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Söderström M, Grönlund C, Liv P, Nyman E, Näslund U, Wester P. Aortic arterial stiffness associates with carotid intima-media thickness and carotid plaques in younger middle-aged healthy people. Blood Press 2024; 33:2405161. [PMID: 39291635 DOI: 10.1080/08037051.2024.2405161] [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: 06/20/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Aortic stiffness, assessed as estimated aortic pulse wave velocity (aPWV), and carotid intima-media thickness (cIMT) are markers of vascular age, and carotid plaques are a marker of early atherosclerosis. In this cross-sectional study we aimed to investigate the association between aPWV, cIMT and plaques across different age groups and in women and men, in a middle-aged healthy population. MATERIALS AND METHODS Participants in the 6.5-year follow-up of the VIPVIZA trial who were aged 47, 57 and 67 underwent an oscillometric measurement which estimates aPWV between 2020 and 2023. Carotid ultrasound examinations were also performed. Linear and ordinal regression models were used to investigate how aPWV associates with cIMT and with carotid plaques, for the overall study group and stratified for age groups and sex. RESULTS A total of 1046 subjects were included in the analyses. Linear associations between aPWV and cIMT (β = 0.018, 95% CI: 0.006-0.030, p = 0.003), and between aPWV and plaques (OR: 1.19, 95% CI: 1.03-1.38, p = 0.018), were seen in the 57-year-olds. In the 47-year-olds a significant association was seen between aPWV and plaques (OR: 2.98 95% CI: 1.44-6.14, p = 0.003). No significant associations were seen in the 67-year-olds. For women, a significant association between aPWV and cIMT (β = 0.011, 95% CI: 0.004-0.017, p = 0.002) was shown. CONCLUSION Estimated aPWV was positively associated with increasing cIMT and the presence of carotid plaques in younger middle-aged individuals, and with cIMT in women, suggesting that measurement of estimated aPWV may improve cardiovascular risk assessment in younger middle-aged individuals and women.Clinical Trial Registration date 8 May 2013: URL: www.clinicaltrials.gov. Unique identifier: NCT01849575.
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Affiliation(s)
- Martina Söderström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christer Grönlund
- Department of Diagnostics and Intervention, Radiation Physics and Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Emma Nyman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ulf Näslund
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Wester
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Lin WH, Zheng D, Li G, Chen F. Age-Related Changes in Blood Volume Pulse Wave at Fingers and Ears. IEEE J Biomed Health Inform 2024; 28:5070-5080. [PMID: 37276108 DOI: 10.1109/jbhi.2023.3282796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The decline in vascular elasticity with aging can be manifested in the shape of pulse wave. The study investigated the pulse wave features that are sensitive to age and the pattern of these features change with increasing age were examined. METHODS Five features were proposed and extracted from the photoplethysmography (PPG)-based pulse wave or its first derivative wave. The correlation between these PPG features and ages was studied in 100 healthy subjects with a wide range of ages (20-71 years). Piecewise regression coefficients were calculated to examine the rates of change of the PPG features with age at different age stages. RESULTS The proposed PPG features obtained from the finger showed a strong and significant correlation with age (with r = 0.76 - 0.77, p < 0.01), indicating higher sensitivity to age changes compared to the PPG features reported in previous studies (with r = 0.66 - 0.75). The correlation remained significant even after correcting for other clinical variables. The rate of change of the PPG feature values was found to be significantly faster in subjects aged ≥40 years compared to those aged < 40 years in the healthy population. This rate of change was similar to the age-related progression of arterial stiffness evaluated by pulse wave velocity (PWV), which is considered a gold standard for evaluating vascular stiffness. CONCLUSIONS The proposed PPG features showed a high correlation with chronological age in healthy subjects and exhibited a similar age-related change trend as PWV. SIGNIFICANCE With the convenience of PPG measures, the proposed age-related features have the potential to be used as biomarkers for vascular aging and estimating the risk of cardiovascular disease.
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Agrawal SP, Desai D, Maheta D, Abouarab AG, Soni Z, Frishman WH, Aronow WS. A Comprehensive Guide to Aortic Atheroma: Delving in Its Causes, Detection, and Treatment. Cardiol Rev 2024:00045415-990000000-00309. [PMID: 39140758 DOI: 10.1097/crd.0000000000000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Aortic atheroma, a common disease, is characterized by the formation and accumulation of atheromatous plaques within the aorta. The disease manifestations range from asymptomatic conditions to life-threatening complications like stroke or aortic dissection. The severity of this condition necessitates a detailed look at its pathophysiology, diagnostics, and management options. This guide provides a detailed overview of aortic atheroma, its definition, worldwide occurrence, demographic patterns, and underlying pathophysiology. It also elucidates the symptomatology associated with atheromatous changes in the aorta, diagnostic criteria for identifying the disease, and the latest epidemiological data. This article presents current treatment modalities, focusing on preventive and lifestyle approaches to cease further progression of atheromatous disease. It additionally reviews relevant case studies to give practical insights into the challenges faced and consequences of managing aortic atheroma. The in-depth discussion of aortic atheroma improves the perspective to a broader public health relevance, giving importance to the need for continuous improvement in medical practices, and personalized healthcare strategies to reduce risk and better patient outcomes.
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Affiliation(s)
- Siddharth Pravin Agrawal
- From the Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI
| | - Dev Desai
- Department of Medicine, Smt. NHLMMC, Ahmedabad, India
| | | | | | - Zeal Soni
- Department of Medicine, Smt. NHLMMC, Ahmedabad, India
| | | | - Wilbert S Aronow
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
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Olukorode JO, Onwuzo CN, Otabor EO, Nwachukwu NO, Omiko R, Omokore O, Kristilere H, Oladipupo Y, Akin-Adewale R, Kuku O, Ugboke JO, Joseph-Erameh T. Aortic Size Index Versus Aortic Diameter in the Prediction of Rupture in Women With Abdominal Aortic Aneurysm. Cureus 2024; 16:e58673. [PMID: 38774170 PMCID: PMC11106735 DOI: 10.7759/cureus.58673] [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] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Abdominal aortic aneurysms (AAAs) pose significant challenges in clinical management, particularly in female patients, whose unique anatomical and physiological characteristics influence rupture risk. While aortic diameter (AD) has traditionally been the primary metric for predicting rupture, its limitations, especially in women, have spurred exploration into alternative measures such as the aortic size index (ASI). This review examines the anatomy and physiology of AAAs in women, gender-specific challenges in diagnosis and management, and the comparative effectiveness of ASI versus AD in predicting rupture risk. ASI, calculated as AD divided by body surface area (BSA), offers a more nuanced assessment by adjusting for individual body size differences, potentially mitigating gender disparities in rupture rates. Comparative analyses indicate ASI's superiority in predicting adverse aortic events, particularly in women, thereby advocating for its integration into clinical practice to improve patient outcomes. Additionally, emerging techniques such as 3D volumetric measurements and biomechanical assessments show promise in enhancing rupture risk prediction, heralding a shift toward more personalized and effective management strategies for AAA patients.
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Affiliation(s)
- John O Olukorode
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Chidera N Onwuzo
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Emmanuel O Otabor
- Internal Medicine, University Hospital Coventry and Warwickshire, Coventry, GBR
| | - Nwachukwu O Nwachukwu
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Raymond Omiko
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Olutomiwa Omokore
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Heritage Kristilere
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | | | - Rolake Akin-Adewale
- Internal Medicine, College of Health Sciences, University of Ilorin, Ilorin, NGA
| | - Oluwatosin Kuku
- Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Ogun, NGA
| | - Joshua O Ugboke
- Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA
| | - Thummim Joseph-Erameh
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
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Salih AM, Galazzo IB, Menegaz G, Altmann A. Leukocyte Telomere Length and Cardiac Structure and Function: A Mendelian Randomization Study. J Am Heart Assoc 2024; 13:e032708. [PMID: 38293941 PMCID: PMC11056120 DOI: 10.1161/jaha.123.032708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Existing research demonstrates the association of shorter leukocyte telomere length with increased risk of age-related health outcomes including cardiovascular diseases. However, the direct causality of these relationships has not been definitively established. Cardiovascular aging at an organ level may be captured using image-derived phenotypes of cardiac anatomy and function. METHODS AND RESULTS In the current study, we use 2-sample Mendelian randomization to assess the causal link between leukocyte telomere length and 54 cardiac magnetic resonance imaging measures representing structure and function across the 4 cardiac chambers. Genetically predicted shorter leukocyte telomere length was causally linked to smaller ventricular cavity sizes including left ventricular end-systolic volume, left ventricular end-diastolic volume, lower left ventricular mass, and pulmonary artery. The association with left ventricular mass (β =0.217, Pfalse discovery rate=0.016) remained significant after multiple testing adjustment, whereas other associations were attenuated. CONCLUSIONS Our findings support a causal role for shorter leukocyte telomere length and faster cardiac aging, with the most prominent relationship with left ventricular mass.
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Affiliation(s)
- Ahmed M. Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonUK
- Department of Population Health SciencesUniversity of LeicesterUK
- Department of Computer ScienceUniversity of ZakhoKurdistan of IraqIraq
| | | | | | - André Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonUK
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Hou X, Hashemi D, Erley J, Neye M, Bucius P, Tanacli R, Kühne T, Kelm M, Motzkus L, Blum M, Edelmann F, Kuebler WM, Pieske B, Düngen HD, Schuster A, Stoiber L, Kelle S. Noninvasive evaluation of pulmonary artery stiffness in heart failure patients via cardiovascular magnetic resonance. Sci Rep 2023; 13:22656. [PMID: 38114509 PMCID: PMC10730605 DOI: 10.1038/s41598-023-49325-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
Heart failure (HF) presents manifestations in both cardiac and vascular abnormalities. Pulmonary hypertension (PH) is prevalent in up 50% of HF patients. While pulmonary arterial hypertension (PAH) is closely associated with pulmonary artery (PA) stiffness, the association of HF caused, post-capillary PH and PA stiffness is unknown. We aimed to assess and compare PA stiffness and blood flow hemodynamics noninvasively across HF entities and control subjects without HF using CMR. We analyzed data of a prospectively conducted study with 74 adults, including 55 patients with HF across the spectrum (20 HF with preserved ejection fraction [HFpEF], 18 HF with mildly-reduced ejection fraction [HFmrEF] and 17 HF with reduced ejection fraction [HFrEF]) as well as 19 control subjects without HF. PA stiffness was defined as reduced vascular compliance, indicated primarily by the relative area change (RAC), altered flow hemodynamics were detected by increased flow velocities, mainly by pulse wave velocity (PWV). Correlations between the variables were explored using correlation and linear regression analysis. PA stiffness was significantly increased in HF patients compared to controls (RAC 30.92 ± 8.47 vs. 50.08 ± 9.08%, p < 0.001). PA blood flow parameters were significantly altered in HF patients (PWV 3.03 ± 0.53 vs. 2.11 ± 0.48, p < 0.001). These results were consistent in all three HF groups (HFrEF, HFmrEF and HFpEF) compared to the control group. Furthermore, PA stiffness was associated with higher NT-proBNP levels and a reduced functional status. PA stiffness can be assessed non-invasively by CMR. PA stiffness is increased in HFrEF, HFmrEF and HFpEF patients when compared to control subjects.Trial registration The study was registered at the German Clinical Trials Register (DRKS, registration number: DRKS00015615).
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Affiliation(s)
- Xuewen Hou
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Djawid Hashemi
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Charitéplatz 1, 10117, Berlin, Germany
| | - Jennifer Erley
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marthe Neye
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Paulius Bucius
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Radu Tanacli
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Titus Kühne
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Deutsches Herzzentrum der Charité, Institute of Computer-Assisted Cardiovascular Medicine, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Congenital Heart Disease-Pediatric Cardiology, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Marcus Kelm
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Deutsches Herzzentrum der Charité, Institute of Computer-Assisted Cardiovascular Medicine, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Congenital Heart Disease-Pediatric Cardiology, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Laura Motzkus
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Moritz Blum
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frank Edelmann
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Wolfgang M Kuebler
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Burkert Pieske
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Hans-Dirk Düngen
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
| | - Lukas Stoiber
- Royal Brompton Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Sebastian Kelle
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany.
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
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Chen J, Jin L, Wu L, Zhang M, Wu X, Hong Y, Luo X, Li Z. Gender and age disparities in small-to-medium arterial stiffness among the Chinese population. Nutr Metab Cardiovasc Dis 2023; 33:2355-2362. [PMID: 37788957 DOI: 10.1016/j.numecd.2023.08.006] [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: 03/01/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS Arterial pressure-volume index (API) is a non-invasive tool for assessing small-to-medium-sized arterial stiffness. This study aimed to investigate the potential age- and sex-related differences in the API and explore the practical implications of such differences. METHODS AND RESULTS The study analysed 7620 subjects for whom API measurements were available. Linear regression and restrictive cubic spline models were used to investigate the associations between potential risk conditions and the API. Additionally, this study employed a backward stepwise regression method to identify the independent factors associated with a high API. Middle-aged to older women had higher API values and a higher prevalence of high API than men in the same age group. However, the opposite was observed among younger individuals, with women having lower API values than men. This study also identified a J-shaped relationship between API and age, where API values began to increase at a certain age and rapidly increased after that. In women, the API started to increase at 31 years of age and rapidly increased after 54 years of age. In men, the API started to increase at 38 years of age, followed by a rapid increase after 53 years of age. CONCLUSION This study's observation of a significant age-sex interaction in small-to-medium-sized arterial stiffening offers a valuable explanation for cardiovascular disease risk and provides important parameters for using API measurements to evaluate such risk.
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Affiliation(s)
- Jianxiong Chen
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Lin Jin
- Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingheng Wu
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Mengjiao Zhang
- Department of Medical Imaging, Weifang Medical University, Weifang 261053, Shandong, China; Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiuqin Wu
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Yongqiang Hong
- Department of Ultrasound, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
| | - Xianghong Luo
- Department of Echocardiography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhaojun Li
- Department of Ultrasound, Shanghai General Hospital Jiading Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Shah M, Buscot MJ, Tian J, Phan HT, Marwick TH, Dwyer T, Venn A, Gall S. Sex differences in the association between stroke risk factors and pre-clinical predictors of stroke in the childhood determinants of Adult Health study. Atherosclerosis 2023; 384:117171. [PMID: 37391336 DOI: 10.1016/j.atherosclerosis.2023.06.077] [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: 11/27/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND AND AIMS It is unclear why blood pressure (BP), metabolic markers and smoking increase stroke incidence in women more than men. We examined these associations with carotid artery structure and function in a prospective cohort study. METHODS Participants in the Australian Childhood Determinants of Adult Health study at ages 26-36 years (2004-06) were followed-up at 39-49 years (2014-19). Baseline risk factors included smoking, fasting glucose, insulin, systolic and diastolic BP. Carotid artery plaques, intima-media thickness [IMT], lumen diameter and carotid distensibility [CD] were assessed at follow up. Log binomial and linear regression with risk factor × sex interactions predicted carotid measures. Sex-stratified models adjusting for confounders were fitted when significant interactions were identified. RESULTS Among 779 participants (50% women), there were significant risk factor × sex interactions with baseline smoking, systolic BP and glucose associated with carotid measures in women only. Current smoking was associated with incidence of plaques (RRunadjusted 1.97 95% CI 1.4, 3.39), which reduced when adjusted for sociodemographics, depression, and diet (RRadjusted 1.82 95% CI 0.90, 3.66). Greater systolic BP was associated with lower CD adjusted for sociodemographics (βadjusted -0.166 95% CI -0.233, -0.098) and hypertension with greater lumen diameter (βunadjusted 0.131 95% CI 0.037, 0.225), which decreased when adjusted for sociodemographics, body composition and insulin (βadjusted 0.063 95% CI -0.052, 0.178). Greater glucose (βunadjusted -0.212 95% CI -0.397, -0.028) was associated with lower CD, which decreased when adjusted for sociodemographics, BP, depression and polycystic ovary syndrome (βadjusted -0.023 95% CI -0.249, 0.201). CONCLUSIONS Smoking, SBP and glucose affect carotid structure and function more in women than men with some of this risk due to co-occurring risk factors.
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Affiliation(s)
- Mohammad Shah
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Epidemiology Department, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Hoang T Phan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Public Health Management, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
| | - Thomas H Marwick
- Baker Heart and Diabetes Institute, PO Box 6492, Melbourne, Victoria 3004, Australia; Cardiology Department, Western Health, Melbourne, Australia; Departments of Cardiometabolic Health and Medicine, University of Melbourne, Melbourne, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; The George Institute for Global Health, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK; Murdoch Children's Research Institute, Australia Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
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Affiliation(s)
- Richmond W. Jeremy
- Central Clinical School, Faculty of Medicine and Health, University of Sydney. Sydney, New South Wales, Australia
- Marfan and Aortic Disease Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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10
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Bianchini E, Lønnebakken MT, Wohlfahrt P, Piskin S, Terentes‐Printzios D, Alastruey J, Guala A. Magnetic Resonance Imaging and Computed Tomography for the Noninvasive Assessment of Arterial Aging: A Review by the VascAgeNet COST Action. J Am Heart Assoc 2023; 12:e027414. [PMID: 37183857 PMCID: PMC10227315 DOI: 10.1161/jaha.122.027414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Magnetic resonance imaging and computed tomography allow the characterization of arterial state and function with high confidence and thus play a key role in the understanding of arterial aging and its translation into the clinic. Decades of research into the development of innovative imaging sequences and image analysis techniques have led to the identification of a large number of potential biomarkers, some bringing improvement in basic science, others in clinical practice. Nonetheless, the complexity of some of these biomarkers and the image analysis techniques required for their computation hamper their widespread use. In this narrative review, current biomarkers related to aging of the aorta, their founding principles, the sequence, and postprocessing required, and their predictive values for cardiovascular events are summarized. For each biomarker a summary of reference values and reproducibility studies and limitations is provided. The present review, developed in the COST Action VascAgeNet, aims to guide clinicians and technical researchers in the critical understanding of the possibilities offered by these advanced imaging modalities for studying the state and function of the aorta, and their possible clinically relevant relationships with aging.
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Affiliation(s)
| | - Mai Tone Lønnebakken
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Department of Heart DiseaseHaukeland University HospitalBergenNorway
| | - Peter Wohlfahrt
- Department of Preventive CardiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
- Centre for Cardiovascular PreventionCharles University Medical School I and Thomayer HospitalPragueCzech Republic
- Department of Medicine IICharles University in Prague, First Faculty of MedicinePragueCzech Republic
| | - Senol Piskin
- Department of Mechanical Engineering, Faculty of Engineering and Natural SciencesIstinye UniversityIstanbulTurkey
- Modeling, Simulation and Extended Reality LaboratoryIstinye UniversityIstanbulTurkey
| | - Dimitrios Terentes‐Printzios
- First Department of Cardiology, Hippokration Hospital, Athens Medical SchoolNational and Kapodistrian University of AthensGreece
| | - Jordi Alastruey
- School of Biomedical Engineering and Imaging SciencesKing’s College LondonLondonUK
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain
- CIBER‐CV, Instituto de Salud Carlos IIIMadridSpain
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11
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Picone DS, Stoneman E, Cremer A, Schultz MG, Otahal P, Hughes AD, Black JA, Bos WJ, Chen CH, Cheng HM, Dwyer N, Lacy P, Laugesen E, Liang F, Kim HL, Ohte N, Okada S, Omboni S, Ott C, Pereira T, Pucci G, Rajani R, Schmieder R, Sinha MD, Stewart R, Stouffer GA, Takazawa K, Wang J, Weber T, Westerhof BE, Williams B, Yamada H, Sharman JE. Sex Differences in Blood Pressure and Potential Implications for Cardiovascular Risk Management. Hypertension 2023; 80:316-324. [PMID: 35912678 DOI: 10.1161/hypertensionaha.122.19693] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Accurate blood pressure (BP) measurement is critical for optimal cardiovascular risk management. Age-related trajectories for cuff-measured BP accelerate faster in women compared with men, but whether cuff BP represents the intraarterial (invasive) aortic BP is unknown. This study aimed to determine the sex differences between cuff BP, invasive aortic BP, and the difference between the 2 measurements. METHODS Upper-arm cuff BP and invasive aortic BP were measured during coronary angiography in 1615 subjects from the Invasive Blood Pressure Consortium Database. This analysis comprised 22 different cuff BP devices from 28 studies. RESULTS Subjects were 64±11 years (range 40-89) and 32% women. For the same cuff systolic BP (SBP), invasive aortic SBP was 4.4 mm Hg higher in women compared with men. Cuff and invasive aortic SBP were higher in women compared with men, but the sex difference was more pronounced from invasive aortic SBP, was the lowest in younger ages, and the highest in older ages. Cuff diastolic blood pressure overestimated invasive diastolic blood pressure in both sexes. For cuff and invasive diastolic blood pressure separately, there were sex*age interactions in which diastolic blood pressure was higher in younger men and lower in older men, compared with women. Cuff pulse pressure underestimated invasive aortic pulse pressure in excess of 10 mm Hg for both sexes in older age. CONCLUSIONS For the same cuff SBP, invasive aortic SBP was higher in women compared with men. How this translates to cardiovascular risk prediction needs to be determined, but women may be at higher BP-related risk than estimated by cuff measurements.
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Affiliation(s)
- Dean S Picone
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Elif Stoneman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Antoine Cremer
- Department of Cardiology/Hypertension, University Hospital of Bordeaux, France (A.C.)
| | - Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Sciences, University College London, United Kingdom (A.D.H.)
| | - J Andrew Black
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.).,Royal Hobart Hospital, Hobart, Australia (J.A.B., N.D.)
| | - Willem Jan Bos
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands (W.J.B.).,Department of Internal Medicine, Leiden University Medical Center, The Netherlands (W.J.B.)
| | - Chen-Huan Chen
- Department of Internal Medicine, National Yang Ming Chiao Tung University College of Medicine (C.-H.C.)
| | - Hao-Min Cheng
- Department of Medicine (H.-M.C.), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.,Institute of Public Health (H.-M.C.), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.,Center for Evidence-based Medicine (H.-M.C.), Taipei Veterans General Hospital, Taiwan.,Department of Medical Education (H.-M.C.), Taipei Veterans General Hospital, Taiwan.,Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan (H.-M.C.)
| | - Nathan Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.).,Royal Hobart Hospital, Hobart, Australia (J.A.B., N.D.)
| | - Peter Lacy
- Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, United Kingdom (P.L., B.W.)
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark (E.L.)
| | - Fuyou Liang
- School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, China (F.L.).,World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Russia (F.L.)
| | - Hack-Lyoung Kim
- Division of Cardiology, Seoul National University Boramae Hospital, Seoul, South Korea (H.-L.K.)
| | - Nobuyuki Ohte
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan (N.O.)
| | - Sho Okada
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan (S.O.)
| | - Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy (S.O.).,Department of Cardiology, Sechenov First Moscow State Medical University, Russian Federation (S.O.)
| | - Christian Ott
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany (C.O., R.S.)
| | - Telmo Pereira
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal (T.P.).,Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal (T.P.)
| | - Giacomo Pucci
- Unit of Internal Medicine at Terni University Hospital, Department of Medicine, University of Perugia, Italy (G.P.)
| | - Ronak Rajani
- Cardiology Department, Guy's and St. Thomas' Hospitals, London, United Kingdom (R.R.)
| | - Roland Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany (C.O., R.S.)
| | - Manish D Sinha
- Kings College London British Heart Foundation Centre and Department of Clinical Pharmacology and Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, United Kingdom (M.D.S)
| | - Ralph Stewart
- Green Lane Cardiovascular Service, Auckland City Hospital, University of Auckland, New Zealand (R.S.)
| | - George A Stouffer
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill (G.A.S)
| | - Kenji Takazawa
- Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Japan (K.T.)
| | - Jiguang Wang
- Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.W.)
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Berend E Westerhof
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, The Netherlands (B.E.W.)
| | - Bryan Williams
- Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, United Kingdom (P.L., B.W.)
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima Graduate School of Biomedical Sciences, Japan (H.Y.)
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12
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High-normal diastolic blood pressure as a risk factor for left ventricular diastolic dysfunction in healthy postmenopausal women. Hypertens Res 2022; 45:1891-1898. [PMID: 36202980 DOI: 10.1038/s41440-022-01024-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/09/2022]
Abstract
Left ventricular (LV) diastolic dysfunction is associated with heart failure with preserved ejection fraction, and metabolic syndrome (MetS) is a risk factor. However, there is limited knowledge regarding the metabolic factors that contribute to LV dysfunction in postmenopausal women without comorbidities. This study aimed to analyze the relationship between LV diastolic dysfunction and MetS, as well as other cardiovascular risk factors, and to determine risks for LV diastolic dysfunction. Postmenopausal women without hypertension, diabetes mellitus, LV systolic dysfunction, or other heart diseases underwent physical examinations, including echocardiography. The study participants were diagnosed with LV diastolic dysfunction based on several echocardiographic parameters. Logistic regression analyses of LV diastolic dysfunction and cardiovascular risk factors were performed. Of the 269 postmenopausal women examined, 29 (10.7%) and 40 (14.9%) had MetS and LV diastolic dysfunction, respectively. Abnormal diastolic blood pressure (odds ratio, 3.6; 95% confidence interval, 1.16-10.9; P < 0.05) and age (odds ratio, 1.1; 95% confidence interval, 1.07-1.19; P < 0.01) were predictors of LV diastolic dysfunction. In healthy postmenopausal women, high-normal diastolic blood pressure was the only independent risk factor for LV diastolic dysfunction, and it thus may be a useful predictor of diastolic heart failure during routine physical examinations.
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13
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Xu K, Zheng Q, Shao J, Yang L, Dai Y, Zhang J, Liang Y, Huang W, Liu Y, Cheng J, Pan Y, Yang M, Tang L, Du C. Sex differences in the association between visceral adipose tissue and atherosclerosis in type 2 diabetes patients with normal bodyweight: A study in a Chinese population. J Diabetes Investig 2022; 14:92-101. [PMID: 36161704 PMCID: PMC9807154 DOI: 10.1111/jdi.13913] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 01/07/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the impact of visceral adipose tissue (VAT) on atherosclerosis in type 2 diabetes patients with normal bodyweight (OB[-]) in the Chinese population, and to further assess the sex-age differences between them. MATERIALS AND METHODS A total of 8,839 type 2 diabetes patients from two of the National Metabolic Management Centers in China were included in this study. Participants were classified into four groups by visceral fat area (VFA; cm2 ) and body mass index (BMI; kg/m2 ): VFA < 100 and BMI < 23.9 (VA[-]OB[-]), VFA < 100 and BMI ≥ 23.9 (VA[-]OB[+]), VFA ≥ 100 and BMI < 23.9 (VA[+]OB[-]), VFA ≥ 100 and BMI ≥ 23.9 (VA[+]OB[+]). Atherosclerosis was defined by brachial-ankle pulse wave velocity (baPWV; cm/s), and we analyzed the association between VFA, BMI and the tertiles of baPWV values. RESULTS The VA(+)OB(-) prevalence was 3.7% among these participants. Patients with VA(+)OB(-) had the highest baPWV value (P < 0.001) and the highest proportion of the tertile 3 of baPWV (P < 0.001) among four groups, and were significantly associated with baPWV (standardized β = 0.026, P = 0.008). VFA was significantly related to tertile 2 to tertile 3 of baPWV in (OB[-]) type 2 diabetes patients, when compared with tertile 1 of baPWV, respectively. In sex-age stratified analysis, the association of VFA and the tertiles of baPWV showed sex differences. For the 55 years age stratification analysis, there was no age difference in the relationship between VFA and baPWV in (OB[-]) patients. CONCLUSION Increased VAT was an independent risk factor for atherosclerosis in female type 2 diabetes patients with normal weight.
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Affiliation(s)
- Kun Xu
- Department of Internal MedicineShengzhou Hospital of Traditional Chinese MedicineShengzhouChina
| | - Qidong Zheng
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Jianlin Shao
- Zhejiang Provincial Center for Cardiovascular Disease Prevention and ControlZhejiang HospitalHangzhouChina
| | - Lin Yang
- Department of Geriatrics, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Yuancheng Dai
- Department of Internal Medicine of Traditional Chinese MedicineSheyang Diabetes Specialist HospitalYanchengChina
| | - Jingyuan Zhang
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Yao Liang
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Wenhao Huang
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Yajun Liu
- Department of Medicine, The Second College of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Jian Cheng
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Yuping Pan
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Mengyao Yang
- Department of Internal MedicineThe Second People’s Hospital of YuhuanTaizhouChina
| | - Lijiang Tang
- Department of CardiologyZhejiang HospitalHangzhouChina
| | - Changqing Du
- Department of CardiologyZhejiang HospitalHangzhouChina
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14
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Francis CM, Futschik ME, Huang J, Bai W, Sargurupremraj M, Teumer A, Breteler MMB, Petretto E, Ho ASR, Amouyel P, Engelter ST, Bülow R, Völker U, Völzke H, Dörr M, Imtiaz MA, Aziz NA, Lohner V, Ware JS, Debette S, Elliott P, Dehghan A, Matthews PM. Genome-wide associations of aortic distensibility suggest causality for aortic aneurysms and brain white matter hyperintensities. Nat Commun 2022; 13:4505. [PMID: 35922433 PMCID: PMC9349177 DOI: 10.1038/s41467-022-32219-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 07/20/2022] [Indexed: 12/13/2022] Open
Abstract
Aortic dimensions and distensibility are key risk factors for aortic aneurysms and dissections, as well as for other cardiovascular and cerebrovascular diseases. We present genome-wide associations of ascending and descending aortic distensibility and area derived from cardiac magnetic resonance imaging (MRI) data of up to 32,590 Caucasian individuals in UK Biobank. We identify 102 loci (including 27 novel associations) tagging genes related to cardiovascular development, extracellular matrix production, smooth muscle cell contraction and heritable aortic diseases. Functional analyses highlight four signalling pathways associated with aortic distensibility (TGF-β, IGF, VEGF and PDGF). We identify distinct sex-specific associations with aortic traits. We develop co-expression networks associated with aortic traits and apply phenome-wide Mendelian randomization (MR-PheWAS), generating evidence for a causal role for aortic distensibility in development of aortic aneurysms. Multivariable MR suggests a causal relationship between aortic distensibility and cerebral white matter hyperintensities, mechanistically linking aortic traits and brain small vessel disease.
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Affiliation(s)
- Catherine M Francis
- National Heart and Lung Institute, Imperial College London, Programme in Cardiovascular Genetics and Genomics, London, UK
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, SW3 6NP, UK
| | - Matthias E Futschik
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, W12 0NN, UK
| | - Jian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Wenjia Bai
- Department of Brain Sciences, Imperial College London, London, UK
- Department of Computing, Imperial College London, London, UK
| | - Muralidharan Sargurupremraj
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Enrico Petretto
- Programme in Cardiovascular & Metabolic Disorders and Centre for Computational Biology, Duke-NUS Medical School, Singapore, 169857, Republic of Singapore
- Institute of Big Data and Artificial Intelligence, China Pharmaceutical University (CPU), 211198, Nanjing, China
- Computational Biology Programme, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Amanda S R Ho
- Computational Biology Programme, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Philippe Amouyel
- LabEx DISTALZ-U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, University of Lille, Lille, France
- Inserm, U1167, Lille, France
- Centre Hospitalier Universitaire Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, University Hospital and University of Basel, Petersgraben 4, CH - 4031, Basel, Switzerland
- Department of Clinical Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Robin Bülow
- Department of Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Mohammed-Aslam Imtiaz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - N Ahmad Aziz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Valerie Lohner
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - James S Ware
- National Heart and Lung Institute, Imperial College London, Programme in Cardiovascular Genetics and Genomics, London, UK
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, SW3 6NP, UK
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, W12 0NN, UK
| | - Stephanie Debette
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Diseases, Bordeaux University Hospital - CHU Bordeaux, 33000, Bordeaux, France
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- UK Dementia Research Institute at Imperial College London, London, UK
- Health Data Research (HDR) UK London at Imperial College London, London, UK
- Britsh Heart Foundation Centre of Research Excellence at Imperial College London, London, UK
- National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
- UK Dementia Research Institute at Imperial College London, London, UK.
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London, UK.
- UK Dementia Research Institute at Imperial College London, London, UK.
- National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK.
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15
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Diaz-Canestro C, Siebenmann C, Montero D. Marked improvements in cardiac function in postmenopausal women exposed to blood withdrawal plus endurance training. J Sports Sci 2022; 40:1609-1617. [PMID: 35767591 DOI: 10.1080/02640414.2022.2095489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The cardiac phenotype of a substantial fraction of the population, i.e., mature women, is mainly unresponsive to endurance training (ET), the most effective intervention to improve cardiorespiratory fitness. This study assessed whether a novel intervention comprising additional haemodynamic stimuli may overcome the generalized limitations to modify the cardiac phenotype of middle-aged and older women. Fifteen healthy postmenopausal women (52-75 yr) were recruited. Transthoracic echocardiography and central haemodynamics were assessed during incremental cycle ergometry (i) in baseline conditions, (ii) after standard (10%) blood withdrawal and (iii) subsequent 8-week ET. Main outcomes such as left ventricular (LV) function and structure and blood volume (BV) were determined. Phlebotomy induced a 0.5 ± 0.1 l reduction of BV, which was re-established after ET. Decrements in LV end-systolic volume (-27%) and increments in LV ejection fraction (+8%) during exercise as well as improved E/A ratio were detected after ET compared with baseline. In parallel, ET induced a 10% increment in LV mass without a concomitant increase in LV size. In conclusion, postmenopausal women exhibit large improvements in cardiac systolic and diastolic functions along with LV concentric remodelling in response to the sequenced combination of blood withdrawal and ET.
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Affiliation(s)
- Candela Diaz-Canestro
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | | | - David Montero
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.,Department of Cardiac Sciences, Cumming School of Medicine, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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16
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Watson AMD, Chen YC, Peter K. Vascular Aging and Vascular Disease Have Much in Common! Arterioscler Thromb Vasc Biol 2022; 42:1077-1080. [PMID: 35735019 DOI: 10.1161/atvbaha.122.317892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anna M D Watson
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Central Clinical School, Monash University, Melbourne, VIC, Australia. Department of Cardiometabolic Health, University of Melbourne, VIC, Australia
| | - Yung-Chih Chen
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Central Clinical School, Monash University, Melbourne, VIC, Australia. Department of Cardiometabolic Health, University of Melbourne, VIC, Australia
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Central Clinical School, Monash University, Melbourne, VIC, Australia. Department of Cardiometabolic Health, University of Melbourne, VIC, Australia
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17
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Maharaj A, Fischer SM, Dillon KN, Kang Y, Martinez MA, Figueroa A. Acute Citrulline Blunts Aortic Systolic Pressure during Exercise and Sympathoactivation in Hypertensive Postmenopausal Women. Med Sci Sports Exerc 2022; 54:761-768. [PMID: 34974502 DOI: 10.1249/mss.0000000000002848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Hypertensive postmenopausal women (PMW) have exaggerated exercise systolic blood pressure (SBP) due to impaired functional sympatholysis. l-Citrulline (CIT) supplementation attenuates aortic SBP responses to cold pressor test (CPT)-induced vasoconstriction in young men. We hypothesized that acute CIT ingestion would attenuate aortic SBP and leg hemodynamic responses during exercise and CPT (EX + CPT). METHODS Fifteen hypertensive PMW (61 ± 7 yr) were randomly assigned to consume either 6 g of CIT or placebo (PL) separated by a minimum 3-d washout phase. Brachial and aortic blood pressure, femoral artery blood flow (FBF), and vascular conductance (FVC) were measured at rest and during 5 min of unilateral plantarflexion exercise with a CPT applied during minutes 4 and 5. RESULTS No differences between conditions were found in FBF, FVC, and brachial and aortic blood pressure at rest and during exercise alone. Changes in brachial SBP (CIT vs PL, 29 ± 12 vs 40 ± 10 mm Hg) and mean arterial pressure (CIT vs PL, 21 ± 10 vs 33 ± 11 mm Hg), and aortic SBP (CIT vs PL, 27 ± 11 vs 38 ± 9 mm Hg) and mean arterial pressure (CIT vs PL, 23 ± 9 vs 33 ± 11 mm Hg) to EX + CPT were lower in the CIT versus PL condition (P < 0.05). FBF, FVC, and functional sympatholysis (%ΔFVC) were not significantly different between conditions. CONCLUSIONS Acute CIT ingestion attenuated aortic SBP response to exercise and cold-induced sympathetic activation that may prevent left ventricle overload in hypertensive PMW.
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Affiliation(s)
- Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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18
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Ryffel CP, Eser P, Marcin T, Herrsche D, Brugger N, Trachsel LD, Wilhelm M. Young endurance training starting age in non-elite athletes is associated with higher proximal aortic distensibility. Open Heart 2022; 9:openhrt-2021-001771. [PMID: 35264414 PMCID: PMC8915284 DOI: 10.1136/openhrt-2021-001771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/09/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Decreased proximal aortic distensibility (AD) is known to significantly predict all-cause mortality and cardiovascular events among individuals without overt cardiovascular disease. This cross-sectional study investigated the association of endurance training (ET) parameters, namely, ET starting age, ET years and yearly ET volume with AD in non-elite endurance athletes. Methods Healthy, normotensive, male Caucasian participants of a 10-mile race were assessed with a 2D echocardiogram and comprehensive interview. Ascending aortic diameters were measured simultaneously with pulse pressure. Aortic strain, AD and aortic stiffness index were calculated. Predictors of AD were investigated among training parameters by linear regression models corrected for age, resting heart rate, stroke volume index and mean blood pressure. Results Ninety-two of 121 athletes (aged 42±8 years) had sufficient echocardiogram quality and were used for analysis. ET starting age (range 6–52 years) and years of ET (range 2–46 years) were highly collinear and used in two separate models for AD. Significant factors for AD were ET starting age, 10-mile race time and resting heart rate in model I, and age, years of ET, 10-mile race time and heart rate in model II (all p<0.01). Conclusions In our cohort of healthy, non-elite, middle-aged runners, AD was significantly higher in athletes with younger ET starting age or more years of ET (in the model adjusted for confounders). In the model with years of ET, age had a negative contribution to AD, suggesting that with older age, the benefit of more years of ET on AD decreased. Future studies assessing the effect of exercise training on arterial properties should include training starting age.
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Affiliation(s)
- Christoph P Ryffel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Prisca Eser
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thimo Marcin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dario Herrsche
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lukas D Trachsel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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19
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Kwak S, Kim HL, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Sex-specific associations of brachial-ankle pulse wave velocity with adverse cardiac remodeling and long-term cardiovascular outcome. J Hypertens 2022; 40:364-373. [PMID: 34611109 DOI: 10.1097/hjh.0000000000003021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It remains unclear whether the cardiovascular consequences of arterial stiffness differ by sex. This study aimed to investigate the sex-specific association of brachial-ankle pulse wave velocity (baPWV) with adverse cardiac remodeling and cardiovascular outcome. METHOD We studied 11 767 patients (57.6% men) with cardiovascular risk factors, whose baPWV was measured. The primary endpoint was composite cardiovascular events. Restricted cubic spline (RCS) analyses were performed to delineate the association of baPWV with echocardiography parameters and risks of cardiovascular events. RESULTS RCS curves showed that structural/functional echocardiography parameters gradually worsened with increasing baPWV more prominently in women than in men. The prevalence of left ventricular hypertrophy and diastolic dysfunction increases with baPWV increase more steeply in women (P-for-interaction by sex <0.001). During the median follow-up of 3.64 years (interquartile interval, 1.56-5.38 years), 350 cardiovascular events (3.0%) and 155 deaths (1.3%) occurred. Cumulative cardiovascular events and deaths were significantly higher in patients with elevated baPWV in both sexes (P < 0.001). Cox analyses showed that the increase in baPWV was associated with the higher risks of cardiovascular events and deaths more strongly in women [cardiovascular events: men, adjusted hazard ratio 1.10, 95% confidence interval (1.08-1.13), P < 0.001; women, adjusted hazard ratio 1.18, 95% confidence interval (1.13-1.24), P < 0.001 by 100 cm/s increase in baPWV; P-for-interaction by sex = 0.022]. CONCLUSION The detrimental effects of baPWV on adverse cardiac remodeling and cardiovascular outcome were stronger in women than in men. The prognostic information provided by baPWV may be particularly crucial for women.
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Affiliation(s)
- Soongu Kwak
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, South Korea
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20
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Benjamins JW, Yeung MW, van de Vegte YJ, Said MA, van der Linden T, Ties D, Juarez-Orozco LE, Verweij N, van der Harst P. Genomic insights in ascending aortic size and distensibility. EBioMedicine 2022; 75:103783. [PMID: 34968759 PMCID: PMC8718733 DOI: 10.1016/j.ebiom.2021.103783] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alterations in the anatomic and biomechanical properties of the ascending aorta (AAo) can give rise to various vascular pathologies. The aim of the current study is to gain additional insights in the biology of the AAo size and function. METHODS We developed an AI based analysis pipeline for the segmentation of the AAo, and the extraction of AAO parameters. We then performed genome-wide association studies of AAo maximum area, AAo minimum area and AAo distensibility in up to 37,910 individuals from the UK Biobank. Variants that were significantly associated with AAo phenotypes were used as instrumental variables in Mendelian randomization analyses to investigate potential causal relationships with coronary artery disease, myocardial infarction, stroke and aneurysms. FINDINGS Genome-wide association studies revealed a total of 107 SNPs in 78 loci. We annotated 101 candidate genes involved in various biological processes, including connective tissue development (THSD4 and COL6A3). Mendelian randomization analyses showed a causal association with aneurysm development, but not with other vascular diseases. INTERPRETATION We identified 78 loci that provide insights into mechanisms underlying AAo size and function in the general population and provide genetic evidence for their role in aortic aneurysm development.
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Affiliation(s)
- Jan Walter Benjamins
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands.
| | - Ming Wai Yeung
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherland
| | - Yordi J van de Vegte
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - M Abdullah Said
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Thijs van der Linden
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Daan Ties
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Luis E Juarez-Orozco
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherland
| | - Niek Verweij
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherland
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21
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Du J, Ren Y, Liu J, Li T, Zhang Y, Yang S, Kang T, Ning S, Chen L, Guo X, Liu W, Pan L. Association of Prolonged Disease Duration and TG/HDL-C Ratio in Accelerating Atherosclerosis in Patients with Takayasu's Arteritis. Clin Appl Thromb Hemost 2022; 28:10760296221121297. [PMID: 35979594 PMCID: PMC9393669 DOI: 10.1177/10760296221121297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and aim: Takayasu's arteritis (TA) is a chronic
inflammation that frequently involves the aorta and its major branches. It has
been known that atherosclerosis can occur in some TA patients.
Objectives: This study aimed to identify the risk factors
associated with the development of atherosclerosis in TA. Methods:
This retrospective study enrolled a total of 101 TA patients. All patients were
divided into two groups according to the absence or presence of atherosclerosis.
Baseline demographic features and clinical characteristics were compared between
two groups. A logistic model was applied to determine the risk factors
associated with the development of atherosclerosis. Results: Our
data suggested that the disease duration of patients in the atherosclerosis
group was significantly longer than that of patients in the non-atherosclerosis
group [96(18.00, 180.00) versus 48.00(12.00, 111.00) months]
(P = .015). In addition, the average age of patients with
atherosclerosis was significantly older compared to patients without
atherosclerosis [44.00(38.00, 48.00)versus 28.50(24.00,37.00)years]
(P < .001). Logistic regression
analysis showed that the risk of developing atherosclerosis increased by 9.2%
per 1 year increase in the disease duration (P = .005, OR
1.092, 95%CI: 1.027-1.162). Patients with TG/HDL-C ratio more than 0.8875 were
associated with a 5.861fold increase of risk developing atherosclerosis
(P < .001, OR 5.861, 95%CI:
2.299-14.939). Conclusion: Our study indicated that prolonged
disease duration and elevated TG/HDL-C ratio are associated with the development
of atherosclerosis in TA patients.
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Affiliation(s)
- Juan Du
- Department of Rheumatology and Immunology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanlong Ren
- Department of Cardiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Department of Radiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Taotao Li
- Department of Rheumatology and Immunology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yaxin Zhang
- Department of Rheumatology and Immunology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shiyu Yang
- Department of Rheumatology and Immunology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tieduo Kang
- Department of Cardiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shangqiu Ning
- Department of Cardiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Liying Chen
- Department of Cardiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xi Guo
- Department of Interventional Radiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wenxian Liu
- Department of Cardiology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lili Pan
- Department of Rheumatology and Immunology, Beijing 12667Anzhen Hospital, Capital Medical University, Beijing, China
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22
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Vatner SF, Zhang J, Vyzas C, Mishra K, Graham RM, Vatner DE. Vascular Stiffness in Aging and Disease. Front Physiol 2021; 12:762437. [PMID: 34950048 PMCID: PMC8688960 DOI: 10.3389/fphys.2021.762437] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/26/2021] [Indexed: 01/01/2023] Open
Abstract
The goal of this review is to provide further understanding of increased vascular stiffness with aging, and how it contributes to the adverse effects of major human diseases. Differences in stiffness down the aortic tree are discussed, a topic requiring further research, because most prior work only examined one location in the aorta. It is also important to understand the divergent effects of increased aortic stiffness between males and females, principally due to the protective role of female sex hormones prior to menopause. Another goal is to review human and non-human primate data and contrast them with data in rodents. This is particularly important for understanding sex differences in vascular stiffness with aging as well as the changes in vascular stiffness before and after menopause in females, as this is controversial. This area of research necessitates studies in humans and non-human primates, since rodents do not go through menopause. The most important mechanism studied as a cause of age-related increases in vascular stiffness is an alteration in the vascular extracellular matrix resulting from an increase in collagen and decrease in elastin. However, there are other mechanisms mediating increased vascular stiffness, such as collagen and elastin disarray, calcium deposition, endothelial dysfunction, and the number of vascular smooth muscle cells (VSMCs). Populations with increased longevity, who live in areas called “Blue Zones,” are also discussed as they provide additional insights into mechanisms that protect against age-related increases in vascular stiffness. Such increases in vascular stiffness are important in mediating the adverse effects of major cardiovascular diseases, including atherosclerosis, hypertension and diabetes, but require further research into their mechanisms and treatment.
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Affiliation(s)
- Stephen F Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Jie Zhang
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Christina Vyzas
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Kalee Mishra
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Robert M Graham
- Victor Chang Cardiac Research Institute, University of New South Wales, Darlinghurst, NSW, Australia
| | - Dorothy E Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
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23
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Diaz-Canestro C, Pentz B, Sehgal A, Montero D. Blood withdrawal acutely impairs cardiac filling, output and aerobic capacity in proportion to induced hypovolemia in middle-aged and older women. Appl Physiol Nutr Metab 2021; 47:1-8. [PMID: 34875180 DOI: 10.1139/apnm-2021-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Blood donation entails acute reductions of cardiorespiratory fitness in healthy men. Whether these effects can be extrapolated to blood donor populations comprising women remains uncertain. The purpose of this study was to comprehensively assess the acute impact of blood withdrawal on cardiac function, central hemodynamics and aerobic capacity in women throughout the mature adult lifespan. Transthoracic echocardiography and O2 uptake were assessed at rest and throughout incremental exercise (cycle ergometry) in healthy women (n = 30, age: 47-77 yr). Left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac output (Q̇) and peak O2 uptake (V̇O2peak), and blood volume (BV) were determined with established methods. Measurements were repeated following a 10% reduction of BV within a week period. Individuals were non-smokers, non-obese and moderately fit (V̇O2peak = 31.4 ± 7.3 mL·min-1·kg-1). Hematocrit and BV ranged from 38.0 to 44.8% and from 3.8 to 6.6 L, respectively. The standard 10% reduction in BV resulted in 0.5 ± 0.1 L withdrawal of blood, which did not alter hematocrit (P = 0.953). Blood withdrawal substantially reduced cardiac LVEDV and SV at rest as well as during incremental exercise (≥10% decrements, P ≤ 0.009). Peak Q̇ was proportionally decreased after blood withdrawal (P < 0.001). Blood withdrawal induced a 10% decrement in V̇O2peak (P < 0.001). In conclusion, blood withdrawal impairs cardiac filling, Q̇ and aerobic capacity in proportion to the magnitude of hypovolemia in healthy mature women. Novelty: The filling of the heart and therefore cardiac output are impaired by blood withdrawal in women. Oxygen delivery and aerobic capacity are reduced in proportion to blood withdrawal.
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Affiliation(s)
- Candela Diaz-Canestro
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Brandon Pentz
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Arshia Sehgal
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - David Montero
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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24
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Vasan RS, Song RJ, Xanthakis V, Mitchell GF. Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study. Hypertension 2021; 78:1278-1286. [PMID: 34601969 PMCID: PMC8516742 DOI: 10.1161/hypertensionaha.121.17702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA
- Framingham Heart Study, Framingham, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Rebecca J. Song
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA
- Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
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25
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Diaz-Canestro C, Siebenmann C, Montero D. Blood Oxygen Carrying Capacity Determines Cardiorespiratory Fitness in Middle-Age and Older Women and Men. Med Sci Sports Exerc 2021; 53:2274-2282. [PMID: 34107511 DOI: 10.1249/mss.0000000000002720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE Whether blood oxygen (O2)-carrying capacity plays a substantial role in determining cardiorespiratory fitness, a strong predictor of mortality, remains uncertain in women and elderly individuals because of the scarcity of experimental investigations. This study experimentally assessed the role of blood O2-carrying capacity on cardiorespiratory fitness in middle-age and older individuals. METHODS Healthy women and men (n = 31, 35-76 yr) matched by age and fitness were recruited. Transthoracic echocardiography, central hemodynamics, and O2 uptake were assessed throughout incremental exercise in (i) control conditions and (ii) after a 10% reduction of blood O2-carrying capacity via carbon monoxide administration, in a blinded manner. Effects on cardiac function, blood pressure, peak O2 uptake, and effective hemoglobin (Hb) were determined with established methods. RESULTS Blood O2-carrying capacity, represented by effective Hb, was similarly reduced in women (11.8 ± 0.6 vs 10.7 ± 0.6 g·dL-1, P < 0.001) and men (13.0 ± 0.9 vs 11.7 ± 0.6 g·dL-1, P < 0.001) (P for sex effect = 0.580). Reduced O2-carrying capacity did not induce major effects on cardiac function and hemodynamics during exercise, except for a 10%-15% decrement in peak systolic blood pressure in both sexes (P ≤ 0.034). Peak O2 uptake decreased from 35 ± 6 to 31 ± 6 mL·min-1·kg-1, P < 0.001) in women and from 35 ± 9 to 32 ± 9 mL·min-1·kg-1 (P = 0.024) in men in approximate proportion to the reduction of O2-carrying capacity, an effect that did not differ between sexes (P = 0.778). CONCLUSIONS Blood O2-carrying capacity stands out as a major determinant of cardiorespiratory fitness in healthy mature women and men, with no differential effect of sex.
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26
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Dao E, Barha CK, Santos M, Welch M, Liu-Ambrose T. Sex Differences in the Relationship Between Arterial Stiffness and Cognitive Function in Older Adults. J Stroke Cerebrovasc Dis 2021; 31:106175. [PMID: 34715522 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To examine potential sex differences in the relationship between arterial stiffness and global cognitive function and executive functions. METHODS Baseline data from 80 older adults were included from two randomized controlled trials (NCT02669394 and NCT02737878). Arterial stiffness was measured by carotid-femoral pulse wave velocity (cf-PWV). Cognitive function assessment included global cognition (Mini-Mental State Examination [MMSE]) and executive functions (set shifting [Trail Making Test Part B minus A], inhibition [Stroop Test], and working memory [Verbal Digit Span Backwards Test]). Separate statistical models were constructed to assess the effect of cf-PWV on each cognitive outcome for females and males. Each statistical model controlled for Framingham cardiovascular disease risk score and education. RESULTS Higher cf-PWV was associated with impaired MMSE performance in males (β = -0.48; p = 0.018), but not females (p ≥ 0.389). For executive processes, higher cf-PWV was associated with impaired Trail Making Test Part B minus A (β = 0.56; p = 0.005) and Stroop Test (β = 0.59; p = 0.004) in males, but not in females (ps ≥ 0.108). cf-PWV was not significantly associated with Verbal Digit Span Forward minus Backward Test in males or females (ps ≥ 0.108). CONCLUSIONS Arterial stiffness is more strongly associated with cognitive impairment in males than females. These results further elucidate the interplay between vascular health and cognitive function by providing support for sex-specific mechanisms.
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Affiliation(s)
- Elizabeth Dao
- Department of Radiology, University of British Columbia (UBC), 2775 Laurel St., Vancouver V5Z 1M9, Canada; Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada.
| | - Cindy K Barha
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
| | - Mij Santos
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada.
| | - Madison Welch
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
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27
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Aryal SR, Siddiqui M, Sharifov OF, Coffin MD, Zhang B, Gaddam KK, Gupta H, Denney TS, Dell'Italia LJ, Oparil S, Calhoun DA, Lloyd SG. Spironolactone Reduces Aortic Stiffness in Patients With Resistant Hypertension Independent of Blood Pressure Change. J Am Heart Assoc 2021; 10:e019434. [PMID: 34459249 PMCID: PMC8649301 DOI: 10.1161/jaha.120.019434] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Aortic stiffness is an independent predictor of cardiovascular events in patients with arterial hypertension. Resistant hypertension is often linked to hyperaldosteronism and associated with adverse outcomes. Spironolactone, a mineralocorticoid receptor antagonist, has been shown to reduce both the arterial blood pressure (BP) and aortic stiffness in resistant hypertension. However, the mechanism of aortic stiffness reduction by spironolactone is not well understood. We hypothesized that spironolactone reduces aortic stiffness in resistant hypertension independently of BP change. Methods and Results Patients with uncontrolled BP (≥140/90 mm Hg) despite use of ≥3 antihypertensive medications (including diuretics) were prospectively recruited. Participants were started on spironolactone at 25 mg/d, and increased to 50 mg/d at 4 weeks while other antihypertensive medications were withdrawn to maintain constant mean BP. Phase‐contrast cardiac magnetic resonance imaging of the ascending aorta was performed in 30 participants at baseline and after 6 months of spironolactone treatment to measure aortic pulsatility, distensibility, and pulse wave velocity. Pulse wave velocity decreased (6.3±2.3 m/s to 4.5±1.8 m/s, P<0.001) and pulsatility and distensibility increased (15.9%±5.3% to 22.1%±7.9%, P<0.001; and 0.28%±0.10%/mm Hg to 0.40%±0.14%/mm Hg, P<0.001, respectively) following 6 months of spironolactone. Conclusions Our results suggest that spironolactone improves aortic properties in resistant hypertension independently of BP, which may support the hypothesis of an effect of aldosterone on the arterial wall. A larger prospective study is needed to confirm our findings.
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Affiliation(s)
- Sudeep R Aryal
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL
| | - Mohammed Siddiqui
- Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL
| | - Oleg F Sharifov
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL
| | - Megan D Coffin
- School of Medicine University of Alabama at Birmingham Birmingham AL
| | - Bin Zhang
- Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Krishna K Gaddam
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL
| | | | - Thomas S Denney
- Department of Electrical and Computer Engineering Auburn University Auburn AL
| | - Louis J Dell'Italia
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL.,VA Medical Center Birmingham AL
| | - Suzanne Oparil
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL.,Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL
| | - David A Calhoun
- Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL
| | - Steven G Lloyd
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL.,VA Medical Center Birmingham AL
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28
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Estimated pulse wave velocity (ePWV) as a potential gatekeeper for MRI-assessed PWV: a linear and deep neural network based approach in 2254 participants of the Netherlands Epidemiology of Obesity study. Int J Cardiovasc Imaging 2021; 38:183-193. [PMID: 34304318 PMCID: PMC8818644 DOI: 10.1007/s10554-021-02359-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/15/2021] [Indexed: 12/03/2022]
Abstract
Pulse wave velocity (PWV) assessed by magnetic resonance imaging (MRI) is a prognostic marker for cardiovascular events. Prediction modelling could enable indirect PWV assessment based on clinical and anthropometric data. The aim was to calculate estimated-PWV (ePWV) based on clinical and anthropometric measures using linear ridge regression as well as a Deep Neural Network (DNN) and to determine the cut-off which provides optimal discriminative performance between lower and higher PWV values. In total 2254 participants from the Netherlands Epidemiology of Obesity study were included (age 45–65 years, 51% male). Both a basic and expanded prediction model were developed. PWV was estimated using linear ridge regression and DNN. External validation was performed in 114 participants (age 30–70 years, 54% female). Performance was compared between models and estimation accuracy was evaluated by ROC-curves. A cut-off for optimal discriminative performance was determined using Youden’s index. The basic ridge regression model provided an adjusted R2 of 0.33 and bias of < 0.001, the expanded model did not add predictive performance. Basic and expanded DNN models showed similar model performance. Optimal discriminative performance was found for PWV < 6.7 m/s. In external validation expanded ridge regression provided the best performance of the four models (adjusted R2: 0.29). All models showed good discriminative performance for PWV < 6.7 m/s (AUC range 0.81–0.89). ePWV showed good discriminative performance with regard to differentiating individuals with lower PWV values (< 6.7 m/s) from those with higher values, and could function as gatekeeper in selecting patients who benefit from further MRI-based PWV assessment.
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29
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van Hout MJ, Dekkers IA, Westenberg JJ, Schalij MJ, Widya RL, de Mutsert R, Rosendaal FR, de Roos A, Jukema JW, Scholte AJ, Lamb HJ. Normal and reference values for cardiovascular magnetic resonance-based pulse wave velocity in the middle-aged general population. J Cardiovasc Magn Reson 2021; 23:46. [PMID: 33866975 PMCID: PMC8054386 DOI: 10.1186/s12968-021-00739-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk. However, the scarce availability of normal and reference values for cardiovascular magnetic resonance imaging (CMR) based PWV is limiting clinical implementation. The aim of this study was to determine normal and reference values for CMR assessed PWV in the general population. METHODS From the 2,484 participants of the Netherlands Epidemiology of Obesity (NEO) study that have available CMR-PWV data, 1,394 participants free from cardiovasculard disease, smokers or treatment for diabetes, hypertension or dyslipidaemia were selected (45-65 years, 51% female). Participants were divided into sex, age and blood pressure (BP) subgroups. Normal values were specified for participants with a BP < 130/80 mmHg and reference values for elevated BP subgroups (≥ 130/80 and < 140/90 mmHg; and ≥ 140/90 mmHg). Differences between groups were tested with independent samples t-test or ANOVA. Due to an oversampling of obese individuals in this study, PWV values are based on a weighted analysis making them representative of the general population. RESULTS Normal mean PWV was 6.0 m/s [95% CI 5.8-6.1]. PWV increased with advancing age and BP categories (both p < 0.001). There was no difference between sex in normal PWV, however in the BP > 140/90 mmHg women had a higher PWV (p = 0.005). The interpercentile ranges were smaller for participants < 55 years old compared to participants ≥ 55 years, indicating an increasing variability of PWV with age. PWV upper limits were particularly elevated in participants ≥ 55 years old in the high blood pressure subgroups. CONCLUSION This study provides normal and reference values for CMR-assessed PWV per sex, age and blood pressure category in the general population.
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Affiliation(s)
- Max J van Hout
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Jos J Westenberg
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Martin J Schalij
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Ralph L Widya
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Renée de Mutsert
- Department of Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
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Kirkham AA, Paterson DI, Haykowsky MJ, Beaudry RI, Mackey JR, Pituskin E, Grenier JG, Thompson RB. Aerobic Fitness Is Related to Myocardial Fibrosis Post-Anthracycline Therapy. Med Sci Sports Exerc 2021; 53:267-274. [PMID: 32826630 DOI: 10.1249/mss.0000000000002469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE We evaluated the impact of anthracyclines on left ventricular function and myocardial tissue characteristics using cardiovascular magnetic resonance (CMR) imaging to determine their relationship with V˙O2peak. METHODS Women with breast cancer who had not yet received treatment (No-AT, n = 16) and had received anthracycline treatment ~1 yr earlier (Post-AT, n = 16) and controls without cancer (CON, n = 16) performed a maximal exercise test and a comprehensive 3T CMR examination, including native myocardial T1 mapping, where elevated T1 times are indicative of myocardial fibrosis. ANOVA and linear regression were used to compare CMR variables between groups and to determine associations with V˙O2peak. Subgroup analysis was performed by categorizing participants as "fit" or "unfit" based on whether their V˙O2peak value was greater or less than 100% of reference value for age, respectively. RESULTS Left ventricular end-diastolic volume, ejection fraction, and mass were similar between groups. Post-AT, T1 times were elevated (1534 ± 32 vs 1503 ± 28 ms, P < 0.01), and V˙O2peak was reduced (23.1 ± 7.5 vs 29.5 ± 7.7 mL·kg-1⋅min-1, P = 0.02) compared with CON. In No-AT, T1 times and V˙O2peak were similar to CON. In the Post-AT group, T1 time was associated with V˙O2peak (R2 = 64%), whereas in the absence of anthracyclines (i.e., No-AT and CON groups), T1 time was not associated with V˙O2peak. Regardless of group, all fit women had similar T1 times, whereas unfit women Post-AT had higher T1 than unfit CON (1546 ± 22 vs 1500 ± 33 ms, P < 0.01). CONCLUSIONS After anthracycline chemotherapy, an elevated T1 time suggesting greater extent of myocardial fibrosis, was associated with lower V˙O2peak. However, those who were fit did not have evidence of myocardial fibrosis after anthracycline treatment.
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Affiliation(s)
- Amy Ashley Kirkham
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, CANADA
| | - D Ian Paterson
- Division of Cardiology, University of Alberta, Edmonton, AB, CANADA
| | | | - Rhys I Beaudry
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, AB, CANADA
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, AB, CANADA
| | - Justin G Grenier
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, CANADA
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, CANADA
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Wang Z, Li W, Liu W, Tian J. Gender is a determinant of carotid artery stiffness independent of age and blood pressure. Br J Radiol 2021; 94:20200796. [PMID: 33476176 DOI: 10.1259/bjr.20200796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify the gender-specific differences in carotid artery structural and stiffening parameters by radiofrequency ultrasound (RFU) with an automatic arterial stiffness analyzing system. METHODS Seventy-two consecutive individuals (32 males and 40 females, age range from 36 to 62 years) with no history of significant cardiovascular diseases or carotid artery plaques were enrolled between September and December 2017. Quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) parameters were automatically computed, including pulse wave velocity (PWV), vascular distension, compliance coefficient (CC), distensibility coefficient (DC), stiffness index α and β, augmentation pressure (AP), and augmentation index (AIx). Those parameters were compared between males and females. Multiple linear regression analysis was performed to assess the independent association between gender and RFU parameters. RESULTS The mean age had no difference between males and females (47.8 ± 3.3 vs 50.0 ± 8.5 years, p = 0.19). Females had higher systolic blood pressure (134.53 ± 9.65 vs 127.78 ± 6.12 mm Hg) and diastolic blood pressure (85.83 ± 3.94 vs 78.03 ± 5.22 mm Hg), greater carotid QIMT (598.73 ± 72.16 vs 550.84 ± 29.37 µm), advanced PWV (8.08 ± 1.60 vs 6.24 ± 0.70 m/s), higher stiffness index α (6.21 ± 1.94 vs 3.95 ± 0.78) and β (9.43 ± 3.17 vs 6.38 ± 0.78), higher AP (6.68 ± 2.24 vs 3.64 ± 1.22 mm Hg) and AIx (7.42 ± 2.08 vs 4.69 ± 1.26%), all p < 0.001. Multiple linear regression analysis demonstrated gender was independently associated with carotid structural and elastic parameters. CONCLUSION Gender independently impacts carotid structure and function, with females more vulnerable to the progression of arterial aging. Awareness of the gender differences on the risk stratification of carotid artery disease will benefit reliable assessments and specific management recommendations in clinical practice. ADVANCES IN KNOWLEDGE (1) RFU provides an μm-unit quality IMT measurement and multiple quality arterial stiffness parameters. (2) Gender is an independent determinant in both the arterial structural and elastic aspects, with females of stiffer arteries in low CVD risk individuals.
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Affiliation(s)
- Zhenzhen Wang
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Li
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Liu
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Tian
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Joseph J, Nabeel PM, Rao SR, Venkatachalam R, Shah MI, Kaur P. Assessment of Carotid Arterial Stiffness in Community Settings With ARTSENS®. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2020; 9:1900111. [PMID: 33329943 PMCID: PMC7732146 DOI: 10.1109/jtehm.2020.3042386] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/25/2020] [Accepted: 11/16/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We investigate the field feasibility of carotid stiffness measurement using ARTSENS® Touch and report the first community-level data from India. METHOD In an analytical cross-sectional survey among 1074 adults, we measured specific stiffness index ([Formula: see text]), pressure-strain elastic modulus ([Formula: see text]), arterial compliance (AC), and one-point pulse wave velocity (PWV[Formula: see text]) from the left common carotid artery. Data for established risk factors (waist circumference, blood pressure, plasma glucose, triglycerides, and HDL-C) were also collected. The association of carotid stiffness with age, gender, hypertension/diabetes, smoking, and clustering of risk factors was studied. RESULTS Measurements were repeatable with a relative difference (RD) between consecutive readings of < 5% for blood pressure and < 15% for [Formula: see text]% of arterial diameter values. The average RDs for [Formula: see text], [Formula: see text], AC, and PWV[Formula: see text], were 20.51%, 22.31%, 25.10%, and 14.13%, respectively. Typical range for stiffness indices among females and males were [Formula: see text]: 8.12 ± 3.59 vs 6.51 ± 2.78, [Formula: see text]: 113.24 ± 56.12 kPa vs 92.33 ± 40.65 kPa, PWV[Formula: see text]: 6.32 ± 1.38 ms-1 vs 5.81 ± 1.16 ms-1, and AC: 0.54 ± 0.36 mm2 kPa-1 vs 0.72 ± 0.38 mm2 kPa-1. Mean [Formula: see text], [Formula: see text], and PWV[Formula: see text] increased (and mean AC decreased) across decades of age; the trend persisted even after excluding hypertensives and subjects with diabetes. The odds ratio of presence of multiple risk factors for [Formula: see text] kPa and/or PWV[Formula: see text] ms-1 was ≥ 2.12 or above in males. In females, it was just above 2.00 for [Formula: see text] kPa and/or PWV[Formula: see text] ms-1 and increased to ≥ 3.33 for [Formula: see text] kPa and ≥ 3.25 for PWV[Formula: see text] ms-1. CONCLUSION The study demonstrated the feasibility of carotid stiffness measurement in a community setting. A positive association between the risk factors and carotid artery stiffness provides evidence for the device's use in resource-constrained settings. Clinical Impact: The device paves the way for epidemiological and clinical studies that are essential for establishing population-level nomograms for wide-spread use of carotid stiffness in clinical practice and field screening of 'at-risk' subjects.
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Affiliation(s)
- Jayaraj Joseph
- Department of Electrical EngineeringIndian Institute of Technology MadrasChennai600036India
| | - P. M. Nabeel
- Healthcare Technology Innovation CentreIndian Institute of Technology MadrasChennai600113India
| | - Sudha Ramachandra Rao
- Indian Council of Medical ResearchNational Institute of EpidemiologyChennai600077India
| | | | - Malay Ilesh Shah
- Healthcare Technology Innovation CentreIndian Institute of Technology MadrasChennai600113India
| | - Prabhdeep Kaur
- Indian Council of Medical ResearchNational Institute of EpidemiologyChennai600077India
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Bawa-Allah A, Mashao MM, Nyundu TF, Phukubje EM, Nkosi BG, Ngema MV, Mlambo BW, Maseko MJ. SERUM LIPID PROFILE AND ARTERIAL STIFFNESS IN NON-DIPPERS. INTERNATIONAL JOURNAL OF MEDICINE AND MEDICAL RESEARCH 2020. [DOI: 10.11603/ijmmr.2413-6077.2020.1.11014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. A non-dipping blood pressure profile (NDP) is associated with increased arterial stiffness and other cardiovascular target organ damage. Serum lipid profiles have been shown to be important determinants of arterial stiffness.
Objective. The aim of the research was to assess serum lipid profiles and arterial stiffness in non-dippers.
Methods. This cross-sectional study was conducted involving 796 (288 males and 508 females) participants of black African origin. A twenty-four-hour ambulatory BP monitoring was done using a Spacelabs 90207 (Spacelabs Inc., Redmond, Washington, USA) monitor. Carotid-Femoral pulse wave velocity measurements were performed using a high fidelity SPC-301 micromanometer (Millar instruments Inc., Houston, TX).
Results. Of the 288 males, 140 were classified as non-dippers. Of the 508 females, 273 were classified as non-dippers. In the general population, males had higher triglycerides when compared with females 1.46±0.96 vs 1.13±1.02, p<0.0001. Additionally, dipper males had higher serum TRGL when compared with dipper females 1.32±0.98 vs 1.06±0.58, p = 0.0012. Non-dipper males also had higher serum TRGL when compared with non-dipper females 1.61±2.05 vs 1.19±1.14, p=0.0078. Serum HDLc was lower in the non-dipper male group when compared to the non-dipper female group (p=0.008). In both male and female groups, non-dippers had higher CFPWV when compared with dippers; 7.53±3.60 vs 5.74±2.47, p<0.0001 and 6.64±2.52 vs 5.98±2.23, p=0.0021 respectively. However, non-dipper males had significantly higher CFPWV when compared with non-dipper females (7.53±3.60 vs 6.64±2.52, p=0.0031).
Conclusions. Therapies targeting a reduction of serum triglycerides levels might be beneficial in improving arterial compliance with or without the presence of non-dipping.
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Bai W, Suzuki H, Huang J, Francis C, Wang S, Tarroni G, Guitton F, Aung N, Fung K, Petersen SE, Piechnik SK, Neubauer S, Evangelou E, Dehghan A, O'Regan DP, Wilkins MR, Guo Y, Matthews PM, Rueckert D. A population-based phenome-wide association study of cardiac and aortic structure and function. Nat Med 2020; 26:1654-1662. [PMID: 32839619 PMCID: PMC7613250 DOI: 10.1038/s41591-020-1009-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/07/2020] [Indexed: 12/14/2022]
Abstract
Differences in cardiac and aortic structure and function are associated with cardiovascular diseases and a wide range of other types of disease. Here we analyzed cardiovascular magnetic resonance images from a population-based study, the UK Biobank, using an automated machine-learning-based analysis pipeline. We report a comprehensive range of structural and functional phenotypes for the heart and aorta across 26,893 participants, and explore how these phenotypes vary according to sex, age and major cardiovascular risk factors. We extended this analysis with a phenome-wide association study, in which we tested for correlations of a wide range of non-imaging phenotypes of the participants with imaging phenotypes. We further explored the associations of imaging phenotypes with early-life factors, mental health and cognitive function using both observational analysis and Mendelian randomization. Our study illustrates how population-based cardiac and aortic imaging phenotypes can be used to better define cardiovascular disease risks as well as heart-brain health interactions, highlighting new opportunities for studying disease mechanisms and developing image-based biomarkers.
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Affiliation(s)
- Wenjia Bai
- Data Science Institute, Imperial College London, London, UK. .,Department of Brain Sciences, Imperial College London, London, UK.
| | - Hideaki Suzuki
- Department of Brain Sciences, Imperial College London, London, UK.,Department of Cardiovascular Medicine, Tohoku University Hospital, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Jian Huang
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,UK Dementia Research Institute, Imperial College London, London, UK
| | - Catherine Francis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Shuo Wang
- Data Science Institute, Imperial College London, London, UK
| | - Giacomo Tarroni
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK.,CitAI Research Centre, Department of Computer Science, City University of London, London, UK
| | | | - Nay Aung
- NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Kenneth Fung
- NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Steffen E Petersen
- NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Stefan K Piechnik
- NIHR Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- NIHR Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Evangelos Evangelou
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Abbas Dehghan
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,UK Dementia Research Institute, Imperial College London, London, UK
| | - Declan P O'Regan
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Martin R Wilkins
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Yike Guo
- Data Science Institute, Imperial College London, London, UK
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London, UK.,UK Dementia Research Institute, Imperial College London, London, UK
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK
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Gomes VC, Raghavan ML, Silva LFFD, Gomes J, Silvestre GC, Queiroz A, Marques MA, Zyngier SP, Kwang-Joon Chung T, Silva ESD. Experimental Study of Rupture Pressure and Elasticity of Abdominal Aortic Aneurysms Found at Autopsy. Ann Vasc Surg 2020; 70:517-527. [PMID: 32891747 DOI: 10.1016/j.avsg.2020.08.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Resistance and elasticity of normal and aneurysmal aorta walls are directly associated with this vessel's growth and rupture. This study aims to experimentally analyze the biomechanical behavior of aneurysmal specimens found at autopsy, comparing them with normal diameter aortas removed from age-matched donors. METHODS Thirty-eight human aortas (30 normal aortas; 8 infrarenal abdominal aortic aneurysms) were harvested during autopsy. An apparatus was built with a digital gauge, plastic tray, connections, and hoses that conducted fluid (air) from a pump through the system. Specimens were dissected, and a flexible balloon was introduced in each of them to avoid leakage. The specimens were fastened on the test tray, and activation of the air pump enhanced system pressure up to their rupture. RESULTS All 8 aneurysms and all 30 normal aortas specimens evolved to rupture under inflation pressures above 590 mm Hg (mean ± standard deviation = 1,035 ± 375 mm Hg) and 840 mm Hg (mean ± SD = 1,405 ± 342 mm Hg), respectively. In the aneurysm group, 25% of specimens did not rupture in their most dilated region. Percentage of increment in diameter was higher in normal aortas (mean ± SD = 0.2106 ± 0.144) than in aneurysms (mean ± SD = 0.093 ± 0.070). CONCLUSIONS In the present experiment, unruptured infrarenal abdominal aortic aneurysms could support high pressures nearly as much as nonaneurysmal abdominal aortas. In some specimens, the most dilated part of the aneurysm was not the most vulnerable under pressure. Normal aortas presented higher elasticity than aneurysms.
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Affiliation(s)
- Vivian Carla Gomes
- Vascular and Endovascular Surgery Division, Department of Surgery, Laboratory for Medical Investigation #2, (LIM 02). University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil.
| | - Madhavan Lakshmi Raghavan
- Department of Biomedical Engineering, Seamans Center for the Engineering Arts and Sciences, University of Iowa, Iowa City, IA
| | | | - Jorge Gomes
- Shamah Engineering - Project Division - Av. Fagundes Filho, 361, room 11, São Paulo, São Paulo, Brazil
| | - Gina Camillo Silvestre
- Vascular and Endovascular Surgery Division, Department of Surgery, Laboratory for Medical Investigation #2, (LIM 02). University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil
| | - Alexandre Queiroz
- Vascular and Endovascular Surgery Division, Department of Surgery, Laboratory for Medical Investigation #2, (LIM 02). University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil
| | - Michele Alberto Marques
- Vascular and Endovascular Surgery Division, Department of Surgery, Laboratory for Medical Investigation #2, (LIM 02). University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil
| | - Selene Perrotti Zyngier
- Department of Pathology, University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil
| | - Timothy Kwang-Joon Chung
- Department of Biomedical Engineering, Seamans Center for the Engineering Arts and Sciences, University of Iowa, Iowa City, IA
| | - Erasmo Simão da Silva
- Vascular and Endovascular Surgery Division, Department of Surgery, Laboratory for Medical Investigation #2, (LIM 02). University of São Paulo School of Medicine (FMUSP), São Paulo, São Paulo, Brazil
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The Impact of Sex on Left Ventricular Cardiac Adaptations to Endurance Training: a Systematic Review and Meta-analysis. Sports Med 2020; 50:1501-1513. [DOI: 10.1007/s40279-020-01294-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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37
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Vera L, Van Steenkiste G, Decloedt A, Chiers K, van Loon G. Age-related differences in blood pressure, ultrasound-derived arterial diameters and arterial wall stiffness parameters in horses. Equine Vet J 2020; 52:868-875. [PMID: 32196729 DOI: 10.1111/evj.13263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Arterial rupture mainly affects older horses. The reason why older horses are more prone to arterial rupture and which underlying vascular changes predispose older horses to aortic rupture is still unclear. OBJECTIVES To investigate the effect of ageing on the equine arterial wall and blood pressure. STUDY DESIGN Cohort study. METHODS Non-invasive blood pressure measurement using a tail cuff and vascular ultrasound from aorta, common carotid artery and external iliac artery was performed in 50 healthy young (3-7 years) and 50 healthy old Warmblood horses (>18 years). Arterial diameters and cross-sectional areas, and arterial wall thickness were measured offline. Regional arterial wall stiffness of the aorta and common carotid artery were assessed using pulse wave velocity, while lumen area/diameter change, strain, compliance and distensibility were calculated to assess local arterial wall stiffness. RESULTS No difference in blood pressure was found between old and young horses. All arterial dimensions and intima-media thickness of the common carotid artery were significantly larger in old horses. A significantly higher local arterial wall stiffness was found for the aorta and the caudal common carotid artery in older horses. For the external iliac artery, no significant differences in arterial wall stiffness were found. Both aortic and carotid pulse wave velocities were higher in older horses compared with younger horses. MAIN LIMITATIONS Blood pressure was measured non-invasively. CONCLUSIONS In horses, arteries stiffen with age, in combination with luminal enlargement and arterial wall thickening. This might, at least partially, explain the increased incidence of arterial rupture in older horses.
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Affiliation(s)
- Lisse Vera
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Equine Cardioteam Ghent University, Ghent University, Merelbeke, Belgium
| | - Glenn Van Steenkiste
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Equine Cardioteam Ghent University, Ghent University, Merelbeke, Belgium
| | - Annelies Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Equine Cardioteam Ghent University, Ghent University, Merelbeke, Belgium
| | - Koen Chiers
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Gunther van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Equine Cardioteam Ghent University, Ghent University, Merelbeke, Belgium
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Li Y, Hickson SS, McEniery CM, Wilkinson IB, Khir AW. Stiffening and ventricular-arterial interaction in the ascending aorta using MRI: ageing effects in healthy humans. J Hypertens 2020; 37:347-355. [PMID: 30645209 PMCID: PMC6365245 DOI: 10.1097/hjh.0000000000001886] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Supplemental Digital Content is available in the text Objectives: The aim of this study was to investigate the effect of age and sex on nPWV and ndI in the ascending aorta of healthy humans. Background: Local pulse wave velocity (nPWV) and wave intensity (ndI) in the human ascending aorta have not been studied adequately, because of the need for invasive pressure measurements. However, a recently developed technique made the noninvasive determination of nPWV and ndI possible using measurements of flow velocity and arterial diameter. Methods: Diameter and flow velocity were measured at the level of the ascending aorta in 144 healthy participants (aged 20–77 years, 66 men), using MRI. nPWV, ndI parameters; forward (FCW); backward (BCW) compression waves, forward decompression wave (FDW), local aortic distensibility (nDs) and reflection index (nRI) were calculated. Results: nPWV increased significantly with age from 4.7 ± 0.3 m/s for those 20–30 years to 6.4 ± 0.2 m/s for those 70–80 years (P < 0.001) and did not differ between sexes. nDs decreased with age (5.3 ± 0.5 vs. 2.6 ± 0.2 10−5 1/Pa, P < 0.001) and nRI increased with age (0.17 ± 0.03 vs. 0.39 ± 0.06, P < 0.01) for those 20–30 and 70–80 years, respectively. FCW, BCW and FDW decreased significantly with age by 86.3, 71.3 and 74.2%, respectively (P < 0.001), all compared to the lowest age-band. Conclusion: In healthy humans, ageing results in stiffer ascending aorta, with increase in nPWV and decrease in nDs. A decrease in FCW and FDW indicates decline in left ventricular early and late systolic functions with age in healthy humans with no differences between sexes. nRI is more sensitive than BCW in establishing the effects of ageing on reflected waves measured in the ascending aorta.
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Affiliation(s)
- Ye Li
- King's College London, British Heart Foundation Centre, London.,Brunel Institute for Bioengineering, Brunel University, Uxbridge, Middlesex, UK
| | - Stacey S Hickson
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge
| | - Carmel M McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge
| | - Ian B Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge
| | - Ashraf W Khir
- Brunel Institute for Bioengineering, Brunel University, Uxbridge, Middlesex, UK
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Lu Y, Pechlaner R, Cai J, Yuan H, Huang Z, Yang G, Wang J, Chen Z, Kiechl S, Xu Q. Trajectories of Age-Related Arterial Stiffness in Chinese Men and Women. J Am Coll Cardiol 2020; 75:870-880. [DOI: 10.1016/j.jacc.2019.12.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Ki YJ, Kim HL, Oh S, Jeon WK, Rhee TM, Lim WH, Seo JB, Kim SH, Kim MA, Zo JH. Gender Related Association between Arterial Stiffness and Aortic Root Geometry. J Cardiovasc Imaging 2019; 27:11-21. [PMID: 30701711 PMCID: PMC6358431 DOI: 10.4250/jcvi.2019.27.e3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/22/2018] [Accepted: 12/03/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The gender-related change in aortic morphology by arterial stiffness has not been well studied. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and aortic root size according to gender. METHODS A total of 263 consecutive subjects (63.2 ± 10.6 years, 71.1% men) without overt cardiovascular disease who underwent both baPWV measurement and transthoracic echocardiography on the same day were retrospectively analyzed. The diameters of the aortic annulus (AN), sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) were measured using 2-dimensional echocardiography. RESULTS The body surface area (BSA)-corrected diameters of AN, SV, STJ, and AA were significantly higher in women than in men. Univariable analyses showed that baPWV was significantly correlated with SV/BSA and STJ/BSA in men, and with SV/BSA, STJ/BSA, and AA/BSA in women (p < 0.05 for each). In men, however, these associations disappeared in multiple linear regression models after controlling for potential confounders (p > 0.05 for each). In women, the associations of baPWV with diameters of STJ/BSA (β = 0.407, p < 0.001) and AA/BSA (β = 0.391, p = 0.005) remained significant in the same multivariate models. Women-specific correlation between aortic root size and baPWV was also similarly demonstrated in age-matched analyses (n = 61 in each gender). CONCLUSIONS Among Korean adult without overt cardiovascular disease, the association between increased arterial stiffness and aortic root dilatation is stronger in women than in men.
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Affiliation(s)
- You Jeong Ki
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hack Lyoung Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Boramae Medical Center, Seoul, Korea
| | - Won Kyeong Jeon
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Min Rhee
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Lim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Bin Seo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyun Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung A Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Hee Zo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Iffrig E, Wilson JS, Zhong X, Oshinski JN. Demonstration of circumferential heterogeneity in displacement and strain in the abdominal aortic wall by spiral cine DENSE MRI. J Magn Reson Imaging 2018; 49:731-743. [PMID: 30295345 DOI: 10.1002/jmri.26304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/30/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Knowledge of tissue properties of the abdominal aorta can improve understanding of vascular disease and guide interventional approaches. Existing MRI methods to quantify aortic wall displacement and strain are unable to discern circumferential heterogeneity. PURPOSE To assess regional variation in abdominal aortic wall displacement and strain as a function of circumferential position using spiral cine displacement encoding with stimulated echoes (DENSE). STUDY TYPE Prospective. POPULATION Cardiovascular disease-free men (n = 8) and women (n = 9) ages 30-42. SEQUENCES Prospective electrocardiogram (ECG)-gated and navigator echo-gated spiral, cine 2D DENSE and retrospective ECG-gated phase contrast MR (PCMR) sequences at 3T. ASSESSMENT In-plane displacement values of the aortic wall acquired with DENSE were used to determine radial and circumferential aortic wall motion. A quadrilateral-based 2D strain calculation method was implemented to determine strain from the displacement field. Peak displacement and its radial and circumferential contributions as well as peak circumferential strain were compared among eight circumferential wall segments. Distensibility was calculated using PCMR and compared with homogenized circumferential strain. STATISTICAL TESTS To account for repeated measurements in volunteers, linear mixed models for mean sector values were created for displacement magnitude, circumferential displacement, radial displacement, and circumferential strain. Comparisons were made between sectors. Calculated distensibility and homogenized circumferential strain were compared using Bland-Altman analysis. Statistical significance was defined as P < 0.05. RESULTS Displacement was highest in the anterior wall (1.5 ± 0.7 mm) and was primarily in the radial as compared with circumferential direction (1.04 ± 0.05 mm vs. 0.81 ± 0.42 mm). Circumferential strain was highest in the lateral walls (left 0.16 ± 0.05 and right 0.21 ± 0.12) with homogenized circumferential strain of 0.14 ± 0.05. DATA CONCLUSION DENSE imaging in the abdominal aortic wall demonstrated that the anterior aortic wall exhibits the greatest displacement, while the lateral wall experiences the largest circumferential strain. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:731-743.
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Affiliation(s)
- Elizabeth Iffrig
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - John S Wilson
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Xiadong Zhong
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - John N Oshinski
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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Ogola BO, Zimmerman MA, Clark GL, Abshire CM, Gentry KM, Miller KS, Lindsey SH. New insights into arterial stiffening: does sex matter? Am J Physiol Heart Circ Physiol 2018; 315:H1073-H1087. [PMID: 30028199 DOI: 10.1152/ajpheart.00132.2018] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This review discusses sexual dimorphism in arterial stiffening, disease pathology interactions, and the influence of sex on mechanisms and pathways. Arterial stiffness predicts cardiovascular mortality independent of blood pressure. Patients with increased arterial stiffness have a 48% higher risk for developing cardiovascular disease. Like other cardiovascular pathologies, arterial stiffness is sexually dimorphic. Young women have lower stiffness than aged-matched men, but this sex difference reverses during normal aging. Estrogen therapy does not attenuate progressive stiffening in postmenopausal women, indicating that currently prescribed drugs do not confer protection. Although remodeling of large arteries is a protective adaptation to higher wall stress, arterial stiffening increases afterload to the left ventricle and transmits higher pulsatile pressure to smaller arteries and target organs. Moreover, an increase in aortic stiffness may precede or exacerbate hypertension, particularly during aging. Additional studies are needed to elucidate the mechanisms by which females are protected from arterial stiffness to provide insight into its mechanisms and, ultimately, therapeutic targets for treating this pathology.
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Affiliation(s)
- Benard O Ogola
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | | | - Gabrielle L Clark
- Department of Biomedical Engineering, Tulane University , New Orleans, Louisiana
| | - Caleb M Abshire
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | - Kaylee M Gentry
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | - Kristin S Miller
- Department of Biomedical Engineering, Tulane University , New Orleans, Louisiana
| | - Sarah H Lindsey
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
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Harloff A, Mirzaee H, Lodemann T, Hagenlocher P, Wehrum T, Stuplich J, Hennemuth A, Hennig J, Grundmann S, Vach W. Determination of aortic stiffness using 4D flow cardiovascular magnetic resonance - a population-based study. J Cardiovasc Magn Reson 2018; 20:43. [PMID: 29925388 PMCID: PMC6011486 DOI: 10.1186/s12968-018-0461-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/22/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Increased aortic stiffness is an independent predictor of cardiovascular disease. Optimal measurement is highly beneficial for the detection of atherosclerosis and the management of patients at risk. Thus, it was our purpose to selectively measure aortic stiffness using a novel imaging method and to provide reference values from a population-based study. METHODS One hundred twenty six inhabitants of Freiburg, Germany, between 20 and 80 years prospectively underwent 3 Tesla cardiovascular magnetic resonance (CMR) of the thoracic aorta. 4D flow CMR (spatial/temporal resolution 2mm3/20ms) was executed to calculate aortic pulse wave velocity (PWV) in m/s using dedicated software. In addition, we calculated distensibility coefficients (DC) using 2D CINE CMR imaging of the ascending (AAo) and descending aorta (DAo). Segmental aortic diameter and thickness of aortic plaques were determined by 3D T1 weighted CMR (spatial resolution 1mm3). RESULTS PWV increased from 4.93 ± 0.54 m/s in 20-30 year-old to 8.06 ± 1.03 m/s in 70-80 year-old subjects. PWV was significantly lower in women compared to men (p < 0.0001). Increased blood pressure (systolic r = 0.36, p < 0.0001; diastolic r = 0.33, p = 0.0001; mean arterial pressure r = 0.37, p < 0.0001) correlated with PWV after adjustment for age and gender. Finally, PWV increased with increasing diameter of the aorta (ascending aorta r = 0.20, p = 0.026; aortic arch r = 0.24, p = 0.009; descending aorta r = 0.26, p = 0.004). Correlation of PWV and DC of the AAo and DAo or the mean of both was high (r = 0.69, r = 0.68, r = 0.73; p < 0.001). CONCLUSIONS 4D flow CMR was successfully applied to calculate aortic PWV and thus aortic stiffness. Findings showed a high correlation with distensibility coefficients representing local compliance of the aorta. Our novel method and reference data for PWV may provide a reliable biomarker for the identification of patients with underlying cardiovascular disease and optimal guidance of future treatment in studies or clinical routine.
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Affiliation(s)
- Andreas Harloff
- Department of Neurology, Medical Center – University of Freiburg, 79106 Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Thomas Lodemann
- Department of Neurology, Medical Center – University of Freiburg, 79106 Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Paul Hagenlocher
- Department of Neurology, Medical Center – University of Freiburg, 79106 Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Thomas Wehrum
- Department of Neurology, Medical Center – University of Freiburg, 79106 Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Judith Stuplich
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Cardiology and Angiology I, Heart Center Freiburg University, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anja Hennemuth
- Fraunhofer MEVIS, Bremen, Germany
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Hennig
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Diagnostic Radiology – MR Physics, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
| | - Sebastian Grundmann
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Cardiology and Angiology I, Heart Center Freiburg University, University of Freiburg, Freiburg im Breisgau, Germany
| | - Werner Vach
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Institute for Medical Biometry and Statistics, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Orthopedics & Traumatology, University Hospital Basel, Basel, Switzerland
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Kuo AH, Li J, Li C, Huber HF, Nathanielsz PW, Clarke GD. Poor perinatal growth impairs baboon aortic windkessel function. J Dev Orig Health Dis 2018; 9:137-142. [PMID: 29017630 PMCID: PMC5922776 DOI: 10.1017/s2040174417000770] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The ability of the aorta to buffer blood flow and provide diastolic perfusion (Windkessel function) is a determinant of cardiovascular health. We have reported cardiac dysfunction indicating downstream vascular abnormalities in young adult baboons who were intrauterine growth restricted (IUGR) at birth as a result of moderate maternal nutrient reduction. Using 3 T MRI, we examined IUGR offspring (eight male, eight female; 5.7 years; human equivalent 25 years) and age-matched controls (eight male, eight female; 5.6 years) to quantify distal descending aortic cross-section (AC) and distensibility (AD). ANOVA showed decreased IUGR AC/body surface area (0.9±0.05 cm2/m2 v. 1.2±0.06 cm2/m2, M±s.e.m., P<0.005) and AD (1.7±0.2 v. 4.0±0.5×10-3/mmHg, P<0.005) without sex difference or group-sex interaction, suggesting intrinsic vascular pathology and impaired development persisting in adulthood. Future studies should evaluate potential consequences of these changes on coronary perfusion, afterload and blood pressure.
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Affiliation(s)
- A H Kuo
- 1Department of Radiology and Research Imaging Institute,University of Texas Health Science Center at San Antonio,San Antonio,TX,USA
| | - J Li
- 2Xiangya School of Medicine,Central South University,Changsha,Hunan,China
| | - C Li
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - H F Huber
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - P W Nathanielsz
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - G D Clarke
- 1Department of Radiology and Research Imaging Institute,University of Texas Health Science Center at San Antonio,San Antonio,TX,USA
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Kim MN, Shim JM, Choi JI, Park SM, Kim YH, Shim WJ. Evaluation of sex differences in the relationship between diastolic dysfunction and thromboembolism using propensity score analysis. Echocardiography 2018; 35:817-826. [PMID: 29460490 DOI: 10.1111/echo.13843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Female sex is a risk factor for thromboembolism (TE) in atrial fibrillation (AF); however, the underlying mechanisms are unclear. We postulated that left ventricular (LV) diastolic dysfunction (LVDD) could be associated with increased thromboembolic risk in women. METHODS From a retrospective cohort, 158 patients (female : male = 79:79) with nonvalvular AF were propensity score-matched for age, presence of diabetes, hypertension, coronary artery disease, congestive heart failure, embolic history, AF type, and AF duration. Cardiac size and function and central aortic stiffness parameters were evaluated. Diastolic function was classified as normal, indeterminate, and LVDD according to recent guidelines. Surrogate markers for thromboembolism (dense spontaneous echo contrast and thrombus) were evaluated using transesophageal echocardiography. RESULTS Surrogate markers for TE showed a trend to be more frequent in women than in men (21.5% vs 11.4%, P = .086). LVDD was more prevalent in women than in men (22.8% vs 2.5%, P < .001); however, the prevalence of indeterminate diastolic function was not different between sexes (26.6% vs 20.3%, P = .453). Surrogate markers for TE were detected mostly in women with LVDD. LV diastolic parameters showed a restrictive pattern, and aortic stiffness parameters were worse in women than in men. Women with LVDD had increased aortic stiffness compared to women with indeterminate and normal function, whereas aortic stiffness did not differ among men in all groups. Significant relations between LV diastolic function and aortic stiffness parameters were observed only in women. CONCLUSION LVDD due to increased aortic stiffness could be related to a higher thromboembolic risk in women with AF.
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Affiliation(s)
- Mi-Na Kim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Jae-Min Shim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Jong-Il Choi
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Young Hoon Kim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Wan Joo Shim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Peng H, Zhu Y, Yeh F, Cole SA, Best LG, Lin J, Blackburn E, Devereux RB, Roman MJ, Lee ET, Howard BV, Zhao J. Impact of biological aging on arterial aging in American Indians: findings from the Strong Heart Family Study. Aging (Albany NY) 2017; 8:1583-92. [PMID: 27540694 PMCID: PMC5032684 DOI: 10.18632/aging.101013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/28/2016] [Indexed: 11/25/2022]
Abstract
Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD). Increased arterial stiffness, an indicator of arterial aging, predicts adverse CVD outcomes. However, the relationship between telomere length and arterial stiffness is less well studied. Here we examined the cross-sectional association between leukocyte telomere length (LTL) and arterial stiffness in 2,165 American Indians in the Strong Heart Family Study (SHFS). LTL was measured by qPCR. Arterial stiffness was assessed by stiffness index β. The association between LTL and arterial stiffness was assessed by generalized estimating equation model, adjusting for sociodemographics (age, sex, education level), study site, metabolic factors (fasting glucose, lipids, systolic blood pressure, and kidney function), lifestyle (BMI, smoking, drinking, and physical activity), and prevalent CVD. Results showed that longer LTL was significantly associated with a decreased arterial stiffness (β=-0.070, P=0.007). This association did not attenuate after further adjustment for hsCRP (β=-0.071, P=0.005) or excluding participants with overt CVD (β=-0.068, P=0.012), diabetes (β=-0.070, P=0.005), or chronic kidney disease (β=-0.090, P=0.001). In summary, shorter LTL was significantly associated with an increased arterial stiffness, independent of known risk factors. This finding may shed light on the potential role of biological aging in arterial aging in American Indians.
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Affiliation(s)
- Hao Peng
- Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA 70112, USA
| | - Yun Zhu
- Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA 70112, USA
| | - Fawn Yeh
- Center for American Indian Health Research, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Shelley A Cole
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Lyle G Best
- Missouri Breaks Industries Research Inc, Timber Lake, SD 57656, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics at the University of California, San Francisco, CA 94143, USA
| | - Elizabeth Blackburn
- Department of Biochemistry and Biophysics at the University of California, San Francisco, CA 94143, USA
| | - Richard B Devereux
- Greenberg Division of Cardiology, Weill Cornell Medical College, New York, NY 10065, USA
| | - Mary J Roman
- Greenberg Division of Cardiology, Weill Cornell Medical College, New York, NY 10065, USA
| | - Elisa T Lee
- Center for American Indian Health Research, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | | | - Jinying Zhao
- Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA 70112, USA
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Aortic stiffness and blood pressure variability in young people: a multimodality investigation of central and peripheral vasculature. J Hypertens 2017; 35:513-522. [PMID: 27846043 PMCID: PMC5278891 DOI: 10.1097/hjh.0000000000001192] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: Increased blood pressure (BP) variability is a cardiovascular risk marker for young individuals and may relate to the ability of their aorta to buffer cardiac output. We used a multimodality approach to determine relations between central and peripheral arterial stiffness and BP variability. Methods: We studied 152 adults (mean age of 31 years) who had BP variability measures based on SD of awake ambulatory BPs, 24-h weighted SD and average real variability (ARV). Global and regional aortic distensibility was measured by cardiovascular magnetic resonance, arterial stiffness by cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) by SphygmoCor (carotid–femoral) and Vicorder (brachial–femoral). Results: In young people, free from overt cardiovascular disease, all indices of SBP and DBP variability correlated with aortic distensibility (global aortic distensibility versus awake SBP SD: r = −0.39, P < 0.001; SBP ARV: r = −0.34, P < 0.001; weighted 24-h SBP SD: r = −0.42, P < 0.001). CAVI, which closely associated with aortic distensibility, also related to DBP variability, as well as awake SBP SD (r = 0.19, P < 0.05) and weighted 24-h SBP SD (r = 0.24, P < 0.01), with a trend for SBP ARV (r = 0.17, P = 0.06). In contrast, associations with PWV were only between carotid–femoral PWV and weighted SD of SBP (r = 0.20, P = 0.03) as well as weighted and ARV of DBP. Conclusion: Greater BP variability in young people relates to increases in central aortic stiffness, strategies to measure and protect aortic function from a young age may be important to reduce cardiovascular risk.
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Liu H, Liu J, Zhao H, Zhou Y, Li L, Wang H. Relationship between Serum Uric Acid and Vascular Function and Structure Markers and Gender Difference in a Real-World Population of China-From Beijing Vascular Disease Patients Evaluation Study (BEST) Study. J Atheroscler Thromb 2017; 25:254-261. [PMID: 28904249 PMCID: PMC5868511 DOI: 10.5551/jat.39685] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIM The study was done to establish the relationship between serum uric acid (UA) and vascular function and structure parameters including carotid femoral pulse wave velocity (CF-PWV), carotid radial pulse wave velocity (CR-PWV), cardio ankle vascular index (CAVI), ankle brachial index (ABI), and carotid intima-media thickness (CIMT), and the gender difference in a real-world population from China. METHODS A total of 979 subjects were enrolled (aged 60.86±11.03 years, male 416 and female 563). Value of UA was divided by 100 (UA/100) for analysis. RESULTS Body mass index (BMI), diastolic blood pressure (DBP), fasting plasma glucose (FPG), UA, and UA/100 were significantly higher in males compared with females (all p<0.05); pulse pressure (PP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were lower in males than females (all p<0.05). All vascular parameters including CF-PWV, CR-PWV, CAVI, ABI, and CIMT were higher in males than females (all p<0.05). Multiple linear regression analysis showed that UA/100 was independently positively linearly correlated with CAVI (B=0.143, p=0.001) and negatively correlated with ABI in the male population (B=-0.012, p=0.020). In people with higher UA, the risk of higher CF-PWV was 1.593 (p<0.05). CONCLUSIONS 1. All vascular parameters were higher in males than females. There was no gender difference in the relationship between UA and vascular markers except in ABI. 2. UA was independently linearly correlated with CAVI. 3. In people with higher UA level, the risk of higher CF-PWV increased. Therefore, higher UA may influence the vascular function mainly instead of vascular structure.
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Affiliation(s)
- Huan Liu
- Department of Vascular Medicine, Peking University Shougang Hospital
| | - Jinbo Liu
- Department of Vascular Medicine, Peking University Shougang Hospital
| | - Hongwei Zhao
- Department of Vascular Medicine, Peking University Shougang Hospital
| | - Yingyan Zhou
- Department of Vascular Medicine, Peking University Shougang Hospital
| | - Lihong Li
- Department of Vascular Medicine, Peking University Shougang Hospital
| | - Hongyu Wang
- Department of Vascular Medicine, Peking University Shougang Hospital
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