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Hrabak Paar M, Muršić M, Bremerich J, Heye T. Cardiovascular Aging and Risk Assessment: How Multimodality Imaging Can Help. Diagnostics (Basel) 2024; 14:1947. [PMID: 39272731 PMCID: PMC11393882 DOI: 10.3390/diagnostics14171947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
Aging affects the cardiovascular system, and this process may be accelerated in individuals with cardiovascular risk factors. The main vascular changes include arterial wall thickening, calcification, and stiffening, together with aortic dilatation and elongation. With aging, we can observe left ventricular hypertrophy with myocardial fibrosis and left atrial dilatation. These changes may lead to heart failure and atrial fibrillation. Using multimodality imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging, it is possible to detect these changes. Additionally, multimodality imaging, mainly via CT measurements of coronary artery calcium or ultrasound carotid intima-media thickness, enables advanced cardiovascular risk stratification and helps in decision-making about preventive strategies. The focus of this manuscript is to briefly review cardiovascular changes that occur with aging, as well as to describe how multimodality imaging may be used for the assessment of these changes and risk stratification of asymptomatic individuals.
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Affiliation(s)
- Maja Hrabak Paar
- Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, Kispaticeva 12, HR-10000 Zagreb, Croatia
| | - Miroslav Muršić
- Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, Kispaticeva 12, HR-10000 Zagreb, Croatia
| | - Jens Bremerich
- Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, CH-4031 Basel, Switzerland
| | - Tobias Heye
- Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, CH-4031 Basel, Switzerland
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Nicolosi G, Donzella M, Polizzi A, Angjelova A, Santonocito S, Zanoli L, Annunziata M, Isola G. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients. Open Med (Wars) 2024; 19:20241003. [PMID: 39034949 PMCID: PMC11260002 DOI: 10.1515/med-2024-1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives This narrative review aims to update the current evidence and offer insight into the new non-invasive ultrasound techniques used to early identify degenerative vascular changes in subjects with periodontitis and to investigate if these methodologies could be useful to identify subclinical cardiovascular disease (CVD) dysfunction in periodontitis patients and to monitor changes in CVD risk after periodontal treatment. Methods Studies examining the assessment of vascular endothelial function through the latest methodologies were analyzed. Systematic reviews, observational studies, and clinical trials in the English language were identified using PubMed, Web of Science, and Google Scholar databases with key search terms such as "periodontitis," "endothelial dysfunction (ED)," "arterial stiffness," and "periodontal therapy." Results Several mechanisms are involved in the association between periodontitis and CVD. The key players are periodontal bacteria and their toxins, which can enter the circulation and infiltrate blood vessel walls. The increase in proinflammatory molecules such as interleukins and chemokines, c-reactive protein, fibrinogen, and oxidative stress also plays a decisive role. In addition, an increase in parameters of ED, arterial stiffness, and atherosclerosis, such as carotid intima-media thickness, pulse wave velocity, and flow-mediated dilatation, has been shown in periodontal patients. Conclusions The literature today agrees on the association of periodontitis and CVD and the positive role of periodontal therapy on systemic inflammatory indices and cardiovascular outcomes. Hopefully, these non-invasive methodologies could be extended to periodontal patients to provide a comprehensive understanding of the CVD-periodontitis link from the perspective of a personalized medicine approach in periodontology.
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Affiliation(s)
- Giada Nicolosi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Martina Donzella
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Angela Angjelova
- University Dental Clinical Center St. Pantelejmon, Faculty of Dentistry, Ss. Cyril and Methodius University in Skopje, 1000, Skopje, North Macedonia
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124, Catania, Italy
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Li Y, Yi M, Wang X, Zhang Y, Xiao K, Si J, Sun L, Zhang H, Sun J, Liu Z, Zhao J, Chu X, Li J. Association between triglyceride-glucose index and endothelial dysfunction. Endocrine 2024:10.1007/s12020-024-03785-5. [PMID: 38514591 DOI: 10.1007/s12020-024-03785-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Triglyceride-glucose (TyG) index, a simple surrogate marker for insulin resistance (IR), has been reported as an independent predictor of arterial structural damage and future cardiovascular events. The association between TyG index and endothelial dysfunction remains uncertain. OBJECTIVE The purpose of this study was to investigate the association between TyG index and endothelial dysfunction. METHODS Endothelial dysfunction was measured using flow-mediated dilation (FMD). A total of 840 subjects, who voluntarily accepted FMD measurement at the Health Management Department of Xuanwu Hospital from October 2016 to January 2020, were included in this study. TyG index was calculated as Ln [fasting triglyceride (TG)(mg/dL) × fasting plasma glucose (FPG) (mg/dL)/2]. RESULTS The mean age was 59.92 ± 10.28 years and 559 (66.55%) participants were male. The TyG index was correlated with FMD values (P = 0.022). Each unit increment in TyG index was associated with lower FMD values (β = -0.330, 95%CI -0.609 to -0.052, P = 0.020) after adjusting for covariates. Age (β = -0.069, 95%CI -0.088 to -0.051, P < 0.001), female (β = 0.592, 95%CI 0.172 to1.012, P = 0.006), smoking (β = -0.430, 95%CI -0.859 to -0.002, P = 0.049) and hypertension (β = -0.741, 95%CI -1.117 to -0.365, P < 0.001) were also independent predictors for endothelial dysfunction. A significant association between the TyG index and endothelial dysfunction was found only in populations younger than 60 years (β = -0.843, 95%CI -1.371 to -0.316, P = 0.002), females (β = -0.612, 95%CI -1.147 to -0.077, P = 0.025), and populations without diabetes mellitus (DM) (β = -0.594, 95%CI -1.042 to -0.147, P = 0.009). CONCLUSIONS Subjects with an elevated TyG index are more likely to have endothelial dysfunction, particularly in populations without DM.
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Affiliation(s)
- Yan Li
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Ming Yi
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Xinyi Wang
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Yinghua Zhang
- Department of Cardiology, Chui Yang Liu Hospital affiliated to Tsinghua University, Beijing, 100021, China
| | - Keling Xiao
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Jin Si
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Lijie Sun
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Haoyu Zhang
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Jinghao Sun
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Zhaoli Liu
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China
| | - Jing Zhao
- Health Management Center, Xuanwu hospital, Capital Medical University, Beijing, 100053, China
| | - Xi Chu
- Health Management Center, Xuanwu hospital, Capital Medical University, Beijing, 100053, China.
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053, China.
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Attia J, Horvat JC, Hunter T, Hansbro PM, Hure A, Peel R, Ren S, Dizon J, Chiu S, Srikusalanukul W, Greenough R, Abhayaratna WP. Persistence of Detectable Anti-Pneumococcal Antibodies 4 Years After Pneumococcal Polysaccharide Vaccination in a Randomised Controlled Trial: The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE). Heart Lung Circ 2023; 32:1378-1385. [PMID: 37919117 DOI: 10.1016/j.hlc.2023.09.006] [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: 06/04/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 11/04/2023]
Abstract
AIM Mouse models have indicated that the pneumococcal polysaccharide vaccine (PPV) can reduce atherosclerosis. This is probably through a process of molecular mimicry, where phosphorylcholine in the capsular polysaccharide of the vaccine elicits antibodies that cross-react with oxidised low-density lipoprotein and reduce plaque. We investigated whether a similar mechanism occurs in humans. METHODS A large national blinded, randomised, placebo-controlled trial of the PPV (Australian Study for the Prevention through Immunisation of Cardiovascular Events [AUSPICE]) is underway with fatal and nonfatal cardiovascular disease (CVD) events as the primary outcome. Participants at one centre agreed to a substudy measuring a number of biomarkers and surrogates of CVD over 4 years, including anti-pneumococcal antibodies (immunoglobulin G and immunoglobulin M), C-reactive protein, carotid intima-media thickness, pulse wave velocity, insulin, fasting blood glucose, glycated haemoglobin, and hepatorenal index. RESULTS Antipneumococcal immunoglobulin G and immunoglobulin M were both present and statistically significantly increased in the treated group compared to control at 4 years. However, there were no differences in any of the surrogate measures of CVD or metabolic markers at 4 years. CONCLUSIONS While there were prolonged differences in anti-pneumococcal antibody titres following PPV vaccination, these did not appear to provide any cardioprotective effect, as measured by a range of markers. Final results using the fatal and nonfatal CVD events await the completion of national health record linkage next year. TRIAL REGISTRATION ACTRN12615000536561.
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Affiliation(s)
- John Attia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
| | - Jay C Horvat
- Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Tegan Hunter
- Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Philip M Hansbro
- Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia; Centenary UTS Centre for Inflammation, Sydney, NSW, Australia
| | - Alexis Hure
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Shu Ren
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Joshua Dizon
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Simon Chiu
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Wichat Srikusalanukul
- Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| | | | - Walter P Abhayaratna
- Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
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Simon AB, Derella CC, Blackburn M, Thomas J, Layman LC, Nicholson MS, Waller J, Elmarakby A, Saad KM, Harris RA. Endogenous estradiol contributes to vascular endothelial dysfunction in premenopausal women with type 1 diabetes. Cardiovasc Diabetol 2023; 22:243. [PMID: 37679748 PMCID: PMC10486136 DOI: 10.1186/s12933-023-01966-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Endogenous estrogen is cardio-protective in healthy premenopausal women. Despite this favorable action of estrogen, animal models depict a detrimental effect of estradiol on vascular function in the presence of diabetes. The present study sought to determine the role of endogenous estradiol on endothelial function in women with type 1 diabetes. METHOD 32 women with type 1 diabetes (HbA1c = 8.6 ± 1.7%) and 25 apparently healthy women (HbA1c = 5.2 ± 0.3%) participated. Flow-mediated dilation (FMD), a bioassay of nitric-oxide bioavailability and endothelial function was performed during menses (M) and the late follicular (LF) phase of the menstrual cycle to represent low and high concentrations of estrogen, respectively. In addition, a venous blood sample was collected at each visit to determine circulating concentrations of estradiol, thiobarbituric acid reactive substances (TBARS), and nitrate/nitrite (NOx), biomarkers of oxidative stress and nitric oxide, respectively. Data were collected in (1) 9 additional women with type 1 diabetes using oral hormonal birth control (HBC) (HbA1c = 8.3 ± 2.1%) during the placebo pill week and second active pill week, and (2) a subgroup of 9 demographically matched women with type 1 diabetes not using HBC (HbA1c = 8.9 ± 2.1%). RESULTS Overall, estradiol was significantly increased during the LF phase compared to M in both type 1 diabetes (Δestradiol = 75 ± 86 pg/mL) and controls (Δestradiol = 71 ± 76 pg/mL); however, an increase in TBARS was only observed in patients with type 1 diabetes (ΔTBARS = 3 ± 13 µM) compared to controls (ΔTBARS = 0 ± 4 µM). FMD was similar (p = 0.406) between groups at M. In addition, FMD increased significantly from M to the LF phase in controls (p = 0.024), whereas a decrease was observed in type 1 diabetes. FMD was greater (p = 0.015) in patients using HBC compared to those not on HBC, independent of menstrual cycle phase. CONCLUSION Endogenous estradiol increases oxidative stress and contributes to endothelial dysfunction in women with diabetes. Additionally, HBC use appears to be beneficial to endothelial function in type 1 diabetes.
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Affiliation(s)
- Abigayle B Simon
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, Augusta, GA, 30912, Georgia
| | - Cassandra C Derella
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, Augusta, GA, 30912, Georgia
| | - Marsha Blackburn
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, Augusta, GA, 30912, Georgia
| | - Jeffrey Thomas
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, Augusta, GA, 30912, Georgia
| | - Lawrence C Layman
- Section of Reproductive Endocrinology, Infertility, & Genetics, Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, Georgia
| | - Matthew S Nicholson
- Department of Endocrinology, Medical College of Georgia, Augusta University, Augusta, GA, Georgia
| | - Jennifer Waller
- Department of Biostatistics and Data Science, Medical College of Georgia, Augusta University, Augusta, GA, Georgia
| | - Ahmed Elmarakby
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, Georgia
| | - Karim M Saad
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, Georgia
| | - Ryan A Harris
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, Augusta, GA, 30912, Georgia.
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Barhwal KK, Parida B, Pattnaik J, Rowlo P, Mahakud S, Patra S, Rao BN, Mahapatra B. Reduced reward responsiveness in treatment resistant depression of middle-aged adults: Association with carotid artery stiffness and tetrahydrobiopterin. PLoS One 2023; 18:e0290784. [PMID: 37651359 PMCID: PMC10470903 DOI: 10.1371/journal.pone.0290784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
Nearly one third of the population diagnosed with major depressive disorder (MDD) fail to respond to two or more antidepressant drugs of adequate dose and duration. This necessitates identification of confounding psychological and physiological factors that could contribute to treatment resistant depression (TRD). The present longitudinal study investigated the influence of behavioural inhibition system (BIS) and behavioural approach system (BAS) in treatment resistance. Further, the association of depression severity with physiological factors contributing to arterial stiffness was also investigated. Baseline data was acquired from 101 middle-aged (36-56 years) patients on immediate diagnosis with MDD using DSM-V criteria. Follow ups were conducted at 06 months and 12 months during treatment. Psychological assessment battery at baseline and follow ups comprised of Hamilton depression rating (HAM-D) for depression severity, WHODAS-2 and BIS-BAS score. Atherosclerosis and central arterial stiffness were measured by intima-media thickness of internal carotid artery and brachial-ankle pulse wave velocity. Physiological factors influencing central vascular function viz., body-mass index, estimated glomerular filtration rate, HbA1c, central systolic and diastolic blood pressure, heart rate and tetrahydrobiopterin were also investigated. Our results show lower reward responsiveness (BAS-RR) and higher BIS scores in TRD patients along with differentially higher intima-media thickness of left internal carotid artery. Higher depression severity at all stages of the study was correlated with lower tetrahydrobiopterin and BAS-RR scores. We, therefore, suggest that vascular depression resulting due to increased intima-media thickness of left carotid artery and lower tetrahydrobiopterin could be contributing factors for treatment resistance in middle-aged MDD patients.
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Affiliation(s)
- Kalpana K. Barhwal
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Barsha Parida
- Department of Physiology, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India
| | - Jigyansa Pattnaik
- Department of Psychiatry, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India
| | - Praveen Rowlo
- Department of Biomedical Sciences in Dentistry, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sudipta Mahakud
- Department of Radiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Bodepudi N. Rao
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
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Ucar AK, Ozdede A, Kayadibi Y, Adaletli I, Melikoglu M, Fresko I, Seyahi E. INCREASED ARTERIAL STIFFNESS AND ACCELERATED ATHEROSCLEROSIS IN TAKAYASU ARTERITIS. Semin Arthritis Rheum 2023; 60:152199. [PMID: 37011578 DOI: 10.1016/j.semarthrit.2023.152199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Cardiovascular diseases are the leading causes of morbidity and mortality in patients with Takayasu arteritis (TAK). Arterial stiffness and accelerated atherosclerosis have been reported in TAK, however, morphological changes in the arterial wall have not been adequately addressed. Shear wave elastography (SWE) is a new, non-invasive, direct and quantitative method of ultrasonography (US) that evaluates elasticity of biological tissues. METHODS A total of 50 patients with TAK (44F/6 M; mean age: 39.8 ± 8.2 years), 43 with systemic lupus erythematosus (SLE) (38F/5 M; 38.0 ± 7.9 years) and 57 healthy controls (HCs) (50F/7M: 39.5 ± 7.1 years) were studied using carotid B mode US and SWE. Carotid artery intima-media thickness (CCA IMT) and SWE were measured and the atherosclerotic plaques were recorded. Clinical characteristics and cardiovascular risk factors were determined. Intra and inter observer reproducibility was assessed and found good agreement. RESULTS The mean IMT in the right and left carotid arteries was significantly higher only among patients with TAK when compared to SLE and HCs. Carotid artery plaques were significantly increased only in patients with TAK. On the other hand, the mean SWE value was significantly increased among both TAK and SLE patients when compared to HCs, whereas patients with TAK had the highest value. These were also true after adjustments were made for atherosclerotic risk factors and after all those with atherosclerotic plaques were excluded from the analysis. TAK itself, diastolic blood pressure levels and IMT were independently associated with SWE. CONCLUSIONS Markedly increased CCA IMT and SWE values appear to be uniquely associated with TAK, suggesting that they could be used as diagnostic tools. Arterial stiffness occurs independently from atherosclerosis and is associated with arterial thickening. Further studies should investigate whether CCA SWE values could predict cardiovascular morbidity and mortality. Strong association with premature atherosclerosis could be also considered as a unique feature of TAK.
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Affiliation(s)
- Ayse Kalyoncu Ucar
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayse Ozdede
- Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 81310, Turkey
| | - Yasemin Kayadibi
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ibrahim Adaletli
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melike Melikoglu
- Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 81310, Turkey
| | - Izzet Fresko
- Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 81310, Turkey
| | - Emire Seyahi
- Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 81310, Turkey.
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Moriconi D, Nannipieri M, Armenia S, Boutouryie P, Taddei S, Bruno RM. Morbid obesity is associated with hypertrophic outward remodeling and increased stiffness of small conduit arteries: An ultra-high frequency ultrasound study. Nutr Metab Cardiovasc Dis 2023; 33:408-415. [PMID: 36604263 DOI: 10.1016/j.numecd.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/24/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND AIMS Although many studies have been published on the effect of obesity on large and small arteries, there are no data in the literature regarding the effect of obesity on medium-sized arteries, and in particular of small conduit arteries. The aim of the present study was to investigate whether patients with severe obesity presented structural or functional alterations in different arterial segments. METHODS AND RESULTS 34 patients with severe obesity (BMI≥35 kg/m2) and 34 age-and sex-matched normal weight patients were recruited as controls. Aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid, radial and interdigital arteries were acquired for the assessment of wall-to-lumen ratio, wall cross-sectional area (WCSA), compliance, distensibility coefficient (DC) and Young's elastic modulus (Einc). Insulin sensitivity was calculated by oral glucose sensitivity index (OGIS). No differences between groups in carotid artery remodeling were found, while WCSA of the radial and interdigital arteries were higher in obese group than in controls. As regard the parameters of vascular elasticity, the DC of radial and interdigital arteries were lower (p = 0.025 and p = 0.001, respectively), as well as the Einc of radial arteries was higher (p = 0.021), in subject with obesity compared to controls. All these correlations were consistent after adjustment for the main covariates. Finally, in a multiple regression analysis OGIS was and independent determinant of interdigital artery DC (R2 = 0.29, p = 0.001). CONCLUSIONS For the first time, we describe an outward remodeling and increased stiffness in small conduit arteries in severe obesity.
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Affiliation(s)
- Diego Moriconi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Silvia Armenia
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Pierre Boutouryie
- Service de Pharmacologie, AP-HP, Hôpital Europeen Georges Pompidou, France; Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Rosa Maria Bruno
- Service de Pharmacologie, AP-HP, Hôpital Europeen Georges Pompidou, France; Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
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Lee SJ, Lee JS, Kim M, Park SY, Park JH, Park B, Jung WS, Choi JW, Hong JM. Influence of endothelial function and arterial stiffness on the behavior of cervicocephalic arterial dissections: An observational study. Front Neurol 2022; 13:968488. [PMID: 36105775 PMCID: PMC9464973 DOI: 10.3389/fneur.2022.968488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background The mechanical and physiological properties of the arterial wall might affect the behavior of spontaneous cervicocephalic arterial dissections (CCAD). We aimed to determine the effects of endothelial function and arterial stiffness on the clinical characteristics and outcomes of CCAD using brachial flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (PWV). Methods From a single-center database, we identified patients admitted from April 2011 to December 2021 with a diagnosis of CCAD who underwent both FMD and PWV. FMD was classified as normal and decreased according to institutional thresholds. PWV was categorized into tertiles. Comparative and multivariable analyses were performed to determine the effects of FMD and PWV values on major clinical outcomes. Results A total of 146 patients (age: 47 ± 11 years; men: 77.4%) were included. The main presentation was ischemic stroke in 76.7% of the patients, while 23.3% presented with headache or other symptoms. Healing of the dissection was observed in 55.8%. In multivariable analysis, Normal FMD levels (vs. decreased; adjusted OR: 4.52, 95% CI [1.95 −10.52]) were associated with spontaneous healing of the dissection. Highest PWV tertile (vs. lowest; adjusted OR: 17.05, 95% CI [3.07–94.82]) was associated with ischemic presentation. There was a higher ischemic stroke recurrence in the 3rd PWV tertile, and more frequent aneurysmal enlargement in the lowest PWV tertile, but their frequency was low, precluding multivariable analysis. Conclusion In spontaneous CCAD, preserved endothelial function was associated with spontaneous arterial healing. Arterial stiffness is associated with ischemic presentation.
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Affiliation(s)
- Seong-Joon Lee
- Department of Neurology, Ajou University School of Medicine, Suwon-si, South Korea
- *Correspondence: Seong-Joon Lee
| | - Jin Soo Lee
- Department of Neurology, Ajou University School of Medicine, Suwon-si, South Korea
| | - Min Kim
- Department of Neurology, Ajou University School of Medicine, Suwon-si, South Korea
| | - So Young Park
- Department of Neurology, Ajou University School of Medicine, Suwon-si, South Korea
| | - Ji Hyun Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon-si, South Korea
| | - Bumhee Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon-si, South Korea
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon-si, South Korea
| | - Woo Sang Jung
- Department of Radiology, Ajou University School of Medicine, Suwon-si, South Korea
| | - Jin Wook Choi
- Department of Radiology, Ajou University School of Medicine, Suwon-si, South Korea
| | - Ji Man Hong
- Department of Neurology, Ajou University School of Medicine, Suwon-si, South Korea
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10
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Seki M, Minami T. Kawasaki Disease: Pathology, Risks, and Management. Vasc Health Risk Manag 2022; 18:407-416. [PMID: 35711626 PMCID: PMC9196282 DOI: 10.2147/vhrm.s291762] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Kawasaki disease (KD), first reported as an acute febrile mucocutaneous lymph node syndrome, is a self-limiting vasculitis of unknown etiology. The most important aspect of KD is the prevention of coronary artery lesion (CAL) because myocardial ischemia or infarction due to CAL might be lethal. In addition to the CAL, patients with KD develop systemic vasculitis, which indicates the presence of vascular endothelial damage. Studies assessing pulse wave velocity or percentage change in flow-mediated dilatation have shown that aortic stiffness is increased in patients with KD history. In contrast, the cardio-ankle vascular index, a novel parameter not affected by blood pressure, has not demonstrated increased aortic stiffness in patients with KD. Although many studies using various parameters have suggested a risk of atherosclerosis in patients with a history of KD, a few others have reported no significant differences between KD patients and controls. Therefore, it will be necessary to thoroughly understand the characteristics of each parameter, before evaluating the results of those studies, to understand systemic vascular dysfunction in these populations, and to manage their vascular health. Although it is controversial whether the risk of atherosclerosis in patients with KD is higher, those with CAL are thought to be at a high risk of atherosclerosis. Therefore, appropriate treatment to prevent CAL in the acute phase and subsequent regular follow-up is important. Here, we review the pathology, risk, and management of vascular disorders, especially systemic vascular disorders, in patients with KD history.
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Affiliation(s)
- Mitsuru Seki
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Takaomi Minami
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
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11
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Oreska S, Storkanova H, Kudlicka J, Tuka V, Mikes O, Krupickova Z, Satny M, Chytilova E, Kvasnicka J, Spiritovic M, Hermankova B, Cesak P, Rybar M, Pavelka K, Senolt L, Mann H, Vencovsky J, Vrablik M, Tomcik M. Cardiovascular Risk in Myositis Patients Compared to the General Population: Preliminary Data From a Single-Center Cross-Sectional Study. Front Med (Lausanne) 2022; 9:861419. [PMID: 35602501 PMCID: PMC9118331 DOI: 10.3389/fmed.2022.861419] [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: 01/24/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Idiopathic inflammatory myopathies (IIM) are associated with systemic inflammation, limited mobility, and glucocorticoid therapy, all of which can lead to metabolism disturbances, atherogenesis, and increased cardiovascular (CV) risk. The aim of this study was to assess the CV risk in IIM patients and healthy controls (HC), and its association with disease-specific features. Methods Thirty nine patients with IIM (32 females; mean age 56; mean disease duration 4.8 years; dermatomyositis: n = 16, polymyositis: n = 7, immune-mediated necrotizing myopathy: n = 8, anti-synthetase syndrome: n = 8) and 39 age-/sex-matched HC (32 females, mean age 56) without rheumatic diseases were included. In both groups, subjects with a history of CV disease (angina pectoris, myocardial infarction, cerebrovascular, and peripheral arterial vascular events) were excluded. Muscle involvement, disease activity, and tissue damage were evaluated (Manual Muscle Test-8, Myositis Intention to Treat Activity Index, Myositis Damage Index). Comorbidities and current treatment were recorded. All participants underwent examinations of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), ankle-brachial index (ABI), and body composition (by densitometry and bioelectric impedance). The risk of fatal CV events was evaluated by the Systematic COronary Risk Evaluation (SCORE, charts for the European population) and its modifications. Results Compared to HC, there was no significant difference in IIM patients regarding blood pressure, ABI, PWV, CIMT, and the risk of fatal CV events by SCORE or SCORE2, or subclinical atherosclerosis (CIMT, carotid plaques, ABI, and PWV). The calculated CV risk scores by SCORE, SCORE2, and SCORE multiplied by the coefficient 1.5 (mSCORE) were reclassified according to the results of carotid plaque presence and CIMT; however, none of them was demonstrated to be significantly more accurate. Other significant predictors of CV risk in IIM patients included age, disease duration and activity, systemic inflammation, lipid profile, lean body mass, and blood pressure. Conclusions No significant differences in CV risk factors between our IIM patients and HC were observed. However, in IIM, CV risk was associated with age, disease duration, duration of glucocorticoid therapy, lipid profile, and body composition. None of the currently available scoring tools (SCORE, SCORE2, mSCORE) used in this study seems more accurate in estimating CV risk in IIM.
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Affiliation(s)
- Sabina Oreska
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Hana Storkanova
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Jaroslav Kudlicka
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Vladimir Tuka
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Ondrej Mikes
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Zdislava Krupickova
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Martin Satny
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Eva Chytilova
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Jan Kvasnicka
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Maja Spiritovic
- Institute of Rheumatology, Prague, Czechia.,Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Barbora Hermankova
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Petr Cesak
- Department of Human Movement Laboratory, Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Marian Rybar
- Faculty of Mathematics and Physics, Charles University, Prague, Czechia
| | - Karel Pavelka
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Ladislav Senolt
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Herman Mann
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Jiri Vencovsky
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Michal Vrablik
- 3rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Michal Tomcik
- Institute of Rheumatology, Prague, Czechia.,Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czechia
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12
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Cheok A, Xu Y, Zhang Z, Caton PW, Rodriguez-Mateos A. Betalain-rich dragon fruit (pitaya) consumption improves vascular function in men and women: a double-blind, randomized controlled crossover trial. Am J Clin Nutr 2022; 115:1418-1431. [PMID: 35265960 DOI: 10.1093/ajcn/nqab410] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Betalains are natural red color pigments abundant in red-fleshed dragon fruit (Hylocereus polyrhizus). Recent research has shown that dragon fruit consumption may help improve blood glucose and lipid profile. However, investigations of its cardioprotective properties in human trials, especially in nutritionally achievable amounts, remain nonexistent. OBJECTIVES The aim of this study was to investigate the effects of acute and short-term consumption of dragon fruit on vascular function in a healthy population. METHODS A randomized, double-blind, placebo-controlled, crossover trial was conducted in 19 young, healthy, nonsmoking men and women assigned to consume 24 g whole dragon fruit powder (33 mg betalains) or a nutrient-matched placebo, daily for 14 d. Flow-mediated dilation (FMD), arterial stiffness, and blood pressure (BP) were measured at 0 h, 1 h, 2 h, 3 h, and 4 h and finally at 14 d after daily consumption. RESULTS A total of 18 participants completed the trial. Dragon fruit consumption significantly improved acute FMD at 2 h (+0.8 ± 0.3%, P = 0.01), 3 h (+1.0 ± 0.3%, P = 0.001), and 4 h (+1.3 ± 0.4%, P < 0.001) postconsumption compared with placebo. This effect was sustained up until 14 d (+1.3 ± 0.2%, P < 0.001). Pulse-wave velocity was acutely significantly reduced at 3 h (-0.5 ± 0.2 m/s, P = 0.003), whereas augmentation index (AIx) also improved after 14 d (-7.0 ± 3.3%, P = 0.02) when compared with placebo. No differences were found in either peripheral or central BP across all time points. CONCLUSIONS Acute and short-term consumption of dragon fruit in dietary achievable amounts improved endothelial function and arterial stiffness in healthy individuals. This implies that regular dragon fruit consumption may have a meaningful impact on cardiovascular disease risk likely due to the high betalain content. This trial was registered at ClinicalTrials.gov as NCT03995602.
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Affiliation(s)
- Alex Cheok
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Yifan Xu
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Zicheng Zhang
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Paul W Caton
- Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King's College London, London, United Kingdom.,Department of Diabetes, School of Life Course and Population Sciences, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - 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, United Kingdom
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13
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Gong L, Liu Y. Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations. Int J Sports Med 2022; 43:996-1012. [PMID: 35468651 PMCID: PMC9622304 DOI: 10.1055/a-1795-2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The purpose was to analyze the effects of exercise training (ET) on arterial
stiffness in all-age overweight or obese individuals. Sixty-one trials were
included with ET improving flow-mediated dilation (FMD), pulse wave velocity
(PWV), and intima-media thickness (IMT). In the subgroup analysis: (i) ET
improved FMD in overweight or obese children and adolescents with a large effect
size (SMD=0.83, 95% CI 0.42–1.25). PWV was decreased
after ET regardless of age. IMT was decreased by ET in participants younger than
60, (ii) ET improved FMD, PWV, and IMT in participants whose BMI were smaller
than 30 kg/m
2
, but ET only improved PWV of
participants whose BMI were larger than 30 kg/m
2
.
(iii) AE improved FMD, PWV, and IMT. High-intensity interval training (HIIT)
decreased IMT. (iv) The increase of FMD only happened when training duration was
longer than eight weeks. However, ET decreased PWV when the training duration
was no longer than 12 weeks. IMT was decreased when the training duration was
longer than eight weeks. ET instigated an improvement in endothelial function
and arterial stiffness in overweight or obese populations, but depending on the
different characteristics of exercise intervention and participants’
demographics.
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Affiliation(s)
- Lijing Gong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China
| | - Yujia Liu
- Physical education, Jiangsu Normal University, Xuzhou, China
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14
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Ren S, Hansbro PM, Srikusalanukul W, Horvat JC, Hunter T, Brown AC, Peel R, Faulkner J, Evans TJ, Li SC, Newby D, Hure A, Abhayaratna WP, Tsimikas S, Gonen A, Witztum JL, Attia J, Hansbro PM, Peel R, Srikusalanukul W, Abhayaratna W, Newby D, Hure A, D'Este C, Tonkin A, Hopper I, Thrift A, Levi C, Sturm J, Durrheim D, Hung J, Briffa T, Chew D, Anderson P, Moon L, McEvoy M, Attia J. Generation of cardio-protective antibodies after pneumococcal polysaccharide vaccine: Early results from a randomised controlled trial. Atherosclerosis 2022; 346:68-74. [PMID: 35290813 DOI: 10.1016/j.atherosclerosis.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND AIMS Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may be mediated through IgM antibodies to OxLDL, which have previously been associated with cardioprotective effects. The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is a double-blind, randomised controlled trial (RCT) of PPV in preventing ischaemic events. Participants received PPV or placebo once at baseline and are being followed-up for incident fatal and non-fatal myocardial infarction or stroke over 6 years. METHODS A subgroup of participants at one centre (Canberra; n = 1,001) were evaluated at 1 month and 2 years post immunisation for changes in surrogate markers of atherosclerosis, as pre-specified secondary outcomes: high-sensitive C-reactive protein (CRP), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT). In addition, 100 participants were randomly selected in each of the intervention and control groups for measurement of anti-pneumococcal antibodies (IgG, IgG2, IgM) as well as anti-OxLDL antibodies (IgG and IgM to CuOxLDL, MDA-LDL, and PC-KLH). RESULTS Concentrations of anti-pneumococcal IgG and IgG2 increased and remained high at 2 years in the PPV group compared to the placebo group, while IgM increased and then declined, but remained detectable, at 2 years. There were statistically significant increases in all anti-OxLDL IgM antibodies at 1 month, which were no longer detectable at 2 years; there was no increase in anti-OxLDL IgG antibodies. There were no significant changes in CRP, PWV or CIMT between the treatment groups at the 2-year follow-up. CONCLUSIONS PPV engenders a long-lasting increase in anti-pneumococcal IgG, and to a lesser extent, IgM titres, as well as a transient increase in anti-OxLDL IgM antibodies. However, there were no detectable changes in surrogate markers of atherosclerosis at the 2-year follow-up. Long-term, prospective follow-up of clinical outcomes is continuing to assess if PPV reduces CVD events.
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Affiliation(s)
- Shu Ren
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Philip M Hansbro
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Centenary UTS Centre for Inflammation, Sydney, NSW, Australia
| | - Wichat Srikusalanukul
- Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| | - Jay C Horvat
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Tegan Hunter
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Alexandra C Brown
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.
| | - Jack Faulkner
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | | | - Shu Chuen Li
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - David Newby
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Alexis Hure
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Walter P Abhayaratna
- Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| | - Sotirios Tsimikas
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Ayelet Gonen
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Joseph L Witztum
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
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15
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Goswami N, Fredriksen PM, Lundin KEA, Agu C, Elias SO, Motaung KS, Brix B, Cvirn G, Sourij H, Stelzl E, Kessler HH, Saloň A, Nkeh-Chungag B. COVID-19 and its effects on endothelium in HIV-positive patients in sub-Saharan Africa: Cardiometabolic risk, thrombosis and vascular function (ENDOCOVID STUDY). BMC Infect Dis 2021; 21:719. [PMID: 34332551 PMCID: PMC8325201 DOI: 10.1186/s12879-021-06426-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/10/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND COVID-19 has affected almost every country in the world, especially in terms of health system capacity and economic burden. People from sub-Saharan Africa (SSA) often face interaction between human immunodeficiency virus (HIV) infection and non-communicable diseases such as cardiovascular disease. Role of HIV infection and anti-retroviral treatment (ART) in altered cardiovascular risk is questionable and there is still need to further carry out research in this field. However, thus far it is unclear, what impact the COVID-19 co-infection in people living with HIV (PLHIV), with or without therapy will have. The ENDOCOVID project aims to investigate whether and how HIV-infection in COVID-19 patients modulates the time course of the disease, alters cardiovascular risk, and changes vascular endothelial function and coagulation parameters/ thrombosis risk. METHODS A total of 1026 patients will be included into this study. Cardiovascular research PLHIV with (n = 114 in each of the three recruiting centers) - or without - ART (n = 114 in each of the three recruiting centers) with COVID-19 and HIV-negative with COVID-19 (n = 114 in each of the three recruiting centers) will be carried out via clinical and biochemical measurements for cardiovascular risk factors and biomarkers of cardiovascular disease (CVD). Vascular and endothelial function will be measured by brachial artery flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) assessments, and retinal blood vessel analyses, along with vascular endothelial biomarkers and cogualation markers. The correlation between HIV-infection in COVID-19 PLHIV with or without ART and its role in enhancement of cardiovascular risk and endothelial dysfunction will be assessed at admission, weekly, at discharge and, 4 weeks post-discharge (if possible). IMPACT OF PROJECT The ENDOCOVID project aims to evaluate in the long-term the cardiovascular risk and vascular endothelial function in PLHIV thus revealing an important transitional cardiovascular phenotype in COVID-19. The study was registered under clinicaltrials.gov (NCT04709302).
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Affiliation(s)
- Nandu Goswami
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria.
- Divison of Health Sciences, Alma Mater Europea Maribor, Maribor, Slovenia.
- Department of Biological & Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University (WSU), Mthatha, South Africa.
| | - Per Morten Fredriksen
- School of Health Sciences, Kristiania University College, Prinsensgate 7-9, 0152, Oslo, Norway
| | - Knut E A Lundin
- KG Jebsen Coeliac Disease Research Centre, University of Oslo and Oslo University Hospital- Rikshospitalet, 0372, Oslo, Norway
| | - Chidozie Agu
- Management Sciences for Health, Global Fund RSSH Project, Abuja, Nigeria
| | - Simiat Olanike Elias
- Department of Physiology, Faculty of Basic Medical Sciences, University College of Medicine, Lagos, Nigeria
| | - Keolebogile Shirley Motaung
- Department of Technology Transfer & Innovation, Durban University of Technology, Tromso Annex, Steve Biko Campus, Durban, 4000, South Africa
| | - Bianca Brix
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria
| | - Gerhard Cvirn
- Physiological Chemistry Section, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Harald Sourij
- Clinical Division for Endocrinology and Diabetology, Medical University Graz, Graz, Austria
| | - Evelyn Stelzl
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Harald H Kessler
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Adam Saloň
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, A-8010, Graz, Austria
| | - Benedicta Nkeh-Chungag
- Department of Biological & Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University (WSU), Mthatha, South Africa
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16
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Wolters TLC, van der Heijden CDCC, Pinzariu O, Hijmans-Kersten BTP, Jacobs C, Kaffa C, Hoischen A, Netea MG, Smit JWA, Thijssen DHJ, Georgescu CE, Riksen NP, Netea-Maier RT. The association between treatment and systemic inflammation in acromegaly. Growth Horm IGF Res 2021; 57-58:101391. [PMID: 33964727 DOI: 10.1016/j.ghir.2021.101391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Acromegaly is characterized by an excess of growth hormone (GH) and insulin like growth-factor 1 (IGF1), and it is strongly associated with cardiovascular diseases (CVD). Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Previous results suggest the presence of systemic inflammation in treated patients. Here we assessed the association between treatment of acromegaly, systemic inflammation and vascular function. DESIGN Ex vivo cytokine production and circulating inflammatory markers were assessed in peripheral blood from treated and untreated acromegaly patients (N = 120), and compared them with healthy controls. A more comprehensive prospective inflammatory and vascular assessment was conducted in a subgroup of six treatment-naive patients with follow-up during treatment. RESULTS Circulating concentrations of VCAM1, E-selectin and MMP2 were higher in patients with uncontrolled disease, whereas the concentrations of IL18 were lower. In stimulated whole blood, cytokine production was skewed towards a more pro-inflammatory profile in patients, especially those with untreated disease. Prospective vascular measurements in untreated patients showed improvement of endothelial function during treatment. CONCLUSIONS Acromegaly patients are characterized by a pro-inflammatory phenotype, most pronounced in those with uncontrolled disease. Treatment only partially reverses this pro-inflammatory bias. These findings suggest that systemic inflammation could contribute to the increased risk of CVD in acromegaly patients.
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Affiliation(s)
- T L C Wolters
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - C D C C van der Heijden
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, the Netherlands
| | - O Pinzariu
- 6(th) Department of Medical Sciences, Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - B T P Hijmans-Kersten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C Jacobs
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C Kaffa
- Centre for Molecular and Biomolecular Informatics (CMBI), Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A Hoischen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M G Netea
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; Department for Genomics & Immunoregulation, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - J W A Smit
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom
| | - C E Georgescu
- 6(th) Department of Medical Sciences, Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Endocrinology Clinic, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - N P Riksen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R T Netea-Maier
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
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17
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Fagundes RR, Vitorino PVO, Lelis EDS, Jardim PCBV, Souza ALL, Jardim TDSV, Cunha PMGM, Barroso WKS. Relationship between Pulse Wave Velocity and Cardiovascular Biomarkers in Patients with Risk Factors. Arq Bras Cardiol 2021; 115:1125-1132. [PMID: 33470311 PMCID: PMC8133733 DOI: 10.36660/abc.20190348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The relationship between pulse wave velocity (PWV) and biomarkers of structural changes of the left ventricle and carotid arteries remains poorly understood. OBJECTIVE To investigate the relationship between PWV and these biomarkers. METHODS This was an analytical, retrospective, cross-sectional study. Medical records of patients with diabetes mellitus, dyslipidemia, and pre-hypertension or hypertension, who underwent central blood pressure (CBP) measurement using Mobil-O-Graph®, and carotid doppler or echocardiography three months before and after the CBPM were analyzed. Statistical analysis was performed using Pearson or Spearman correlation, linear bivariate and multiple regression analysis, and the t test (independent) or Mann-Whitney test. A p <0.05 indicated statistical significance. RESULTS Medical records of 355 patients were analyzed, mean age 56.1 (±14.8) years, 51% male. PWV was correlated with intima-media thickness (IMT) of carotids (r=0.310) and left ventricular septal thickness (r=0.191), left ventricular posterior wall thickness (r=0.215), and left atrial diameter (r=0.181). IMT was associated with PWV adjusted by age and peripheral systolic pressure (p=0.0004); IMT greater than 1 mm increased the chance of having PWV above 10 m/s by 3.94 times. PWV was significantly higher in individuals with left ventricular hypertrophy (p=0.0001), IMT > 1 mm (p=0.006), carotid plaque (p=0.0001), stenosis ≥ 50% (p=0.003), and target-organ damage (p=0.0001). CONCLUSION PWV was correlated with IMT and echocardiographic parameters, and independently associated with IMT. This association was stronger in individuals with left ventricular hypertrophy, increased IMT, carotid plaque, stenosis ≥ 50%, and target organ damage. (Arq Bras Cardiol. 2020; 115(6):1125-1132).
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Affiliation(s)
| | | | - Ellen de Souza Lelis
- Pontifícia Universidade Católica de Goiás - Escola de Ciências Sociais e da Saúde, Goiânia, GO - Brasil
| | | | - Ana Luiza Lima Souza
- Universidade Federal de Goiás,Goiânia, GO - Brasil.,Universidade Federal de Goiás - Liga de Hipertensão, Goiânia, GO - Brasil
| | - Thiago de Souza Veiga Jardim
- Universidade Federal de Goiás,Goiânia, GO - Brasil.,Universidade Federal de Goiás - Liga de Hipertensão, Goiânia, GO - Brasil
| | | | - Weimar Kunz Sebba Barroso
- Universidade Federal de Goiás,Goiânia, GO - Brasil.,Universidade Federal de Goiás - Liga de Hipertensão, Goiânia, GO - Brasil
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18
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Abstract
Acromegaly is characterized by Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-1) excess. Uncontrolled acromegaly is associated with a strongly increased risk of cardiovascular disease (CVD), and numerous cardiovascular risk factors remain present after remission. GH and IGF-1 have numerous effects on the immune and cardiovascular system. Since endothelial damage and systemic inflammation are strongly linked to the development of CVD, and have been suggested to be present in both controlled as uncontrolled acromegaly, they may explain the presence of both micro- and macrovascular dysfunction in these patients. In addition, these changes seem to be only partially reversible after remission, as illustrated by the often reported presence of endothelial dysfunction and microvascular damage in controlled acromegaly. Previous studies suggest that insulin resistance, oxidative stress, and endothelial dysfunction are involved in the development of CVD in acromegaly. Not surprisingly, these processes are associated with systemic inflammation and respond to GH/IGF-1 normalizing treatment.
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Affiliation(s)
- Thalijn L C Wolters
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
- Department for Genomics & Immunoregulation, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Niels P Riksen
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
| | - Adrianus R M M Hermus
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
| | - Romana T Netea-Maier
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands
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19
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Barroso WKS, Melo MDA, Vitorino PV, Gonçalves C, Berigó JA, Arantes AC, Rezende J, Jardim TV, Souza ALL, Jardim PCV. Carotid Intima and Media Thickness Correlation with Central Blood Pressure Measurements by Tonometric and Oscillometric Methods: A Proof of Concept. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20190117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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20
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Shirokane K, Tamaki T, Kim K, Tsuchiya M, Yamazaki M, Morita A. Relationship between Flow-mediated Endothelial Vasodilation and the Pulse Wave Velocity, and Cervical Carotid Artery Stenosis. Neurol Med Chir (Tokyo) 2020; 60:293-298. [PMID: 32404574 PMCID: PMC7301127 DOI: 10.2176/nmc.oa.2019-0193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Carotid artery stenosis is elicited by atherosclerosis and is the main cause of cerebral thrombosis. Flow-mediated endothelial vasodilation (FMD) can be measured noninvasively to assess vascular endothelial function related to atherosclerosis. The pulse wave velocity (PWV) is used to evaluate the vascular media involved in atherosclerosis. We investigated the relationship between these measurements in 75 consecutive patients with atherosclerotic cerebral thrombosis. They were assigned to three equal groups based on the severity of carotid artery stenosis on ultrasonograms. Group 1 had no stenosis, group 2 manifested moderate stenosis (<60%), and group 3 presented with severe stenosis (≥60%). We compared the FMD and PWV among the three groups. The PWV was significantly lower in group 1 than the other two groups. The FMD was significantly lower in group 3; it was significantly lower in group 2 than group 1. There was an inverse correlation between the FMD and the severity of carotid artery stenosis. Our findings show that for assessing the severity of carotid artery stenosis, the FMD is more useful than the PWV.
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Affiliation(s)
- Kazutaka Shirokane
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School.,Department of Neurological Surgery, Chiba Hokusoh Hospital, Nippon Medical School
| | - Tomonori Tamaki
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School
| | - Kyongsong Kim
- Department of Neurological Surgery, Chiba Hokusoh Hospital, Nippon Medical School
| | | | - Michio Yamazaki
- Department of Neurological Surgery, Tama Nagayama Hospital, Nippon Medical School
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21
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Kartal Öztürk G, Conkar S, Eşki A, Gülen F, Keskinoğlu A, Demir E. Evaluation of increased arterial stiffness in pediatric patients with cystic fibrosis by augmentation index and pulse wave velocity analysis. Pediatr Pulmonol 2020; 55:1147-1153. [PMID: 32057197 DOI: 10.1002/ppul.24688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/03/2020] [Indexed: 01/04/2023]
Abstract
With the increase in life expectancy, cardiovascular complications of cystic fibrosis (CF) have come to the forefront. Increased arterial stiffness is a marker of increased cardiovascular risk. The aim of this study was to compare both pulse wave velocity (PWV) and augmentation index (Aix) measurements in children with CF and to compare them with healthy controls. We hypothesized that children with CF had increased arterial stiffness, although traditional risk factors for CVD were not observed. Forty-four patients and age and sex-matched 30 healthy controls were included in the study. Hemodynamic measurements were compared in both groups, together with traditional risk factors. Peripheral blood pressure parameters of CF and control groups were similar (P > .05). Bodyweight and BMI were significantly lower in the CF group (P < .001). Serum cholesterol, HDL, and LDL levels were significantly lower in the CF group, whereas fasting blood glucose and triglyceride levels were significantly higher than the control group (P < .05). Mean ± SD Aix was significantly higher in the CF group (33.22 ± 13.87%) compared with the control group (24.93 ± 10.58%), respectively (P < .05), while PWV was similar. No significant correlation between PWV and Aix and fasting blood glucose and lipid profile in both groups (P > .05). Children with CF have been shown to have increased arterial stiffness compared to healthy children. Although there are not many traditional risk factors, increased arterial stiffness have been demonstrated in children with CF. The effects of this process starting from childhood on the development of CVD in adulthood are not known. Therefore, further studies are needed.
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Affiliation(s)
- Gökçen Kartal Öztürk
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Seçil Conkar
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Aykut Eşki
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Figen Gülen
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Ahmet Keskinoğlu
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Esen Demir
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Turkey
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22
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Sabbatinelli J, Orlando P, Galeazzi R, Silvestri S, Cirilli I, Marcheggiani F, Dludla PV, Giuliani A, Bonfigli AR, Mazzanti L, Olivieri F, Antonicelli R, Tiano L. Ubiquinol Ameliorates Endothelial Dysfunction in Subjects with Mild-to-Moderate Dyslipidemia: A Randomized Clinical Trial. Nutrients 2020; 12:nu12041098. [PMID: 32326664 PMCID: PMC7231284 DOI: 10.3390/nu12041098] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/07/2023] Open
Abstract
In this randomized, double-blind, single-center trial (ANZCTR number ACTRN12619000436178) we aimed to investigate changes in endothelium-dependent vasodilation induced by ubiquinol, the reduced form of coenzyme Q10 (CoQ10), in healthy subjects with moderate dyslipidemia. Fifty-one subjects with low-density lipoprotein (LDL) cholesterol levels of 130–200 mg/dL, not taking statins or other lipid lowering treatments, moderate (2.5%–6.0%) endothelial dysfunction as measured by flow-mediated dilation (FMD) of the brachial artery, and no clinical signs of cardiovascular disease were randomized to receive either ubiquinol (200 or 100 mg/day) or placebo for 8 weeks. The primary outcome measure was the effect of ubiquinol supplementation on FMD at the end of the study. Secondary outcomes included changes in FMD on week 4, changes in total and oxidized plasma CoQ10 on week 4 and week 8, and changes in serum nitrate and nitrite levels (NOx), and plasma LDL susceptibility to oxidation in vitro on week 8. Analysis of the data of the 48 participants who completed the study demonstrated a significantly increased FMD in both treated groups compared with the placebo group (200 mg/day, +1.28% ± 0.90%; 100 mg/day, +1.34% ± 1.44%; p < 0.001) and a marked increase in plasma CoQ10, either total (p < 0.001) and reduced (p < 0.001). Serum NOx increased significantly and dose-dependently in all treated subjects (p = 0.016), while LDL oxidation lag time improved significantly in those receiving 200 mg/day (p = 0.017). Ubiquinol significantly ameliorated dyslipidemia-related endothelial dysfunction. This effect was strongly related to increased nitric oxide bioavailability and was partly mediated by enhanced LDL antioxidant protection.
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Affiliation(s)
- Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy
- Correspondence: ; Tel.: +39-0712206243
| | - Patrick Orlando
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
| | - Roberta Galeazzi
- Clinical Laboratory and Molecular Diagnostics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy
| | - Sonia Silvestri
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
| | - Ilenia Cirilli
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
| | - Fabio Marcheggiani
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
| | - Phiwayinkosi V. Dludla
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
- Biomedical Research and Innovation Platform, South African Medical Research Council, P.O. Box 19070, Tygerberg, South Africa
| | - Angelica Giuliani
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy
| | - Anna Rita Bonfigli
- Scientific Direction, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy
| | - Laura Mazzanti
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, 60121 Ancona, Italy
| | | | - Luca Tiano
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60128 Ancona, Italy
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23
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Lambrinoudaki I, Stergiotis S, Chatzivasileiou P, Augoulea A, Anagnostis P, Armeni E, Rizos D, Kaparos G, Alexandrou A, Georgiopoulos G, Kontogiannis C, Stamatelopoulos K. Anti-Müllerian Hormone Concentrations Are Inversely Associated With Subclinical Atherosclerosis in Premenopausal Women. Angiology 2020; 71:552-558. [DOI: 10.1177/0003319720914493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anti-Müllerian hormone (AMH), which is secreted by granulosa cells of late preantral and small antral follicles, is a marker of ovarian reserve. The association of ovarian reserve with subclinical atherosclerosis in women of reproductive age is currently unknown. We primary investigated whether AMH levels are associated with markers of subclinical atherosclerosis in healthy, normally menstruating women. In this cross-sectional study, vascular structure and function were assessed by measurement of carotid and femoral intima–media thickness (IMT), flow-mediated dilation, carotid–femoral pulse wave velocity and augmentation index. Lipid profile and serum AMH concentrations were also measured. Seventy premenopausal women, aged 32.7 ± 6.5 years, were included. Mean AMH levels were lower in smokers than in non-smokers and negatively associated with total cholesterol (TC) levels. An inverse association between mean AMH concentrations and femoral and carotid IMT in all segments was observed. No correlation with other markers of subclinical atherosclerosis or established cardiovascular (CV) risk factors was found. After multivariable adjustment, the association between AMH concentrations and combined carotid IMT or carotid bulb IMT remained significant. In conclusion, in healthy, normally ovulating women, AMH concentrations are negatively associated with subclinical atherosclerosis indices and TC levels, independently of established CV risk factors.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Stefanos Stergiotis
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Panagiota Chatzivasileiou
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Rizos
- Hormonal and Biochemical Laboratory, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - George Kaparos
- Hormonal and Biochemical Laboratory, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Andreas Alexandrou
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Georgios Georgiopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Christos Kontogiannis
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Kimon Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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24
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Knowles L, Nadeem N, Chowienczyk PJ. Do anti-tumour necrosis factor-α biologics affect subclinical measures of atherosclerosis and arteriosclerosis? A systematic review. Br J Clin Pharmacol 2020; 86:837-851. [PMID: 31957052 DOI: 10.1111/bcp.14215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 12/13/2022] Open
Abstract
AIMS Inflammatory cytokines, particularly tumour necrosis factor-α (TNFα), are thought to promote arterial disease through a variety of mechanisms leading to arteriosclerosis and atherosclerosis. We reviewed the existing evidence of the effect of anti-TNFα treatment on arteriosclerosis and atherosclerosis in chronic inflammatory disease. METHODS We performed a systematic review of studies examining effects of monoclonal antibodies against TNFα on subclinical measures of arteriosclerosis (arterial pulse wave velocity) and atherosclerosis (endothelial function measured by flow-mediated dilation or forearm blood flow responses to endothelium-dependent agonists, and common carotid intima-media thickness). RESULTS We identified 60 studies (of 854 potential studies identified using a systematic search) in which effects of anti-TNFα biologics on these measures were assessed in patients receiving anti-TNFα therapy for a clinical indication (usually an inflammatory disease such as an inflammatory arthritis, psoriasis or inflammatory bowel disease). Of these, only 6 were randomised clinical controlled trials. Whilst many observational studies and noncontrolled studies reported positive findings, positive finding were reported in only 1 of 6 randomised clinical controlled trials. CONCLUSIONS There is no strong evidence for an effect of anti-TNFα biologics on the subclinical measures of arteriosclerosis or atherosclerosis examined in this review. This does not exclude a positive effect of TNFα biologics on clinical outcomes through alternate pathways including those induced by remission of the primary inflammatory disease.
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Affiliation(s)
| | - Nida Nadeem
- King's College London, British Heart Foundation Centre, London, UK
| | - Philip J Chowienczyk
- Guy's and St Thomas's Foundation Trust, London, UK.,King's College London, British Heart Foundation Centre, London, UK
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25
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Pettersson-Pablo P, Cao Y, Bäckström T, Nilsson TK, Hurtig-Wennlöf A. Body fat percentage and CRP correlates with a composite score of vascular risk markers in healthy, young adults - The Lifestyle, Biomarkers, and Atherosclerosis (LBA) study. BMC Cardiovasc Disord 2020; 20:77. [PMID: 32046640 PMCID: PMC7014751 DOI: 10.1186/s12872-020-01376-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 02/03/2020] [Indexed: 11/19/2022] Open
Abstract
Background Identification of early signs of atherosclerosis in young adults have the potential to guide early interventions to prevent later cardiovascular disease. We therefore analyzed measures of vascular structure and function and biomarkers of cardiovascular risk in a sample of young healthy adults. Methods Pulse-wave velocity (PWV), carotid-intima media thickness (cIMT) and augmentation index (AIX) were measured in 834 healthy non-smokers (ages 18.0–25.9). Emphasis was put on discriminating between individuals having a vascular structure and function associated with a higher or lower risk, and cluster analysis algorithms were employed to assign the subjects into groups based on these vascular measurements. In addition, a vascular status score (VSS) was calculated by summarizing the results according to quintiles of the vascular measurements. The associations between VSS and cardiovascular biomarkers were examined by regression analyses. Results The cluster analyses did not yield sufficiently distinct clustering (groups of individuals that could be categorized unequivocally as having either a vascular structure and function associated with a higher or lower CVD risk). VSS proved a better classificatory variable. The associations between VSS and biomarkers of cardiovascular risk were analyzed by univariable and multivariable regressions. Only body fat percentage and C-reactive protein (CRP) were independently associated with VSS. Conclusions A VSS calculation, which integrates PWV, cIMT, and AIX measurements is better suited for cardiovascular risk evaluation in young adults than cluster analyses. The independent associations of VSS with body fat percentage and CRP highlight the decisive role of adiposity and systemic inflammation in early atherosclerotic progression and suggests a subordinate role of insulin and lipid metabolism in this age span.
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Affiliation(s)
- Paul Pettersson-Pablo
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden. .,School of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. .,Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden.
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Torbjörn Bäckström
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Torbjörn K Nilsson
- Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Anita Hurtig-Wennlöf
- School of Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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26
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Post-exercise Response of Arterial Parameters for Arterial Health Assessment Using a Microfluidic Tactile Sensor and Vibration-Model-Based Analysis: A Proof-of-Concept Study. Cardiovasc Eng Technol 2020; 11:295-307. [PMID: 32002815 DOI: 10.1007/s13239-020-00454-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/05/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Arterial stiffness and endothelial function are two established surrogate markers of subclinical atherosclerosis and are quantified by three arterial parameters: elasticity, viscosity and radius of the arterial wall. Yet, the current methods for their assessment are unsuitable for routine use. Post-exercise response of the cardiovascular (CV) system serves as a more sensitive detection of subclinical arterial abnormalities that are not apparent at-rest. The objective of this study is to propose a novel method that can measure post-exercise response of arterial parameters and is also suitable for routine use. APPROACH A microfluidic tactile sensor with a location-insensitive configuration was used for arterial pulse signal measurements on six asymptomatic male subjects, offering measurement reliability, ease use by a layperson, and affordability. By treating the arterial pulse signal as a vibration signal of the arterial wall, vibration-model-based analysis of only one measured pulse signal with no calibration was conducted for simultaneous estimation of three arterial parameters. Exercise-intensity-normalized percent changes in arterial parameters were utilized to remove the influence of variation in exercise intensity on post-exercise response, and then their measured values were compared for difference in post-exercise response between the subjects. MAIN RESULTS One subject who was obese, on subject who had insomnia, and the oldest subject in the study demonstrated differences in post-exercise response at the radial artery (RA), as compared with the three subjects free of those three factors. Despite a lack of statistical significance, the observed difference at the RA between subjects was supported by (i) their consistency with the related findings in the literature, and (ii) their consistency with the measured values at the carotid artery (CA) and superficial temporal artery (STA) and the anatomical difference between the three arteries. SIGNIFICANCE The proposed method has the potential of offering an affordable and convenient diagnosis tool for routine arterial health assessment.
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27
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Cerebral and peripheral vascular differences between pre- and postmenopausal women. ACTA ACUST UNITED AC 2020; 27:170-182. [DOI: 10.1097/gme.0000000000001442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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28
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Wolters TLC, van der Heijden CDCC, van Leeuwen N, Hijmans-Kersten BTP, Netea MG, Smit JWA, Thijssen DHJ, Hermus ARMM, Riksen NP, Netea-Maier RT. Persistent inflammation and endothelial dysfunction in patients with treated acromegaly. Endocr Connect 2019; 8:1553-1567. [PMID: 31751301 PMCID: PMC6933829 DOI: 10.1530/ec-19-0430] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/11/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Acromegaly is characterized by an excess of growth hormone (GH) and insulin-like growth factor 1 (IGF1). Cardiovascular disease (CVD) risk factors are common in acromegaly and often persist after treatment. Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Therefore, we hypothesized that inflammation persists in treated acromegaly and may contribute to CVD risk. METHODS In this cross-sectional study, we assessed cardiovascular structure and function, and inflammatory parameters in treated acromegaly patients. Immune cell populations and inflammatory markers were assessed in peripheral blood from 71 treated acromegaly patients (with controlled or uncontrolled disease) and 41 matched controls. Whole blood (WB) was stimulated with Toll-like receptor ligands. In a subgroup of 21 controls and 33 patients with controlled disease, vascular ultrasound measurements were performed. RESULTS Leukocyte counts were lower in patients with controlled acromegaly compared to patients with uncontrolled acromegaly and controls. Circulating IL18 concentrations were lower in patients; concentrations of other inflammatory mediators were comparable with controls. In stimulated WB, cytokine production was skewed toward inflammation in patients, most pronounced in those with uncontrolled disease. Vascular measurements in controlled patients showed endothelial dysfunction as indicated by a lower flow-mediated dilatation/nitroglycerine-mediated dilatation ratio. Surprisingly, pulse wave analysis and pulse wave velocity, both markers of endothelial dysfunction, were lower in patients, whereas intima-media thickness did not differ. CONCLUSIONS Despite treatment, acromegaly patients display persistent inflammatory changes and endothelial dysfunction, which may contribute to CVD risk and development of CVD.
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Affiliation(s)
- T L C Wolters
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C D C C van der Heijden
- Division of Experimental Internal Medicine, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Division of Vascular Medicine, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N van Leeuwen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B T P Hijmans-Kersten
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M G Netea
- Division of Experimental Internal Medicine, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J W A Smit
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - A R M M Hermus
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N P Riksen
- Division of Vascular Medicine, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R T Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Correspondence should be addressed to R T Netea-Maier:
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Johnson SA, Litwin NS, Seals DR. Age-Related Vascular Dysfunction: What Registered Dietitian Nutritionists Need to Know. J Acad Nutr Diet 2019; 119:1785-1796. [DOI: 10.1016/j.jand.2019.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/13/2019] [Accepted: 03/22/2019] [Indexed: 12/11/2022]
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Rodríguez-Mortera R, Luevano-Contreras C, Solorio-Meza S, Caccavello R, Bains Y, Garay-Sevilla ME, Gugliucci A. Higher D-lactate levels are associated with higher prevalence of small dense low-density lipoprotein in obese adolescents. Clin Chem Lab Med 2019; 56:1100-1108. [PMID: 29447114 DOI: 10.1515/cclm-2017-0733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/10/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Childhood obesity is associated with insulin resistance (IR), increased levels of small dense low-density lipoprotein (sd-LDL) as well as with augmented hepatic de novo lipogenesis, which implies increased triose phosphate fluxes that may lead to increased methylglyoxal (MG) and its catabolic end product D-lactate. We hypothesized that obese adolescents have increased D-lactate serum levels associated with high incidence of sd-LDL. METHODS This is a cross-sectional study where the anthropometric characteristics, atherogenic dyslipidemia complex, sd-LDL (Lipoprint, Quantimetrix) and D-lactate (kinetic enzymatic analysis) were explored in 30 lean vs. 30 obese adolescents (16 females and 14 males per group) without metabolic syndrome (MetS). Endothelial function by flow-mediated dilation (FMD, by ultrasound) and arterial lesion by carotid intima media thickness (CIMT, by ultrasound) were also measured. RESULTS The mean age of participants was 16.8 ± 1.4 years. Obese adolescents had a body mass index of 32.7 ± 3.8 vs. 21.8 ± 2.1 in lean participants. The obesity group showed higher D-lactate levels: 6.2 ± 3.0 vs. 4.5 ± 2.5 μmol/L, higher levels of insulin: 15 (9.6-23.5) vs. 7.9 (6.5-10.5) μIU/mL; triglyceride (TG): 1.46 (1.1-1.8) vs. 0.84 (0.6-1.2) mmol/L; non-high-density lipoprotein-cholesterol (NON-HDL-C): 2.8 ± 0.9 vs. 2.3 ± 0.7 mmol/L; total cholesterol (TC)/HDL-C) index: 2.9 ± 0.7 vs. 2.4 ± 0.5; TG/HDL-C index: 2.2 (1.5-2.8) vs. 1.1 (0.8-1.8); %LDL-3: 4.2 ± 4.07 vs. 1.9 ± 2.7; smaller LDL size: 270.6 ± 3 vs. 272.2 ± 1.1 Å. D-lactate correlated positively with LDL-2: r = 0.44 and LDL-3 (sd-LDL): r = 0.49 and negatively with large LDL-1: r = -0.48 and LDL size: r = -0.46; (p<0.05, p<0.01, p<0.001 and p<0.0001, respectively). Obese adolescents showed higher CIMT: 0.51 ± 0.08 vs. 0.46 ± 0.08 mm and lower FMD: 20.3% ± 6.7% vs. 26.0% ± 9.3%. CONCLUSIONS Obese adolescents display subclinical signs of IR and endothelial dysfunction. Higher serum sd-LDL levels correlated positively with D-lactate levels. These findings suggest an association between atherogenic dyslipoproteinemia and whole body MG fluxes already detectable in apparently healthy obese adolescents.
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Affiliation(s)
- Reyna Rodríguez-Mortera
- Department of Medical Science, University of Guanajuato, Guanajuato, Mexico.,Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
| | | | | | - Russell Caccavello
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
| | - Yasmin Bains
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
| | | | - Alejandro Gugliucci
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University, Vallejo, CA, USA.,Touro University-California, 1310 Club Drive, 94592, Vallejo, CA, USA
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Bruno RM, Marais L, Khettab H, Lorthioir A, Frank M, Jeunemaitre X, Laurent S, Boutouyrie P, Azizi M. Deep Vascular Phenotyping in Patients With Renal Multifocal Fibromuscular Dysplasia. Hypertension 2019; 73:371-378. [DOI: 10.1161/hypertensionaha.118.12189] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Rosa Maria Bruno
- From the Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B.)
- INSERM U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B., L.M., X.J., S.L., P.B.)
| | - Louise Marais
- INSERM U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B., L.M., X.J., S.L., P.B.)
| | - Hakim Khettab
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
| | - Aurélien Lorthioir
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
| | - Michael Frank
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
| | - Xavier Jeunemaitre
- INSERM U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B., L.M., X.J., S.L., P.B.)
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
| | - Stéphane Laurent
- INSERM U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B., L.M., X.J., S.L., P.B.)
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
- Department of Pharmacology, Paris Descartes University, France (S.L., P.B., M.A.)
| | - Pierre Boutouyrie
- INSERM U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B., L.M., X.J., S.L., P.B.)
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
- Department of Pharmacology, Paris Descartes University, France (S.L., P.B., M.A.)
| | - Michel Azizi
- APHP, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France (H.K., A.L., M.F., X.J., S.L., P.B., M.A.)
- Department of Pharmacology, Paris Descartes University, France (S.L., P.B., M.A.)
- INSERM, CIC1418, Paris, France (M.A.)
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Kozan M, Ozan ZT, Demir V, Ede H. The relation of novel cardiovascular risk parameters in patients with familial Mediterranean fever. JRSM Cardiovasc Dis 2019; 8:2048004018823856. [PMID: 30643639 PMCID: PMC6322093 DOI: 10.1177/2048004018823856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/27/2018] [Accepted: 09/26/2018] [Indexed: 11/17/2022] Open
Abstract
Objective In this study, we aimed at correlating the thickness of epicardial adipose tissue and levels of Vitamin D with cardiac risk in patients with familial Mediterranean fever. Methods Sixty-five patients with familial Mediterranean fever and 38 healthy controls with matching age and sex were included in the study. The patients with a history of familial Mediterranean fever attacks within the previous two weeks or with any history of inflammatory or cardiovascular disease were excluded. Data regarding age, gender, weight, height, waist circumference, body mass index (calculated as weight/height2), pulse wave velocity, serum Vitamin D levels from fasting blood samples, and Homeostatic Model Assessment for insulin resistance were obtained for the patients and controls. The epicardial adipose tissue was visualized as an echo-free space between the outer surface of myocardium and visceral pericardium using two-dimensional echocardiography, and the thickness of epicardial adipose tissue was measured in parasternal long-axis view at the end of diastole. Results The patients with familial Mediterranean fever had significantly higher levels of C-reactive protein, epicardial adipose tissue, and pulse wave velocity (p < 0.001, <0.05, <0.005, respectively) as compared with the control group. However, the serum Vitamin D levels in the two groups were observed to be similar (p = 0.486). Weak but significant positive correlations were observed between epicardial adipose tissue thickness and C-reactive protein (r = 0.302, p < 0.005), epicardial adipose tissue thickness and pulse wave velocity (r = 0.263, p < 0.01), and C-reactive protein and pulse wave velocity (r = 0.235, p < 0.05). Conclusion Thickness of epicardial adipose tissue and pulse wave velocity were observed to increase in patients with familial Mediterranean fever.
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Affiliation(s)
- Mustafa Kozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Zeynep Tugba Ozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Vahit Demir
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Hüseyin Ede
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
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Maffei P, Dassie F, Wennberg A, Parolin M, Vettor R. The Endothelium in Acromegaly. Front Endocrinol (Lausanne) 2019; 10:437. [PMID: 31396153 PMCID: PMC6667653 DOI: 10.3389/fendo.2019.00437] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/18/2019] [Indexed: 12/12/2022] Open
Abstract
Growth hormone (GH) and insulin like growth factor-1 (IGF-1) excess induce well-known deleterious effects on the cardiovascular system, especially after long-term exposition. Acromegaly, a condition of chronic GH and IGF-1 hypersecretion, is frequently associated to cardiovascular complications, although recent studies have shown a reduction in the prevalence of these comorbidities in well-controlled patients and a mortality risk similar to normal aging population. Many factors could contribute to the increased cardiovascular risk of acromegaly patients. Among these factors, the endothelium plays a key role in the pathogenesis of atherosclerotic plaques and could be considered an early marker of atherosclerosis and cardiovascular dysfunction. In this review we examined the relationship between GH/IGF-1 excess and the endothelium, from basic studies to clinical evidence. Many studies involving various arterial districts (microvascular arteries of retina, kidney and brain, and major vessels as carotid and aorta) showed that GH/IGF-1 excess promotes endothelial dysfunction via several different mechanisms. Increased endothelial proliferation, dysfunction of endothelial progenitor cells, increased oxidative stress, and compromised oxidative defenses are the main factors that are associated with endothelial dysfunction. In the general population, these alterations are associated with the development of atherosclerosis with an increased incidence of coronary artery disease and cerebrovascular complications. However, in acromegaly this is still a debated issue, despite the presence of many pro-atherogenic factors and comorbidities, such as hypertension, diabetes, sleep apnoea, and metabolic syndrome. Preclinical markers of atherosclerosis as arterial intima media thickness, pulse wave velocity and flow mediated dilation seem to be impaired in acromegaly and partly mediated by the endothelium dysfunction. In conclusion, the pathophysiology of endothelial dysfunction in the condition of GH and IGF-1 excess remains a crucial area of investigation to fully dissect the association of acromegaly with cardiovascular disease complications.
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Affiliation(s)
- Pietro Maffei
- Clinica Medica 3, Department of Medicine (DIMED), Padua University Hospital, Padua, Italy
- *Correspondence: Pietro Maffei
| | - Francesca Dassie
- Clinica Medica 3, Department of Medicine (DIMED), Padua University Hospital, Padua, Italy
| | - Alexandra Wennberg
- Clinica Neurologica, Department of Neurosciences (DNS), Padua University Hospital, Padua, Italy
| | - Matteo Parolin
- Clinica Medica 3, Department of Medicine (DIMED), Padua University Hospital, Padua, Italy
| | - Roberto Vettor
- Clinica Medica 3, Department of Medicine (DIMED), Padua University Hospital, Padua, Italy
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Doi H, Ishigami T, Nakashima-Sasaki R, Kino T, Chen L, Arakawa K, Teranaka S, Minegishi S, Abe K, Ishikawa T, Sugano T, Tamura K. New non-invasive indexes of arterial stiffness are significantly correlated with severity and complexity of coronary atherosclerosis. Clin Exp Hypertens 2018; 41:1-7. [PMID: 29737880 DOI: 10.1080/10641963.2018.1465072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Endothelial dysfunction and increased arterial stiffness gradually develop before the manifestation of catastrophic cardiovascular events. Therefore, detection and assessment of vascular function are required to address pre-existing pathological conditions. However, the currently available diagnostic devices and methods are insufficient due to variability among investigators and the time-consuming nature of manual procedures. METHODS Recently, novel devices were developed for the detection of both arterial stiffness and endothelial dysfunction in a single blood pressure measurement using a cuff-oscillometric technique (AVE-1500, Shisei Datum, Japan). API (arterial pressure volume index) is defined as the reciprocal of the slope of the tangent of the brachial artery pressure-volume curve, and AVI (arterial velocity pulse index) is defined as the ratio of the difference between the ejection and reflection waves. In the present study, we performed retrospective, cross-sectional analyses of subjects (n = 102; mean age = 70.5 ± 10.4 years) with detailed coronary angiographic examinations and clinical background parameters. RESULTS After adjusting for various variables using multiple linear regression analyses, we found that API, but not AVI, was significantly correlated with coronary artery severity and complexity scores. CONCLUSIONS We propose that API may be a new vascular index useful for monitoring and assessing the severity and complexity of atherosclerosis in subjects with coronary artery disease and for evaluating atherosclerotic diseases.
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Affiliation(s)
- Hiroshi Doi
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Tomoaki Ishigami
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Rie Nakashima-Sasaki
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Tabito Kino
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Lin Chen
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kentaro Arakawa
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Sae Teranaka
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Shintaro Minegishi
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kaito Abe
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Toshiyuki Ishikawa
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Teruyasu Sugano
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
| | - Kouichi Tamura
- a Department of Medical Science and Cardiorenal Medicine , Yokohama City University Graduate School of Medicine , Yokohama , Japan
- b Department of Cardiology , Yokohama City University Hospital , Yokohama , Japan
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Calderón-Gerstein WS, López-Peña A, Macha-Ramírez R, Bruno-Huamán A, Espejo-Ramos R, Vílchez-Bravo S, Ramírez-Breña M, Damián-Mucha M, Matos-Mucha A. Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population. Vasc Health Risk Manag 2017; 13:421-426. [PMID: 29200863 PMCID: PMC5701560 DOI: 10.2147/vhrm.s151886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo, Peru (3,250 meters above sea level). Methods Participants included 61 patients: 28 cases and 33 controls. The cases were subjects with hypertension, diabetes mellitus, obesity, or a history of stroke or coronary artery disease. Flow-mediated vasodilation (FMD) of the brachial artery was measured in the supine position, at noon, after 5 minutes of resting. The brachial artery was identified above the elbow. Its basal diameter was measured during diastole, and FMD was tested after 5 minutes of forearm ischemia. Intima–media complex in the right carotid artery was also determined. An increase in the artery’s baseline diameter <10% indicated a positive test. Endothelium-independent vasodilation was evaluated with sublingual nitrate administration. The intima–media complex in the right carotid artery was also measured. Results 100% of diabetics had ED; ED was also found in 68.8% of obese individuals, 55% of hypertensive patients, and 46.5% of controls. Age, height, body mass index, and waist diameter were higher in the cases as compared with the controls. A total of 57.9% (n=11) of the cases and 45.2% (n=19) of the controls presented ED. Patients without ED had a mean increase in brachial artery diameter of 23.16%, while in those with ED it was only 3.84%. Individuals with diabetes or hypertension had a greater thickness of the carotid artery intima media layer (1.092 versus 0.664 cm) (p=0.037). A positive test for ED was associated with a greater basal diameter of the brachial artery (4.66±0.62 versus 4.23±0.59 cm) (p=0.02). A total of 7 patients presented paradoxical response, developing posthyperemia vasoconstriction. Discussion The proportion of ED was high among controls and among patients with risk factors. Controls showed better FMD profiles than subjects studied in Tibet and the Himalayas.
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Affiliation(s)
- Walter S Calderón-Gerstein
- Department of Medicine, National Hospital Ramiro Prialé Prialé, Essalud Junín, Huancayo, Junín, Peru.,Faculty of Medicine, Continental University, Huancayo, Junín, Peru
| | - Antonio López-Peña
- Department of Radiology, National Hospital Ramiro Prialé Prialé, Essalud Junín, Huancayo, Junín, Peru
| | - Raúl Macha-Ramírez
- Department of Radiology, National Hospital Ramiro Prialé Prialé, Essalud Junín, Huancayo, Junín, Peru
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Cardiovascular disease in patients with autoinflammatory syndromes. Rheumatol Int 2017; 38:37-50. [DOI: 10.1007/s00296-017-3854-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 12/16/2022]
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Emamifar A, Hess S, Gerke O, Hermann AP, Laustrup H, Hansen PS, Thye-Rønn P, Marcussen N, Svendstrup F, Gildberg-Mortensen R, Bang JC, Farahani ZA, Chrysidis S, Toftegaard P, Andreasen RA, le Greves S, Andersen HR, Olsen RN, Hansen IMJ. Polymyalgia rheumatica and giant cell arteritis-three challenges-consequences of the vasculitis process, osteoporosis, and malignancy: A prospective cohort study protocol. Medicine (Baltimore) 2017; 96:e7297. [PMID: 28658131 PMCID: PMC5500053 DOI: 10.1097/md.0000000000007297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common inflammatory conditions. The diagnosis of PMR/GCA poses many challenges since there are no specific diagnostic tests. Recent literature emphasizes the ability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to assess global disease activity in inflammatory diseases. 18F-FDG PET/CT may lead to the diagnosis at an earlier stage than conventional imaging and may also assess response to therapy. With respect to the management of PMR/GCA, there are 3 significant areas of concern as follows: vasculitis process/vascular stiffness, malignancy, and osteoporosis. METHODS AND ANALYSIS All patients with suspected PMR/GCR referred to the Rheumatology section of Medicine Department at Svendborg Hospital, Denmark. The 4 separate studies in the current protocol focus on: the association of clinical picture of PMR/GCA with PET findings; the validity of 18F-FDG PET/CT scan for diagnosis of PMR/GCA compared with temporal artery biopsy; the prevalence of newly diagnosed malignancies in patients with PMR/GCA, or PMR-like syndrome, with the focus on diagnostic accuracy of 18F-FDG PET/CT scan compared with conventional workup (ie, chest X-ray/abdominal ultrasound); and the impact of disease process, and also steroid treatment on bone mineral density, body composition, and vasculitis/vascular stiffness in PMR/GCA patients. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethics Committee of the Region of Southern Denmark (identification number: S-20160098) and Danish Data Protection Agency (J.nr 16/40522). Results of the study will be disseminated via publications in peer-reviewed journals, and presentation at national and international conferences.
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Affiliation(s)
- Amir Emamifar
- Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg
| | - Søren Hess
- Faculty of Health Sciences, University of Southern Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense
- Department of Radiology and Nuclear Medicine, Hospital Southwest Jutland, Esbjerg
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense
- Centre of Health Economics Research, University of Southern Denmark
| | | | - Helle Laustrup
- Department of Rheumatology, Odense University Hospital, Odense
| | - Per Syrak Hansen
- Diagnostic center, Odense University Hospital, Svendborg Hospital, Svendborg
| | - Peter Thye-Rønn
- Diagnostic center, Odense University Hospital, Svendborg Hospital, Svendborg
| | | | | | | | - Jacob Christian Bang
- Department of Radiology, Odense University Hospital, Svendborg Hospital, Svendborg
| | | | | | - Pia Toftegaard
- Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg
| | | | | | - Hanne Randi Andersen
- Patient Research Partner, Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark
| | - Rudolf Nezlo Olsen
- Patient Research Partner, Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark
| | - Inger Marie Jensen Hansen
- Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg
- Faculty of Health Sciences, University of Southern Denmark
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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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Abstract
Salt resistance/sensitivity refers specifically to the effect of dietary sodium chloride (salt) intake on BP. Increased dietary salt intake promotes an early and uniform expansion of extracellular fluid volume and increased cardiac output. To compensate for these hemodynamic changes and maintain constant BP in salt resistance, renal and peripheral vascular resistance falls and is associated with an increase in production of nitric oxide. In contrast, the decline in peripheral vascular resistance and the increase in nitric oxide are impaired or absent in salt sensitivity, promoting an increase in BP in these individuals. Endothelial dysfunction may pose a particularly significant risk factor in the development of salt sensitivity and subsequent hypertension. Vulnerable salt-sensitive populations may have in common underlying endothelial dysfunction due to genetic or environmental influences. These individuals may be very sensitive to the hemodynamic stress of increased effective blood volume, setting in motion untoward molecular and biochemical events that lead to overproduction of TGF-β, oxidative stress, and limited bioavailable nitric oxide. Finally, chronic high-salt ingestion produces endothelial dysfunction, even in salt-resistant subjects. Thus, the complex syndrome of salt sensitivity may be a function of the endothelium, which is integrally involved in the vascular responses to high salt intake.
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Affiliation(s)
| | - Louis J Dell'Italia
- Departments of Medicine and.,Department of Medicine, Veterans Affairs Medical Center, Birmingham, Alabama
| | - Paul W Sanders
- Departments of Medicine and .,Department of Medicine, Veterans Affairs Medical Center, Birmingham, Alabama.,Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama; and
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Faconti L, Bruno RM, Buralli S, Barzacchi M, Dal Canto E, Ghiadoni L, Taddei S. Arterial-ventricular coupling and parameters of vascular stiffness in hypertensive patients: Role of gender. JRSM Cardiovasc Dis 2017; 6:2048004017692277. [PMID: 28210489 PMCID: PMC5302172 DOI: 10.1177/2048004017692277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/03/2017] [Accepted: 01/06/2017] [Indexed: 11/28/2022] Open
Abstract
Objective Non-invasive estimation of arterial–ventricular coupling has been extensively used for the evaluation of cardiovascular performance, however, a relative small amount of data is available regarding arterial–ventricular coupling and its components in hypertension. The present study was designed to investigate the relationship between left ventricular elastance, arterial elastance, parameters of vascular stiffness and the influence of gender in a population of hypertensive individuals. Methods In 102 patients, trans-thoracic cardiac ultrasound, parameters of aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid arteries were acquired for the assessment of intima-media thickness as well as carotid compliance and distensibility coefficient. Results Mean age was 61 years, 32% diabetes, 56% dyslipidemia, 9% previous cardiovascular events; women (n = 32) and men were superimposable for cardiovascular risk factors prevalence. In the population, ventricular elastance was significantly correlated with arterial elastance (r = 0.887), age (r = 0.334), gender (r = −0.494), BMI (r = −0.313), augmentation index (r = 0.479) (all p < 0.001); and with carotid compliance and distensibility coefficient (r = 0.229 and r = − 0.250, respectively, both p < 0.05); however, only arterial elastance and gender were independently associated with ventricular elastance in multiple regression models adjusted for confounding factors. Gender-specific analysis revealed that arterial elastance and augmentation index remained statistically significant associated with ventricular elastance in men (r = 0.275, p = 0.04); instead augmentation index was no longer significant (r = 0.052, p = 0.77) in the female sex. Conclusions In hypertensive patients, main determinants of ventricular elastance are arterial elastance, as an integrated index of arterial vascular load, and gender; however, pressure augmentation might play an additional role in men.
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Affiliation(s)
- Luca Faconti
- Department of Clinical and experimental Medicine, University of Pisa, Italy; Department of Clinical Pharmacology, King's College London, UK
| | - Rosa Maria Bruno
- Department of Clinical and experimental Medicine, University of Pisa, Italy; Institute of Clinical Physiology, CNR, Italy
| | - Simona Buralli
- Department of Clinical and experimental Medicine, University of Pisa, Italy
| | - Marta Barzacchi
- Department of Clinical and experimental Medicine, University of Pisa, Italy
| | - Elisa Dal Canto
- Department of Clinical and experimental Medicine, University of Pisa, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and experimental Medicine, University of Pisa, Italy
| | - Stefano Taddei
- Department of Clinical and experimental Medicine, University of Pisa, Italy
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Bruno RM, Reesink KD, Ghiadoni L. Advances in the non-invasive assessment of vascular dysfunction in metabolic syndrome and diabetes: Focus on endothelium, carotid mechanics and renal vessels. Nutr Metab Cardiovasc Dis 2017; 27:121-128. [PMID: 27773467 DOI: 10.1016/j.numecd.2016.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/28/2016] [Accepted: 09/04/2016] [Indexed: 12/29/2022]
Abstract
AIM The present paper is a selective review on the methodology and clinical significance of techniques to assess specifically endothelial function, carotid mechanics and renal vascular function, particularly in the light of vascular dysfunction in metabolic syndrome and type 2 diabetes. DATA SYNTHESIS Endothelial dysfunction appears to be earlier detectable in the microcirculation of patients with altered glucose metabolism, while it attains significance in the macrocirculation at more advanced disease stages. Smooth muscle cell dysfunction is now increasingly recognized to play a role both in the development of endothelial dysfunction and abnormal arterial distensibility. Furthermore, impaired glucose metabolism affects carotid mechanics through medial calcification, structural changes in extracellular matrix due to advanced glycation and modification of the collagen/elastin material stiffness. The assessment of renal vascular function by dynamic ultrasound or magnetic resonance imaging has recently emerged as an appealing target for identifying subtle vascular alterations responsible for the development of diabetic nephropathy. CONCLUSIONS Vascular dysfunction represents a major mechanism for the development of cardiovascular disease in patients with abnormal glucose metabolism. Hence, the currently available non-invasive techniques to assess early structural and vascular abnormalities merit recommendation in this population, although their predictive value and sensitivity to monitor treatment-induced changes have not yet been established and are still under investigation.
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Affiliation(s)
- R M Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - K D Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Netherlands; Department of Biomedical Engineering, Cardiovascular Center, Maastricht University Medical Center, Netherlands
| | - L Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
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Successful prediction of cardiovascular risk by new non-invasive vascular indexes using suprasystolic cuff oscillometric waveform analysis. J Cardiol 2017; 69:30-37. [DOI: 10.1016/j.jjcc.2016.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/03/2016] [Accepted: 06/13/2016] [Indexed: 11/20/2022]
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CUCIUREANU TUDOR, CHIRIAC STEFAN, CHIORESCU MADALINA, GÎRLEANU IRINA, TRIFAN ANCA. Chronic hepatitis C virus infection: a new modifiable cardio-metabolic risk factor? CLUJUL MEDICAL (1957) 2017; 90:251-255. [PMID: 28781519 PMCID: PMC5536202 DOI: 10.15386/cjmed-793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/27/2017] [Indexed: 02/05/2023]
Abstract
Chronic hepatitis C infection is a systemic disease that leads to a high risk of cirrhosis and hepatic carcinoma, as well as extrahepatic related disorders, immune-related and metabolic alterations such as glucose metabolism impairment and steatosis, thus being a new cardio-metabolic risk factor. It has been shown that, due to chronic inflammation, HCV infection has a direct effect on the arterial wall, initiating endothelial dysfunction which is the first step in atherosclerotic processes with proatherogenic effects and numerous cardiovascular events. The recent data emphasize that HCV infection can induce insulin resistance in the liver and peripheral tissues through multiple mechanisms which interfere with insulin signaling, inducing the production of several proinflammatory cytokines, and modify the lipid metabolism with the result of hepatic steatosis, which is more pronounced in patients with HCV. The emergence of new direct acting, interferon-free antiviral treatment, leading to HCV cure in most cases with a satisfactory safety profile is, according to numerous studies, improving the glucose metabolism disorders and lowering the number of cardiovascular events in patients who obtained sustained viral response, thiugh further studies are needed to clarify definitively the role of HCV infection in cardiovascular and metabolic alterations, as well as the impact of viral eradication on cardiovascular outcomes.
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Affiliation(s)
- TUDOR CUCIUREANU
- Institute of Gastroenterology and Hepatology, Iasi, Romania
- “Grigore T. Popa“ University of Medicine and Pharmacy, Iasi, Romania
- Address for correspondence:
| | - STEFAN CHIRIAC
- Institute of Gastroenterology and Hepatology, Iasi, Romania
- “Grigore T. Popa“ University of Medicine and Pharmacy, Iasi, Romania
| | - MADALINA CHIORESCU
- Department of Medical Specialties, “Grigore T. Popa“ University of Medicine and Pharmacy, Iasi, Romania
| | - IRINA GÎRLEANU
- Institute of Gastroenterology and Hepatology, Iasi, Romania
- “Grigore T. Popa“ University of Medicine and Pharmacy, Iasi, Romania
| | - ANCA TRIFAN
- Institute of Gastroenterology and Hepatology, Iasi, Romania
- “Grigore T. Popa“ University of Medicine and Pharmacy, Iasi, Romania
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Muscogiuri G, Annweiler C, Duval G, Karras S, Tirabassi G, Salvio G, Balercia G, Kimball S, Kotsa K, Mascitelli L, Bhattoa HP, Colao A. Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2016; 230:577-584. [PMID: 28043680 DOI: 10.1016/j.ijcard.2016.12.053] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/14/2016] [Accepted: 12/16/2016] [Indexed: 12/24/2022]
Abstract
There continues to be interest in understanding the role of vitamin D in the pathogenesis, epidemiology and prevention of cardiovascular disease (CVD). In fact vitamin D deficiency has been associated to an increased risk of developing CVD given to the relationship between low vitamin D levels and obesity, diabetes mellitus, dyslipidaemia, endothelial dysfunction and hypertension. However, although vitamin D has been identified as a potentially important marker of CVD, the mechanisms through which vitamin D deficiency leads from endothelial dysfunction to myocardial infarction and stroke are not fully understood. Thus, the goal of this review is to provide an updated review of the literature on the basic science of how vitamin D may affect the cardiovascular system and in particular to analyze the role that vitamin D may have in the whole dynamic process from the initiation of endothelial dysfunction to the development of myocardial infarction and stroke.
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Affiliation(s)
| | - Cedric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France; University Memory Clinic, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
| | - Guillaume Duval
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France
| | - Spyridon Karras
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, AHEPA Hospital, Thessaloniki, Greece
| | - Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | | | - Kalliopi Kotsa
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, AHEPA Hospital, Thessaloniki, Greece
| | - Luca Mascitelli
- Comando Brigata alpina "Julia"/Multinational Land Force, Medical Service, Udine, Italy
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Endocrinology Unit, Faculty of Medicine, University of Debrecen, Hungary
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Abstract
Kawasaki disease (KD) is an acute childhood febrile disease of unknown etiology. It exhibits not only coronary artery aneurysms in some cases but also systemic vasculitis. Whether KD is associated with accelerated atherosclerosis remains debatable. The measurement of pulse wave velocity (PWV) is useful as a simple, noninvasive measurement of arterial stiffness, an atherosclerotic manifestation. We herein present a systematic review of clinical studies that focused on PWV in patients with KD. A PubMed-based search identified 8 eligible studies published until June 2015. The PWV of patients with KD, regardless of antecedent coronary artery lesions, was high relative to controls, even though their blood pressure appeared to be similar. Although definitive conclusions cannot be made with the limited information, patients with KD may be at risk of systemic atherosclerosis in association with arterial stiffness. Further research, including longitudinal and outcome studies, is needed to determine the clinical significance of a potential increase in PWV in patients with KD.
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Affiliation(s)
- Yoshitaka Iwazu
- Department of Clinical Laboratory Medicine, Jichi Medical University, Tochigi, Japan
| | - Takaomi Minami
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Kazuhiko Kotani
- Department of Clinical Laboratory Medicine, Jichi Medical University, Tochigi, Japan
- Division of Community and Family Medicine, Jichi Medical University, Tochigi, Japan
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Sherwood A, Blumenthal JA, Smith PJ, Watkins LL, Hoffman BA, Hinderliter AL. Effects of Exercise and Sertraline on Measures of Coronary Heart Disease Risk in Patients With Major Depression: Results From the SMILE-II Randomized Clinical Trial. Psychosom Med 2016; 78:602-9. [PMID: 26867076 PMCID: PMC4905719 DOI: 10.1097/psy.0000000000000301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the effects of supervised and home-based aerobic exercise training, and antidepressant pharmacotherapy (sertraline) on coronary heart disease (CHD) risk factors in a sample of participants with major depressive disorder (MDD). METHODS The Standard Medical Intervention versus Long-term Exercise (SMILE)-II study randomized 202 adults (153 women, 49 men) diagnosed as having MDD to one of four interventions, each of 4-month duration: supervised exercise, home-based exercise, antidepressant medication (sertraline, 50-200 mg daily), or placebo pill. Patients underwent a structured clinical interview for depression and completed the Hamilton Depression Rating Scale. CHD risk factors included brachial artery flow-mediated dilation, carotid intima-media thickness, serum lipids, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk. RESULTS Compared with placebo, active treatment of depression (supervised exercise, home-based exercise, sertraline therapy) was associated with an improvement in CHD risk factors (improved flow-mediated dilation [p = .032], reduced progression of intima-media thickness [p = .037], and a reduction in 10-year ASCVD [p = .049]). The active treatments did not differ from each other in their effects on the CHD risk outcomes. CONCLUSIONS Both exercise and antidepressant medication improved CHD risk factors and lowered ASCVD risk in patients with MDD. Because MDD is associated with increased risk for CHD events, treatment of depression with exercise or sertraline may reduce the risk of developing CHD in patients with MDD. TRIAL REGISTRATION Clinical Trials Government Identifier: NCT-00331305.
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Affiliation(s)
- Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Benson A. Hoffman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Alan L. Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials. Proc Nutr Soc 2016; 75:328-41. [PMID: 27150497 DOI: 10.1017/s0029665116000264] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The prevalence of cardiometabolic diseases is a significant public health burden worldwide. Emerging evidence supports the inverse association between greater dairy consumption and reduced risk of cardiometabolic diseases. Dairy proteins may have an important role in the favourable impact of dairy on human health such as blood pressure (BP), blood lipid and glucose control. The purpose of this review is to update and critically evaluate the evidence on the impacts of casein and whey protein in relation to metabolic function. Evidence from short-term clinical studies assessing postprandial responses to milk protein ingestion suggests benefits on vascular function independent of BP, as well as improvement in glycaemic homeostasis. Long-term interventions have been less conclusive, with some showing benefits and others indicating a lack of improvement in vascular function. During chronic consumption BP appears to be lowered and both dyslipidaemia and hyperglacaemia seem to be controlled. Limited number of trials investigated the effects of dairy proteins on oxidative stress and inflammation. Although the underlying mechanisms of milk proteins on cardiometabolic homeostasis remains to be elucidated, the most likely mechanism is to improve insulin resistance. The incorporation of meals enriched with dairy protein in the habitual diet may result in the beneficial effects on cardiometabolic health. Nevertheless, future well-designed, controlled studies are needed to investigate the relative effects of both casein and whey protein on BP, vascular function, glucose homeostasis and inflammation.
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48
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Fogelman Y, Gaitini D, Carmeli E. Antiatherosclerotic effects of licorice extract supplementation on hypercholesterolemic patients: decreased CIMT, reduced plasma lipid levels, and decreased blood pressure. Food Nutr Res 2016; 60:30830. [PMID: 27113136 PMCID: PMC4845696 DOI: 10.3402/fnr.v60.30830] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 02/01/2023] Open
Abstract
Background Ethanolic extract of licorice root has been shown to reduce low-density lipoprotein (LDL) oxidation in atherosclerotic mice and in both hypercholesterolemic and normal lipidemic humans. Objective This study examined the effect of licorice-root extract on carotid intima-media thickness (CIMT) in individuals with hypercholesterolemia. Design Individuals with hypercholesterolemia (total cholesterol ≥6.18 mmol/L [240 mg/dL]) and without significant stenosis were randomly allocated to two groups: an experimental group that consumed 0.2 g/day of ethanolic extract of licorice root for 12 months, and a control group that received a placebo. Results Of 110 eligible participants, 94 (41–80 years old) completed the study. A significant CIMT decrease from 0.92±0.25 mm to 0.84±0.21 mm was observed in the experimental group compared with an increase from 0.85±0.17 mm to 0.88±0.19 mm in the control group. Mean plasma total cholesterol levels and LDL cholesterol decreased, at the range baseline to 1 year, from 284±32 mg/dl to 262±25 mg/dl and from 183±8.5 mg/dl to 174±9.1 mg/dl, respectively, for the experimental group (p<0.001) and from 291±35 to 289±31 mg/dl and from 177.6±10.7 to 179.3±9.6 (p=0.08), respectively, for the control group. Mean high-density lipoprotein (HDL) did not change significantly in either group. In the experimental group, systolic blood pressure decreased from 138±12 mmHg to 125±13 mmHg after 1 year (p=0.01) and increased from 136±15 mmHg to 137±13 mmHg in the control group. Diastolic blood pressure decreased from 92±9 mmHg to 84±10 mmHg (p=0.01) in the experimental group and increased from 89±11 mmHg to 90±8 mmHg in the control group. Conclusion Following 1 year of licorice consumption, mean CIMT, total cholesterol, LDL levels, and blood pressure were decreased. This suggests that licorice may attenuate the development of atherosclerosis and of related cardiovascular diseases.
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Affiliation(s)
- Yacov Fogelman
- Department of Family Practice, Leumit Health Services, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel;
| | - Diana Gaitini
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,Department of Medical Imaging, Unit of Ultrasound, Rambam Health Care Center, Haifa, Israel
| | - Eli Carmeli
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, Haifa University, Haifa, Israel
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49
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Feng W, Ying WZ, Aaron KJ, Sanders PW. Transforming growth factor-β mediates endothelial dysfunction in rats during high salt intake. Am J Physiol Renal Physiol 2015; 309:F1018-25. [PMID: 26447221 DOI: 10.1152/ajprenal.00328.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/06/2015] [Indexed: 01/08/2023] Open
Abstract
Endothelial dysfunction has been shown to be predictive of subsequent cardiovascular events and death. Through a mechanism that is incompletely understood, increased dietary salt intake promotes endothelial dysfunction in healthy, salt-resistant humans. The present study tested the hypothesis that dietary salt-induced transforming growth factor (TGF)-β promoted endothelial dysfunction and salt-dependent changes in blood pressure (BP). Sprague-Dawley rats that received diets containing 0.3% NaCl [low salt (LS)] or 8.0% NaCl [high salt (HS)] were treated with vehicle or SB-525334, a specific inhibitor of TGF-β receptor I/activin receptor-like kinase 5, beginning on day 5. BP was monitored using radiotelemetry in four groups of rats (LS, LS + SB-525334, HS, and HS + SB-525334) for up to 14 days. By day 14 of the study, mean daytime systolic BP and mean pulse pressure of the HS group treated with vehicle was greater than those in the other three groups; mean daytime systolic BP and pulse pressure of the HS + SB-525334 group did not differ from the LS and LS + SB-525334-treated groups. Whereas mean systolic BP, mean diastolic BP, and mean arterial pressure did not differ among the groups on the seventh day of the study, endothelium-dependent vasorelaxation was impaired specifically in the HS group; treatment with the activin receptor-like kinase 5 inhibitor prevented the dietary HS intake-induced increases in phospho-Smad2 (Ser(465/467)) and NADPH oxidase-4 in endothelial lysates and normalized endothelial function. These findings suggest that HS-induced endothelial dysfunction and the development of salt-dependent increases in BP were related to endothelial TGF-β signaling.
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Affiliation(s)
- Wenguang Feng
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wei-Zhong Ying
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kristal J Aaron
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paul W Sanders
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, Alabama; Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Veterans Affairs Medical Center, Birmingham, Alabama
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50
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Ampuero J, Romero-Gómez M. Assessing cardiovascular risk in hepatitis C: An unmet need. World J Hepatol 2015; 7:2214-2219. [PMID: 26380047 PMCID: PMC4561776 DOI: 10.4254/wjh.v7.i19.2214] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/13/2015] [Accepted: 08/31/2015] [Indexed: 02/06/2023] Open
Abstract
Chronic hepatitis C virus (HCV) is associated with significant morbidity and mortality, as a result of the progression towards cirrhosis and hepatocellular carcinoma. Additionally, HCV seems to be an independent risk factor for cardiovascular diseases (CVD) due to its association with insulin resistance, diabetes and steatosis. HCV infection represents an initial step in the chronic inflammatory cascade, showing a direct role in altering glucose metabolism. After achieving sustained virological response, the incidence of insulin resistance and diabetes dramatically decrease. HCV core protein plays an essential role in promoting insulin resistance and oxidative stress. On the other hand, atherosclerosis is a common disease in which the artery wall thickens due to accumulation of fatty deposits. The main step in the formation of atherosclerotic plaques is the oxidation of low density lipoprotein particles, together with the increased production of proinflammatory markers [tumor necrosis factor-α, interleukin (IL)-6, IL-18 or C-reactive protein]. The advent of new direct acting antiviral therapy has dramatically increased the sustained virological response rates of hepatitis C infection. In this scenario, the cardiovascular risk has emerged and represents a major concern after the eradication of the virus. Consequently, the number of studies evaluating this association is growing. Data derived from these studies have demonstrated the strong link between HCV infection and the atherogenic process, showing a higher risk of coronary heart disease, carotid atherosclerosis, peripheral artery disease and, ultimately, CVD-related mortality.
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