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van der Wurff I, Kirschner M, Golsteijn R, de Jonge M, Berendsen B, Singh A, Savelberg H, de Groot R. School-based physical activity interventions: which intervention characteristics are associated with participation and retention? A meta-analysis. Prev Med 2024; 182:107925. [PMID: 38437923 DOI: 10.1016/j.ypmed.2024.107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Many school-based intervention studies are conducted to increase students' physical activity (PA). Recruitment and retention problems potentially impact the robustness of RCT findings. We conducted a meta-analysis to summarize recruitment and retention rates in long-term secondary school-based PA intervention studies and examined associated participant and intervention characteristics. METHODS Web of Science, Pubmed, Medline, and PsychInfo were searched until March 20th 2023. We included studies on secondary school-based PA interventions ≥12 weeks, aimed at typically developing adolescents. We abstracted number of schools and students invited, randomized, and participating at follow-up to calculate pooled recruitment and retention rates; participant and intervention characteristics were abstracted to execute subgroup or meta-regression analyses. RESULTS Recruitment rates were 51% for invited schools and 80% for invited students, the retention for schools was almost 100% and for students 91%. Interventions with fixed and flexible components, executed in Asia and South America, and from later publication years had higher student recruitment rates. Students' retention rates were lower for interventions which had flexible components, were theory/model-based, used an accelerometer, had a longer intervention duration, and included more females. CONCLUSION Recruitment and retention rates in school-based PA interventions are high. Some participant and intervention characteristics influence these rates: flexibility of the intervention, theory/model-based intervention, accelerometer use, intervention duration, continent, and number of females. Researchers should consider these characteristics in intervention development to achieve optimal balance between intervention effectiveness, recruitment, and retention.
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Affiliation(s)
- I van der Wurff
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands.
| | - M Kirschner
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - R Golsteijn
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - M de Jonge
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands
| | - B Berendsen
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands
| | - A Singh
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands; Human Movement. School and Sport, Applied University of Windesheim, Zwolle, the Netherlands
| | - H Savelberg
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands; SHE, School of Health Professions Education, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - R de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
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Drożdż D, Drożdż M, Wójcik M. Endothelial dysfunction as a factor leading to arterial hypertension. Pediatr Nephrol 2023; 38:2973-2985. [PMID: 36409370 PMCID: PMC10432334 DOI: 10.1007/s00467-022-05802-z] [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: 02/11/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/22/2022]
Abstract
Hypertension remains the main cause of cardiovascular complications leading to increased mortality. The discoveries of recent years underline the important role of endothelial dysfunction (ED) in initiating the development of arterial hypertension. The endothelium lines the interior of the entire vascular system in the body and acts as a physical barrier between blood and tissues. Substances and mediators produced by the endothelium exhibit antithrombotic and anti-inflammatory properties. Oxidative stress and inflammation are conditions that damage the endothelium and shift endothelial function from vasoprotective to vasoconstrictive, prothrombotic, and pro-apoptotic functions. A dysfunctional endothelium contributes to the development of hypertension and further cardiovascular complications. Reduced nitric oxide (NO) bioavailability plays an essential role in the pathophysiology of ED-associated hypertension. New technologies provide tools to identify pathological changes in the structure and function of the endothelium. Endothelial dysfunction (ED) contributes to the development of arterial hypertension and should be considered in therapeutic strategies for children with hypertension.
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Affiliation(s)
- Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland.
| | - Monika Drożdż
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland
| | - Małgorzata Wójcik
- Deapartment of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Krakow, Poland
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Edwards S, Foster M, Ahmed SF, Lucas-Herald AK. Preventative interventions that target cardiovascular dysfunction in children and young people: a systematic review of their effectiveness and an investigation of sexual dimorphism. J Hum Hypertens 2023; 37:726-734. [PMID: 36463360 PMCID: PMC10403341 DOI: 10.1038/s41371-022-00780-z] [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: 08/01/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Given that cardiovascular diseases remain a primary cause of mortality and morbidity, there is a need to consider preventative strategies to improve vascular function from early in life. The aims of this study were therefore to investigate which interventions may improve endothelial function, intima media thickness and arterial stiffness in children and young people and to assess whether these interventions differ in boys and girls. A systematic literature search of Science Direct, Pubmed, Google Scholar and the Cochrane Library by two independent reviewers was performed to source articles. Inclusion criteria were any studies including any child ≤18 years of age receiving an intervention, which measured vascular function other than blood pressure. Exclusion criteria were studies assessing children with chronic medical conditions. A total of 72 studies were identified, which met the inclusion criteria. A measurable change in outcome was more likely to be reported in studies investigating endothelial function (p = 0.03). Interventions which improved vascular function included physical activity and dietary programmes. Under 10% of studies considered sex differences. In conclusion, school-based physical activity interventions are most likely to result in improvements in vascular function. Endothelial function may be the first variable of vascular function to change secondary to an intervention. Standardisation of reporting of differences between the sexes is essential to be able to ensure interventions are equally effective for boys and girls.
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Affiliation(s)
- Sophie Edwards
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Murray Foster
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - S Faisal Ahmed
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Angela K Lucas-Herald
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK.
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Hayden J, O'Donnell G, deLaunois I, O'Gorman C. Endothelial Peripheral Arterial Tonometry (Endo-PAT 2000) use in paediatric patients: a systematic review. BMJ Open 2023; 13:e062098. [PMID: 36657756 PMCID: PMC9853225 DOI: 10.1136/bmjopen-2022-062098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Endo Peripheral Artery Tonometry (EndoPAT-2000) is a non-invasive technology for measuring endothelial dysfunction (ED). The reactive hyperaemia index (RHI) is resulted and is low when ED is present. We aim to synthesise the literature on paediatric ED that used Endo-PAT analysis. DESIGN A comprehensive systematic review was conducted from January 2015 to March 2021. The databases included Cochrane, MEDLINE EBSCO, EMBASE (Ovid), PUBMED and CINAHL EBSCO. Exclusion criteria were: (1) If a study used a different device, for example, (2) If the study had no results. Inclusion criteria were: (1) Published in the English, (2) more than 50% of study subjects were in the paediatric age range, (3) data relevant to paediatric age range children could be extrapolated from all data, where not all study subjects were children. RESULTS Following the removal of duplicates, 156 articles were initially identified. Following exclusion, 50 articles were included for review. We have subdivided these papers into different systems for ease of reference and have reported our findings in six tables: patients with type 1/2 diabetes, obesity, cardiovascular, respiratory, psychiatric conditions and miscellaneous diseases. For each, the study design, population, control group (if available), RHI results and conclusions were reported. CONCLUSIONS A number of papers using Endo-PAT for children with various chronic diseases have evidence of ED. However, in many cases, there has only been a single cohort study using Endo-PAT. Further studies are required to validate these findings and to help characterise the cardiovascular risk profile of children with chronic disease. Further studies are also required that will characterise more completely the cardiovascular risk profile of these children.Consensus on other vascular risk markers that could be included in future studies is ideal and if accomplished, this would facilitate meta-analyses of studies of relatively rare conditions.
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Affiliation(s)
- Jenny Hayden
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - Gill O'Donnell
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | | | - Clodagh O'Gorman
- Paediatrics, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
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Alvarez-Pitti J, Herceg-Čavrak V, Wójcik M, Radovanović D, Brzeziński M, Grabitz C, Wühl E, Drożdż D, Melk A. Blood pressure response to exercise in children and adolescents. Front Cardiovasc Med 2022; 9:1004508. [PMID: 36247478 PMCID: PMC9561233 DOI: 10.3389/fcvm.2022.1004508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/08/2022] [Indexed: 11/27/2022] Open
Abstract
Blood pressure changes during exercise are part of the physiological response to physical activity. Exercise stress testing can detect an exaggerated blood pressure response in children and adolescent. It is applied for certain clinical conditions, but is also commonly used as part of the assessment of athletes. The interpretation of blood pressure values in response to exercise during childhood and adolescence requires appropriate reference data. We discuss the available reference values and their limitations with regard to device, exercise protocol and normalization. While the link between an exaggerated blood pressure response and cardiovascular events and mortality has been demonstrated for adults, the situation is less clear for children and adolescents. We discuss the existing evidence and propose that under certain circumstances it might be reasonable to have children and adolescents undergo exercise stress testing as a rather non-invasive procedure to add additional information with regard to their cardiovascular risk profile. Based on the existing data future studies are needed to extend our current knowledge on possible links between the presence of certain clinical conditions, the detectability of an exaggerated blood pressure response during childhood and adolescence and the risk of developing cardiovascular morbidity and mortality in later life.
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Affiliation(s)
- Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Carl Grabitz
- Children’s Hospital, Hannover Medical School, Hanover, Germany
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
- Dorota Drożdż,
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hanover, Germany
- *Correspondence: Anette Melk,
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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Munusamy G, Shanmugam R. Effectiveness of structured interventional strategy for middle-aged adolescence (SISMA-PA) for preventing atherosclerotic risk factors—A study protocol. PLoS One 2022; 17:e0271599. [PMID: 35853088 PMCID: PMC9295980 DOI: 10.1371/journal.pone.0271599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Atherosclerotic risk starts at an early stage in adolescents and interventions on adolescents’ lifestyles are most important. The pandemic of obesity-related morbidities like atherosclerosis among young adults and atherosclerotic risk factors for middle-aged adolescents in India is known. Yet, there is a lack of cost-effective and integrated intervention programs to treat this important health problem. Objective The main objective of this study is to evaluate the effect of a 12-week structured interventional strategy program, containing integrated education and supervised physical activity interventions for middle-aged adolescents. Methods/design This will be a school-based pre-experimental one-group pre-post time-series research design. The sample size is estimated to include 154 adolescents of 10th to 12th grade; aged 15–17 years will be grouped as a single arm. Data will be collected from July 2021 to January 2022. The intervention duration will be 3 months. The following measures will be evaluated before, during, and after intervention: knowledge, body mass index, level of physical activity, dietary habits, and sedentary activity. Discussion We believe that the structured interventional strategy approach which includes education related to atherosclerosis, physical activity, dietary habits, and sedentary activity, and cost-effective physical activity training will be more effective in preventing atherosclerotic-related changes among middle-aged adolescents. Further, this kind of approach may be applied in similar study areas elsewhere in India. Trial registration Clinical Trials Registry—India (Registered Number: CTRI/2021/03/032271).
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Affiliation(s)
- Gomathi Munusamy
- Department of Community Heal Nursing, Centre of Postgraduate Studies, Faculty of Nursing, Lincoln University College, Selangor, Malaysia
- * E-mail:
| | - Ramesh Shanmugam
- Department of Medical Surgical Nursing, Centre of Postgraduate Studies, Faculty of Nursing, Lincoln University College, Selangor, Malaysia
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8
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Jurko T, Mestanik M, Mestanikova A, Zeleňák K, Jurko A. Early Signs of Microvascular Endothelial Dysfunction in Adolescents with Newly Diagnosed Essential Hypertension. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071048. [PMID: 35888136 PMCID: PMC9321176 DOI: 10.3390/life12071048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022]
Abstract
Endothelial dysfunction represents one of the key pathomechanisms in many diseases, including hypertension. Peripheral arterial tonometry (PAT) evaluates the functional status of microvascular endothelium and offers a biomarker of early, potentially reversible, vascular damage. This study aimed to assess endothelial function using conventional and novel indices of PAT in pediatric hypertensives. As such, 100 adolescents with normal blood pressure, and essential and white-coat hypertension were examined using EndoPAT 2000. Conventional reactive hyperemia index (RHI) and novel indices of hyperemic response, including the area under the curve of hyperemic response (AUC), were evaluated. AUC was the only parameter sensitive to the effect of hypertension, with significantly lower values in essential hypertensives compared to normotensives and white-coat hypertensives (p = 0.024, p = 0.032, respectively). AUC was the only parameter significantly correlating with mean ambulatory monitored blood pressure (r = −0.231, p = 0.021). AUC showed a significant negative association with age (p = 0.039), but a significant positive association with pubertal status indexed by plasma levels of dehydroepiandrosterone (p = 0.027). This is the first study reporting early signs of microvascular endothelial dysfunction evaluated using PAT in adolescents with newly diagnosed essential hypertension. Detailed analysis of hyperemic response using overall magnitude indexed by AUC provided a more robust method compared to the conventional evaluation of RHI.
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Affiliation(s)
- Tomas Jurko
- Clinic of Neonatology, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 03659 Martin, Slovakia;
| | - Michal Mestanik
- Pediatric Cardiology Clinic, Kollarova 13, 03601 Martin, Slovakia; (M.M.); (A.M.)
| | - Andrea Mestanikova
- Pediatric Cardiology Clinic, Kollarova 13, 03601 Martin, Slovakia; (M.M.); (A.M.)
| | - Kamil Zeleňák
- Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 03659 Martin, Slovakia;
| | - Alexander Jurko
- Pediatric Cardiology Clinic, Kollarova 13, 03601 Martin, Slovakia; (M.M.); (A.M.)
- Correspondence:
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Santos MJ, Picco S, Fernández R, Pedreira ME, Boccia M, Klappenbach M, Krawczyk MC. Remembering how to run: a descriptive wheel run analysis in CF1 males and females mice. IBRO Neurosci Rep 2022; 12:333-341. [PMID: 35746966 PMCID: PMC9210458 DOI: 10.1016/j.ibneur.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/15/2022] [Indexed: 12/01/2022] Open
Abstract
Physical exercise is known to have beneficial effects on general health and wellbeing in humans and it is also related to neuronal plasticity, increasing neurogenesis and consequently leading to improvements in processes such as learning and memory. In this sense, wheel running performance in mice appears as an extensively used behavioral approach for neurobiological studies. Here, we explored the running patterns in CF1 male and female mice allowing voluntary wheel running for 20 min along three consecutive days. We analyzed differences in the accumulated distance traveled, instant velocity, and latency to run and breaks taken in both males and females, comparing performance between days. Results revealed that after a first experience with the wheel, animals that had learnt how to run on day 1 quickly look forward to stepping into the wheel in subsequent training days, reflected by a significant increase in daily running distance and velocity. Further, no differences were found in the running performance between males and females. In summary, in a first experience with the wheel, animals get familiarized with the wheel and grow accustomed to it.
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10
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Pecoraro L, Zoller T, Atkinson RL, Nisi F, Antoniazzi F, Cavarzere P, Piacentini G, Pietrobelli A. Supportive treatment of vascular dysfunction in pediatric subjects with obesity: the OBELIX study. Nutr Diabetes 2022; 12:2. [PMID: 35013093 PMCID: PMC8748969 DOI: 10.1038/s41387-021-00180-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 10/18/2021] [Accepted: 11/18/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Overweight or obese children develop abnormal endothelial cell dysfunction and arterial intima-media thickening with increased vasomotor tone and inflammation. Curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D have shown beneficial effects on endothelial function. We test, among overweight and obese pediatric subjects, the effects on the endothelium of a combination of curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D. METHODS Forty-eight subjects (6-17 years) were randomized into two groups (placebo vs treatment) attended three visits at 0, 3, and 6 months (±15 days). Endothelial function was assessed by means of a post-occlusive release hyperemic (PORH) test for estimation of delta flow (DF) and hyperemic AUC index, and a heat provocation test (HPT) to measure DF HPT (DFHPT). RESULTS Significant DF difference was noted at 6 months in both groups (p < 0.001). Overall time trend was significantly different between baseline, 3 months, and 6 months both in placebo (p < 0.05) and treatment (p < 0.001) groups and their comparison (p < 0.001). No differences were noted in hyperemic AUC index (3 and 6 months), whilst there were significant differences in time trends of rreatment (p < 0.001) and placebo (p < 0.05) groups and their comparison (p < 0.001). DFHPT difference between groups was significant at 3 and 6 months (p < 0.05). The overall time trend was significant exclusively in Treatment group between 3 and 6 months (p < 0.05). Correlation with anthropometrics was found for DF and body mass index (r = 0.677 6 months, p < 0.05), as well as for hyperemic AUC index and males (r = 0.348, p < 0.05), while DFHPT showed no correlation. CONCLUSION Curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D appear to be promising in enhancing endothelial function by improvement of both DF in the PORH test and DF in the HPT, lowering the risk of developing cardiovascular diseases in overweight and obese pediatric subjects.
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Affiliation(s)
- Luca Pecoraro
- Department of Medicine, University of Verona, Verona, Italy.,Paediatric Clinic, ASST Mantua, Mantua, Italy
| | - Thomas Zoller
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Richard L Atkinson
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Fulvio Nisi
- Humanitas Clinical and Research Center-IRCCS, Rozzano, MI, Italy
| | - Franco Antoniazzi
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Paolo Cavarzere
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Giorgio Piacentini
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Angelo Pietrobelli
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy. .,Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Climie RE, Park C, Avolio A, Mynard JP, Kruger R, Bruno RM. Vascular Ageing in Youth: A Call to Action. Heart Lung Circ 2021; 30:1613-1626. [PMID: 34275753 DOI: 10.1016/j.hlc.2021.06.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Vascular ageing (the deterioration in vascular structure and function) is a pivotal progenitor of health degeneration associated with elevated BP. Exposure to adverse environmental and genetic factors from fetal life promotes the development and accumulation of subclinical vascular changes that direct an individual towards a trajectory of early vascular ageing (EVA)-an independent predictor of target organ damage in the heart, brain, and kidneys. Therefore, characterising vascular ageing from youth may provide a window into cardiovascular risk later in life. However, vascular ageing measurements only have value when techniques are accurate/validated and when reliable thresholds are available for defining normal ranges and ranges that signal increased risk of disease. The aim of this paper is to summarise current evidence on the importance of vascular ageing assessment in youth and the impact of interventions to prevent or delay EVA, to highlight the need for standardisation and validation of measurement techniques in children and adolescents, and the importance of establishing reference values for vascular ageing measures in this population.
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Affiliation(s)
- R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France.
| | - C Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, UCL, London, UK
| | - A Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia
| | - R Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - R-M Bruno
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. https://twitter.com/rosam_bruno
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12
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Allen J, Zareen Z, Doyle S, Whitla L, Afzal Z, Stack M, Franklin O, Green A, James A, Leahy TR, Quinn S, Elnazir B, Russell J, Paran S, Kiely P, Roche EF, McDonnell C, Baker L, Hensey O, Gibson L, Kelly S, McDonald D, Molloy EJ. Multi-Organ Dysfunction in Cerebral Palsy. Front Pediatr 2021; 9:668544. [PMID: 34434904 PMCID: PMC8382237 DOI: 10.3389/fped.2021.668544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
Cerebral Palsy (CP) describes a heterogenous group of non-progressive disorders of posture or movement, causing activity limitation, due to a lesion in the developing brain. CP is an umbrella term for a heterogenous condition and is, therefore, descriptive rather than a diagnosis. Each case requires detailed consideration of etiology. Our understanding of the underlying cause of CP has developed significantly, with areas such as inflammation, epigenetics and genetic susceptibility to subsequent insults providing new insights. Alongside this, there has been increasing recognition of the multi-organ dysfunction (MOD) associated with CP, in particular in children with higher levels of motor impairment. Therefore, CP should not be seen as an unchanging disorder caused by a solitary insult but rather, as a condition which evolves over time. Assessment of multi-organ function may help to prevent complications in later childhood or adulthood. It may also contribute to an improved understanding of the etiology and thus may have an implication in prevention, interventional methods and therapies. MOD in CP has not yet been quantified and a scoring system may prove useful in allowing advanced clinical planning and follow-up of children with CP. Additionally, several biomarkers hold promise in assisting with long-term monitoring. Clinicians should be aware of the multi-system complications that are associated with CP and which may present significant diagnostic challenges given that many children with CP communicate non-verbally. A step-wise, logical, multi-system approach is required to ensure that the best care is provided to these children. This review summarizes multi-organ dysfunction in children with CP whilst highlighting emerging research and gaps in our knowledge. We identify some potential organ-specific biomarkers which may prove useful in developing guidelines for follow-up and management of these children throughout their lifespan.
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Affiliation(s)
- John Allen
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland.,Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | | | - Samantha Doyle
- Department of Clinical Genetics, Birmingham Women's Hospital, Birmingham, United Kingdom
| | - Laura Whitla
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Zainab Afzal
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Maria Stack
- Children's Health Ireland at Crumlin, Dublin, Ireland.,Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Orla Franklin
- Children's Health Ireland at Crumlin, Dublin, Ireland.,Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Andrew Green
- Children's Health Ireland at Crumlin, Dublin, Ireland.,Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Adam James
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland.,Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Timothy Ronan Leahy
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Shoana Quinn
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Basil Elnazir
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - John Russell
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Sri Paran
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Patrick Kiely
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Edna Frances Roche
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland.,Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Ciara McDonnell
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland.,Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland.,Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | - Louise Baker
- Children's Health Ireland at Temple St. Dublin, Dublin, Ireland
| | | | - Louise Gibson
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - Stephanie Kelly
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Denise McDonald
- Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland
| | - Eleanor J Molloy
- Discipline of Pediatrics, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Trinity Research in Childhood Centre, Trinity College Dublin, Dublin, Ireland.,Children's Health Ireland (CHI) at Tallaght, Dublin, Ireland.,Children's Health Ireland at Crumlin, Dublin, Ireland.,Department of Neonatology, The Coombe Women and Infants University Hospital, Dublin, Ireland
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13
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Mahtab S, Zar HJ, Ntusi NAB, Joubert S, Asafu-Agyei NAA, Luff NJ, Jele N, Zuhlke L, Myer L, Jao J. Endothelial Dysfunction in South African Youth Living With Perinatally Acquired Human Immunodeficiency Virus on Antiretroviral Therapy. Clin Infect Dis 2020; 71:e672-e679. [PMID: 32285090 PMCID: PMC7744981 DOI: 10.1093/cid/ciaa396] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) and antiretroviral therapy (ART) confer cardiovascular disease (CVD) risk in adults with HIV. Few studies have assessed endothelial dysfunction (ED), an early marker of subclinical CVD risk, in youth living with perinatally acquired HIV (YLPHIV). METHODS Using peripheral arterial tonometry, we compared ED in YLPHIV and age-matched youth without HIV. A reactive hyperemic index ≤1.35 was defined as ED. Eligible participants included those aged 9-14 years and on ART ≥6 months at enrollment. RESULTS Overall, 431 YLPHIV and 93 youth without HIV with a median age of 14.1 versus 13.9 years, respectively, were included. YLPHIV had a lower BMI z score (BMIZ; -0.2 vs 0.4; P < .01) but higher rates of hypercholesterolemia (10% vs 1%; P = .01) than youth without HIV. Among YLPHIV, mean log viral load (VL) was 4.83 copies/mL with 21.7% having a CD4 count <500 cell/mm3; median duration on ART was 9.8 years with 38% initiating at <2 years of age. YLPHIV had higher rates of ED than youth without HIV (50% vs 34%; P = .01); this relationship persisted after adjusting for age, sex, BMIZ, elevated BP, and hypercholesterolemia (RR, 1.43; P = .02). Among YLPHIV, CD4 count >500 cell/mm3 (RR, 1.04; P = .76), VL (RR, 1.01; P = .78), and current ART class (protease inhibitor based vs nonnucleoside inhibitor based: relative risk, 0.90; P = .186) were not associated with ED after adjustment. CONCLUSIONS Even after adjusting for physiologic differences, YLPHIV appear to be at increased risk of ED compared with age-matched youth without HIV. These findings have important implications for the life course of YLPHIV who may be at increased risk of premature CVD and complications.
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Affiliation(s)
- Sana Mahtab
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Ntobeko A B Ntusi
- Division of Cardiology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Susan Joubert
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Nana Akua A Asafu-Agyei
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Norme J Luff
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Nomawethu Jele
- Department of Pediatrics and Child Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa.,SA MRC unit on child and adolescent Health, Red Cross War Memorial Hospital, University of Cape Town, Cape Town, South Africa
| | - Liesl Zuhlke
- Division of Pediatric Cardiology, Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jennifer Jao
- Department of Pediatrics, Division of Infectious Diseases, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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14
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Physical Activity Is Associated With Better Vascular Function in Children and Adolescents With Congenital Heart Disease. Can J Cardiol 2019; 36:1474-1481. [PMID: 32603699 DOI: 10.1016/j.cjca.2019.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/13/2019] [Accepted: 12/22/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Aortic stiffness is an important marker of cardiovascular risk and is elevated in children and adolescents with congenital heart disease (CHD) compared with healthy children; however, in children with CHD, little is known about the interaction between aortic stiffness and physical activity-a key determinant of aortic stiffness. METHODS For this cross-sectional cohort study, we recruited children and adolescents aged 9-16 years with moderate-to-complex CHD from British Columbia Children's Hospital and travelling partnership clinics across the province of British Columbia and the Yukon territory. Mean daily minutes of moderate-to-vigorous physical activity were objectively assessed using an ActiGraph accelerometer worn over the right hip during waking hours for 7 days. Aortic pulse wave velocity (cm/s) was measured using standard 2-dimensional echocardiography and Doppler ultrasound. RESULTS Participants (n = 104, 61% male; 85% consent rate) had a mean (standard deviation) age of 12.4 (2.4) years. Daily moderate-to-vigorous physical activity was 46.7 (20.0) minutes/d, with 25% meeting guidelines of ≥ 60 minutes of moderate-to-vigorous physical activity per day. Mean (standard deviation) aortic pulse wave velocity was 490.5 (161.9) cm/s, which was not significantly different between cardiac diagnoses. Higher levels of moderate-to-vigorous physical activity were associated with lower aortic pulse wave velocity (r = -0.226, P = 0.021). CONCLUSION In children and adolescents with CHD, higher levels of physical activity are associated with better vascular function. Given this association, promoting physical activity should be a high priority in the care of children and adolescents with CHD.
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Adelnia F, Cameron D, Bergeron CM, Fishbein KW, Spencer RG, Reiter DA, Ferrucci L. The Role of Muscle Perfusion in the Age-Associated Decline of Mitochondrial Function in Healthy Individuals. Front Physiol 2019; 10:427. [PMID: 31031645 PMCID: PMC6473080 DOI: 10.3389/fphys.2019.00427] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/27/2019] [Indexed: 12/25/2022] Open
Abstract
Maximum oxidative capacity of skeletal muscle measured by in vivo phosphorus magnetic resonance spectroscopy (31P-MRS) declines with age, and negatively affects whole-body aerobic capacity. However, it remains unclear whether the loss of oxidative capacity is caused by reduced volume and function of mitochondria or limited substrate availability secondary to impaired muscle perfusion. Therefore, we sought to elucidate the role of muscle perfusion on the age-related decline of muscle oxidative capacity and ultimately whole-body aerobic capacity. Muscle oxidative capacity was assessed by 31P-MRS post-exercise phosphocreatine recovery time (τPCr), with higher τPCr reflecting lower oxidative capacity, in 75 healthy participants (48 men, 22–89 years) of the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study. Muscle perfusion was characterized as an index of blood volume at rest using a customized diffusion-weighted MRI technique and analysis method developed in our laboratory. Aerobic capacity (peak-VO2) was also measured during a graded treadmill exercise test in the same visit. Muscle oxidative capacity, peak-VO2, and resting muscle perfusion were significantly lower at older ages independent of sex, race, and body mass index (BMI). τPCr was significantly associated with resting muscle perfusion independent of age, sex, race, and BMI (p-value = 0.004, β = −0.34). τPCr was also a significant independent predictor of peak-VO2 and, in a mediation analysis, significantly attenuated the association between muscle perfusion and peak-VO2 (34% reduction for β in perfusion). These findings suggest that the age-associated decline in muscle oxidative capacity is partly due to impaired muscle perfusion and not mitochondrial dysfunction alone. Furthermore, our findings show that part of the decline in whole-body aerobic capacity observed with aging is also due to reduced microvascular blood volume at rest, representing a basal capacity of the microvascular system, which is mediated by muscle oxidative capacity. This finding suggests potential benefit of interventions that target an overall increase in muscle perfusion for the restoration of energetic capacity and mitochondrial function with aging.
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Affiliation(s)
- Fatemeh Adelnia
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Donnie Cameron
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Christopher M Bergeron
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Kenneth W Fishbein
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Richard G Spencer
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - David A Reiter
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Luigi Ferrucci
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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16
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Czippelova B, Turianikova Z, Krohova J, Wiszt R, Lazarova Z, Pozorciakova K, Ciljakova M, Javorka M. Arterial Stiffness and Endothelial Function in Young Obese Patients - Vascular Resistance Matters. J Atheroscler Thromb 2019; 26:1015-1025. [PMID: 30930343 PMCID: PMC6845697 DOI: 10.5551/jat.47530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: Motivated by the paradoxical and differing results of the early atherosclerosis related indices – Cardio-Ankle Vascular Index (CAVI) reflecting arterial stiffness and Reactive Hyperemia Index (RHI) evaluating endothelium dependent flow-induced vasodilation – in obesity, we aimed to assess CAVI and RHI in obese adolescents and young adults in the context of differences in systemic vascular resistance (SVR). Methods: We examined 29 obese (14f, 15.4 [12.3–18.5] y; BMI: 33.2 ± 4.4 kg.m−2) and 29 non-obese gender and age matched adolescents and young adults (BMI: 21.02 ± 2.3 kg.m−2). CAVI and RHI were measured using VaSera VS-1500 (Fukuda Denshi, Japan) and Endo-PAT 2000 (Itamar Medical, Israel), respectively. Hemodynamic measures were recorded using volume-clamp plethysmography (Finometer Pro, FMS, Netherlands) and impedance cardiography (CardioScreen 2000, Medis GmbH, Germany). SVR and sympathetic activity related indices – Velocity Index (VI) and Heather Index (HI), and LFSAP (spectral power in low frequency band of systolic blood pressure oscillations) were determined. Results: In obese group, CAVI (4.59 ± 0.88 vs. 5.18 ± 0.63, p = 0.002) and its refined version CAVI0 (6.46 ± 1.39 vs. 7.33 ± 0.99, p = 0.002) were significantly lower. No significant difference in RHI was found. SVR and sympathetic activity indices were all significantly lower in the obese group than in the non-obese group. RHI correlated positively with SVR (r = 0.390, p = 0.044) in obese subjects. Conclusion: Our results indicate that both indices used for the detection of early atherosclerotic changes are influenced by vascular tone. Vascular resistance could influence CAVI and RHI results impairing their interpretation.
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Affiliation(s)
- Barbora Czippelova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology.,Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin
| | - Zuzana Turianikova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology.,Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin
| | - Jana Krohova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology
| | - Radovan Wiszt
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology
| | - Zuzana Lazarova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology
| | - Katarina Pozorciakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents
| | - Miriam Ciljakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents
| | - Michal Javorka
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology.,Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin
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17
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Low self-reported sports activity before stroke predicts poor one-year-functional outcome after first-ever ischemic stroke in a population-based stroke register. BMC Neurol 2018; 18:181. [PMID: 30390631 PMCID: PMC6215339 DOI: 10.1186/s12883-018-1189-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 10/25/2018] [Indexed: 12/26/2022] Open
Abstract
Background Physical activity (PA) is associated with lower risk of stroke. We tested the hypothesis that lack of pre-stroke PA is an independent predictor of poor outcome after first-ever ischemic stroke. Methods We assessed recent self-reported PA and other potential predictors for loss of functional independence - modified Rankin Scale (mRS) > 2 - one year after first-ever ischemic stroke in 1370 patients registered between 2006 and 2010 in the Ludwigshafen Stroke Study, a population-based stroke registry. Results After 1 year, 717 (52.3%) of patients lost their independence including 251 patients (18.3%) who had died. In multivariate logistic regression analysis lack of regular PA prior to stroke (Odds Ratio (OR) 1.7, Confidence Interval (CI) 1.1–2.5), independently predicted poor outcome together with higher age (65–74: OR 1.7; CI 1.1–2.8, 75–84 years: OR 3.3; CI 2.1–5.3; ≥85 years OR 14.5; CI 7.4–28.5), female sex (OR 1.5; CI 1.1–2.1), diabetes mellitus (OR 1.8; CI 1.3–2.5), stroke severity (OR 1.2; CI 1.1–1.2), probable atherothrombotic stroke etiology (OR 1.8; CI 1.1–2.8) and high leukocyte count (> 9.000/mm3; OR 1.4; CI 1.0–1.9) at admission. Subclassifying unknown stroke etiology, embolic stroke of unknown source (ESUS; n = 40, OR 2.2; CI 0.9–5.5) tended to be associated with loss of independence. Conclusion In addition to previously reported factors, lack of PA prior to stroke as potential indicator of worse physical condition, high leukocyte count at admission as indicator of the inflammatory response and probable atherothrombotic stroke etiology might be independent predictors for non-functional independence in first-ever ischemic stroke.
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18
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Si D, Ni L, Wang Y, Liu J, Yang J, Yang P. A new method for the assessment of endothelial function with peripheral arterial volume. BMC Cardiovasc Disord 2018; 18:81. [PMID: 29728052 PMCID: PMC5935917 DOI: 10.1186/s12872-018-0821-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 04/26/2018] [Indexed: 11/24/2022] Open
Abstract
Background Currently, many methodological approaches have been developed to assess peripheral endothelial function. However, a development of the noninvasive and automated technique for routinely assessing endothelial function is still required. We evaluated the potential value of a new method to measure peripheral endothelial function with reactive hyperemia peripheral arterial volume (RH-PAV) in patients with chest pain. Methods We used a novel oximeter-like probe to detect the peripheral arterial volume (PAV) of the finger and compared it with brachial flow-mediated dilation (FMD) performed in 93 consecutive patients with chest pain. The RH-PAV index was defined as the ratio of the digital pulse volume during reactive hyperemia relative to the baseline. Results Ninety-three patients (53 men, 58 ± 5 years) completed the study, and 53 patients demonstrated coronary artery disease (CAD) following scheduled coronary angiography. There was a moderate linear relationship between PAV and FMD (r = 0.69, p < 0.01). Similar to FMD, PAV was more impaired in patients who have more cardiovascular risk factors (CRFs). The subjects with CAD had lower PAV and FMD, compared with those without CAD (1.05 ± 0.23 VS. 1.41 ± 0.37, p < 0.01; 6.7% ± 2.9% VS. 10.4% ± 2.9%, p < 0.01, respectively), and the relationships between FMD and PAV were also significant in both CAD (r = 0.54, p < 0.01) and non-CAD (r = 0.62, p < 0.01) patients. Conclusions Endothelial function of digital artery assessed with the novel PAV method demonstrated a profile similar to that of brachial artery measured with FMD. The hyperemia PAV was decreased by factors which were considered to impair endothelial function, suggesting that PAV has the potential to be a novel method to study endothelial function.
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Affiliation(s)
- Daoyuan Si
- Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Lujia Ni
- Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Yunfei Wang
- Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Jinsha Liu
- Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Jining Yang
- Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Ping Yang
- Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China.
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Abstract
OBJECTIVE Evaluating cardiovascular disease risk in children and youth 13 to 24 years old who are facing a life time exposure to both HIV and antiretroviral therapy is a research priority. This study compares endothelial function measured by peripheral arterial tonometry in HIV-positive youth infected perinatally and behaviorally as well as HIV-negative controls. METHODS Three groups of participants aged 8-30 year were enrolled; HIV-positive perinatally infected, HIV-positive behaviorally infected on antiretroviral therapy with HIV-1 RNA less than 1000 copies/ml, and HIV-negative controls. We measured the reactive hyperemic index, a measure of endothelial function, using endoPAT (Caesarea, Israel). Markers of systemic inflammation, monocyte activation, and gut integrity were also assessed. Spearman correlations and regression analyses were used to explore relationships between endothelial function measures and other measured variables. RESULTS Overall, 119 participants were enrolled: 53 HIV-positive behaviorally infected, 18 HIV-positive perinatally infected, and 48 controls. Overall, 71% were men; 77% African Americans and median age was 22 years old. Median (interquartile range) reactive hyperemic index was lower in the HIV-positive perinatally infected group [1.34 (1.20, 1.42)], compared with the behaviorally infected group [1.52 (1.34, 1.75)] and the control group [1.52 (1.27, 1.80; P < 0.01)]. Soluble CD14, a marker of monocyte activation, intestinal fatty acid-binding protein, a marker of gut integrity and soluble vascular cell adhesion molecule, a marker of vascular dysfunction, were different among the three groups (P ≤ 0.01). CONCLUSION HIV-positive youth infected perinatally appear to have higher levels of endothelial dysfunction and immune activation when compared with behaviorally infected youth. Further longitudinal studies are needed to determine whether perinatally infected youth have higher risks of cardiovascular disease.
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20
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Noma K, Kihara Y, Higashi Y. Outstanding Effect of Physical Exercise on Endothelial Function Even in Children and Adolescents. Circ J 2017; 81:637-639. [DOI: 10.1253/circj.cj-17-0291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kensuke Noma
- Department of Cardiovascular Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical Sciences, Hiroshima University
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital
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