Affiliation(s)
- Gianluigi Mazzoccoli
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Andrea Fontana
- Unit of Biostatistics, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S.Giovanni Rotondo, Italy
| | - Massimo Grilli
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Mariangela Pia Dagostino
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S.Giovanni Rotondo, Italy
| | - Fabio Pellegrini
- Unit of Biostatistics, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S.Giovanni Rotondo, Italy
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Chieti, Italy
| | - Gianluigi Vendemiale
- Unit of Internal Medicine, Department of Medical Sciences, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
- Unit of Geriatrics, Department of Medical Sciences, University of Foggia, Foggia, Italy
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50
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Stoner L, Stoner KR, Young JM, Fryer S. Preventing a Cardiovascular Disease Epidemic among Indigenous Populations through Lifestyle Changes. Int J Prev Med 2012; 3:230-40. [PMID: 22624079 PMCID: PMC3354392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 01/22/2012] [Indexed: 11/12/2022] Open
Abstract
Cardiovascular disease (CVD) is the driving force behind the discrepancy in life expectancy between indigenous and non-indigenous groups in many countries. Preceding CVD many indigenous groups exhibit a cluster of cardiometabolic risk factors, including overweight-obesity, diabetes, high cholesterol, and high blood pressure. In turn, modifiable lifestyle risk factors contribute to the development of this cluster of cardiometabolic conditions. Modifiable lifestyle risk factors include, but are not limited to, physical inactivity, poor nutrition, excessive alcohol consumption, and cigarette smoking. Notably, these metabolic and lifestyle risk factors are relatively simple to monitor and track. The current review will look at modifiable cardiometabolic (overweight-obesity, diabetes mellitus, high cholesterol, and high blood pressure) and lifestyle (physical inactivity, poor nutrition, risky alcohol behavior, and cigarette smoking) risk factors among indigenous populations from Australia (Aboriginal Australians and Torres Strait Islanders), New Zealand (Māori) and the United States (Native Americans). Discussion will focus on the causal relationship between modifiable lifestyle risk factors and cardiometabolic outcomes, as well as, simple measurements for tracking these risk factors.
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Affiliation(s)
- Lee Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand,Correspondence to: Dr. Lee Stoner, School of Sport and Exercise, Massey University, PO Box 756, Wellington 6140, New Zealand. E-mail:
| | - Krystina R Stoner
- School of Educational Studies and Human Development, University of Canterbury, Christchurch, New Zealand
| | - Joanna M Young
- Lipid and Diabetes Research Group, Christchurch Hospital, Christchurch, New Zealand
| | - Simon Fryer
- School of Sciences and Physical Education, University of Canterbury, Christchurch, New Zealand
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