1
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Triantafyllidou P, Papadopoulou A, Thymara E, Papaevangelou V, Mastorakos G, Papadimitriou A, Kalantaridou S, Stratakis CA, Alexopoulou E. Aortic Intima-Media Thickness is Increased in Neonates of Mothers with Gestational Diabetes Mellitus: The Role of Thioredoxin-Interacting Protein as a Marker of Oxidative Stress. Curr Vasc Pharmacol 2023; 21:234-245. [PMID: 37518994 DOI: 10.2174/1570161121666230727150854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/07/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Offspring exposed in foetal life to gestational diabetes mellitus (GDM) are at increased risk for future metabolic diseases. OBJECTIVE To explore the prognostic role of abdominal aorta intima-media thickness (aIMT) in neonates exposed to GDM as a possible biomarker for later atherogenesis and its possible correlation with thioredoxin- interacting protein (TXNIP), a protein involved in oxidative stress. METHODS In this prospective, observational study, mother-infant pairs were studied in 2 groups (57 patients with GDM and 51 controls without GDM). TXNIP levels were measured in the placenta, as well as in the umbilical and neonatal blood. The data were correlated with aIMT in neonates. RESULTS aIMT was increased in GDM offspring (patients: median [range]=0.39 mm [0.31-0.46] vs controls: median=0.28 mm [0.23-0.33]; p=0.001) and remained significant after adjusting for possible confounders (e.g., triglycerides, blood pressure, vitamin D, birth weight and gender; β coefficient=0.131 p=0.049). TXNIP levels were increased in trophoblasts (p=0.001) and syncytiotrophoblasts (p=0.001) and were decreased in endothelial cells (p=0.022) in GDM offspring vs controls. Moreover, TXNIP levels in trophoblasts positively correlated with aIMT (r=0.369; p=0.001). TXNIP levels in umbilical/ neonatal blood were not associated with GDM. CONCLUSION Increased aIMT was demonstrated in the offspring of mothers with GDM. Non-invasive measurement of aIMT could be used as a biomarker to identify children at increased risk for atherogenesis later in life. This information may encourage early preventive measures. TXNIP may be associated with GDM and/or aIMT.
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Affiliation(s)
- Pinelopi Triantafyllidou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Papadopoulou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Thymara
- Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vassiliki Papaevangelou
- 3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Endocrinology, Diabetes mellitus and Metabolism Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Papadimitriou
- Department of Pediatrics-Endocrinology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantine A Stratakis
- Human Genetics & Precision Medicine, Institute for Molecular Biology & Biotechnology (IMBB), Foundation for Research & Technology Hellas (FORTH), Heraklion, Crete, Greece
- Medical Genetics, ELPEN, Inc., ELPEN Research Institute & H. Dunant Hospital, Athens, Greece
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
- National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Efthymia Alexopoulou
- 2nd Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
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2
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Varley BJ, Henry A, Roberts L, Davis G, Skilton MR, Craig ME, Gow ML. Intrauterine exposure to preeclampsia does not impair vascular health in children. Front Public Health 2022; 10:1071304. [PMID: 36620255 PMCID: PMC9814159 DOI: 10.3389/fpubh.2022.1071304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background and objectives Preeclampsia is a serious multisystem blood pressure disorder during pregnancy that is associated with increased long-term risk of cardiovascular disease to the mother and offspring. We investigated the vascular health of children exposed to intrauterine preeclampsia. Materials and methods This was a cross-sectional study of offspring in a prospective cohort of women with complications during pregnancy. Children aged between 2 and 5 years [median age 4.7 (2.8, 5.1) years] exposed to intrauterine preeclampsia (n = 26) or normotensive controls (n = 34), were recruited between July 2020 and April 2021. Vascular health was assessed by measuring aortic intima-media thickness and pulse wave velocity. Univariate generalized linear regression models were used to explore associations between vascular measurements and explanatory variables. Results Children exposed to preeclampsia had a lower body mass index at assessment (15.5 vs. 16.2 kg/m2, p = 0.04), birth weight (2.90 vs. 3.34 kg, p = 0.004), gestational age at birth (37.5 vs. 39.4 weeks, p < 0.001) and higher frequency of preterm birth (27% vs. 6%, p = 0.02). There were no differences in vascular health between children exposed to preeclampsia vs. controls (mean aortic intima-media thickness 0.575 mm vs. 0.563 mm, p = 0.51, pulse wave velocity 4.09 vs. 4.18 m/s, p = 0.54) and there were no significant associations in univariate analyses. Conclusions There were no major adverse differences in vascular health which contrasts with existing studies. This suggests exposure to intrauterine preeclampsia may result in a less severe cardiovascular phenotype in young children. While reassuring, longitudinal studies are required to determine if and when exposure to intrauterine preeclampsia affects vascular health in children.
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Affiliation(s)
- Benjamin J. Varley
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Department of Paediatrics and Child Health, St George Hospital, Kogarah, NSW, Australia
| | - Amanda Henry
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,The George Institute for Global Health, Sydney, NSW, Australia
| | - Lynne Roberts
- Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Gregory Davis
- Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Michael R. Skilton
- Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia,Sydney Medical School, University of Sydney, Sydney, NSW, Australia,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia
| | - Maria E. Craig
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Department of Paediatrics and Child Health, St George Hospital, Kogarah, NSW, Australia,Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia
| | - Megan L. Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,*Correspondence: Megan L. Gow ✉
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3
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Moustafa A, Popat H, Ayer J, Haghighi M, Skilton M, Carmo KB. Infants With Congenital Heart Disease at Risk of Early Atherosclerotic Disease. J Am Heart Assoc 2022; 11:e025772. [DOI: 10.1161/jaha.122.025772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background
Aortic intima‐media thickness (aIMT) measurement is an established indicator of preclinical atherosclerosis. We aimed to describe the aIMT in infants with congenital heart disease undergoing cardiac surgery over the first year of life and explore its association with cardiopulmonary bypass, growth velocity, and a diagnosis of left heart obstruction.
Methods and Results
A prospective cohort study measuring mean and maximum aIMT preoperatively, at 3 months, and 1 year of age in neonates with congenital heart disease undergoing cardiac surgery. Twenty‐four infants with a median gestation of 39 weeks and a median birth weight of 3184 g were included. Sixteen (67%) infants had left outflow tract obstruction. Gestation correlated inversely with baseline mean aIMT (β=−0.027,
P
=0.018) and positively with the percentage of increase in mean and maximum aIMT between baseline and 3 months (β=17%,
P
=0.027 and β=15%,
P
=0.023). The presence of left outflow obstruction was significantly associated with increasing mean and maximum aIMT between baseline and 1 year (mean aIMT change: β=34%,
P
=0.017 and maximum aIMT change β=43%,
P
=0.001). Both subgroups of left heart obstruction and non‐left heart obstruction significantly changed over time (
P
=0.001 and
P
<0.001) but trends were not statistically different between both subgroups (
P
=0.21). Growth velocity and cardiopulmonary bypass were not associated with baseline or change in aIMT over the first year of life.
Conclusions
AIMT significantly increased over the first 3 months in our cohort of infants with repaired congenital heart disease. Increasing gestation was associated with decreasing aIMT at 3 months. Growth velocity and cardiopulmonary bypass were not associated with aIMT changes over the first year. Left heart obstruction was associated with a trend toward increased aIMT.
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Affiliation(s)
- Ahmed Moustafa
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Himanshu Popat
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Julian Ayer
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
- The Heart Centre for Children The Children’s Hospital at Westmead Sydney New South Wales Australia
| | - Marjan Haghighi
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
- The Heart Centre for Children The Children’s Hospital at Westmead Sydney New South Wales Australia
| | - Michael Skilton
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Kathryn Browning Carmo
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
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4
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Markopoulou P, Papanikolaou E, Loukopoulou S, Galina P, Mantzou A, Siahanidou T. Increased circulating endothelial progenitor cells (EPCs) in prepubertal children born prematurely: a possible link between prematurity and cardiovascular risk. Pediatr Res 2021; 90:156-165. [PMID: 33038874 DOI: 10.1038/s41390-020-01190-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/17/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) ensure vascular integrity and neovascularization. No studies have investigated EPCs in preterm-born children beyond infancy. METHODS One hundred and thirty-six prepubertal children were enrolled: 63 preterm and 73 born at term (controls). Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were measured in preterm-born children compared to controls. Body mass index (BMI), waist-to-hip ratio (WHR), neck circumference, systolic and diastolic blood pressure (SBP and DBP, respectively), fasting glucose, insulin, lipid profile, common carotid and abdominal aortic intima-media thickness (cIMT and aIMT, respectively), endothelium-dependent brachial artery flow-mediated dilation (FMD), and echocardiographic parameters were also assessed. RESULTS Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were significantly higher in preterm-born children compared to controls (p < 0.001 and p < 0.001, respectively). In total study population and in the preterm-born group, EPCs were significantly lower in children born to mothers with gestational diabetes compared to non-diabetic mothers. Prematurity was associated with higher WHR, neck circumference, SBP, DBP, cIMT, aIMT, mean pressure, and velocity of pulmonary artery; the peak velocity of the brachial artery was significantly lower in children born prematurely. In multiple regression analysis, preterm birth and maternal gestational diabetes were recognized as independent predictors of EPCs. CONCLUSIONS Circulating EPCs were increased in prepubertal preterm-born children in comparison with peers born full-term. Maternal gestational diabetes was associated with a decrease in EPCs. IMPACT Mounting evidence supports the adverse effect of prematurity on cardiovascular health. However, the underlying mechanisms that could lead to endothelial dysfunction in preterm-born individuals are not fully understood. Endothelial progenitor cells (EPCs) ensure vascular integrity, normal endothelial function and neovascularization. No studies have investigated the EPCs counts in peripheral blood beyond infancy in children born prematurely. Circulating EPCs were significantly higher in preterm-born prepubertal children compared to controls, thus indicating that prematurity is possibly associated with endothelial damage. In total study population and in the preterm-born group, maternal gestational diabetes was associated with decreased EPCs concentrations.
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Affiliation(s)
- Panagiota Markopoulou
- Neonatal Unit, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Papanikolaou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Loukopoulou
- Department of Cardiology, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Paraskevi Galina
- Radiology Department, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Tania Siahanidou
- Neonatal Unit, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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5
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Mansell T, Burgner D, Ponsonby AL, Collier F, Pezic A, Vuillermin P, Juonala M, Ryan J, Saffery R. HIF3A cord blood methylation and systolic blood pressure at 4 years - a population-based cohort study. Epigenetics 2020; 15:1361-1369. [PMID: 32530724 DOI: 10.1080/15592294.2020.1781027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Methylation levels at the hypoxia-inducible factor 3α gene (HIF3A) in blood have been linked to body mass index (BMI) in adults. Despite evidence implicating HIF3A in angiogenesis and metabolism, no studies have examined links between HIF3A methylation in early life and cardiovascular health. Here, we investigated the relationship between HIF3A methylation in blood at birth and 12 months of age with cardiovascular measures at 4 years. We also examined influences of prenatal exposures, birth outcomes, and genetic variation. Methylation of two HIF3A promoter regions in cord blood was measured using Sequenom EpiTYPER mass-spectrometry. The first promoter region was also measured in 12-month blood. Four-year cardiovascular measures included blood pressure, pulse wave velocity, and aortic and carotid intima-media thickness. Associations were tested using partial correlation tests and linear regression modelling. Methylation of the first HIF3A promoter in cord and 12-month blood was not associated with four-year measures. There was modest evidence of an association between DNA methylation at the second HIF3A promoter in cord blood and four-year systolic blood pressure (n = 353, r = 0.12, p = 0.03). In sex-stratified analysis, methylation of the second promoter was modestly associated with systolic and diastolic blood pressure (r = 0.16, p = 0.03 for both) in males only. In conclusion, HIF3A methylation at birth shows some evidence of an association with later blood pressure in childhood. Further work should determine whether this relationship persists into later childhood, and should assess potential functional links between HIF3A methylation and cardiovascular health more generally.
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Affiliation(s)
- Toby Mansell
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia
| | - David Burgner
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia.,Department of Paediatrics, Monash University , Clayton, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia.,Neuroepidemiology Research Group, The Florey Institute of Neuroscience and Mental Health , Parkville, Australia
| | - Fiona Collier
- Murdoch Children's Research Institute , Parkville, Australia.,School of Medicine, Deakin University , Geelong, Australia.,Child Health Research Unit, Barwon Health , Geelong, Australia
| | - Angela Pezic
- Murdoch Children's Research Institute , Parkville, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute , Parkville, Australia.,School of Medicine, Deakin University , Geelong, Australia.,Child Health Research Unit, Barwon Health , Geelong, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Medicine, University of Turku , Turku, Finland.,Division of Medicine, Turku University Hospital , Turku, Finland
| | - Joanne Ryan
- Murdoch Children's Research Institute , Parkville, Australia.,School of Public Health & Preventive Medicine, Monash University , Melbourne, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia
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6
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Natural History of Atherosclerosis and Abdominal Aortic Intima-Media Thickness: Rationale, Evidence, and Best Practice for Detection of Atherosclerosis in the Young. J Clin Med 2019; 8:jcm8081201. [PMID: 31408952 PMCID: PMC6723244 DOI: 10.3390/jcm8081201] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022] Open
Abstract
Atherosclerosis underlies most myocardial infarctions and ischemic strokes. The timing of onset and the rate of progression of atherosclerosis differ between individuals and among arterial sites. Physical manifestations of atherosclerosis may begin in early life, particularly in the abdominal aorta. Measurement of the abdominal aortic intima-media thickness by external ultrasound is a non-invasive methodology for quantifying the extent and severity of early atherosclerosis in children, adolescents, and young adults. This review provides an evidence-based rationale for the assessment of abdominal aortic intima-media thickness-particularly as an age-appropriate methodology for studying the natural history of atherosclerosis in the young in comparison to other methodologies-establishes best practice methods for assessing abdominal aortic intima-media thickness, and identifies key gaps in the literature, including those that will identify the clinical relevance of this measure.
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7
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Manterola HL, Lo Vercio L, Díaz A, Del Fresno M, Larrabide I. Validation of an Open-Source Tool for Measuring Carotid Lumen Diameter and Intima-Media Thickness. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1873-1881. [PMID: 29773245 DOI: 10.1016/j.ultrasmedbio.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/20/2018] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
In low- and middle-income regions, a relatively large number of deaths occur from cardiovascular disease or stroke. Carotid intima-media thickness (cIMT) and carotid lumen diameter (cLD) are strong indicators of cardiovascular event risk and stenosis severity, respectively. The interactive open-source software described here, Cimtool, is based on active contours for measuring these indicators in clinical practice and thus helping in preventive diagnosis and treatment. Cimtool was validated using carotid phantoms and real images obtained using ultrasound. Expert users measured cIMT and cLD in regular practice and also with Cimtool. The results obtained with Cimtool were then compared with the results for the manual approach in terms of measurement agreement, time spent on the measurements and usability. Intra-observer variability when using Cimtool was also analyzed. Statistical analysis revealed strong agreement between the manual method and Cimtool (p > 0.01 for cIMT and cLD). The correlation coefficient for both cIMT and cLD measurements was r > 0.9. Moreover, this software allowed the users to spend considerably less time on each measurement (3.5 min per study versus 50 s with Cimtool on average). An open-source, interactive, validated tool for measuring cIMT and cLD clinically was thus developed. Compared with the manual approach, Cimtool's straightforward measurement flow allows the user to spend less time per measurement and has less standard deviation. The coefficients of variation for measurements and intra-observer variability were lower than those reported for recent automated approaches, even with low-quality images.
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Affiliation(s)
- Hugo Luis Manterola
- Pladema Institute, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - Lucas Lo Vercio
- Pladema Institute, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Alejandro Díaz
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Mariana Del Fresno
- Pladema Institute, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina; Comisión de Investigaciones Científicas de la Provincia de Buenos Aires (CICPBA), Buenos Aires, Argentina
| | - Ignacio Larrabide
- Pladema Institute, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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8
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McCloskey K, Vuillermin P, Carlin JB, Cheung M, Skilton MR, Tang ML, Allen K, Gilbert GL, Ranganathan S, Collier F, Dwyer T, Ponsonby AL, Burgner D. Perinatal microbial exposure may influence aortic intima-media thickness in early infancy. Int J Epidemiol 2018; 46:209-218. [PMID: 27059546 DOI: 10.1093/ije/dyw042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2016] [Indexed: 12/17/2022] Open
Abstract
Background The maternal and infant microbiome may influence infant cardiovascular risk through immune programming. The maternal vagino-enteric microbiome is often sampled for group B streptococcus (GBS) colonization during pregnancy. Our aim was to investigate the association between maternal GBS colonization, intrapartum antibiotics, antenatal pet exposure and infant aortic intima-media thickness (aIMT), an intermediate vascular phenotype, and whether this association varied by mode of delivery. Methods The Barwon Infant Study is a population-derived pre-birth cohort. Perinatal data were collected on participants. Women were tested for vagino-enteric group B streptococcus (GBS) colonization during third trimester. Six-week infant aIMT was measured by trans-abdominal ultrasound. Adjustment for confounders included maternal age, pre-pregnancy body mass index (BMI), smoking, socioeconomic status, gestational diabetes, length of gestation, infant sex, birthweight and aortic internal diameter. Results Data were available on 835 mother-infant pairs. Of these, 574 (69%) women delivered vaginally; of those, 129 (22%) were GBS-colonized; and of these women, 111 (86%) received prophylactic intrapartum antibiotics. An association between maternal GBS colonization and infant aIMT was observed among those delivered vaginally (β = 19.5 µm, 95% CI 9.5, 29.4; P < 0.0001) but not by Caesarean section ( P for interaction = 0.02). A similar pattern was seen for intrapartum antibiotics. There was a negative association between antenatal pet exposure and aIMT observed in those delivered vaginally. Conclusion Maternal GBS colonization and intrapartum antibiotics were associated with increased infant aIMT in those delivered vaginally, whereas antenatal pet exposure was associated with decreased aIMT. These data suggest that differences in early life microbial experience may contribute to an increased cardiovascular risk.
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Affiliation(s)
- Kate McCloskey
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Peter Vuillermin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.,Department of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - John B Carlin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Michael Cheung
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Michael R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders
| | - Mimi Lk Tang
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Katie Allen
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Gwendolyn L Gilbert
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, WA, Australia
| | - Sarath Ranganathan
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Fiona Collier
- Child Health Research Unit, University Hospital Barwon Health, Geelong, VIC, Australia.,Department of Medicine, Deakin University, Waurn Ponds, VIC, Australia
| | - Terence Dwyer
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Anne-Louise Ponsonby
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - David Burgner
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
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9
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Chen KYH, Curtis N, Cheung M, Burgner D. Cardiovascular Risk After Kawasaki Disease - Findings From an Australian Case-Control Study. Heart Lung Circ 2017; 27:6-8. [PMID: 29198833 DOI: 10.1016/s1443-9506(17)31473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katherine Y H Chen
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital, Parkville, Vic, Australia
| | - Nigel Curtis
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital, Parkville, Vic, Australia
| | - Michael Cheung
- Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia; Heart Research Group, Murdoch Children's Research Institute and Department of Cardiology, The Royal Children's Hospital, Parkville, Vic, Australia
| | - David Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia; Department of Paediatrics, Monash University, Clayton, Vic, Australia.
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Chen KY, Zannino D, Curtis N, Cheung M, Burgner D. Increased aortic intima-media thickness following Kawasaki disease. Atherosclerosis 2017; 260:75-80. [PMID: 28359981 DOI: 10.1016/j.atherosclerosis.2017.03.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/02/2017] [Accepted: 03/17/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The cardiovascular risk following Kawasaki disease (KD), especially in those without coronary artery changes or with regressed coronary artery lesions, is unclear. We assessed markers of early atherosclerosis in individuals following KD, including those with and without coronary artery abnormalities. METHODS We performed a cross-sectional case-control study of 60 patients (25 with always normal coronary arteries and 35 with abnormalities) and 60 controls, at least two years after KD. Non-invasive assessment of arterial structure (carotid and aortic intima-media thickness (IMT)) and function (pulse wave velocity, carotid artery distensibility and diameter compliance) was done. Analyses were adjusted for traditional cardiovascular risk factors. RESULTS Kawasaki disease patients had increased aortic IMT compared to controls (0.53 mm (95% CI 0.51-0.56) versus 0.49 (95% CI 0.47-0.52), p = 0.04), largely driven by those with abnormal coronary arteries. There were no differences in carotid IMT. Kawasaki disease patients with coronary artery abnormalities had reduced carotid distensibility compared to controls (15.16% (95% CI 13.67-16.65) versus 17.50 (95% CI 16.43-18.58), p = 0.02). CONCLUSIONS Patients with KD have increased aortic IMT and reduced carotid distensibility, indicating heightened cardiovascular risk, especially in those with coronary artery abnormalities. In our study, we used validated surrogates for cardiovascular disease risk. Our findings, therefore, warrant follow-up investigations in KD patients.
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Affiliation(s)
- Katherine Yh Chen
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia
| | - Diana Zannino
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Nigel Curtis
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Infectious Diseases Unit and Department of General Medicine, The Royal Children's Hospital Melbourne, Victoria, Australia
| | - Michael Cheung
- Department of Paediatrics, University of Melbourne, Victoria, Australia; Heart Research Group, Murdoch Childrens Research Institute and Department of Cardiology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - David Burgner
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Department of Paediatrics, Monash University, Victoria, Australia.
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Akazawa Y, Kamiya M, Yamazaki S, Kawasaki Y, Nakamura C, Takeuchi Y, Hachiya A, Kusakari M, Miyosawa Y, Motoki N, Koike K, Nakamura T. Impact of Decreased Serum Insulin-Like Growth Factor-1 Levels on Central Aortic Compliance in Small-for-Gestational-Age Infants. Neonatology 2017; 111:30-36. [PMID: 27508295 DOI: 10.1159/000447480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/08/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Intrauterine growth restriction is associated with arterial hypertension in adulthood; however, the underlying mechanism is unclear. OBJECTIVES We hypothesized that serum insulin-like growth factor-1 (IGF-1) levels affect central aortic elastic properties and structure in small-for-gestational-age (SGA) infants. METHODS Eighteen SGA infants and 22 appropriate-for-gestational-age (AGA) infants were enrolled in this study. The serum IGF-1 level within 1 h of birth and abdominal aortic echo parameters at 1 week of age were retrospectively compared. RESULTS In the SGA infants, IGF-1 levels (27.6 ± 17.7 vs. 42.6 ± 15 ng/ml, p = 0.006), aortic strain (10.2 ± 3.1 vs. 12.8 ± 3.1%, p = 0.01), and aortic distensibility (0.73 ± 0.19 vs. 0.92 ± 0.34 cm2/dyn × 10-4, p = 0.05) were significantly lower compared with AGA infants. By contrast, blood pressure, aortic intima-media thickness (aIMT) in relation to body weight (383 ± 163 vs. 256 ± 43 μm/kg, p < 0.001), aortic stiffness index in relation to body weight (2.0 ± 1.7 vs. 1.1 ± 0.4, p = 0.005), and arterial pressure-strain elastic modulus (293 ± 72 vs. 242 ± 78 mm Hg, p = 0.04) were higher compared with AGA infants. In the SGA infants, IGF-1 levels were significantly correlated with aortic strain (r = 0.49, p = 0.04), aIMT in relation to body weight (r = -0.61, p = 0.007), and aortic stiffness index in relation to body weight (r = -0.63, p = 0.005). CONCLUSIONS Decreased serum IGF-1 levels in SGA infants may affect the vascular compliance and structure of the central aorta.
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Affiliation(s)
- Yohei Akazawa
- Department of Paediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Huang X, Zhang Y, Qian M, Meng L, Xiao Y, Niu L, Zheng R, Zheng H. Classification of Carotid Plaque Echogenicity by Combining Texture Features and Morphologic Characteristics. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2253-2261. [PMID: 27582533 DOI: 10.7863/ultra.15.09002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 01/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Anechoic carotid plaques on sonography have been used to predict future cardiovascular or cerebrovascular events. The purpose of this study was to investigate whether carotid plaque echogenicity could be assessed objectively by combining texture features extracted by MaZda software (Institute of Electronics, Technical University of Lodz, Lodz, Poland) and morphologic characteristics, which may provide a promising method for early prediction of acute cardiovascular disease. METHODS A total of 268 plaque images were collected from 136 volunteers and classified into 85 hyperechoic, 83 intermediate, and 100 anechoic plaques. About 300 texture features were extracted from histogram, absolute gradient, run-length matrix, gray-level co-occurrence matrix, autoregressive model, and wavelet transform algorithms by MaZda. The morphologic characteristics, including degree of stenosis, maximum plaque intima-media thickness, and maximum plaque length, were measured by B-mode sonography. Statistically significant features were selected by analysis of covariance. The most discriminative features were obtained from statistically significant features by linear discriminant analysis. The K-nearest neighbor classifier was used to classify plaque echogenicity based on statistically significant and most discriminative features. RESULTS A total of 30 statistically significant features were selected among the plaques, and 2 most discriminative features were obtained from the statistically significant features. The classification accuracy rates for 3 types of plaques based on statistically significant and most discriminative features were 72.03% (κ= 0.571; P < .001) and 88.14% (κ= 0.820; P < .001), respectively. The receiver operating characteristic curve for identifying anechoic plaques showed an area under the curve of 0.918 when the most discriminative features were used to train the classifier. CONCLUSIONS It is feasible to classify carotid plaque echogenicity by combining texture features extracted from sonograms by MaZda and morphologic characteristics.
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Affiliation(s)
- Xiaowei Huang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yanling Zhang
- Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ming Qian
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Long Meng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yang Xiao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lili Niu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Rongqin Zheng
- Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Rafferty AR, McGrory L, Cheung M, Rogerson S, Ziannino D, Pyman J, Davis PG, Burgner D. Inflammation, lipids and aortic intima-media thickness in newborns following chorioamnionitis. Acta Paediatr 2016; 105:e300-6. [PMID: 27002899 DOI: 10.1111/apa.13410] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 03/10/2016] [Accepted: 03/17/2016] [Indexed: 12/23/2022]
Abstract
AIM This study investigated whether chorioamnionitis was associated with increased inflammation, dyslipidaemia and adverse cardiovascular phenotypes in the immediate postnatal period. METHODS This prospective case-control study included preterm infants (30(+0) -35(+6) weeks gestational age, GA) whose mothers did not have pregnancy-related conditions that may influence outcomes. Chorioamnionitis was diagnosed by placental histology, and infants were divided retrospectively into cases (chorioamnionitis-exposed) and controls (unexposed). Serum high-sensitivity C-reactive protein (hsCRP), lipid profile, far-wall abdominal aortic intima-media thickness (aIMT) and blood pressure (BP) were measured in the first week of life. RESULTS There were 20 (16 male, mean GA 32.4 weeks) cases and 31 (12 male, mean GA 32.6 weeks) controls. Histological chorioamnionitis was associated with a significant increase in hsCRP and a non-significant trend towards an adverse lipid profile. There was no evidence of differences in aIMT or BP. CONCLUSION Preterm infants exposed to chorioamnionitis have greater postnatal inflammation. There were no early postnatal differences in aIMT or BP. The inflammatory stimulus of chorioamnionitis late in gestation may be of insufficient intensity and duration to result in immediate postnatal alterations to arterial structure. Cardiovascular follow-up of infants exposed to chorioamnionitis may identify differential risk trajectories and subsequent inflammatory responses.
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Affiliation(s)
- Anthony R. Rafferty
- Newborn Research Centre; Royal Women's Hospital; Parkville Australia
- Murdoch Childrens Research Institute; Parkville Australia
| | - Lorraine McGrory
- Newborn Research Centre; Royal Women's Hospital; Parkville Australia
- Murdoch Childrens Research Institute; Parkville Australia
- University of Dundee; Dundee United Kingdom
| | - Michael Cheung
- Murdoch Childrens Research Institute; Parkville Australia
- Department of Paediatrics; The University of Melbourne; Parkville Australia
| | - Sheryle Rogerson
- Newborn Research Centre; Royal Women's Hospital; Parkville Australia
| | - Diana Ziannino
- Murdoch Childrens Research Institute; Parkville Australia
| | - Jan Pyman
- Anatomical Pathology; The Royal Women's Hospital; Parkville Australia
| | - Peter G. Davis
- Newborn Research Centre; Royal Women's Hospital; Parkville Australia
- Murdoch Childrens Research Institute; Parkville Australia
- Department of Paediatrics; The University of Melbourne; Parkville Australia
| | - David Burgner
- Murdoch Childrens Research Institute; Parkville Australia
- Department of Paediatrics; The University of Melbourne; Parkville Australia
- Department of Paediatrics; Monash University; Clayton Australia
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Saba L, Banchhor SK, Suri HS, Londhe ND, Araki T, Ikeda N, Viskovic K, Shafique S, Laird JR, Gupta A, Nicolaides A, Suri JS. Accurate cloud-based smart IMT measurement, its validation and stroke risk stratification in carotid ultrasound: A web-based point-of-care tool for multicenter clinical trial. Comput Biol Med 2016; 75:217-34. [PMID: 27318571 DOI: 10.1016/j.compbiomed.2016.06.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/05/2016] [Accepted: 06/07/2016] [Indexed: 11/29/2022]
Abstract
This study presents AtheroCloud™ - a novel cloud-based smart carotid intima-media thickness (cIMT) measurement tool using B-mode ultrasound for stroke/cardiovascular risk assessment and its stratification. This is an anytime-anywhere clinical tool for routine screening and multi-center clinical trials. In this pilot study, the physician can upload ultrasound scans in one of the following formats (DICOM, JPEG, BMP, PNG, GIF or TIFF) directly into the proprietary cloud of AtheroPoint from the local server of the physician's office. They can then run the intelligent and automated AtheroCloud™ cIMT measurements in point-of-care settings in less than five seconds per image, while saving the vascular reports in the cloud. We statistically benchmark AtheroCloud™ cIMT readings against sonographer (a registered vascular technologist) readings and manual measurements derived from the tracings of the radiologist. One hundred patients (75 M/25 F, mean age: 68±11 years), IRB approved, Toho University, Japan, consisted of Left/Right common carotid artery (CCA) artery (200 ultrasound scans), (Toshiba, Tokyo, Japan) were collected using a 7.5MHz transducer. The measured cIMTs for L/R carotid were as follows (in mm): (i) AtheroCloud™ (0.87±0.20, 0.77±0.20); (ii) sonographer (0.97±0.26, 0.89±0.29) and (iii) manual (0.90±0.20, 0.79±0.20), respectively. The coefficient of correlation (CC) between sonographer and manual for L/R cIMT was 0.74 (P<0.0001) and 0.65 (P<0.0001), while, between AtheroCloud™ and manual was 0.96 (P<0.0001) and 0.97 (P<0.0001), respectively. We observed that 91.15% of the population in AtheroCloud™ had a mean cIMT error less than 0.11mm compared to sonographer's 68.31%. The area under curve for receiving operating characteristics was 0.99 for AtheroCloud™ against 0.81 for sonographer. Our Framingham Risk Score stratified the population into three bins as follows: 39% in low-risk, 70.66% in medium-risk and 10.66% in high-risk bins. Statistical tests were performed to demonstrate consistency, reliability and accuracy of the results. The proposed AtheroCloud™ system is completely reliable, automated, fast (3-5 seconds depending upon the image size having an internet speed of 180Mbps), accurate, and an intelligent, web-based clinical tool for multi-center clinical trials and routine telemedicine clinical care.
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Affiliation(s)
- Luca Saba
- Department of Radiology, University of Cagliari, Italy
| | - Sumit K Banchhor
- Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India
| | - Harman S Suri
- Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
| | - Narendra D Londhe
- Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Nobutaka Ikeda
- Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Shoaib Shafique
- CorVasc Vascular Laboratory, 8433 Harcourt Rd #100, Indianapolis, IN, USA
| | - John R Laird
- UC Davis Vascular Centre, University of California, Davis, CA, USA
| | - Ajay Gupta
- Brain and Mind Research Institute, Weill Cornell Medical College, NY, USA
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre, London, England; Vascular Diagnostic Centre, University of Cyprus, Nicosia, Cyprus
| | - Jasjit S Suri
- Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA.
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15
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Labombarda F, Castelnuovo S, Goularas D, Sirtori CR. Status and potential clinical value of a transthoracic evaluation of the coronary arteries. Cardiovasc Ultrasound 2016; 14:5. [PMID: 26787070 PMCID: PMC4717568 DOI: 10.1186/s12947-016-0048-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/13/2016] [Indexed: 11/10/2022] Open
Abstract
The growing need for coronary evaluation has raised interest in non-radioactive, non-invasive monitoring systems. In particular, radiation exposure during coronary investigations has been shown to be a possible cause of an enhanced risk of secondary tumors. Literature search has indicated that transthoracic echocardiography (TTE) has been widely applied to coronary arteries up to 2003, following which the lack of adequate equipment and the increased availability of invasive diagnostics, has reduced interest in this low cost, low-risk technology. The more recent availability of newer, more sensitive machines, allows evaluation of a larger number of arterial trees, including the aorta in newborns, the prenatal aortic intima-media thickness, as well as the detection of coronary artery anomalies in the adult. Improved technology for this highly operator sensitive technique may thus predict a possible evolution toward the clinical diagnostics of coronary disease and, eventually, also of the progression/regression of disease. We sought to evaluate the present status of this seldom quoted non-invasive technology.
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Affiliation(s)
- Fabien Labombarda
- Department of Cardiology, CHU de Caen, Avenue cote de nacre, 14000, Caen, France.
| | - Samuela Castelnuovo
- Center E. Grossi Paoletti, University of Milano and Dyslipidemia Center, Niguarda Hospital, Milan, Italy.
| | - Dionysis Goularas
- Department of Computer Engineering, Yeditepe University, Istanbul, Turkey.
| | - Cesare R Sirtori
- Center E. Grossi Paoletti, University of Milano and Dyslipidemia Center, Niguarda Hospital, Milan, Italy.
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Infant adiposity at birth and early postnatal weight gain predict increased aortic intima-media thickness at 6 weeks of age: a population-derived cohort study. Clin Sci (Lond) 2015; 130:443-50. [PMID: 26666445 DOI: 10.1042/cs20150685] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022]
Abstract
Infant body composition and postnatal weight gain have been implicated in the development of adult obesity and cardiovascular disease, but there are limited prospective data regarding the association between infant adiposity, postnatal growth and early cardiovascular parameters. Increased aortic intima-media thickness (aortic IMT) is an intermediate phenotype of early atherosclerosis. The aim of the present study was to investigate the relationship between weight and adiposity at birth, postnatal growth and aortic IMT. The Barwon Infant Study (n=1074 mother-infant pairs) is a population-derived birth cohort. Infant weight and other anthropometry were measured at birth and 6 weeks of age. Aortic IMT was measured by trans-abdominal ultrasound at 6 weeks of age (n=835). After adjustment for aortic size and other factors, markers of adiposity including increased birth weight (β=19.9 μm/kg, 95%CI 11.1, 28.6; P<0.001) and birth skinfold thickness (β=6.9 μm/mm, 95%CI 3.3, 10.5; P<0.001) were associated with aortic IMT at 6 weeks. The association between birth skinfold thickness and aortic IMT was independent of birth weight. In addition, greater postnatal weight gain was associated with increased aortic IMT, independent of birth weight and age at time of scan (β=11.3 μm/kg increase, 95%CI 2.2, 20.3; P=0.01). Increased infant weight and adiposity at birth, as well as increased early weight gain, were positively associated with aortic IMT. Excessive accumulation of adiposity during gestation and early infancy may have adverse effects on cardiovascular risk.
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Vuillermin P, Saffery R, Allen KJ, Carlin JB, Tang MLK, Ranganathan S, Burgner D, Dwyer T, Collier F, Jachno K, Sly P, Symeonides C, McCloskey K, Molloy J, Forrester M, Ponsonby AL. Cohort Profile: The Barwon Infant Study. Int J Epidemiol 2015; 44:1148-60. [DOI: 10.1093/ije/dyv026] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 12/27/2022] Open
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