1
|
Cho KH, Nam HS, Kim NY, Lee MS, Kang DJ. Combination Therapy of Cuban Policosanol (Raydel ®, 20 mg) and Intensive Exercise for 12 Weeks Resulted in Improvements in Obesity, Hypertension, and Dyslipidemia without a Decrease in Serum Coenzyme Q 10: Enhancement of Lipoproteins Quality and Antioxidant Functionality in Obese Participants. Pharmaceuticals (Basel) 2024; 17:132. [PMID: 38276005 PMCID: PMC10820701 DOI: 10.3390/ph17010132] [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: 12/19/2023] [Revised: 01/14/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Obesity and overweight, frequently caused by a lack of exercise, are associated with many metabolic diseases, such as hypertension, diabetes, and dyslipidemia. Aerobic exercise effectively increases the high-density lipoproteins-cholesterol (HDL-C) levels and alleviates the triglyceride (TG) levels. The consumption of Cuban policosanol (Raydel®) is also effective in enhancing the HDL-C quantity and HDL functionality to treat dyslipidemia and hypertension. On the other hand, no study has examined the effects of a combination of high-intensity exercise and policosanol consumption in obese subjects to improve metabolic disorders. In the current study, 17 obese subjects (average BMI 30.1 ± 1.1 kg/m2, eight male and nine female) were recruited to participate in a program combining exercise and policosanol (20 mg) consumption for 12 weeks. After completion, their BMI, waist circumference, total fat mass, systolic blood pressure (SBP), and diastolic blood pressure (DBP) reduced significantly up to around -15%, -13%, -33%, -11%, and -13%, respectively. In the serum lipid profile, at Week 12, a significant reduction was observed in the total cholesterol (TC) and triglyceride (TG) levels, up to -17% and -54% from the baseline, respectively. The serum HDL-C was elevated by approximately +12% from the baseline, as well as the percentage of HDL-C in TC, and HDL-C/TC (%), was enhanced by up to +32% at Week 12. The serum coenzyme Q10 (CoQ10) level was increased 1.2-fold from the baseline in all participants at Week 12. In particular, the male participants exhibited a 1.4-fold increase from the baseline. The larger rise in serum CoQ10 was correlated with the larger increase in the serum HDL-C (r = 0.621, p = 0.018). The hepatic function parameters were improved; the serum γ-glutamyl transferase decreased at Week 12 by up to -55% (p < 0.007), while the aspartate aminotransferase and alanine transaminase levels diminished within the normal range. In the lipoprotein level, the extent of oxidation and glycation were reduced significantly with the reduction in TG content. The antioxidant abilities of HDL, such as paraoxonase (PON) and ferric ion reduction ability (FRA), were enhanced significantly by up to 1.8-fold and 1.6-fold at Week 12. The particle size and number of HDL were elevated up to +10% during the 12 weeks, with a remarkable decline in the TG content, glycation extent, and oxidation. The improvements in HDL quality and functionality were linked to the higher survivability of adult zebrafish and their embryos, under the co-presence of carboxymethyllysine (CML), a pro-inflammatory molecule known to cause acute death. In conclusion, 12 weeks of Cuban policosanol (Raydel®, 20 mg) consumption with high-intensity exercise displayed a significant improvement in blood pressure, body fat mass, blood lipid profile without liver damage, CoQ10 metabolism, and renal impairment.
Collapse
Affiliation(s)
- Kyung-Hyun Cho
- Raydel Research Institute, Medical Innovation Complex, Daegu 41061, Republic of Korea; (H.-S.N.); (N.-Y.K.); (M.-S.L.); (D.-J.K.)
| | | | | | | | | |
Collapse
|
2
|
Lee SJ, Hwan Choi J, Kim SY, Lee JG, Lee SY, Jung Lee H. The effect of home-based cardiac rehabilitation on arterial stiffness and peak oxygen consumption in patients with myocardial infarction. Turk J Phys Med Rehabil 2023; 69:444-452. [PMID: 38766593 PMCID: PMC11099851 DOI: 10.5606/tftrd.2023.11637] [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] [Received: 08/28/2022] [Accepted: 03/22/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives This study aims to investigate the effectiveness of home-based cardiac rehabilitation (CR) on arterial stiffness in patients with acute myocardial infarction (AMI). Patients and methods Between January 2015 and December 2017, a total of 135 patients (120 males, 15 females; mean age: 58.8±11.1 years) with AMI who were referred for CR were included. Home-based CR was prescribed based on a cardiopulmonary exercise test (CPET) for at least six months. All patients completed three consecutive CPETs and brachial-ankle pulse wave velocity (baPWV) measurements at one, four, and seven months after onset. Results After six months of CR, there was an improvement in peak oxygen consumption (pVO2) (Month 1, 28.7±6.4 mL/kg/min; Month 4, 31.6±6.3 mL/kg/min; Month 7, 31.2±7.1 mL/kg/min, p<0.001) and a reduction in baPWV (Month 1, left, 1546.0±311.2 cm/sec, right 1545.5±301.5 cm/sec; Month 4, left, 1374.9±282.5 cm/sec, right 1371.6±287.5 cm/sec; Month 7, left, 1362.9±287.0 cm/sec, right 1365.5±281.1 cm/sec, p<0.001). Conclusion In patients with AMI, arterial stiffness and aerobic capacity improved after six months of home-based CR, particularly in the early stages of rehabilitation. These results suggest that changes in baPWV are useful in determining the effectiveness of CR and pVO2 in the initial stages of CR.
Collapse
Affiliation(s)
- Su Jong Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Jun Hwan Choi
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Song-Yi Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Jae-Geun Lee
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Hyun Jung Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
| |
Collapse
|
3
|
Stone K, Veerasingam D, Meyer ML, Heffernan KS, Higgins S, Maria Bruno R, Bueno CA, Döerr M, Schmidt-Trucksäss A, Terentes-Printzios D, Voicehovska J, Climie RE, Park C, Pucci G, Bahls M, Stoner L. Reimagining the Value of Brachial-Ankle Pulse Wave Velocity as a Biomarker of Cardiovascular Disease Risk-A Call to Action on Behalf of VascAgeNet. Hypertension 2023; 80:1980-1992. [PMID: 37470189 PMCID: PMC10510846 DOI: 10.1161/hypertensionaha.123.21314] [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] [Indexed: 07/21/2023]
Abstract
This review critiques the literature supporting clinical assessment and management of cardiovascular disease and cardiovascular disease risk stratification with brachial-ankle pulse wave velocity (baPWV). First, we outline what baPWV actually measures-arterial stiffness of both large central elastic arteries and medium-sized muscular peripheral arteries of the lower limb. Second, we argue that baPWV is not a surrogate for carotid-femoral pulse wave velocity. While both measures are dependent on the properties of the aorta, baPWV is also strongly dependent on the muscular arteries of the lower extremities. Increased lower-extremity arterial stiffness amplifies and hastens wave reflections at the level of the aorta, widens pulse pressure, increases afterload, and reduces coronary perfusion. Third, we used an established evaluation framework to identify the value of baPWV as an independent vascular biomarker. There is sufficient evidence to support (1) proof of concept; (2) prospective validation; (3) incremental value; and (4) clinical utility. However, there is limited or no evidence to support (5) clinical outcomes; (6) cost-effectiveness; (8) methodological consensus; or (9) reference values. Fourth, we address future research requirements. The majority of the evaluation criteria, (1) proof of concept, (2) prospective validation, (3) incremental value, (4) clinical utility and (9) reference values, can be supported using existing cohort datasets, whereas the (5) clinical outcomes and (6) cost-effectiveness criteria require prospective investigation. The (8) methodological consensus criteria will require an expert consensus statement. Finally, we finish this review by providing an example of a future clinical practice model.
Collapse
Affiliation(s)
- Keeron Stone
- Centre for Cardiovascular Health and Ageing, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom (K.S.)
- National Cardiovascular Research Network, Wales (K.S.)
| | - Dave Veerasingam
- Cardiothoracic Surgery, Galway University Hospital, Ireland (D.V.)
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill (M.L.M.)
| | | | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, PARCC, France (R.M.B.)
- Clinical Pharmacology Unit, AP-HP, Hôpital européen Georges Pompidou, Paris, France (R.M.B.)
| | - Celia Alvarez Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain (C.A.B.)
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay (C.A.B.)
| | - Marcus Döerr
- Department of Internal Medicine B, University Medicine Greifswald, Germany (M.D., M.B.)
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise, and Health (A.S.-T.), University of Basel, Switzerland
- Department of Clinical Research, University Hospital Basel (A.S.-T.), University of Basel, Switzerland
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (D.T.-P.)
| | - Jūlija Voicehovska
- Internal Diseases Department, Riga Stradins University, Latvia (J.V.)
- Nephrology and Renal Replacement Clinics, Riga East University Hospital, Latvia (J.V.)
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania (R.E.C.)
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, London, United Kingdom (C.P.)
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Unit of Internal Medicine, "Santa Maria" Terni Hospital, Italy (G.P.)
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill (L.S.)
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (L.S.)
| |
Collapse
|
4
|
The Effect of Exercise-Based Cardiac Rehabilitation on Neutrophil to Lymphocyte Ratio in Patients with Coronary Artery Disease. COR ET VASA 2023. [DOI: 10.33678/cor.2022.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
5
|
Kovács B, Cseprekál O, Diószegi Á, Lengyel S, Maroda L, Paragh G, Harangi M, Páll D. The Importance of Arterial Stiffness Assessment in Patients with Familial Hypercholesterolemia. J Clin Med 2022; 11:2872. [PMID: 35628997 PMCID: PMC9144855 DOI: 10.3390/jcm11102872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases are still the leading cause of mortality due to increased atherosclerosis worldwide. In the background of accelerated atherosclerosis, the most important risk factors include hypertension, age, male gender, hereditary predisposition, diabetes, obesity, smoking and lipid metabolism disorder. Arterial stiffness is a firmly established, independent predictor of cardiovascular risk. Patients with familial hypercholesterolemia are at very high cardiovascular risk. Non-invasive measurement of arterial stiffness is suitable for screening vascular dysfunction at subclinical stage in this severe inherited disorder. Some former studies found stiffer arteries in patients with familial hypercholesterolemia compared to healthy controls, while statin treatment has a beneficial effect on it. If conventional drug therapy fails in patients with severe familial hypercholesterolemia, PCSK9 inhibitor therapy should be administered; if these agents are not available, performing selective LDL apheresis could be considered. The impact of recent therapeutic approaches on vascular stiffness is not widely studied yet, even though the degree of accelerated athero and arteriosclerosis correlates with cardiovascular risk. The authors provide an overview of the diagnosis of familial hypercholesterolemia and the findings of studies on arterial dysfunction in patients with familial hypercholesterolemia, in addition to presenting the latest therapeutic options and their effects on arterial elasticity parameters.
Collapse
Affiliation(s)
- Beáta Kovács
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
| | - Orsolya Cseprekál
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, 1085 Budapest, Hungary;
| | - Ágnes Diószegi
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
| | - Szabolcs Lengyel
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
| | - László Maroda
- Department of Medical Clinical Pharmacology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - György Paragh
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
| | - Mariann Harangi
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
| | - Dénes Páll
- Division of Metabolism, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.K.); (Á.D.); (S.L.); (G.P.); (D.P.)
- Department of Medical Clinical Pharmacology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| |
Collapse
|
6
|
Toyama K, Igase M, Spin JM, Abe Y, Javkhlant A, Okada Y, Wagenhäuser MU, Schelzig H, Tsao PS, Mogi M. Exosome miR-501-3p Elevation Contributes to Progression of Vascular Stiffness. Circ Rep 2021; 3:170-177. [PMID: 33738350 PMCID: PMC7956882 DOI: 10.1253/circrep.cr-20-0135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Tight junction (TJ) disruption and dysfunction are involved in the progression of arteriosclerosis. miR-501-3p regulates endothelial TJ protein-1, resulting in TJ disruption. Because exosomal microRNAs can travel to distant tissues and influence cell behavior, patients with elevated miR-501-3p may experience accelerated vascular disease progression secondary to miR-501-3p-induced reductions in TJ. This study investigated whether plasma exosome miR-501-3p levels are associated with vascular stiffness, an indicator for arteriosclerotic changes. Methods and Results: Fifty-one subjects (mean [±SD] age 70±8 years, 37% male) enrolled in a medical checkup program were recruited to the study. Brachial-ankle arterial pulse wave velocity (baPWV) and plasma exosome miR-501-3p expression were measured. Patients were divided into 2 groups depending on whether their miR-501-3p ∆Ct values were above ("High"; n=24) or below ("Low"; n=27) the cut-off levels determined by receiver operating characteristic (ROC) curve analysis. Median (interquartile range) baPWV levels were significantly higher in the miR-501-3p High than Low group (1,664 [1,496-1,859] vs. 1,450 [1,353-1,686] cm/s, respectively; P<0.05). Multivariate logistic regression analysis showed a significant association between increased baPWV and High miR-501-3p expression (odds ratio 4.66). At follow-up visits (mean 62 months later), baPWV remained significantly higher in the miR-501-3p High than Low group (1,830 [1,624-2,056] vs. 1,620 [1,377-1,816] cm/s, respectively; P<0.05). Conclusions: High expression levels of exosome miR-501-3p contribute to arteriosclerotic changes.
Collapse
Affiliation(s)
- Kensuke Toyama
- Department of Pharmacology, Ehime University Graduate School of Medicine Toon Japan
| | - Michiya Igase
- Department of Anti-aging Medicine, Ehime University Graduate School of Medicine Toon Japan
| | - Joshua M Spin
- VA Palo Alto Health Care System Palo Alto, CA USA.,Division of Cardiovascular Medicine, Stanford University School of Medicine Stanford, CA USA
| | - Yasunori Abe
- Department of Pharmacology, Ehime University Graduate School of Medicine Toon Japan
| | - Amarsanaa Javkhlant
- Department of Pharmacology, Ehime University Graduate School of Medicine Toon Japan
| | - Yoko Okada
- Department of Anti-aging Medicine, Ehime University Graduate School of Medicine Toon Japan
| | - Markus U Wagenhäuser
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf Germany
| | - Hubert Schelzig
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf Germany
| | - Philip S Tsao
- VA Palo Alto Health Care System Palo Alto, CA USA.,Division of Cardiovascular Medicine, Stanford University School of Medicine Stanford, CA USA
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine Toon Japan
| |
Collapse
|
7
|
Thompson G, Davison GW, Crawford J, Hughes CM. Exercise and inflammation in coronary artery disease: A systematic review and meta-analysis of randomised trials. J Sports Sci 2020; 38:814-826. [DOI: 10.1080/02640414.2020.1735684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Gareth Thompson
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| | - Gareth W. Davison
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, County Antrim
| | - Jacqui Crawford
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| | - Ciara M. Hughes
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| |
Collapse
|
8
|
Kelly C, Mwandumba HC, Heyderman RS, Jambo K, Kamng'ona R, Chammudzi M, Sheha I, Peterson I, Rapala A, Mallewa J, Walker AS, Klein N, Khoo S. HIV-Related Arterial Stiffness in Malawian Adults Is Associated With the Proportion of PD-1-Expressing CD8+ T Cells and Reverses With Antiretroviral Therapy. J Infect Dis 2019; 219:1948-1958. [PMID: 30629187 PMCID: PMC6534190 DOI: 10.1093/infdis/jiz015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The contribution of immune activation to arterial stiffness and its reversibility in human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa is unknown. METHODS HIV-uninfected and HIV-infected Malawian adults initiating antiretroviral therapy (ART) with a CD4+ T-cell count of <100 cells/μL were enrolled and followed for 44 weeks; enrollment of infected adults occurred 2 weeks after ART initiation. We evaluated the relationship between carotid femoral pulse wave velocity (cfPWV) and T-cell activation (defined as HLA-DR+CD38+ T cells), exhaustion (define as PD-1+ T cells), and senescence (defined as CD57+ T cells) and monocyte subsets, using normal regression. RESULTS In 279 HIV-infected and 110 HIV-uninfected adults, 142 (37%) had hypertension. HIV was independently associated with a 12% higher cfPWV (P = .02) at baseline and a 14% higher cfPWV at week 10 (P = .02), but the increases resolved by week 22. CD4+ and CD8+ T-cell exhaustion were independently associated with a higher cfPWV at baseline (P = .02). At 44 weeks, arterial stiffness improved more in those with greater decreases in the percentage of CD8+ T cells and the percentage of PD-1+CD8+ T cells (P = .01 and P = .03, respectively). When considering HIV-infected participants alone, the adjusted arterial stiffness at week 44 tended to be lower in those with higher baseline percentage of PD-1+CD8+ T cells (P = .054). CONCLUSIONS PD-1+CD8+ T-cells are associated with HIV-related arterial stiffness, which remains elevated during the first 3 months of ART. Resources to prevent cardiovascular disease in sub-Saharan Africa should focus on blood pressure reduction and individuals with a low CD4+ T-cell count during early ART.
Collapse
Affiliation(s)
- Christine Kelly
- Insitute of Translational Medicine, University of Liverpool
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
- HIV Molecular Research Group, University College Dublin, Ireland
| | - Henry C Mwandumba
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Robert S Heyderman
- Division of Infection and Immunity
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | - Kondwani Jambo
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | - Raphael Kamng'ona
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | - Mishek Chammudzi
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | - Irene Sheha
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | - Ingrid Peterson
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine
| | | | - Jane Mallewa
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Nigel Klein
- Institute of Child Health, University College London, London, United Kingdom
| | - Saye Khoo
- Insitute of Translational Medicine, University of Liverpool
| |
Collapse
|
9
|
Arterial Stiffness is Associated With Moderate to Vigorous Physical Activity Levels in Post-Myocardial Infarction Patients. J Cardiopulm Rehabil Prev 2019; 39:325-330. [PMID: 30913044 DOI: 10.1097/hcr.0000000000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Arterial stiffness has shown independent predictive value for all-cause and cardiovascular mortalities, as well as fatal and nonfatal coronary events. Physical activity (PA) is associated with reduced cardiovascular morbidity and mortality. The study aims to analyze the cross-sectional association of arterial stiffness with objectively measured PA in patients following acute myocardial infarction. METHODS One hundred patients were consecutively recruited after experiencing an acute myocardial infarction. Central arterial stiffness was measured through carotid-femoral pulse wave velocity (cf-PWV) and daily PA was assessed objectively during 7 consecutive days with accelerometers. To be valid, data required recordings of at least 8 hr/d on 5 d. RESULTS The cf-PWV showed a negative and significant association with total weekly time spent in moderate to vigorous PA (MVPA) (r = -0.416, P < .001). Patients classified as having higher risk according to arterial stiffness values (cf-PWV ≥10 m/sec) showed significantly lower time spent in MVPA than those below that threshold. The cf-PWV was significantly lower in patients performing >300 min of MVPA/wk than in those performing <150 min/wk (8.53 ± 2.08 vs 10.3 ± 2.44 m/sec, P = .021). Differences remained significant after adjustment for several confounders. CONCLUSIONS Moderate to vigorous PA was inversely associated with arterial stiffness and time spent in MVPA was lower in patients after acute myocardial infarction, with cf-PWV above the risk threshold value (≥10 m/sec). These results seem to reinforce the importance of PA as a nonpharmacological tool for secondary cardiovascular prevention.
Collapse
|
10
|
Associations of non-high-density lipoprotein cholesterol, triglycerides and the total cholesterol/HDL-c ratio with arterial stiffness independent of low-density lipoprotein cholesterol in a Chinese population. Hypertens Res 2019; 42:1223-1230. [PMID: 30918334 PMCID: PMC8075960 DOI: 10.1038/s41440-019-0251-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 12/14/2022]
Abstract
Several lipid parameters are closely associated with residual cardiovascular risk. We aimed to confirm that in a range of low-density lipoprotein cholesterol (LDL-c) levels (from <70 mg/dl to ≥160 mg/dl), other lipid parameters, such as triglyceride (TG) level, non-high-density lipoprotein cholesterol (non-HDL-c) level, and the total cholesterol (TC)/HDL-c ratio, are still related to arterial stiffness, which is a recognized marker of atherosclerosis. In this cross-sectional study, we measured brachial-ankle pulse wave velocity (baPWV), as well as clinical and biochemical indices in 16,733 Chinese adult volunteers who underwent health check-ups from January 2014 to January 2015. Arterial stiffness was defined as the upper quartile of baPWV. We applied multivariable logistic regression models to examine the associations between lipid parameters and arterial stiffness. Both men and women with high baPWV were more likely to have an atherogenic lipid phenotype. Among participants with LDL-c <70 mg/dl, participants with non-HDL-c ≥100 mg/dl had a multivariable adjusted OR for arterial stiffness of 1.66 (1.11–2.50) compared to those with non-HDL-c <100 mg/dl; participants with TG ≥150 mg/dl had an OR of 2.44 (1.61–3.71) compared to those with TG <150 mg/dl; and participants with a TC/HDL-c ratio ≥4 had an OR of 1.74 (1.15–2.65) compared to those with a TC/HDL-c ratio <4. Similar results were observed at other LDL-c levels. We found that non-HDL-c, TG, and the TC/HDL-c ratio were consistently associated with arterial stiffness in a range of LDL-c levels, even when LDL-c was below 70 mg/dl. These lipid measures are related to residual cardiovascular risk, possibly due to their detrimental effects on vascular structure.
Collapse
|
11
|
[Effects of exercise on the cognition of older women treated with lovastatin]. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2018; 38:496-506. [PMID: 30653863 DOI: 10.7705/biomedica.v38i4.4262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/02/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The deterioration of cognition is highly predominant in older adults. OBJECTIVE The aim of this study was to analyze the effects of a walking program on the cognition and blood concentration of lipids in women over 60 years of age who were being treated with lovastatin. MATERIALS AND METHODS Participants were distributed in two groups: An exercise group (EG, n=45) with aerobic training and an inactive sedentary group (SG, n=22). The cognitive state of the subjects was assessed through the Spanish Mini-Cog Test version of the MMSE; lipoproteins were quantified using a lipid profile test, and the cardiorespiratory fitness was measured using the six-minute walking test (6MWT). RESULTS EG showed a significant increase (p<0.05) in cardiorespiratory fitness and in HDL-C concentrations. Furthermore, the results from the cognition tests showed a large effect size in spatial orientation and in and calculation. The decrease in LDL-C was not significant (p>0.05). CONCLUSION A controlled and progressive walking program for older women treated with Lovastatin may induce a boost of brain activity linked to HDL-C, which could delay cognitive impairment.
Collapse
|
12
|
Ato D, Sawayama T. Factors associated with high brachial-ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors. Vasc Health Risk Manag 2017; 13:383-392. [PMID: 29066906 PMCID: PMC5644576 DOI: 10.2147/vhrm.s144923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
While pulse wave velocity (PWV) correlates with blood pressure (BP), its extent differs between patients, and some cases of high PWV in normotensives are present. Moreover, PWV frequently remains high in hypertensive patients despite adequate BP control. The factors associated with such phenomena are yet to be elucidated. Here, we investigated the factors associated with brachial–ankle PWV (baPWV) in 107 patients whose systolic BP was under 140 mmHg at their latest baPWV measurement. There were 64 controlled hypertensives and 43 normotensives. Multivariate regression analysis identified age, hypertension, body mass index (BMI), systolic BP, and heart rate (HR) as independent factors for baPWV. Next, we divided the subjects into groups according to their age (in 5-year increments) and calculated the mean and standard deviation (SD) of the baPWV for each group. For each age group, we defined patients with a baPWV above the mean + SD baPWV for the group as the high-baPWV cohort. Multivariate logistic regression analysis revealed that BMI, hypertension, and smoking were independent determinants of a high-baPWV subject. This represents the first study to report the existence of the hypertensive state itself as one of the independent predictors of high baPWV in normotensive and well-treated hypertensive patients. This finding implies that the hypertensive state itself possibly worsens arterial stiffness independently from aging in spite of adequate BP maintenance. To prevent the early progression of arterial stiffness, the application of an appropriate intervention during the early stages of hypertension is important and the continuation of an appropriate BP treatment is suggested.
Collapse
Affiliation(s)
- Dai Ato
- Gakujutsu Shien (Academic Support) Co., Ltd. Tokyo
| | | |
Collapse
|
13
|
Toyama K, Sugiyama S, Oka H, Hamada M, Iwasaki Y, Horio E, Rokutanda T, Nakamura S, Spin JM, Tsao PS, Ogawa H. A Pilot Study: The Beneficial Effects of Combined Statin-exercise Therapy on Cognitive Function in Patients with Coronary Artery Disease and Mild Cognitive Decline. Intern Med 2017; 56:641-649. [PMID: 28321063 PMCID: PMC5410473 DOI: 10.2169/internalmedicine.56.7703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective Hypercholesterolemia, a risk factor in cognitive impairment, can be treated with statins. However, cognitive decline associated with "statins" (HMG-CoA reductase inhibitors) is a clinical concern. This pilot study investigated the effects of combining statins and regular exercise on cognitive function in coronary artery disease (CAD) patients with prior mild cognitive decline. Methods We recruited 43 consecutive CAD patients with mild cognitive decline. These patients were treated with a statin and weekly in-hospital aerobic exercise for 5 months. We measured serum lipids, exercise capacity, and cognitive function using the mini mental state examination (MMSE). Results Low-density lipoprotein cholesterol levels were significantly decreased, and maximum exercise capacity (workload) was significantly increased in patients with CAD and mild cognitive decline after treatment compared with before. Combined statin-exercise therapy significantly increased the median (range) MMSE score from 24 (22-25) to 25 (23-27) across the cohort (p<0.01). Changes in body mass index (BMI) were significantly and negatively correlated with changes in the MMSE. After treatment, MMSE scores in the subgroup of patients that showed a decrease in BMI were significantly improved, but not in the BMI-increased subgroup. Furthermore, the patients already on a statin at the beginning of the trial displayed a more significant improvement in MMSE score than statin-naïve patients, implying that exercise might be the beneficial aspect of this intervention as regards cognition. In a multivariate logistic regression analysis adjusted for age >65 years, sex, and presence of diabetes mellitus, a decrease in BMI during statin-exercise therapy was significantly correlated with an increase in the MMSE score (odds ratio: 4.57, 95% confidence interval: 1.05-20.0; p<0.05). Conclusion Statin-exercise therapy may help improve cognitive dysfunction in patients with CAD and pre-existing mild cognitive decline.
Collapse
Affiliation(s)
- Kensuke Toyama
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Relationship Between Echocardiographically Evaluated Aortic Stiffness and Prolidase Activity in Aortic Tissue of Patients with Critical Coronary Artery Disease. Arch Med Res 2016; 47:200-6. [DOI: 10.1016/j.arcmed.2016.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/28/2016] [Indexed: 11/18/2022]
|
15
|
Measurement of Arterial Stiffness: A Novel Tool of Risk Stratification in Hypertension. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 956:475-488. [PMID: 27722956 DOI: 10.1007/5584_2016_78] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cardiovascular diseases are the leading causes of morbidity and mortality in industrialized countries worldwide, despite highly effective preventive treatments available. As a difference continues to exist between the estimated and true number of events, further improvement of risk stratification is an essential part of cardiovascular research.Among hypertensive patients measurement of arterial stiffness parameters, like carotid-femoral pulse wave velocity (cfPWV) or brachial-ankle pulse wave velocity (baPWV) can contribute to the identification of high-risk subpopulation of patients. This is a hot topic of vascular research including the possibility of the non-invasive measurement of central hemodynamics, wave reflections and recently, 24-h arterial stiffness monitoring as well. This chapter discusses the past and the present of this area including the scientific achievements with cfPWV, baPWV and other measures, provides a short overview of methodologies and the representation of arterial stiffness parameters in guidelines.
Collapse
|
16
|
Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cífková R, Cosentino F, De Carlo M, Gallino A, Landmesser U, Laurent S, Lekakis J, Mikhailidis DP, Naka KK, Protogerou AD, Rizzoni D, Schmidt-Trucksäss A, Van Bortel L, Weber T, Yamashina A, Zimlichman R, Boutouyrie P, Cockcroft J, O'Rourke M, Park JB, Schillaci G, Sillesen H, Townsend RR. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis 2015; 241:507-32. [DOI: 10.1016/j.atherosclerosis.2015.05.007] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/29/2015] [Accepted: 05/14/2015] [Indexed: 02/07/2023]
|
17
|
Weir-McCall JR, Struthers AD, Lipworth BJ, Houston JG. The role of pulmonary arterial stiffness in COPD. Respir Med 2015; 109:1381-90. [PMID: 26095859 PMCID: PMC4646836 DOI: 10.1016/j.rmed.2015.06.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 05/10/2015] [Accepted: 06/10/2015] [Indexed: 12/23/2022]
Abstract
COPD is the second most common cause of pulmonary hypertension, and is a common complication of severe COPD with significant implications for both quality of life and mortality. However, the use of a rigid diagnostic threshold of a mean pulmonary arterial pressure (mPAP) of ≥25mHg when considering the impact of the pulmonary vasculature on symptoms and disease is misleading. Even minimal exertion causes oxygen desaturation and elevations in mPAP, with right ventricular hypertrophy and dilatation present in patients with mild to moderate COPD with pressures below the threshold for diagnosis of pulmonary hypertension. This has significant implications, with right ventricular dysfunction associated with poorer exercise capability and increased mortality independent of pulmonary function tests. The compliance of the pulmonary artery (PA) is a key component in decoupling the right ventricle from the pulmonary bed, allowing the right ventricle to work at maximum efficiency and protecting the microcirculation from large pressure gradients. PA stiffness increases with the severity of COPD, and correlates well with the presence of exercise induced pulmonary hypertension. A curvilinear relationship exists between PA distensibility and mPAP and pulmonary vascular resistance (PVR) with marked loss of distensibility before a rapid rise in mPAP and PVR occurs with resultant right ventricular failure. This combination of features suggests PA stiffness as a promising biomarker for early detection of pulmonary vascular disease, and to play a role in right ventricular failure in COPD. Early detection would open this up as a potential therapeutic target before end stage arterial remodelling occurs. Pulmonary hypertension is common in COPD. Right ventricular remodeling occurs at pressures below the diagnostic threshold of PH. Pulmonary arterial stiffening occurs early in the development of PH. Non-invasive measurement of pulmonary stiffness may serve as an early biomarker of PH.
Collapse
Affiliation(s)
- Jonathan R Weir-McCall
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom.
| | - Allan D Struthers
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| | - Brian J Lipworth
- Scottish Centre for Respiratory Research, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| | - J Graeme Houston
- Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom
| |
Collapse
|
18
|
Oliveira NL, Ribeiro F, Silva G, Alves AJ, Silva N, Guimarães JT, Teixeira M, Oliveira J. Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients. Atherosclerosis 2015; 239:150-7. [PMID: 25602857 DOI: 10.1016/j.atherosclerosis.2014.12.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/19/2014] [Accepted: 12/24/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality. OBJECTIVE This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers. Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake. METHODS In this parallel-group trial, 96 patients (56 ± 10 years) were randomized to either the exercise group (EG) or control group (CG) 4 weeks after suffering acute myocardial infarction (MI). ECR consisted of 8 weeks of aerobic exercise at 70-85% of maximal heart rate during 3 sessions weekly, plus usual care. CG participants received only usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cf-PWV), inflammatory and endothelial dysfunction biomarkers, daily physical activity, and dietary intake. (ClinicalTrials.gov: NCT01432639). RESULTS After 8 weeks, no significant changes were found between groups in cf-PWV, inflammatory and endothelial dysfunction biomarkers, daily physical activity, or dietary intake. Excluding those patients (n = 7) who did not attend, at least 80% of the exercise sessions provided similar results, excepting a significant reduction in cf-PWV in the EG compared to the CG. CONCLUSIONS A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication. Nevertheless, the decrease of cf-PWV observed in the EG, when considering only those patients who attended at least 80% of exercise sessions, warrants further investigation.
Collapse
Affiliation(s)
- Nórton Luís Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810.193 Aveiro, Portugal.
| | - Gustavo Silva
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
| | - Alberto Jorge Alves
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal; Higher Institute of Educational Sciences, Rua Dr. Luís Gonzaga F. Moreira, 4610.177 Felgueiras, Portugal.
| | - Nuno Silva
- Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal.
| | - João Tiago Guimarães
- Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal.
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Vila Nova de Gaia, 4434.502 Espinho, Portugal.
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
| |
Collapse
|
19
|
Castro-Perez J, Hatcher N, Kofi Karikari N, Wang SP, Mendoza V, Shion H, Millar A, Shockcor J, Towers M, McLaren D, Shah V, Previs S, Akinsanya K, Cleary M, Roddy TP, Johns DG. In vivo isotopically labeled atherosclerotic aorta plaques in ApoE KO mice and molecular profiling by matrix-assisted laser desorption/ionization mass spectrometric imaging. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2014; 28:2471-2479. [PMID: 25303476 DOI: 10.1002/rcm.7039] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/31/2014] [Accepted: 09/02/2014] [Indexed: 06/04/2023]
Abstract
RATIONALE The ability to quantify rates of formation, regression and/or remodeling of atherosclerotic plaque should facilitate a better understanding of the pathogenesis and management of cardiovascular disease. In the current study, we coupled a stable isotope labeled tracer protocol with matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) to examine spatial and temporal lipid dynamics in atherosclerotic plaque. METHODS To promote plaque formation in the aorta region, ApoE KO mice were fed a high cholesterol diet (0.15% cholesterol) and orally dosed with (2,2,3,4,4,6-d(6))-cholesterol over several weeks. Tissue sections of ~10 µm thickness were analyzed by MALDI-MSI using matrix deposition by either chemical sublimation or acoustic droplet ejection. RESULTS MALDI-MSI yielded distinct spatial distribution information for a variety of lipid classes including specific lysophosphatidylcholines typically associated with atherosclerosis-related tissue damage such as phospholipase 2 (Lp-PLA(2)) that mediate chemotactic responses to inflammation (e.g. LPC 16:0, LPC 18:0 and LPC 18:1) as well as free cholesterol and cholesteryl esters that contribute to atheroma formation. MALDI mass spectra acquired from aorta tissue sections clearly distinguished non-esterified and esterified versions of (2,2,3,4,4,6-d(6))-cholesterol within aortic plaque regions and showed distinct spatial accumulation of the cholesterol tracer. CONCLUSIONS The ability to couple stable isotope based protocols with MALDI-MSI enables a novel strategy to characterize the effects of therapeutic treatments on atherosclerotic plaque formation, regression and potential remodeling of the complex lipid components with high chemical specificity and spatiotemporal information.
Collapse
Affiliation(s)
- Jose Castro-Perez
- Merck & Co., Inc, Merck Research Laboratories, Kenilworth, NJ, 07033, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Oh PC, Han SH, Koh KK, Lee K, Seo JG, Suh SY, Ahn T, Choi IS, Shin EK. Rosuvastatin treatment improves arterial stiffness with lowering blood pressure in healthy hypercholesterolemic patients. Int J Cardiol 2014; 176:1284-7. [DOI: 10.1016/j.ijcard.2014.07.181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 07/27/2014] [Indexed: 10/25/2022]
|
21
|
Moustardas P, Kadoglou NPE, Katsimpoulas M, Kapelouzou A, Kostomitsopoulos N, Karayannacos PE, Kostakis A, Liapis CD. The complementary effects of atorvastatin and exercise treatment on the composition and stability of the atherosclerotic plaques in ApoE knockout mice. PLoS One 2014; 9:e108240. [PMID: 25264981 PMCID: PMC4180453 DOI: 10.1371/journal.pone.0108240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/26/2014] [Indexed: 12/02/2022] Open
Abstract
Aim This study aimed to investigate the effects of combined atorvastatin and exercise treatment on the composition and stability of the atherosclerotic plaques in apolipoproteinE (apoE) knockout mice. Methods Forty male, apoE−/− mice were fed a high-fat diet for 16 weeks. Thereafter, while maintained on high-fat diet, they were randomized into four (n = 10) groups for 8 additional weeks: Group CO: Control. Group AT: Atorvastatin treatment (10 mg/Kg/day). Group EX: Exercise-training on treadmill. Group AT+EX: Atorvastatin and simultaneous exercise training. At the study’s end, plasma cholesterol levels, lipids and triglycerides were measured, along with the circulating concentrations of matrix-metalloproteinases (MMP-2,3,8,9) and their inhibitors (TIMP-1,2,3). Plaque area and the relative concentrations of collagen, elastin, macrophages, smooth muscle cells, MMP-2,3,8,9 and TIMP-1,2,3 within plaques were determined. Lastly, MMP activity was assessed in the aortic arch. Results All intervention groups showed a lower degree of lumen stenosis, with atheromatous plaques containing more collagen and elastin. AT+EX group had less stenosis and more elastin compared to single intervention groups. MMP-3,-8 -9 and macrophage intra-plaque levels were reduced in all intervention groups. EX group had increased TIMP-1 levels within the lesions, while TIMP-2 was decreased in all intervention groups. The blood levels of the above molecules increased during atherosclerosis development, but they did not change after the therapeutic interventions in accordance to their intra-plaque levels. Conclusion The two therapeutic strategies act with synergy regarding the extent of the lesions and lumen stenosis. They stabilize the plaque, increasing its content in elastin and collagen, by influencing the MMP/TIMP equilibrium, which is mainly associated with the macrophage amount. While the increased MMP-2,-3,-8 -9, as well as TIMP-1 and TIMP-2 circulating levels are markers of atherosclerosis, they are not correlated with their corresponding concentrations within the lesions after the therapeutic interventions, and cannot serve as markers for the disease development/amelioration.
Collapse
Affiliation(s)
- Petros Moustardas
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
- * E-mail:
| | - Nikolaos P. E. Kadoglou
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Michalis Katsimpoulas
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Alkistis Kapelouzou
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | | | - Alkiviadis Kostakis
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Christos D. Liapis
- Department of Vascular Surgery, «Attikon» Hospital, Medical School, University of Athens, Athens, Greece
| |
Collapse
|
22
|
Soylu K, Gulel O, Yucel H, Yuksel S, Aksan G, Soylu Aİ, Demircan S, Yılmaz O, Sahin M. The effect of blood cell count on coronary flow in patients with coronary slow flow phenomenon. Pak J Med Sci 2014; 30:936-41. [PMID: 25225502 PMCID: PMC4163207 DOI: 10.12669/pjms.305.4935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background and Objective: The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course, but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates. Methods: Selective coronary angiographies of 3368 patients were analyzed to assess Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) values. Seventy eight of them had CSFP, and their demographic and laboratory findings were compared with 61 patients with normal coronary flow. Results: Patients’ demographic characteristics were similar in both groups. Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (p<0.001). Furthermore, hematocrit and hemoglobin values, and eosinophil and basophil counts of the CSFP patients were significantly elevated compared to the values obtained in the control group (p=0.005, p=0.047, p=0.001 and p=0.002, respectively). The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r=0.288 and r=0.217, respectively). Conclusion: Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow. The increases in hematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.
Collapse
Affiliation(s)
- Korhan Soylu
- Korhan Soylu, MD, Assistant Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Okan Gulel
- Okan Gulel, MD, Associate Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Huriye Yucel
- Huriye Yucel, MD, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Serkan Yuksel
- Serkan Yuksel, MD, Assistant Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Gokhan Aksan
- Gokhan Aksan, MD, Department of Cardiology, Gazi State Hospital, Samsun, Turkey
| | - Ayşegül İdil Soylu
- Ayşegül İdil Soylu, MD, Department of Radiology, Samsun Education Research Hospital, Samsun, Turkey
| | - Sabri Demircan
- Sabri Demircan, MD, Associate Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ozcan Yılmaz
- Özcan Yılmaz, MD, Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Mahmut Sahin
- Mahmut Sahin, MD, Professor, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| |
Collapse
|
23
|
|
24
|
Toyama K, Sugiyama S, Oka H, Iwasaki Y, Sumida H, Tanaka T, Tayama S, Jinnouchi H, Ogawa H. Statins combined with exercise are associated with the increased renal function mediated by high-molecular-weight adiponectin in coronary artery disease patients. J Cardiol 2014; 64:91-7. [DOI: 10.1016/j.jjcc.2013.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 11/07/2013] [Accepted: 11/27/2013] [Indexed: 12/30/2022]
|
25
|
Kawai T, Ohishi M, Onishi M, Ito N, Takeya Y, Oguro R, Takami Y, Yamamoto K, Rakugi H. Prognostic impact of regional arterial stiffness in hypertensive patients. Heart Vessels 2014; 30:338-46. [PMID: 24566589 DOI: 10.1007/s00380-014-0485-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/07/2014] [Indexed: 11/24/2022]
Abstract
Many reports have shown that brachial-ankle pulse wave velocity (baPWV) and carotid-femoral PWV are prognostic factors for cardiovascular diseases. We evaluated heart-carotid PWV, heart-femoral PWV (hfPWV), and femoral-ankle PWV (faPWV) using carotid and femoral sensors. Our objectives were to reveal correlations among PWVs and to determine the clinical importance of the respective PWVs in predicting the cardiovascular events. This prospective cohort study included 338 patients with essential hypertension (mean age 61.3 ± 0.7, mean follow-up period 6.5 ± 0.1 years) whose regional PWVs were measured. Primary end points were stroke, cardiovascular diseases (CVD), and death. Kaplan-Meier analysis showed that subjects with higher faPWV and baPWV had a significantly higher incidence of stroke (p = 0.0288 and 0.0277, respectively), subjects with higher hfPWV had a significantly higher incidence of CVD (p = 0.0212), subjects with higher baPWV and hfPWV had a significantly higher incidence of stroke + CVD (p = 0.0070 and 0.0463, respectively), and subjects with higher baPWV had a significantly higher mortality rate (p = 0.0367). Cox proportional hazard model revealed that baPWV was a significant risk factor for stroke + CVD after adjustment for traditional risk factors (relative risk: 14.50, p = 0.0288). Higher baPWV may be a risk factor for stroke and CVD, but the prognostic impact of regional PWVs is still unclear in patients with hypertension.
Collapse
Affiliation(s)
- Tatsuo Kawai
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka (B6), Suita, Osaka, 565-0871, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review. Diseases 2013. [DOI: 10.3390/diseases1010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
27
|
Oliveira NL, Ribeiro F, Alves AJ, Campos L, Oliveira J. The effects of exercise training on arterial stiffness in coronary artery disease patients: a state-of-the-art review. Clin Physiol Funct Imaging 2013; 34:254-62. [PMID: 24138480 DOI: 10.1111/cpf.12093] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 09/17/2013] [Indexed: 12/23/2022]
Abstract
The purpose of this state-of-the-art review was to examine the effects of exercise training on arterial stiffness (AS) in patients with coronary artery disease (CAD). A PubMed and SCOPUS literature search was conducted up to March of 2013. Two authors performed the selection of the studies and the subsequent data extraction (e.g. information on study design, exercise programme characteristics and outcome measures). Of 34 papers identified, only five studies met the inclusion criteria, with no one being a randomized controlled trial. Within the selected studies, the sample size varied between 28 and 119 patients, with mean ages ranging from 48 to 67 years old in patients with CAD after an acute myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty. Although all studies utilized the aerobic exercise mode, the other characteristics of the exercise programmes varied largely between the studies: programme length (from 6 to 20 weeks), exercise duration (15-20 to 50 min) and exercise intensity, which was based on heart rate reserve (40 to 85%) or heart rate at anaerobic threshold or ventilatory threshold. All the three studies evaluating pulse wave velocity, as well as one of two studies that assessed the augmentation index, reported significant reductions on those variables after exercise training. Results indicated that the majority of the AS and related measures improved after the different exercise training programmes. However, these results need to be confirmed in future randomized clinical studies controlling potential confounders.
Collapse
Affiliation(s)
- Norton Luis Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | | | | | | | | |
Collapse
|
28
|
Exercise perspective on common cardiac medications. Integr Med Res 2013; 2:49-55. [PMID: 28664054 PMCID: PMC5481675 DOI: 10.1016/j.imr.2013.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 04/15/2013] [Accepted: 04/15/2013] [Indexed: 12/20/2022] Open
Abstract
Medicinal tablets have been used for a long time to treat cardiovascular disease. However, mortality rate is steadily increasing partly because of the patients’ sedentary lifestyle and unhealthy diet. By contrast, exercise has been systematically shown to have multiple benefits. Regular exercise training can prevent various diseases in healthy individuals. Combined exercise and cardiac medications may lead to the improvement of heart disease. Numerous exercise training pathways still need further investigations. How exercise can prevent, treat, or attenuate diseases remains somewhat elusive. Thus, this review will discuss cardiac medications in parallel with the mechanism of action of exercise.
Collapse
|