1
|
Aron A, Landrum EJ, Schneider AD, Via M, Evans L, Rawson ES. Effects of acute creatine supplementation on cardiac and vascular responses in older men; a randomized controlled trial. Clin Nutr ESPEN 2024; 63:S2405-4577(24)00214-6. [PMID: 39047868 DOI: 10.1016/j.clnesp.2024.07.008] [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: 02/20/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND AND AIMS In the recent years creatine has been shown promising results in patients with neurodegenerative diseases, myopathies and dystrophies. Cardiovascular diseases could be another pathology that can benefit from creatine supplementation, considering the influence on the risk factors associated with the development of cardiovascular diseases including reduction in chronic inflammation, and improved control of hyperglycemia and dyslipidemia The aim of the present study was to investigate the impact of short-term creatine supplementation on cardiac and vascular health in older adults. METHODS Males between the ages of 55-80 were randomly assigned to three groups: creatine, placebo and control. Creatine or placebo was provided for 7-day supplementation, at a dose of 20g/day. Testing was performed at the same time of the day at baseline and on the eighth day. Vascular responses were assessed using an arterial pulse wave velocity equipment, while cardiac assessment was performed using an impedance cardiography device. RESULTS The placebo group was older (71.1 ± 8.2 yr.) compared to creatine (61.4 ± 5.2 yr.) and control (62.5 ± 7.1 yr.). Cardio-ankle vascular index improved just in the creatine group (8.7 ± 0.5 to 8.2 ± 0.5, p = 0.03). While the upstroke time of the placebo and control groups did not change after 7 days, the creatine group had a nonsignificant reduction, 178.9 ± 26.5 ms to 158.4 ± 28.6 ms, p = 0.07. Similar tendency was seen with the systolic blood pressures, while the placebo and control did not change, the creatine group showed nonsignificant improvement, especially on the right, 144.0 ± 12.7 mmHg to 136.1 ± 13.4 mmHg, p = 0.08. All three groups had similar responses in stroke volume (p=0.61), contractility index (p=0.64) and ejection fraction (p=0.72). CONCLUSIONS In older adults, acute creatine supplementation can positively affect vascular parameters of arterial stiffness and atherosclerosis. Creatine supplementation has the potential to serve as a potent adjuvant in the management of CVD for older adults. CLINICAL TRIAL REGISTRATION clinicaltrials.gov; ID: NCT05329480.
Collapse
Affiliation(s)
- Adrian Aron
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Radford, Virginia, USA.
| | - Eryn J Landrum
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Radford, Virginia, USA
| | - Adam D Schneider
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Radford, Virginia, USA
| | - Megan Via
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Radford, Virginia, USA
| | - Logan Evans
- Department of Physical Therapy, Waldron College of Health and Human Services, Radford University, Radford, Virginia, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, Pennsylvania, USA
| |
Collapse
|
2
|
Kim HL, Jo SH. Arterial Stiffness and Heart Failure With Preserved Ejection Fraction. J Korean Med Sci 2024; 39:e195. [PMID: 38887204 PMCID: PMC11182699 DOI: 10.3346/jkms.2024.39.e195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is prevalent and associated with a poor prognosis, imposing a significant burden on society. Arterial stiffness is increasingly recognized as a crucial factor in the pathophysiology of HFpEF, affecting diagnosis, management, and prognosis. As a hallmark of vascular aging, arterial stiffness contributes to increased afterload on the left ventricle (LV), leading to diastolic dysfunction, a key feature of HFpEF. Elevated arterial stiffness is linked with common cardiovascular risk factors in HFpEF, such as hypertension, diabetes and obesity, exacerbating the progression of disease. Studies have demonstrated that patients with HFpEF exhibit significantly higher levels of arterial stiffness compared to those without HFpEF, highlighting the value of arterial stiffness measurements as both diagnostic and prognostic tools. Moreover, interventions aimed at reducing arterial stiffness, whether through pharmacological therapies or lifestyle modifications, have shown potential in improving LV diastolic function and patient outcomes. Despite these advancements, the precise mechanisms by which arterial stiffness contributes to HFpEF are still not fully understood, necessitating the need for further research.
Collapse
Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Ho Jo
- Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
| |
Collapse
|
3
|
Can Y, Kocayigit I, Kocayiğit H, Sarıbıyık Çakmak B, Şahinöz M, Akdemir R. Ongoing Effects of SARS-CoV-2 Infection on Arterial Stiffness in Healthy Adults. Angiology 2024; 75:116-121. [PMID: 37295020 DOI: 10.1177/00033197231183227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There are limited data on the arterial stiffness changes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The present study evaluated the changes in arterial stiffness in completely healthy patients who had a SARS-CoV-2 infection using the cardio-ankle vascular index (CAVI). The study included 70 patients with SARS-CoV-2 infection between December 2020 and June 2021. A cardiac evaluation was carried out, including chest X-ray, electrocardiography (ECG), and echocardiography in all patients. Within the 1st month and 7th month CAVI was measured. Mean age was 37.8 ± 10.0 years, and 41/70 were female. Mean height was 168.6 ± 9.5 cm, mean weight 73.2 ± 15.1 kg, and mean body mass index (BMI) of the group was 25.6 ± 4.2, respectively. CAVI results from the right arm were 6.45 ± .95 at 1-month follow-up and 6.68 ± 1.05 at 7 months follow-up (P = .016) and from the left arm were 6.43 ± 1.0 at 1-month follow-up, 6.70 ± 1.05 at 7-month follow-up (P = .005). Our results showed an ongoing injury in the arterial system after healthy SARS-COV-2 patients during 7 months, as represented by CAVI measurements.
Collapse
Affiliation(s)
- Yusuf Can
- Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
| | - Ibrahim Kocayigit
- Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
| | - Havva Kocayiğit
- Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
| | | | - Mustafa Şahinöz
- Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Faculty of Medicine, University of Sakarya, Sakarya, Turkey
| |
Collapse
|
4
|
Yeboah K, Essel S, Agyekum J, Dzudzor B. Association between cardio-ankle vascular index and cardiometabolic risk factors in HIV patients in Ghana. Libyan J Med 2023; 18:2215636. [PMID: 37207315 DOI: 10.1080/19932820.2023.2215636] [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: 01/23/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular diseases (CVDs) even in patients with viral suppression by combination antiretroviral therapy (cART). Arterial stiffness is an independent predictor of CVDs in diseased individuals and the general population. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness that has been shown to predict target organ damage. CAVI is less studied in HIV patients. We compared the levels of arterial stiffness using CAVI and associated factors among cART-treated and cART-naïve HIV patients to those of non-HIV controls. In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls were recruited from a periurban hospital. We collected data on CVD risk factors, anthropometric characteristics, CAVI, and fasting blood samples to measure plasma glucose, lipid profile, and CD4+ cell counts. Metabolic abnormalities were defined using the JIS criteria. CAVI increased in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls (7.8 ± 1.4 vs 6.6 ± 1.1 vs 6.7 ± 1.4 respectively, p < 0.001). CAVI was associated with metabolic syndrome in non-HIV controls [OR (95% CI) = 2.14 (1.04-4.4), p = 0.039] and cART-naïve HIV patients [1.47 (1.21-2.38), p = 0.015], but not in cART-treated HIV patients [0.81 (0.52-1.26), p = 0.353]. In cART-treated HIV patients, a tenofovir (TDF)-based regimen (β = -0.46, p = 0.023) was associated with decreased CAVI and decreased CD4+ cell count (β = -0.23, p = 0.047) was associated with increased CAVI. In a periurban hospital in Ghana, compared to non-HIV controls or cART-naïve HIV patients, cART-treated HIV patients had increased arterial stiffness measured as CAVI. CAVI is associated with metabolic abnormalities in non-HIV controls and cART-naïve HIV patients, but not in cART-treated HIV patients. Patients on TDF-based regimens had decreased CAVI.
Collapse
Affiliation(s)
- Kwame Yeboah
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
| | - Samuel Essel
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
- Department of Physician Assistant Studies, Central University, Accra, Ghana
| | - Jennifer Agyekum
- Department of Physiology, University of Ghana Medical School, Accra, Ghana
- Medical Laboratory Unit, Mamprobi Hospital, Ghana Health Service, Accra, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Accra, Ghana
| |
Collapse
|
5
|
Radchenko GD, Botsiuk YA, Sirenko YM. Ventricular Function and Cardio-Ankle Vascular Index in Patients With Pulmonary Artery Hypertension. Vasc Health Risk Manag 2022; 18:889-904. [PMID: 36597509 PMCID: PMC9805732 DOI: 10.2147/vhrm.s385536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/18/2022] [Indexed: 12/29/2022] Open
Abstract
Aim This study aims to evaluate the left ventricle (LV) systolic and diastolic function in patients with idiopathic pulmonary arterial hypertension (IPAH) and its correlation with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI). Patient and methods We included 37 patients with IPAH and 20 healthy people matched by age. All patients were assessed: vital signs, 6-minute walk test, NT-proBNP level, the CAVI, the right ventricular (RV) and LV function parameters, including ejection time (ET), tissue speckle-tracking values - global longitudinal strain (GLS) and strain rate (SR). Results The groups were matched by age, gender, BMI, office SBP and DBP. Patients with IPAH had higher heart rate, NT-proBNP level and lower ferritin level, GFR (CKD-EPI), SaO2 than healthy people. The mean CAVIleft was higher in IPAH patients than in the control group- 8.7±1.1 vs 7.5±0.9, P=0.007. Healthy people had significantly less E/e' and lower IVRT. LVET and RVET were shorter in IPAH patients. Patients with IPAH had mean LVGLS -(-17.6±4.8%) and 35.1% of them were with LVGLS ≤16% compared to healthy people -(-21.8±1.4%) and 0%, respectively. LVSR was significant less in IPAH patients, but in the normal range. We found significant correlations of CAVI with age, history of syncope, bilirubin, uric acid, total cholesterol, cardiac output, cardiac index, RVET, LVET and E/A. Multiple linear regression confirmed the independent significance for age (β=0.083±0.023, CI 0.033-0.133) and RVET (β=-0.018±0.005, CI -0.029 to -0.008) only. The risk to have CAVI ≥8 increased in 5.8 times in IPAH patients with RVET <248 ms (P=0.046). CAVI did not correlate with LVGLS and LVSR. Conclusion Significant worse systolic and diastolic LV functions were stated in pulmonary hypertensive patients compared to the control group. No LV GLS, no LV SR had significant associations with arterial stiffness evaluated by CAVI.
Collapse
Affiliation(s)
- Ganna Dmytrivna Radchenko
- State Institution “National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Medical Science of Ukraine”, Kyiv, Ukraine,Correspondence: Ganna Dmytrivna Radchenko, State Institution National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Medical Science of Ukraine”, 5, Svyatoslava Khorobroho str., Kyiv, 03151, Ukraine, Tel +38-0667128405, Email
| | - Yurii Anatoliiovych Botsiuk
- State Institution “National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Medical Science of Ukraine”, Kyiv, Ukraine
| | - Yuriy Mykolaiyovich Sirenko
- State Institution “National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Medical Science of Ukraine”, Kyiv, Ukraine
| |
Collapse
|
6
|
Kirkham FA, Mills C, Fantin F, Tatsuno I, Nagayama D, Giani A, Zamboni M, Shirai K, Cruickshank JK, Rajkumar C. Are you as old as your arteries? Comparing arterial aging in Japanese and European patient groups using cardio-ankle vascular index. J Hypertens 2022; 40:1758-1767. [PMID: 35943103 DOI: 10.1097/hjh.0000000000003214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most comparisons of arterial stiffness between ethnic groups focus on pulse wave velocity. This study used the cardio-ankle vascular index (CAVI) in European compared to Japanese individuals to investigate how cardiovascular risk factors affect arterial aging across geographic regions. METHODS Four hundred and ninety-four European and 1044 Japanese individuals underwent measurements of CAVI, blood pressure and information on cardiovascular risk factors. Both datasets included individuals with 0-5 cardiovascular risk factors. RESULTS Average CAVI was higher in the Japanese than the European group in every age category, with significant differences up to 75 years for males and 85 for females. The correlation of CAVI with age, controlled for cardiovascular risk factors, was slightly higher in Japanese females (r = 0.594 vs. Europeans r = 0.542) but much higher in European males (r = 0.710 vs. Japanese r = 0.511). There was a significant correlation between CAVI and total cardiovascular risk factors in the Japanese (r = 0.141, P < 0.001) but not the European group. On linear regression, average CAVI was significantly dependent on age, sex, diabetes, BMI, SBP and geographic region. When divided into 'healthy' vs. 'high risk', the healthy group had a steeper correlation with age for Europeans (r = 0.644 vs. Japanese r = 0.472, Fisher's Z P < 0.001), whereas in the high-risk group, both geographic regions had similar correlations. CONCLUSION Japanese patient groups had higher arterial stiffness than Europeans, as measured by CAVI, controlling for cardiovascular risk factors. Europeans had greater increases in arterial stiffness with age in healthy individuals, particularly for males. However, cardiovascular risk factors had a greater impact on the Japanese group.
Collapse
Affiliation(s)
| | | | - Francesco Fantin
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | - Ichiro Tatsuno
- Chiba Prefectural University of Health Sciences, Chiba
- Toho University Medical Center, Sakura Hospital, Sakura
| | - Daiji Nagayama
- Nagayama Clinic, Nagayama
- Toho University Medical Center, Sakura Hospital, Sakura
| | - Anna Giani
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | | | | | - Chakravarthi Rajkumar
- University Hospitals Sussex, NHS Foundation Trust
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| |
Collapse
|
7
|
Saigusa T, Watanabe K, Hada Y, Ishii K, Kameda W, Susa S, Ishizawa K, Ishihara H. Cardio-ankle vascular index is more closely associated than brachial-ankle pulse wave velocity with arterial damage and risk of cardiovascular disease in patients with diabetes. BMC Cardiovasc Disord 2022; 22:365. [PMID: 35945498 PMCID: PMC9364514 DOI: 10.1186/s12872-022-02800-9] [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: 09/04/2021] [Accepted: 08/02/2022] [Indexed: 11/15/2022] Open
Abstract
Background This study aimed to compare the usefulness of arterial stiffness parameters, cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV), for evaluating arterial damage and risk of cardiovascular disease (CVD) in subjects with diabetes. Methods The study subjects were 277 patients with type 1 or type 2 diabetes. All subjects were evaluated for vascular stiffness using CAVI (n = 154) or baPWV (n = 123). Carotid intima-media thickness (IMT) and the Suita score were also measured because these are established risk factors for future CVD. Associations of both CAVI and baPWV with these established parameters were evaluated in all subjects, and then in 174 subjects with adjustment for covariates by using propensity score matching. Results In all subjects, CAVI and baPWV correlated significantly with both IMT (r = 0.462, P < 0.001, and r = 0.212, P = 0.019, respectively) and the Suita score (r = 0.573, P < 0.001, and r = 0.373, P < 0.001, respectively). The correlation between CAVI and IMT was more significant than that between baPWV and IMT (Z = 2.33, P = 0.020). Similarly, the correlation between CAVI and the Suita score was more significant than that between baPWV and the Suita score (Z = 2.13, P = 0.033). After adjustment by propensity score matching, significant correlations between CAVI and IMT (r = 0.432 P < 0.001) and between CAVI and the Suita score (r = 0.544, P < 0.001) were preserved, though only the association between baPWV and the Suita score was significant (r = 0.289, P = 0.007) while that between baPWV and IMT showed no significance. Again, CAVI showed a significant association with the Suita score than baPWV (Z = 2.02, P = 0.043). Conclusions CAVI is more closely associated than baPWV with arterial damage and risk of CVD in patients with diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02800-9.
Collapse
Affiliation(s)
- Taro Saigusa
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
| | - Kentaro Watanabe
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan. .,Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan.
| | - Yurika Hada
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kota Ishii
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Wataru Kameda
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, 990-9585, Yamagata, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, 173-8610, Tokyo, Japan
| |
Collapse
|
8
|
Association between ApoA1 Gene, Plasma Lipid Profile, hsCRP Level, and Risk of Arterial Stiffness in Thai Elderly. Adv Prev Med 2022; 2022:4930033. [PMID: 35873099 PMCID: PMC9303502 DOI: 10.1155/2022/4930033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction. Apolipoprotein A1 (ApoA1) gene polymorphism is linked to high-density lipoprotein cholesterol (HDL-C) levels. Variations in this gene, along with dyslipidemia and inflammation, may increase the risk of vascular stiffness. This study aimed to investigate the link between ApoA1 rs670 genetic variations, various biochemical parameters, and the risk of arterial stiffness in older people. Methods. This population-based cross-sectional study included 355 participants (≥60 years) who completed a demographic and lifestyle information questionnaire. Clinical and anthropometric examination, biochemical analysis, and ApoA1 rs670 genotyping by real-time PCR were performed. The cardio-ankle vascular index (CAVI) was used to assess arterial stiffness. Results. Age, BMI, waist circumference, SBP, LDL-C, and high-sensitivity C-reactive protein (hs-CRP) were associated with high CAVI (≥9) among older people. The mean CAVI (8.19 ± 2.78) for the ApoA1 rs670 AA genotype was lower than that of the GG genotypes (8.94 ± 1.00,
). These results are supported by HDL-C (OR = 0.47, 95% CI: 0.24–0.93;
) and high hs-CRP (OR = 0.30, 95% CI: 0.16–0.57;
) levels together with adjusted ORs of both variables. Conclusion. ApoA1 rs670 genetic variations involved in the synthesis, transport, and processing of HDLs, hypertension, and inflammation are linked to arterial stiffness. Further studies are required to clarify these mechanisms.
Collapse
|
9
|
Park HE, Chung GE, Lee H, Kim MJ, Choi SY, Lee W, Yoon JW. Significance of Low Muscle Mass on Arterial Stiffness as Measured by Cardio-Ankle Vascular Index. Front Cardiovasc Med 2022; 9:857871. [PMID: 35774369 PMCID: PMC9239409 DOI: 10.3389/fcvm.2022.857871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/27/2022] [Indexed: 11/15/2022] Open
Abstract
Aim A link between low muscle mass and arterial stiffness is not always consistent. In this study, we aimed to evaluate the clinical significance of low skeletal muscle mass in relation to arterial stiffness measured by the cardio-ankle vascular index (CAVI). Methods A total of 2,561 asymptomatic Korean subjects who underwent bioelectrical impedance analysis (BIA) and CAVI were included for analysis. Using appendicular skeletal muscle mass (ASM), classes I and II sarcopenia were defined as ASM% greater than 1 standard deviation (SD) and 2 SDs below the gender-specific mean of healthy young Korean adults. Results Compared to normal, CAVI was significantly higher, but the number of patients with a low ankle-brachial index (ABI) was not significantly different (p < 0.001 for CAVI, p = 0.078 for ABI). Classes I and II sarcopenia showed an independent and significant association with CAVI (estimate 0.148, standard error (SE) 0.043, p < 0.001 and estimate 0.304, SE 0.073, p < 0.001 for classes I and II sarcopenia, respectively, adjusted for age groups, gender, body mass index (BMI) ≥25, hypertension, diabetes, hypercholesterolemia, and smoking). Conclusion Low muscle mass is independently and significantly associated with increased CAVI, and should be considered when managing asymptomatic subjects to assess the risk of atherosclerosis.
Collapse
Affiliation(s)
- Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Goh Eun Chung
- Division of Gastroenterology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Heesun Lee
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Min Joo Kim
- Division of Endocrinology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Su-Yeon Choi
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Wonjae Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Yoon
- Division of Endocrinology, Department of Internal Medicine, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul National University Hospital, Seoul, South Korea
- *Correspondence: Ji Won Yoon ; orcid.org/0000-0001-9003-0614
| |
Collapse
|
10
|
Zuo C, Bo S, Li Q, Zhang L. The Effect of Whole-Body Traditional and Functional Resistance Training on CAVI and Its Association With Muscular Fitness in Untrained Young Men. Front Physiol 2022; 13:888048. [PMID: 35694401 PMCID: PMC9174581 DOI: 10.3389/fphys.2022.888048] [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: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Resistance training-induced changes in the muscle function is essential for the health promotion of the young and older, but the discrepancies of the effect of resistance training on arterial stiffness leads to the divergence regarding to the effect of resistance training on cardiovascular health. What confuses our understanding in this field may be the following factors: external load (higher intensity vs. lighter intensity), participants’ cardiovascular health, and arterial stiffness assessment measurement. The purpose of the present study was to investigate the effects of the whole-body traditional high-intensity vs. functional low-intensity resistance training protocol on systemic arterial stiffness, and their association with muscular fitness components in untrained young men. Methods: In this randomized controlled trial, twenty-nine untrained young men (mean age about 22.5 years old) were randomized into a 6-weeks (three sessions per week) supervised whole-body traditional high-intensity resistance group (TRT, n = 15) consisting of 4–5 sets of 12 repetitions (70%1RM, lower-repetitions) or a whole-body functional low-intensity resistance group (FRT, n = 14) with 4–5 sets of 20 repetitions (40%1RM, higher-repetitions) to volitional failure. The systemic arterial stiffness (cardio-ankle vascular index, CAVI) and muscular fitness components were assessed before and after the 6-weeks training program. Results: There was a significant decrease (pre-post) for CAVI only in FRT group (p < 0.05), but no significant difference was observed between two groups. In addition, the TRT and FRT groups showed equally significantly increased in maximal strength, muscular endurance and power (within group: both p < 0.01); however, the independent t test exhibited that the difference between two groups in terms of change in maximal strength, muscular endurance and power were no significant (p > 0.05). Furthermore, the reduction in CAVI was negatively correlated with the increase in 1RM of bench press for all participants (r = −0.490, p < 0.01). Conclusion:Using present criterion-standard assessments measurements demonstrates that CAVI was significantly reduced after 6-weeks functional resistance training with beneficial effect on muscular fitness. Negative and significant association between CAVI and 1RM bench press indicated the cardiovascular health may be involved in the regulation of resistance training.
Collapse
Affiliation(s)
- Chongwen Zuo
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
| | - Shumin Bo
- School of Kinesiology and Health of Capital University of Physical Education and Sports, Beijing, China
- *Correspondence: Shumin Bo,
| | - Qing Li
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
| | - Li Zhang
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
| |
Collapse
|
11
|
Rerkasem A, Tangmunkongvorakul A, Aurpibul L, Sripan P, Parklak W, Nantakool S, Srithanaviboonchai K, Rerkasem K. Association of cardio-ankle vascular index and future major adverse cardiovascular events in older adults living with HIV. AIDS Care 2022; 35:591-599. [PMID: 35499141 DOI: 10.1080/09540121.2022.2029820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACTIncreased arterial stiffness is an indicator of cardiovascular disease (CVD) and death in the general population. The cardio-ankle vascular index (CAVI) is a novel method for measuring arterial stiffness. This study investigated the utility of CAVI as a prognostic indicator of CVD and death in older adults living with HIV(OALHIV). Patients aged ≥50 taking antiretroviral treatment with no history of cardiovascular events enrolled from multiple centers in Chiang Mai, Thailand. Participants (N = 347) who underwent CAVI were followed up for five years. The primary endpoint was major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure. Cox regression analysis determined between normal (<8) and high (≥8) CAVI against the incidence of MACE. Forty-five participants (13.0%) were diagnosed with MACE. The risk of MACE was more significant in high CAVI than normal CAVI (adjusted HR = 2.11, 95% confidence interval 1.06-4.20, p = 0.033). In OALHIV, CAVI was an independent prognosis of MACE, in addition to conventional CVD risk factors. CAVI-assisted to help identify high-risk patients showed the benefit of further evaluation and more intensive therapy to prevent CVD and death.
Collapse
Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Arunrat Tangmunkongvorakul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Linda Aurpibul
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Patumrat Sripan
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wason Parklak
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kriengkrai Srithanaviboonchai
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Surgical Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
12
|
Bulbul E, Aydin E, Yilmaz E. Evaluation of endothelial dysfunction with cardio-ankle vascular index measurements in patients with erectile dysfunction. Andrology 2022; 10:926-930. [PMID: 35466575 DOI: 10.1111/andr.13191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/22/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND It has been reported that there is a relationship between erectile dysfunction (ED) and endothelial dysfunction. However, a practical and non-invasive method to clinically evaluate this relationship has not yet been determined. The cardio-ankle vascular index (CAVI) is a marker of arteriosclerosis that develops as a result of endothelial dysfunction. OBJECTIVE To investigate the correlation between CAVI and the presence and severity of ED. MATERIALS/METHODS This was a case-control study including 74 patients that presented to the urology department of our institution with ED (without cardiovascular risk factors) and 86 healthy individuals of similar age. The patients with ED and the control group were evaluated using the five-item version of the International Index of Erectile Function (IIEF-5). CAVI and ankle-brachial pressure index measurements were performed using the VaSera VS-1000 (Fukuda-Denshi Company, Ltd, Tokyo, Japan) device. RESULTS The mean age was 59.8±1.3 years for the ED group and 57.9±1.1 years for the control group. The mean right (R)-CAVI values of the ED and control groups were 9.20±2.6 and 8.11±1.8, respectively (p = 0.014), and their mean left (L)-CAVI values were 9.08±2.7 and 7.96±1.2, respectively (p = 0.008). The mean IIEF-5 score of the patients with ED was 10.1±3.6. An inverse correlation was found between R-CAVI and L-CAVI and the IIEF-5 score (r = -0.411, p = 0.011 and r = -0.454, p<0.001, respectively). DISCUSSION AND CONCLUSION According to our findings, CAVI was higher in patients with ED than in healthy individuals. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Emre Bulbul
- Department of Urology, Trabzon Vakfıkebir State Hospital, Trabzon, Turkey
| | - Ercan Aydin
- Department of Cardiology, Trabzon Kanuni Education and Research Hospital, Trabzon, Turkey
| | - Emre Yilmaz
- Department of Cardiology, Faculty of Medicine Giresun University, Giresun, Turkey
| |
Collapse
|
13
|
Zuo J, Tang B, O’Rourke MF, Avolio AP, Adji A. Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population. J Cardiovasc Dev Dis 2022; 9:jcdd9030075. [PMID: 35323623 PMCID: PMC8954212 DOI: 10.3390/jcdd9030075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives: Arterial stiffness is widely accepted as an important predictor of cardiovascular disease (CVD) development. While obesity is generally associated with increased CVD risk, there is evidence that overweight patients with existing CVD may have better clinical outcomes than their lean counterparts. Our study sought to observe any potential association between brachial−ankle pulse wave velocity (BAPWV), a marker of arterial stiffness related to CVD risk, and Body Mass Index (BMI), a crude and widely used measure of obesity. Methods: Adult individuals (n = 857) assessed for routine CV risk were included and grouped according to their BMI (<25 kg/m2: normal; 25−30 kg/m2: overweight, ≥30 kg/m2: obese). Their anthropometric parameters, brachial cuff pressures, and BAPWV were measured. Results: Brachial pressure was significantly higher as BMI increased. BAPWV showed a positive linear association with systolic (r = 0.66, p < 0.01), mean (r = 0.60, p < 0.01), diastolic (r = 0.51, p < 0.01), and pulse (r = 0.53, p < 0.01) pressures. However, a linear relationship between BMI and BAPWV was only apparent in males aged <50 years (p = 0.01) and in females aged ≥50 years (p < 0.01). In individuals with similar brachial systolic pressure, BAPWV was higher in normal-weight subjects compared to overweight−obese ones. Conclusions: This conflicting finding is attributed to an overestimation of the degree of arterial stiffness as a measure of CVD risk in individuals with a less ‘healthy’ BMI. This suggests that BMI may not the appropriate obesity indicator to assess CV risk. Our finding emphasizes the importance of establishing a non-linear relationship between CVD risk, age, and BMI, taking into account apparent sex differences, to predict future CV events. While this finding may suggest a lower degree of stiffness in large arteries of overweight−obese subjects compared to their normal-weight counterparts, the potential implications for individuals with higher BMI need be explored further.
Collapse
Affiliation(s)
- Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (J.Z.); (B.T.)
- Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney 2109, Australia;
| | - Biwen Tang
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (J.Z.); (B.T.)
| | - Michael F. O’Rourke
- St Vincent’s Clinical Campus, University of New South Wales Medicine and Health, Sydney 2109, Australia;
| | - Alberto P. Avolio
- Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney 2109, Australia;
| | - Audrey Adji
- Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney 2109, Australia;
- St Vincent’s Clinical Campus, University of New South Wales Medicine and Health, Sydney 2109, Australia;
- Victor Chang Cardiac Research Institute, Sydney 2010, Australia
- St Vincent’s Hospital Applied Medical Research, Sydney 2010, Australia
- Correspondence:
| |
Collapse
|
14
|
Kulthinee S, Nernpermpisooth N, Poomvanicha M, Satiphop J, Chuang-Ngu T, Kaleeluan N, Thawnashom K, Manin A, Kongchan R, Yinmaroeng K, Kitipawong P, Chotimol P. Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults. Pulse (Basel) 2021; 9:30-37. [PMID: 34722353 DOI: 10.1159/000517617] [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: 01/05/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
Objective The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT. Methods 160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m2) and 74 overweight (BMI ≥23 kg/m2). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment. Results At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; p < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; p < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, p < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, p < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group. Conclusions Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.
Collapse
Affiliation(s)
- Supaporn Kulthinee
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Nitirut Nernpermpisooth
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Montatip Poomvanicha
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Jidapa Satiphop
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Thizanamadee Chuang-Ngu
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Napaporn Kaleeluan
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Kittisak Thawnashom
- Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Anuchit Manin
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Rosarin Kongchan
- Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Kingkarn Yinmaroeng
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Peerapong Kitipawong
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Phatiwat Chotimol
- Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| |
Collapse
|
15
|
Hayase T. The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease. Pulse (Basel) 2021; 9:11-16. [PMID: 34722351 DOI: 10.1159/000515357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/13/2021] [Indexed: 01/06/2023] Open
Abstract
Introduction The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk. Methods We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. A total of 96 patients (males, 63) with an abnormal ankle-brachial blood pressure index (ABI) of <0.9 and who underwent extremity arteriography at our hospital from 2015 to 2018 were enrolled in this study. We defined that CAVI with a range of <8.0 was normal. Results Coronary angiography and extremity arteriography were performed for patients who had intermittent claudication and abnormal ABI. We divided the affected limbs into 3 categories: above-the-knee artery stenosis, above-the-knee artery chronic total occlusion, and only below-the-knee artery stenosis/occlusion groups. CAVI pseudonormalization was seen in 28, 76, and 19%, respectively. The above-the-knee artery stenosis and the only below-the-knee artery stenosis/occlusion groups had a high odds ratio of abnormalization of CAVI (3.1, 95% confidence interval [CI]: 1.39-7.22; p = 0.05, 4.56, 95% CI: 1.64-14.7). Discussion/Conclusion In the presence of the above-the-knee artery chronic total occlusion, CAVI pseudonormalization was likely to be seen. The presence of CTO in the above-the-knee artery is one cause of pseudonormalized CAVI. In the range of ABI, in which stenotic lesions and obstructive lesions coexist, it may be possible to detect the existence of CTO by a combination of both ABI and CAVI.
Collapse
Affiliation(s)
- Taichiro Hayase
- Department of Cardiology, Yokohamashintoshi Neurosurgical Hospital, Yokohama, Japan
| |
Collapse
|
16
|
Cardio-ankle vascular index with renal progression and mortality in high atherosclerosis risk: a prospective cohort study in CORE-Thailand. Clin Exp Nephrol 2021; 26:247-256. [PMID: 34643840 DOI: 10.1007/s10157-021-02149-x] [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: 09/05/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increased arterial stiffness is linked to markers of endothelial dysfunction and vasculopathy such as albuminuria, vascular calcification, left ventricular hypertrophy and cardiovascular (CV) diseases. Studies of arterial stiffness on renal progression are limited. OBJECTIVE The study aimed to evaluate the association between high cardio-ankle vascular index (CAVI) and renal endpoint and all-cause mortality in a Thai population with high atherosclerosis risk. METHODS A multicenter prospective cohort study was conducted among subjects with high CV risk or established CV diseases in Thailand. Subjects were divided into 3 groups with mean CAVI < 8, 8-8.9, and ≥ 9, respectively. Primary composite outcome consisted of estimated glomerular filtration rate (eGFR) decline over 40%, eGFR less than 15 mL/min/1.73 m2, doubling of serum creatinine, initiation of dialysis and death related to renal causes. The secondary outcomes were all-cause mortality, CV mortality and eGFR decline. RESULTS A total of 4898 subjects (2743 men and 2155 women) were enrolled. Cox proportional hazards model showed a significant relationship of high CAVI (CAVI ≥ 9) and primary composite outcome. Subjects with high CAVI at baseline had a 1.45-fold (95% CI 1.13-1.84) significant risk for the primary composite outcome and 1.72-fold (95% CI 1.12-2.63) risk for all-cause mortality, compared with normal CAVI (CAVI < 8). After stepwise multivariate analysis, the high CAVI group was only positively associated with primary composite outcome. Kaplan-Meier curve of the primary composite outcome and all-cause mortality demonstrated the worst survival in the high CAVI group (log-rank test with P < 0.05). CONCLUSION In a Thai cohort with high atherosclerosis risk, increased arterial stiffness was a risk factor for worsening renal function, including end-stage renal disease and initiation of dialysis.
Collapse
|
17
|
Weisskopf M, Kron M, Giering T, Walker T, Cesarovic N. The sheep as a pre-clinical model for testing intra-aortic percutaneous mechanical circulatory support devices. Int J Artif Organs 2021; 44:703-710. [PMID: 34405723 PMCID: PMC8450982 DOI: 10.1177/03913988211025537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The save deployment of intra-aortic percutaneous mechanical circulatory support devices is highly dependent on the inner aortic diameter. Finding the anatomically and ethically most suitable animal model for performance testing of new pMCS devices remains challenging. For this study, an ovine model using adult ewes of a large framed breed (Swiss White Alpine Sheep) was developed to test safety, reliability, and biocompatibility of catheter-mounted mechanical support devices placed in the descending thoracic aorta. Following the drawback of fluctuating aortic diameter and device malfunction in the first four animals, the model was improved by stenting the following animals with an aortic stent. Stenting the animals with an intra-aortic over the balloon stent was found to standardize the experimental set-up and to avoid early termination of the experiment due to non-device related issues.
Collapse
Affiliation(s)
- Miriam Weisskopf
- Center of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mareike Kron
- Center of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Nikola Cesarovic
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| |
Collapse
|
18
|
AKSOY MNM, CAN Y, KOCAYİĞİT İ, AĞAÇ MT. Systolic Blood Pressure Variability and Its Relationship with Surrogate Markers of Cardiovascular Risk in Hypertensive Patients. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.890622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
19
|
Agham ND, Chaskar UM. An advanced LAN model based on optimized feature algorithm: Towards hypertension interpretability. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Cerqueira MS, Costa EC, Santos Oliveira R, Pereira R, Brito Vieira WH. Blood Flow Restriction Training: To Adjust or Not Adjust the Cuff Pressure Over an Intervention Period? Front Physiol 2021; 12:678407. [PMID: 34262476 PMCID: PMC8273389 DOI: 10.3389/fphys.2021.678407] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Blood flow restriction (BFR) training combines exercise and partial reduction of muscular blood flow using a pressured cuff. BFR training has been used to increase strength and muscle mass in healthy and clinical populations. A major methodological concern of BFR training is blood flow restriction pressure (BFRP) delivered during an exercise bout. Although some studies increase BFRP throughout a training intervention, it is unclear whether BFRP adjustments are pivotal to maintain an adequate BFR during a training period. While neuromuscular adaptations induced by BFR are widely studied, cardiovascular changes throughout training intervention with BFR and their possible relationship with BFRP are less understood. This study aimed to discuss the need for BFRP adjustment based on cardiovascular outcomes and provide directions for future researches. We conducted a literature review and analyzed 29 studies investigating cardiovascular adaptations following BFR training. Participants in the studies were healthy, middle-aged adults, older adults and clinical patients. Cuff pressure, when adjusted, was increased during the training period. However, cardiovascular outcomes did not provide a plausible rationale for cuff pressure increase. In contrast, avoiding increments in cuff pressure may minimize discomfort, pain and risks associated with BFR interventions, particularly in clinical populations. Given that cardiovascular adaptations induced by BFR training are conflicting, it is challenging to indicate whether increases or decreases in BFRP are needed. Based on the available evidence, we suggest that future studies investigate if maintaining or decreasing cuff pressure makes BFR training safer and/or more comfortable with similar physiological adaptation.
Collapse
Affiliation(s)
- Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Eduardo Caldas Costa
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Brazil
| | - Wouber Hérickson Brito Vieira
- Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
21
|
Effects of long-term air pollution exposure on ankle-brachial index and cardio-ankle vascular index: A longitudinal cohort study using data from the Electricity Generating Authority of Thailand study. Int J Hyg Environ Health 2021; 236:113790. [PMID: 34139634 DOI: 10.1016/j.ijheh.2021.113790] [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: 02/04/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) are surrogate measures of atherosclerosis based on the functional performance of vessels, and are highly related to cardiovascular events. However, only a few longitudinal studies have been conducted on their associations with long-term air pollution exposure. OBJECTIVE This study aimed to examine whether long-term air pollution exposure is associated with ABI and CAVI in workers of the Electricity Generating Authority of Thailand (EGAT) in the Bangkok Metropolitan Region (BMR). METHODS This longitudinal study included 1261 participants (age range, 57-76 years as of 2007) of the EGAT study (2007-2017). ABI and CAVI were measured in 2007, 2012, and 2017. Annual mean concentrations of particulate matter ≤10 μm in diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) were estimated by ordinary kriging using data from 22 background and 7 traffic monitoring stations in BMR between 2002 and 2017. Linear mixed-effects models were used to assess associations between air pollution (expressed as 1-year, 3-year, and 5-year average concentration) and ABI and CAVI (expressed as percent changes per interquartile range (IQR) increase in PM10, O3, NO2, SO2, and CO). We also applied the mixed-effect ordinal logistic models to calculate odds ratios (ORs) of having high or moderate CAVI per an IQR increase in air pollution. RESULTS After controlling for potential confounders, 1-year average CO was negatively associated with ABI, but not significantly (-0.48%, 95% CI: -1.03, 0.07). Three-year average NO2 was positively associated with CAVI (6.67%, 95% CI: 0.21, 13.1). In contrast, 1-year average PM10 was inversely associated with CAVI although the association was not significant. Although not significantly, 1-year average NO2 and CO were positively associated with prevalence of high or moderate CAVI. CONCLUSIONS Although not statistically significant, long-term NO2 and CO exposure was associated with ABI and CAVI in the participants of the EGAT study.
Collapse
|
22
|
Abstract
OBJECTIVE To assess the association between maternal hemodynamic parameters; cardio-ankle vascular index (CAVI), representing arterial stiffness; mean arterial pressure (MAP), uterine artery pulsatility index (Ut-PI), and adverse pregnancy outcomes including preeclampsia (PE), fetal growth restriction (FGR), and gestational diabetes mellitus (GDM). METHODS A prospective cohort study was conducted on low-risk pregnancies. All were serially measured for the mean CAVI, MAP, and Ut-PI for four times at gestational age (GA) 11-14, 18-22, 28-32, and after 36 weeks. Also, the women were followed up for pregnancy outcomes, focusing on PE, FGR, and GDM. RESULTS Of 335 recruited cases meeting the inclusion criteria, 16 cases developed PE, 24 cases had FGR, and 83 cases had GDM. Compared to the non-PE group, women developing PE had a significant increase in CAVI at 18-22, 28-32, and after 36 weeks (P-value = 0.021, 0.003, and <0.001, respectively), a significant increase in MAP at all of the four periods (P-value < 0.001, for all periods), and a significant increase in Ut-PI during GA 18-22 weeks (P-value = 0.021). In pregnancies with FGR, there was a significant increase of CAVI at GA 18-22, 28-32 and after 36 weeks (P-value = 0.012, 0.015, and 0.004, respectively), an increase in Ut-PI in all gestational periods (P-value < 0.05) but no changes of MAP throughout pregnancy. In GDM, the three parameters were not significantly different from those in the non-GDM group in all of the four periods. CAVI could predict PE and FGR with AUC of 0.655-0.835 and 0.673-0.760, respectively. CAVI added predictive values when combined with MAP or Ut-PI. CONCLUSION Increased CAVI, like MAP and Ut-PI, can be used as a predictor of PE and FGR but not GDM. Also, it has an added predictive value when combined with MAP or Ut-PI.
Collapse
|
23
|
Barzilay J, Garvey WT. Arterial Stiffness: Comment on the Article by Pavloska et al. Endocr Pract 2021; 27:640-641. [PMID: 33895316 DOI: 10.1016/j.eprac.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Joshua Barzilay
- Kaiser Permanente of Georgia, Emory University School of Medicine, Georgia.
| | - W Timothy Garvey
- University of Alabama School of Medicine at Birmingham, Birmingham, Alabama
| |
Collapse
|
24
|
Pavlovska I, Mechanick JI, Maranhao Neto GA, Infante-Garcia MM, Nieto-Martinez R, Kunzova S, Polcrova A, Vysoky R, Medina-Inojosa JR, Lopez-Jimenez F, Stokin GB, González-Rivas JP. Arterial Stiffness and Cardiometabolic-Based Chronic Disease: The Kardiovize Study. Endocr Pract 2021; 27:571-578. [PMID: 33722731 DOI: 10.1016/j.eprac.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Arterial stiffness (ArSt) describes a loss of arterial wall elasticity and is an independent predictor of cardiovascular events. A cardiometabolic-based chronic disease model integrates concepts of adiposity-based chronic disease (ABCD), dysglycemia-based chronic disease (DBCD), and cardiovascular disease. We assessed if ABCD and DBCD models detect more people with high ArSt compared with traditional adiposity and dysglycemia classifiers using the cardio-ankle vascular index (CAVI). METHODS We evaluated 2070 subjects aged 25 to 64 years from a random population-based sample. Those with type 1 diabetes were excluded. ABCD and DBCD were defined, and ArSt risk was stratified based on the American Association of Clinical Endocrinologists criteria. RESULTS The highest prevalence of a high CAVI was in stage 2 ABCD (18.5%) and stage 4 DBCD (31.8%), and the lowest prevalence was in stage 0 ABCD (2.2%). In univariate analysis, stage 2 ABCD and all DBCD stages increased the risk of having a high CAVI compared with traditional classifiers. After adjusting for age and gender, only an inverse association between obesity (body mass index ≥30 kg/m2) and CAVI remained significant. Nevertheless, body mass index was responsible for only 0.3% of CAVI variability. CONCLUSION The ABCD and DBCD models showed better performance than traditional classifiers to detect subjects with ArSt; however, the variables were not independently associated with age and gender, which might be explained by the complexity and multifactoriality of the relationship of CAVI with the ABCD and DBCD models, mediated by insulin resistance.
Collapse
Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Jeffrey I Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Geraldo A Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Maria M Infante-Garcia
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts; LifeDoc Health, Memphis, Tennessee
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Faculty of Sport Studies - Department of Health Support, Masaryk University, Brno, Czech Republic
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Minnesota
| | - Gorazd B Stokin
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic
| | - Juan P González-Rivas
- International Clinical Research Centre (ICRC), St Anne's University Hospital Brno (FNUSA), Czech Republic; Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| |
Collapse
|
25
|
Radchenko GD, Sirenko YM. Prognostic Significance of Systemic Arterial Stiffness Evaluated by Cardio-Ankle Vascular Index in Patients with Idiopathic Pulmonary Hypertension. Vasc Health Risk Manag 2021; 17:77-93. [PMID: 33731998 PMCID: PMC7957228 DOI: 10.2147/vhrm.s294767] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In a previous study, the cardio-ankle vascular index (CAVI) was increased significantly in idiopathic pulmonary arterial hypertension (IPAH) patients compared to the healthy group and did not much differ from one in systemic hypertensives. In this study the relations between survival and CAVI was evaluated in patients with IPAH. PATIENTS AND METHODS We included 89 patients with new-diagnosed IPAH without concomitant diseases. Standard examinations, including right heart catheterization (RHC) and systemic arterial stiffness evaluation, were performed. All patients were divided according to CAVI value: the group with CAVI ≥ 8 (n = 18) and the group with CAVI < 8 (n = 71). The mean follow-up was 33.8 ± 23.7 months. Kaplan-Meier and Cox regression analysis were performed for the evaluation of our cohort survival and the predictors of death. RESULTS The group with CAVI≥8 was older and more severe compared to the group with CAVI< 8. Patients with CAVI≥8 had significantly reduced end-diastolic (73.79±18.94 vs 87.35±16.69 mL, P<0.009) and end-systolic (25.71±9.56 vs 33.55±10.33 mL, P<0.01) volumes of the left ventricle, the higher right ventricle thickness (0.77±0.12 vs 0.62±0.20 mm, P < 0.006), and the lower TAPSE (13.38±2.15 vs 15.98±4.4 mm, P<0.018). RHC data did not differ significantly between groups, except the higher level of the right atrial pressure in patients with CAVI≥ 8-11.38±7.1 vs 8.76±4.7 mmHg, P<0.08. The estimated overall survival rate was 61.2%. The CAVI≥8 increased the risk of mortality 2.34 times (CI 1.04-5.28, P = 0.041). The estimated Kaplan-Meier survival in the patients with CAVI ≥ 8 was only 46.7 ± 7.18% compared to patients with CAVI < 8 - 65.6 ± 4.2%, P = 0.035. At multifactorial regression analysis, the CAVI reduced but saved its relevance as death predictor - OR = 1.13, CI 1.001-1.871. SUMMARY We suggested the CAVI could be a new independent predictor of death in the IPAH population and could be used to better risk stratify this patient population if CAVI is validated as a marker in a larger multicenter trial.
Collapse
Affiliation(s)
- Ganna D Radchenko
- Department of Symptomatic Hypertension, “National Scientific Center “The M.D. Strazhesko Institute of Cardiology”” of National Academy of Medical Science, Kyiv, Ukraine
| | - Yuriy M Sirenko
- Department of Symptomatic Hypertension, “National Scientific Center “The M.D. Strazhesko Institute of Cardiology”” of National Academy of Medical Science, Kyiv, Ukraine
| |
Collapse
|
26
|
Šatrauskienė A, Navickas R, Laucevičius A, Krilavičius T, Užupytė R, Zdanytė M, Ryliškytė L, Jucevičienė A, Holvoet P. Mir-1, miR-122, miR-132, and miR-133 Are Related to Subclinical Aortic Atherosclerosis Associated with Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041483. [PMID: 33557426 PMCID: PMC7915826 DOI: 10.3390/ijerph18041483] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
Previously, miR-1, miR-122, miR-126, miR-132, miR-133, and miR-370 were found to be related to coronary artery disease (CAD) progression. However, their relationship with subclinical atherosclerosis, especially in subjects with metabolic syndrome, is unknown. Therefore, our aim was to determine their relationship with arterial markers of subclinical atherosclerosis. Metabolic syndrome subjects (n = 182) with high cardiovascular risk but without overt cardiovascular disease (CVD) were recruited from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program. The ardio-ankle vascular index (CAVI), augmentation index normalized to a heart rate of 75 bpm (AIxHR75), aortic pulse wave velocity (AoPWV), and carotid artery stiffness were assessed. MicroRNAs (miRs) were analyzed in serum. Pearson correlation and a univariate linear regression t-test showed that miR-1, miR-133b, and miR-133a were negatively associated with CAVI mean, whereas miR-122 was positively associated. MiR-1, miR-133b and miR-133a, and miR-145 were negatively associated with AIxHR75. MiR-122 correlated negatively with AoPWV. In multivariate linear regression models, miR-133b and miR-122 predicted CAVImean, miR-133 predicted AIxHR75, and miR-122 predicted AoPWV. MiR-132 predicted right carotid artery stiffness, and miR-1 predicted left carotid artery stiffness. The addition of smoking to miR-133b and miR-122 enhanced the prediction of CAVI. Age and triglycerides enhanced the prediction of AoPWV by miR-122. A cluster of four miRs are related to subclinical atherosclerosis in subjects with metabolic syndrome. Combined, they may have a more substantial diagnostic or prognostic value than any single miR. Future follow-up studies are needed to establish their clinical relevance.
Collapse
Affiliation(s)
- Agnė Šatrauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania; (A.Š.); (A.L.); (L.R.); (A.J.)
- Centre of Cardiology and Angiology, Vilnius University Hospital, Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Rokas Navickas
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania; (A.Š.); (A.L.); (L.R.); (A.J.)
- Centre of Cardiology and Angiology, Vilnius University Hospital, Santaros Klinikos, 08410 Vilnius, Lithuania
- Correspondence:
| | - Aleksandras Laucevičius
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania; (A.Š.); (A.L.); (L.R.); (A.J.)
- Centre of Cardiology and Angiology, Vilnius University Hospital, Santaros Klinikos, 08410 Vilnius, Lithuania
- Experimental, Preventive, and Clinic Medicine Department, Centre for Innovative Medicine, 08406 Vilnius, Lithuania
| | - Tomas Krilavičius
- Informatics Faculty, Vytautas Magnus University, 44248 Kaunas, Lithuania; (T.K.); (R.U.)
- Baltic Institute of Advanced Technology, 01124 Vilnius, Lithuania
| | - Rūta Užupytė
- Informatics Faculty, Vytautas Magnus University, 44248 Kaunas, Lithuania; (T.K.); (R.U.)
- Baltic Institute of Advanced Technology, 01124 Vilnius, Lithuania
- Faculty of Mathematics and Informatics, Vilnius University, 03225 Vilnius, Lithuania
| | - Monika Zdanytė
- Department of Cardiology and Cardiovascular Medicine, Universität Tübingen, 72074 Tübingen, Germany;
| | - Ligita Ryliškytė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania; (A.Š.); (A.L.); (L.R.); (A.J.)
- Centre of Cardiology and Angiology, Vilnius University Hospital, Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Agnė Jucevičienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania; (A.Š.); (A.L.); (L.R.); (A.J.)
- Centre of Cardiology and Angiology, Vilnius University Hospital, Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Paul Holvoet
- Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium;
| |
Collapse
|
27
|
Verner VA, Mel'nik MV, Knjazeva SA. [Cardio-ankle vascular index (CAVI) in diagnostics, risk and severity evaluation of magistral vessels lesion in patients with cardio-vascular diseases and type 2 diabetes]. TERAPEVT ARKH 2021; 93:87-93. [PMID: 33720632 DOI: 10.26442/00403660.2021.01.200599] [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: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
Assesment of arterial stiffness the substantional prognostic factor for evaluating complications of cardiovascular diseases (CVD) in patients with atherosclerosis, hypertension and type 2 diabetes, may be performed using different parameters, including cardio-ankle vascular index (CAVI). The main purpose of this review is to analyze data from studies where CAVI is used to test the arterial wall stiffness in magistral vessels. CAVI measurement is non-invasive and performed by portable devices which makes it comfortable for ambulatory use in patients who come for a check-up and also in those who already are hospitalized. It does not require any special knowledge from investigator and the test lasts a couple of minutes long. CAVI does not depend on blood pressure changes and is more specific in structural changes of arterial wall assessment than brachial-ankle pulse wave velocity (baPWV). CAVI shows considerable correlation with markers of CVD like atherosclerotic plaques in vessels, diastolic disfunction of left ventricle and angina pectoris. CAVI may be used for early monitoring and assessing the lesions of target organs in patients with atherosclerosis, chronic hypertension and type 2 diabetes. Establishing CAVI as a standart parameter in assessing patients who are at risk of CVD can help to improve complications prevention, reduce mortality and prolong their lifespan.
Collapse
Affiliation(s)
- V A Verner
- Sechenov First Moscow State Medical University (Sechenov University)
| | - M V Mel'nik
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S A Knjazeva
- Sechenov First Moscow State Medical University (Sechenov University)
| |
Collapse
|
28
|
Kim S, Lim HJ, Kim JR, Oh KJ, Hong JS, Suh JW. Longitudinal change in arterial stiffness after delivery in women with preeclampsia and normotension: a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:685. [PMID: 33176736 PMCID: PMC7661192 DOI: 10.1186/s12884-020-03374-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022] Open
Abstract
Background Preeclampsia is associated with increased arterial stiffness during pregnancy. However, data on the longitudinal change in arterial stiffness after delivery in women with preeclampsia are lacking. In this pilot study, we aimed to examine the longitudinal change in arterial stiffness using the cardio-ankle vascular index after delivery in women with preeclamptic and normotensive pregnancies. Methods We enrolled pregnant women with preeclampsia (n = 37) and normotension (n = 36) who gave birth at Seoul National University Bundang Hospital between March 2013 and May 2016, and followed-up at day 1, 6 months, and 12 months after delivery. The longitudinal change in the cardio-ankle vascular index and other variables (blood pressure, lipid profiles, serum creatinine, and liver enzymes) were compared between the two groups using the mixed-effects model, and interactions among the main predictors were examined. Results The longitudinal change in the cardio-ankle vascular index did not significantly differ between the two groups (β = 0.11, 95% CI: − 0.31–0.54, p = 0.60). Predictors of the longitudinal change in the cardio-ankle vascular index included age, time since delivery, body mass index, and diabetes mellitus. Women with preeclampsia showed significantly elevated blood pressure, lipid profiles, serum creatinine, and liver enzymes compared to women with normotension over the course of 1 year of follow-up. Conclusions Preeclampsia is associated with unfavorable blood pressure and metabolic indices after delivery. However, we found no difference in the longitudinal change in arterial stiffness between women with preeclampsia and normotension over the course of 1 year after delivery. Trial registration Retrospectively registered at ClinicalTrials.gov on October 29, 2019 (NCT04142268).
Collapse
Affiliation(s)
- Sehun Kim
- Department of Internal Medicine, Seongnam Citizens Hospital, Seongnam, Republic of Korea
| | - Hyun Ja Lim
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Jeung-Ran Kim
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Kyung Joon Oh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea
| | - Joon-Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
| | - Jung-Won Suh
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
| |
Collapse
|
29
|
Singh SR, Garg H, Dogra M. Commentary: Cardio-ankle vascular index: The how and why for an ophthalmologist. Indian J Ophthalmol 2020; 68:872-873. [PMID: 32317467 PMCID: PMC7350465 DOI: 10.4103/ijo.ijo_2291_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Simar Rajan Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Heena Garg
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Mohit Dogra
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
30
|
Maeda E, Koshiba A, Mori T, Ito F, Kataoka H, Okimura H, Sugahara T, Tarumi Y, Kusuki I, Khan KN, Kitawaki J. Atherosclerosis-related biomarkers in women with endometriosis: The effects of dienogest and oral contraceptive therapy. Eur J Obstet Gynecol Reprod Biol X 2020; 7:100108. [PMID: 32715291 PMCID: PMC7379146 DOI: 10.1016/j.eurox.2020.100108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 11/17/2022] Open
Abstract
Objective Chronic inflammation in endometriosis is associated with increased risk of future cardiovascular disease; however, no studies have investigated the cardiovascular risk of women who have undergone hormonal therapy for endometriosis. We investigated atherosclerosis-related biomarkers in women with and without endometriosis and the effects of dienogest (DNG) and oral contraceptive (OC) therapies. Study design In this cross-sectional study, 109 women with endometriosis and 42 control women without endometriosis were enrolled. The endometriosis group was divided into the untreated (n = 34), DNG therapy (n = 33), and OC therapy (n = 42) groups. Lipid profile serum levels, inflammatory marker such as high-sensitivity C-reactive protein, oxidative stress markers such as oxidized low-density lipoprotein and diacron-reactive oxygen metabolites, and atherosclerosis indicators (cardio-ankle vascular index [CAVI] and ankle-brachial pressure index [ABI]) were measured. Results The median treatment duration was 28 months in the DNG group and 32.5 months in the OC group. Triglyceride levels were higher in the OC group than in the other three groups (P < 0.05). Regarding markers of inflammation and oxidative stress, log high-sensitivity C-reactive protein and diacron-reactive oxygen metabolites levels were higher in the untreated group than in the control group (P < 0.05), and these markers were further increased in the OC group (log high-sensitivity C-reactive protein: P < 0.05; diacron-reactive oxygen metabolites: P < 0.01), but not in the DNG group. There was no difference in the CAVI and ABI among all groups. Spearman correlation revealed a positive correlation between duration of OC therapy and CAVI (ρ = +0.49; P = 0.002), but no correlation between the duration of DNG therapy and CAVI (ρ = –0.04; P = 0.81). Conclusions Inflammation and oxidative stress markers are increased in women with untreated endometriosis. Treatment with OC, but not with DNG, further increases these levels. There was a positive association between the duration of OC administration and atherosclerosis risk for women with endometriosis. Our results suggest that DNG could be administered to endometriosis without the increased atherosclerosis risk and short-term OC administration for endometriosis is not harmful, however, atherosclerosis risk should be strictly observed.
Collapse
Affiliation(s)
- Eiko Maeda
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akemi Koshiba
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Fumitake Ito
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Kataoka
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyuki Okimura
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takuya Sugahara
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yosuke Tarumi
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Izumi Kusuki
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Khaleque N Khan
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jo Kitawaki
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
31
|
Kulprachakarn K, Ounjaijean S, Rerkasem K, Molinsky RL, Demmer RT. Cardiovascular disease risk factors among transgender women in Chiang Mai, Thailand. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2020; 10:124-130. [PMID: 32685270 PMCID: PMC7364281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Transgender individuals take hormone therapy (HT) for transitioning secondary sexual characteristics, especially by transgender women assigned male at birth (AMAB). The transgender drug is a relatively new field in health care, but limited data exist to inform the cardiovascular risk factor profile among younger individuals undergoing HT. Therefore, this study was to evaluate the relationship between HT and cardiovascular (CVD) risk factors in Thai transgender women. A cross-sectional study was conducted from October 1st 2018-November 30th 2018 in 100 transgender women not receiving HT (Control group) and 100 transgender women receiving HT (HT group) in Chiang Mai, Thailand. Demographic data were recorded for each consenting subject. Non-invasive arterial examinations were undertaken, including carotid intima-media thickness (CIMT), ankle-brachial index (ABI), and cardio-ankle vascular index (CAVI). CVD risk factors including lipid profiles, fasting plasma glucose (FPG), C-reactive protein (CRP), cardiovascular risk markers (pro b-type natriuretic peptide (proBNP) and cardiac troponin I), and sex hormone levels were determined. The average age in both groups was 24±5.1 years. The average time of HT use was 6.65±0.52 years in the HT group. Mean waist circumference was significantly lower in the HT group compared with the control group (77.50±14.00 vs. 81.20±12.90 cm; P=0.004) while CRP (3.44±6.82 vs. 3.28±5.80 mg/L; P=0.031) and cardiac troponin I (0.029±0.051 vs. 0.014±0.014 ng/mL; P=0.040) values were greater in HT group than the control group. Mean CIMT was lower in the HT group vs. the control group (P=0.094). Among transgender women, receiving HT was associated with enhanced levels of a subset of CVD risk factors. More research is necessary to inform the need for novel CVD prevention and treatment strategies in transgender women.
Collapse
Affiliation(s)
- Kanokwan Kulprachakarn
- NCD Center of Excellence and School of Health Science Research, Research Institute for Health Sciences, Chiang Mai UniversityChiang Mai, Thailand
| | - Sakaewan Ounjaijean
- NCD Center of Excellence and School of Health Science Research, Research Institute for Health Sciences, Chiang Mai UniversityChiang Mai, Thailand
| | - Kittipan Rerkasem
- NCD Center of Excellence and School of Health Science Research, Research Institute for Health Sciences, Chiang Mai UniversityChiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai UniversityChiang Mai, Thailand
| | - Rebecca L Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of MinnesotaMinneapolis, MN, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of MinnesotaMinneapolis, MN, USA
| |
Collapse
|
32
|
Bekki M, Tahara N, Tahara A, Igata S, Honda A, Sugiyama Y, Nakamura T, Sun J, Kumashiro Y, Matsui T, Fukumoto Y, Yamagishi SI. Switching Dipeptidyl Peptidase-4 Inhibitors to Tofogliflozin, a Selective Inhibitor of Sodium-Glucose Cotransporter 2 Improve Arterial Stiffness Evaluated by Cardio-Ankle Vascular Index in Patients with Type 2 Diabetes: A Pilot Study. Curr Vasc Pharmacol 2020; 17:411-420. [PMID: 29766812 DOI: 10.2174/1570161116666180515154555] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/19/2018] [Accepted: 06/19/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND We have found that anagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4) significantly ameliorates arterial stiffness in Type 2 Diabetes Mellitus (T2DM) patients compared with an equivalent hypoglycaemic agent, glimepiride. However, it remains unclear whether switching DPP-4 inhibitors to tofogliflozin, a selective inhibitor of Sodium-Glucose Cotransporter 2 (SGLT2) improves arterial stiffness in T2DM patients. METHODS Nineteen T2DM patients who had received DPP-4 inhibitors for at least 1 year were enrolled in this study. Clinical parameters and arterial stiffness evaluated by cardio-ankle vascular index (CAVI) were measured at baseline and after 6-months treatment with tofogliflozin. RESULTS At 6 months after switching to tofogliflozin, CAVI, waist circumference, body weight, body mass index, subcutaneous and visceral fat volume, white blood cell number, fasting plasma insulin, uric acid, aspartate transaminase (AST), γ-glutamyl transferase (GTP), and advanced glycation end products (AGEs) were significantly reduced, while red blood cell number, haemoglobin, and HbA1c values were increased. When stratified by median values of change in CAVI after switching to tofogliflozin (ΔCAVI), baseline serum levels of AGEs were significantly higher in the low ΔCAVI group (high responder) than in the high one (low responder). ΔAST and ΔGTP were positively correlated with ΔCAVI. CONCLUSION The present study suggests that switching DPP-4 inhibitors to tofogliflozin ameliorates arterial stiffness in T2DM patients partly via improvement of liver function. Baseline serum levels of AGEs may identify patients who improve arterial stiffness more after treatment with tofogliflozin.
Collapse
Affiliation(s)
- Munehisa Bekki
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Nobuhiro Tahara
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Atsuko Tahara
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Sachiyo Igata
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Akihiro Honda
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Yoichi Sugiyama
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Tomohisa Nakamura
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Jiahui Sun
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | | | - Takanori Matsui
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
| | - Sho-Ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| |
Collapse
|
33
|
Kaushal A, Ratra D. Commentary: Retinal branch vein occlusion and arteriosclerosis: Can cardio-ankle vascular index be a useful biomarker? Indian J Ophthalmol 2020; 68:873-874. [PMID: 32317468 PMCID: PMC7350425 DOI: 10.4103/ijo.ijo_2293_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Anshu Kaushal
- Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Dhanashree Ratra
- Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| |
Collapse
|
34
|
Hamal S, Cherukuri L, Birudaraju D, Matsumoto S, Kinninger A, Chaganti BT, Flores F, Shaikh K, Roy SK, Budoff MJ. Short-term impact of aged garlic extract on endothelial function in diabetes: A randomized, double-blind, placebo-controlled trial. Exp Ther Med 2020; 19:1485-1489. [PMID: 32010327 PMCID: PMC6966134 DOI: 10.3892/etm.2019.8377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/21/2019] [Indexed: 01/12/2023] Open
Abstract
Impaired endothelial function portends an increased risk of cardiovascular disease. Vascular oxidative stress and systemic inflammation play a critical role in the pathogenesis and progression of vascular disease. Aged garlic extract (AGE) may improve impaired vascular endothelial function, while decreasing the progression of atherosclerotic plaque. We hypothesized that AGE may improve endothelial function, and in this study, we examined this hypothesis to determine whether this can be achieved over a period of 3 months, measured by the cardio-ankle vascular index (CAVI), by reducing intracellular oxidant stress and stimulating nitric oxide generation in endothelial cells. We conducted a double-blinded placebo controlled, randomized clinical trial to investigate the effects of AGE on CAVI in subjects with type 2 diabetes mellitus. A total of 65 individuals (38 men and 27 women) with a mean age of 58.8±11.1 years were enrolled and randomized to the AGE or placebo group in a double-blind placebo controlled trial. An ANOVA model with treatment as the main effect was used to compare changes in CAVI from baseline to follow-up between groups. The primary objective of this study was reduction in CAVI over a 3-month period. In the AGE group, CAVI was reduced on average by 0.71±1.27 vs. a mean reduction of 0.13±0.94 in the placebo group (P=0.04). On the whole, this study demonstrates that AGE has a positive impact on endothelial function in patients with T2DM and may play a role in the primary prevention of cardiovascular disease.
Collapse
Affiliation(s)
- Sajad Hamal
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Lavanya Cherukuri
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Divya Birudaraju
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Suguru Matsumoto
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - April Kinninger
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Bhanu T. Chaganti
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Ferdinand Flores
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Kashif Shaikh
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Sion K. Roy
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Matthew J. Budoff
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, Torrance, CA 90502, USA
| |
Collapse
|
35
|
Albu A, Para I, Porojan M. Uric Acid and Arterial Stiffness. Ther Clin Risk Manag 2020; 16:39-54. [PMID: 32095074 PMCID: PMC6995306 DOI: 10.2147/tcrm.s232033] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/01/2019] [Indexed: 12/21/2022] Open
Abstract
Hyperuricemia is usually associated with hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease. Accumulating data from epidemiological studies indicate an association of increased uric acid (UA) with cardiovascular diseases. Possible pathogenic mechanisms include enhancement of oxidative stress and systemic inflammation caused by hyperuricemia. Arterial stiffness may be one of the possible pathways between hyperuricemia and cardiovascular disease, but a clear relationship between increased UA and vascular alterations has not been confirmed. The review summarizes the epidemiological studies investigating the relationship between UA and arterial stiffness and highlights the results of interventional studies evaluating arterial stiffness parameters in patients treated with UA-lowering drugs.
Collapse
Affiliation(s)
| | - Ioana Para
- 4th Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | |
Collapse
|
36
|
Radchenko GD, Zhyvylo IO, Titov EY, Sirenko YM. Systemic Arterial Stiffness in New Diagnosed Idiopathic Pulmonary Arterial Hypertension Patients. Vasc Health Risk Manag 2020; 16:29-39. [PMID: 32021226 PMCID: PMC6971813 DOI: 10.2147/vhrm.s230041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/15/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE We suggested: 1) patients with idiopathic pulmonary hypertension (IPAH) have active factors which could damage not only the pulmonary but systemic arteries too as in arterial hypertensive patients; 2) if these changes were present, they might correlate with other parameters influencing on the prognosis. This study is the first attempt to use cardio-ankle vascular index (CAVI) for the evaluation of systemic arterial stiffness in patients with IPAH. METHODS A total of 112 patients were included in the study: group 1 consisted of 45 patients with new diagnosed IPAH, group 2 included 32 patients with arterial hypertension, and in the control group were 35 healthy persons adjusted by age. Right heart catheterization, ECG, a 6-minute walk test (6MWT), echocardiography, blood pressure (BP) measurement and ambulatory BP monitoring, pulse wave elastic artery stiffness (PWVe; segment carotid-femoral arteries) and muscular artery stiffness (PWVm; segment carotid-radial arteries), CAVI, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level were provided. The Spearman correlation, a linear regression and multivariable binary logistic analysis were performed to indicate the predictors associated with PWV and CAVI. RESULTS The groups were adjusted for principal characteristics influenced on arterial stiffness. IPAH patients had significantly (P<0.001 for all) shorter 6MWT distance and higher Borg dyspnea score than the patients with arterial hypertension (systolic/diastolic BP = 146.1±10.7/94.2±9.8 mmHg) and the control group = 330.2±14.6 vs 523.8±35.3 and 560.9±30.2 m respectively and 6.2±1.8 vs 1.2±2.1 and 0.9±2.8 points. The PWVm and PWVe were the highest in hypertensive patients (10.3±1.5 and 11.42±1.70 m/s). The control group and IPAH did not have significant differences in aorta BP, but PWVm/PWVe values were significantly (P<0.003/0.008) higher in IPAH patients than in the control group (8.1±1.9/8.49±1.92 vs 6.63±1.34/7.29±0.87 m/s). The CAVIs on both sides were significantly lower in the healthy subjects (5.91±0.99/5.98±0.87 right/left side). Patients with IPAH did not differ from the arterial hypertension patients by CAVIs in comparison with the control group (7.40±1.32/7.22±1.32 vs 7.19±0.78/7.2±1.1 PWVe) did not correlate with any parameters except uric acid. PWVm correlated with uric acid (r=0.58, P<0.001), NT-proBNP (r=0.33, P=0.03) and male gender (r=0.37, P=0.013) at Spearman analysis, but not at multifactorial linear regression analysis. The CAVI correlated with age and parameters characterized functional capacity (6MWT distance) and right ventricle function (NT-proBNP, TAPSE) at Spearman analysis and with age and TAPSE at multifactorial linear regression analysis. At binary logistic regression analysis CAVI > 8.0 at right and/or left side had a correlation with age, 6MWT distance, TAPSE, but an independent correlation was only with age (β=1.104, P=0.008, CI 1.026-1.189) and TAPSE (β=0.66, P=0.016, CI 0.474-0.925). CONCLUSION In spite of equal and at normal range BP level, the age-adjusted patients with IPAH had significantly stiffer arteries than the healthy persons and they were comparable with the arterial hypertensive patients. Arterial stiffness evaluated by CAVI correlated with age and TAPSE in IPAH patients. Based on our results it is impossible to conclude the pathogenesis of arterial stiffening in IPAH patients, but the discovered changes and correlations suggest new directions for further studies, including pathogenesis and prognosis researches.
Collapse
Affiliation(s)
- GD Radchenko
- Secondary Hypertension Department, State Institution “National Scientific Center “Institute of Cardiology Named After acad.M.D.Strazhesko” of Ukrainian National Academy of Medical Science, Kyiv, Ukraine
| | - IO Zhyvylo
- Secondary Hypertension Department, State Institution “National Scientific Center “Institute of Cardiology Named After acad.M.D.Strazhesko” of Ukrainian National Academy of Medical Science, Kyiv, Ukraine
| | - EY Titov
- Non-Coronary Heart Disease Department, State Institution “National Scientific Center “Institute of Cardiology Named After acad.M.D.Strazhesko” of Ukrainian National Academy of Medical Science, Kyiv, Ukraine
| | - Yuriy M Sirenko
- Secondary Hypertension Department, State Institution “National Scientific Center “Institute of Cardiology Named After acad.M.D.Strazhesko” of Ukrainian National Academy of Medical Science, Kyiv, Ukraine
| |
Collapse
|
37
|
Inthachai T, Demekul K, Phonsatsadee N, Puttitommagool P, Boonyachart N. Effects of physical activity and smoking on cardio-ankle vascular index, respiratory muscle strength, and exercise performance in early normal weight adulthood: a cross-sectional study. J Exerc Rehabil 2020; 15:804-810. [PMID: 31938702 PMCID: PMC6944882 DOI: 10.12965/jer.1938676.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/21/2019] [Indexed: 11/22/2022] Open
Abstract
Few studies have shown the impact of unhealthy habits on arterial stiffness, respiratory muscle strength and exercise performance in early normal weight adulthood. This study sought to determine the effects of physical activity and smoking on its parameters in normal weight male participants. Forty-eight participants were divided into four groups: physically inactive nonsmokers and smokers and physically active nonsmokers and smokers (n=12 in each group). All of the participants were measured for body composition, arterial stiffness, respiratory muscle strength and exercise performance. Two-way analysis of variance design was used to test the main and interaction effects of physical activity by group (smokers vs. nonsmokers). P-value of less than 0.05 was considered as a statistically significant difference. As a result, cardio-ankle vascular index and respiratory muscle strength were diminished in smokers and physically inactive participants, while body and visceral fat mass were increased in both those groups. Fat-free mass was lower in only physically inactive participants. This study also found the interaction effects on body fat and arterial stiffness. In conclusion, participants with healthy normal weight, but smoked and performed inappropriate physical activity, exhibited body composition imbalance, decreased respiratory muscle strength, exercise performance, and increased arterial stiffness. Therefore, smoking cessation and exercise in younger adults are appropriate ways of improving body composition, respiratory muscle strength, aerobic capacity and arterial stiffness instead of trying to control their weight by smoking.
Collapse
Affiliation(s)
- Tharnwimol Inthachai
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Kanokwan Demekul
- Department of Cardio-thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Napaporn Phonsatsadee
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Pannatorn Puttitommagool
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Nontarat Boonyachart
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| |
Collapse
|
38
|
Trush E, Ivanova S, Savin A, Yushchuk E, Teltevskaya I, Melehina I, Dobrovolskaya L. Arterial stiffness in patients with acute cerebrovascular accident. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:16-21. [DOI: 10.17116/jnevro202012012216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
39
|
Hanvivadhanakul P, Buakhamsri A. Disease activity is associated with LV dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease. Adv Rheumatol 2019; 59:56. [PMID: 31843000 DOI: 10.1186/s42358-019-0100-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The cross-sectional study aimed to assess left ventricular systolic function using global longitudinal strain (GLS) by speckle-tracking echocardiography (STE) and arterial stiffness using cardio-ankle vascular index (CAVI) in Thai adults with rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). METHODS Confirmed RA patients were selected from a list of outpatient attendees if they were 18 years (y) without clinical, ECG and echocardiographic evidence of CVD, diabetes mellitus, chronic kidney disease, and excess alcoholic intake. Controls were matched with age and sex to a list of healthy individuals with normal echocardiograms. All underwent STE and CAVI. RESULTS 60 RA patients (females = 55) were analysed. Mean standard deviation of patient and control ages were 50 ± 10.2 and 51 ± 9.9 y, respectively, and mean duration of RA was 9.0 ± 6.8 y. Mean DAS28-CRP and DAS28-ESR were 2.9 ± 0.9 and 3.4 ± 0.9, respectively. There was no between-group differences in left ventricular ejection fraction (LVEF), LV sizes, LVMI, LV diastolic function and CAVI were within normal limits but all GLSs values was significantly lower in patients vs. controls: 17.6 ± 3.4 vs 20.4 ± 2.2 (p = 0.03). Multivariate regression analysis demonstrated significant correlations between GLSs and RA duration (p = 0.02), and GLSs and DAS28-CRP (p = 0.041). CONCLUSIONS Patients with RA and no clinical CV disease have reduced LV systolic function as shown by lower GLSs. It is common and associated with disease activity and RA disease duration. 2D speckle-tracking GLSs is robust in detecting this subclinical LV systolic dysfunction.
Collapse
Affiliation(s)
- Punchong Hanvivadhanakul
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Thammasat University, 99/209 Moo 18, Paholyothin Road, Klong Luang, Pathumthanee, 12120, Thailand.
| | - Adisai Buakhamsri
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Thammasat University, 99/209 Moo 18, Paholyothin Road, Klong Luang, Pathumthanee, 12120, Thailand
| |
Collapse
|
40
|
Cardio-ankle vascular index is linked to deranged metabolic status, especially high HbA1c and monocyte-chemoattractant-1 protein, in predialysis chronic kidney disease. Int Urol Nephrol 2019; 52:137-145. [PMID: 31773386 DOI: 10.1007/s11255-019-02336-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 11/06/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND PURPOSE Arterial stiffness is an independent predictor of cardiovascular disease in chronic kidney disease (CKD). Cardio-ankle vascular index (CAVI) is a newly developed method used to assess arterial stiffness, independent of changes in blood pressure. CAVI reflects stiffness and atherosclerosis at the thoracic, abdominal, common iliac, femoral, and tibial artery levels. In predialysis stage 3-5 diabetic and nondiabetic CKD patients, CAVI levels and its relation to atherosclerosis-associated risk factors including monocyte-chemoattractant protein-1 (MCP-1), sclerostin, fibroblast growth factor-23 (FGF-23), Klotho, and 25-OH vitamin D were determined. MATERIALS AND METHODS The study was performed on three age-matched and gender-matched groups. Group 1 included 46 stage 3-5 nondiabetic CKD patients, group 2 included 44 stage 3-5 diabetic CKD patients, and group 3 included 44 non-uremic controls. All subjects underwent CAVI measurement. Serum glycated hemoglobin (HbA1c), total calcium, phosphorus, parathormone, FGF-23, Klotho, MCP-1, sclerostin, and 25-OH vitamin D were determined using standard methods. RESULTS CAVI level was 8.22 ± 0.18 m/s in diabetic CKD patients and significantly higher than in nondiabetic CKD (7.61 ± 0.18 m/s) and control (7.59 ± 0.17 m/s) patients. FGF-23 level was higher in the CKD groups than controls but not statistically significant. MCP-1 level was significantly higher in diabetic CKD patients. Klotho and sclerostin levels were significantly lower in diabetic CKD patients. In the whole cohort, CAVI showed positive correlations with age (r = 0.447, p < 0.0001), smoking (r = 0.331, p = 0.035), mean arterial blood pressure (MABP; r = 0.327, p < 0.0001), fasting blood glucose (r = 0.185, p = 0.033), and HbA1c (r = 0.258, p = 0.003). Stepwise regression analysis revealed that age (p = 0.0001, B = 0.461), MABP (p < 0.0001, B = 0.365), HbA1c (p = 0.003, B = 0.251), and MCP-1 (p = 0.013, B = 0.214) independently predicted CAVI levels. CONCLUSION Our results indicate higher CAVI levels, therefore, resulting in increased arterial stiffness in the setting of diabetic CKD. Apart from age and MABP, deranged metabolic status, especially increased HbA1c and MCP-1 levels, is also independently associated with increasing CAVI levels in CKD patients. These results emphasize the importance of metabolic control in the development of arterial stiffness in CKD patients, which is an early predictor of developing cardiovascular complications.
Collapse
|
41
|
Satirapoj B, Triwatana W, Supasyndh O. Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks. J Atheroscler Thromb 2019; 27:611-619. [PMID: 31597887 PMCID: PMC7355103 DOI: 10.5551/jat.52084] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims: Arterial stiffness is known to be an important surrogate marker for atherosclerosis and predictor of peripheral vascular and cardiovascular (CV) disease. Whether high cardio-ankle vascular index (CAVI) is associated with the development of rapid glomerular filtration rate (GFR) decline remains uncertain. The study aimed to determine the relationship between CAVI and renal function progression among patients with high CV risk. Methods: This study employed a prospective cohort design with 1-year follow-up among patients with high CV risk. Arterial stiffness was measured using CAVI method. GFR was estimated using the chronic kidney disease (CKD) epidemiology collaboration equation, and rapid decline in GFR was defined with decrease in GFR ≥ 5 mL/min/1.73 m2 yearly. Results: Of 352 patients with mean age 67.8 ± 10.1 years, 224 patients (63.6%) were suspected to have arteriosclerosis (CAVI ≥ 9), and 208 patients (59.1%) had CKD (GFR < 60 mL/min/1.73 m2). Annual decline of GFR was −0.75 [interquartile range (IQR), −1.16 to 6.08] mL/min/1.73 m2/year, and 30.1% of patients experienced a rapid decline in GFR. Compared with normal CAVI (CAVI < 8), high CAVI (CAVI ≥ 9) and borderline CAVI (CAVI 8–8.9) in all subjects and subgroup of baseline GFR > 60 mL/min/1.73 m2 were associated with rapid GFR decline. Multivariable analysis showed that high CAVI and borderline CAVI were associated with 2.47-fold (95% CI, 0.89–6.84; P = 0.082) and 4.04-fold (95% CI, 1.46–11.18; P = 0.007) increased odds ratio of rapid GFR decline, respectively. Conclusion: Among patients with high risk of CV with or without CKD, high CAVI (cut point of ≥ 9) was independently associated with a rapid decline in GFR, suggesting that systemic vascular stiffness predicted a decrease in renal function in this population.
Collapse
Affiliation(s)
- Bancha Satirapoj
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
| | - Wutipong Triwatana
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
| | - Ouppatham Supasyndh
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
| |
Collapse
|
42
|
Shin KA. Relationship between Arterial Stiffness as Measured by the Cardio-Ankle Vascular Index with Body Mass Index in Healthy Elderly Subjects. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.3.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kyung A Shin
- Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea
| |
Collapse
|
43
|
Zhang C, Zhong Y, Tian H. Increased cardio-ankle vascular index is independently associated with chronic kidney disease: A cross-sectional study in Chinese patients with type 2 diabetes mellitus. J Diabetes Complications 2019; 33:623-627. [PMID: 31255433 DOI: 10.1016/j.jdiacomp.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/08/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023]
Abstract
AIMS This cross-sectional study aimed to investigate the association between arterial stiffness and chronic kidney disease (CKD) in Chinese patients with type 2 diabetes mellitus (T2DM). METHODS This study included 1025 patients with T2DM (796 men, 229 women). The cardio-ankle vascular index (CAVI) served as an index to evaluate arterial stiffness. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or urinary albumin-creatine ratio ≥ 30 mg/g. Increased CAVI was defined as a value ≥9. RESULTS The mean CAVI was 8.4 ± 1.2. Among the patients, 314 (40%) had increased CAVI and 229 (22.3%) had CKD. Blood pressure, HbA1c levels, total cholesterol, low-density lipoprotein cholesterol, uric acid and CAVI were higher among patients with CKD than among those without CKD. Patients with increased CAVI were at a 1.82-fold (95% CI, 1.20-2.75; P < 0.001) higher prevalence of CKD after adjusting for other variables. The odds ratio for CKD was 2.69 (95% CI, 1.12-6.47; P = 0.027) in women and 1.62 (95% CI, 1.01-2.61; P = 0.045) in men. CONCLUSION Increased CAVI was independently associated with CKD in patients with T2DM. Further longitudinal studies with large sample sizes are warranted to investigate the effect of CAVI on CKD in patients with T2DM.
Collapse
Affiliation(s)
- Chenghui Zhang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yajun Zhong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haoming Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
44
|
Association between Helicobacter pylori infection and arterial stiffness: Results from a large cross-sectional study. PLoS One 2019; 14:e0221643. [PMID: 31465466 PMCID: PMC6715239 DOI: 10.1371/journal.pone.0221643] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/12/2019] [Indexed: 12/14/2022] Open
Abstract
Background Chronic systemic inflammation is an important causative factor in the pathogenesis of atherosclerosis. However, the effect of chronic Helicobacter pylori (Hp) infection on arterial stiffness, a predictor of cardiovascular events, remains unclear. We evaluated the association between Hp infection and arterial stiffness in asymptomatic healthy individuals. Methods Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). We included subjects who underwent CAVI and anti-Hp IgG antibody evaluations, simultaneously, between March 2013 and July 2017. Demographic characteristics and metabolic and cardiovascular parameters were compared with respect to anti-Hp IgG antibody status. Multivariable logistic regression analyses were performed to determine the effect of Hp-seropositivity and conventional cardiovascular risk factors on arterial stiffness. Results Of 2,251 subjects, 1,326 (58.9%) were included in the Hp-seropositive group. Median age (P < 0.001) and systolic blood pressure (P = 0.027) were significantly higher in the Hp-seropositive than in the Hp-seronegative group. Levels of LDL-cholesterol were significantly higher in the Hp-seropositive than in the Hp-seronegative group (P = 0.016). Other serum metabolic parameters were not significantly different between the two groups. The median CAVI value and the proportion of subjects with a CAVI ≥ 8 were significantly higher in the Hp-seropositive than in the Hp-seronegative group (both P < 0.001). On multivariable logistic regression analyses, Hp-seropositivity, age, body mass index, waist circumference, smoking, hypertension, diabetes mellitus, and dyslipidemia were significantly associated with high CAVI values. In the subgroup analysis conducted according to age group, a tendency towards an increased association between Hp-seropositivity and CAVI was observed with increasing age, even though the difference did not reach the statistical significance. Conclusions Hp-seropositivity was significantly associated with arterial stiffness. Hp infection may contribute to the development of cardiovascular diseases.
Collapse
|
45
|
Zhang M, Bai L, Kang J, Ge J, Peng W. Links between arterial stiffness and bone mineral density in middle-aged and elderly Chinese individuals: a cross-sectional study. BMJ Open 2019; 9:e029946. [PMID: 31401606 PMCID: PMC6701650 DOI: 10.1136/bmjopen-2019-029946] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To explore whether bone mineral density (BMD) is associated with arterial stiffness in middle-aged and elderly people with an advanced arterial stiffness index as indicated by the cardio-ankle vascular index (CAVI). DESIGN A cross-sectional study. SETTING This study was conducted from September 2015 to May 2017 at the geriatrics department of a provincial medical centre in China. PARTICIPANTS A total of 580 patients aged 50 and over were enrolled in the study. The mean age of the group was 64.82±11.4 years, and 63.1% were male. PRIMARY OUTCOME MEASURES Associations of age with CAVI values and BMD. Associations between BMD and CAVI values. RESULTS With increasing age, CAVI values gradually increased (p<0.001) and the femoral neck (FN) and total hip (TH) BMD gradually decreased (p<0.001, all). In the bivariate correlation analyses between the covariates and CAVI values, age and CAVI values showed the greatest positive correlation (r=0.631, p<0.001), and CAVI values were negatively correlated with FN BMD (r=-0.229, p<0.001) and TH BMD (r=-0.218, p<0.001). In the linear regression analyses, TH BMD (B=-1.812 (95% CI -2.475 to -1.149), p<0.001) and FN BMD (B=-1.968 (95% CI -2.651 to -1.284), p<0.001) were negatively correlated with CAVI values. After adjusting for age, gender, body mass index, smoking, history of cardiovascular or cerebrovascular disease, history of diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, blood uric acid, fibrinogen and estimated glomerular filtration rate, only TH BMD was still negatively correlated with CAVI values (B=-0.843 (95%CI -1.454 to -0.232), p=0.007). However, there was no consistent and significant correlation between lumbar spine BMD and CAVI values. CONCLUSION In this cross-sectional study, a significant correlation between TH BMD and CAVI values was observed in middle-aged and elderly Chinese inpatients. However, our cohort was a small sample of inpatients, and prospective studies from more centres are expected.
Collapse
Affiliation(s)
- Meng Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lijuan Bai
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Kang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Ge
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Peng
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
46
|
Fabian V, Matera L, Bayerova K, Havlik J, Kremen V, Pudil J, Sajgalik P, Zemanek D. Noninvasive Assessment of Aortic Pulse Wave Velocity by the Brachial Occlusion-Cuff Technique: Comparative Study. SENSORS 2019; 19:s19163467. [PMID: 31398931 PMCID: PMC6719951 DOI: 10.3390/s19163467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/18/2019] [Accepted: 08/06/2019] [Indexed: 01/14/2023]
Abstract
Cardiovascular diseases are one of most frequent cause of morbidity and mortality in the world. There is an emerging need for integrated, non-invasive, and easy-to-use clinical tools to assess accurately cardiovascular system primarily in the preventative medicine. We present a novel design for a non-invasive pulse wave velocity (PWV) assessment method integrated in a single brachial blood pressure monitor allowing for up to 100 times more sensitive recording of the pressure pulsations based on a brachial occlusion-cuff (suprasystolic) principle. The monitor prototype with built-in proprietary method was validated with a gold standard reference technique SphygmoCor VX device. The blood pressure and PWV were assessed on twenty-five healthy individuals (9 women, age (37 ± 13) years) in a supine position at rest by a brachial cuff blood pressure monitor prototype, and immediately re-tested using a gold standard method. PWV using our BP monitor was (6.67 ± 0.96) m/s compared to PWV determined by SphygmoCor VX (6.15 ± 1.01) m/s. The correlation between methods using a Pearson’s correlation coefficient was r = 0.88 (p < 0.001). The study demonstrates the feasibility of using a single brachial cuff build-in technique for the assessment of the arterial stiffness from a single ambulatory blood pressure assessment.
Collapse
Affiliation(s)
- Vratislav Fabian
- Department of Physics, Faculty of Electrical Engineering, Czech Technical University in Prague, 166 27 Prague, Czech Republic.
| | - Lukas Matera
- Department of Physics, Faculty of Electrical Engineering, Czech Technical University in Prague, 166 27 Prague, Czech Republic
| | - Kristyna Bayerova
- 2nd Department of Internal Medicine-Cardiology and Angiology of General University Hospital and 1st Medical Faculty of Charles University, 128 08 Prague, Czech Republic
| | - Jan Havlik
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, 166 27 Prague, Czech Republic
| | - Vaclav Kremen
- Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University in Prague, 160 00 Prague, Czech Republic
| | - Jan Pudil
- 2nd Department of Internal Medicine-Cardiology and Angiology of General University Hospital and 1st Medical Faculty of Charles University, 128 08 Prague, Czech Republic
| | - Pavol Sajgalik
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 559 05, USA
| | - David Zemanek
- 2nd Department of Internal Medicine-Cardiology and Angiology of General University Hospital and 1st Medical Faculty of Charles University, 128 08 Prague, Czech Republic
| |
Collapse
|
47
|
Nabeel PM, Kiran VR, Joseph J, Abhidev VV, Sivaprakasam M. Local Pulse Wave Velocity: Theory, Methods, Advancements, and Clinical Applications. IEEE Rev Biomed Eng 2019; 13:74-112. [PMID: 31369386 DOI: 10.1109/rbme.2019.2931587] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Local pulse wave velocity (PWV) is evolving as one of the important determinants of arterial hemodynamics, localized vessel stiffening associated with several pathologies, and a host of other cardiovascular events. Although PWV was introduced over a century ago, only in recent decades, due to various technological advancements, has emphasis been directed toward its measurement from a single arterial section or from piecewise segments of a target arterial section. This emerging worldwide trend in the exploration of instrumental solutions for local PWV measurement has produced several invasive and noninvasive methods. As of yet, however, a univocal opinion on the ideal measurement method has not emerged. Neither have there been extensive comparative studies on the accuracy of the available methods. Recognizing this reality, makes apparent the need to establish guideline-recommended standards for the measurement methods and reference values, without which clinical application cannot be pursued. This paper enumerates all major local PWV measurement methods while pinpointing their salient methodological considerations and emphasizing the necessity of global standardization. Further, a summary of the advancements in measuring modalities and clinical applications is provided. Additionally, a detailed discussion on the minimally explored concept of incremental local PWV is presented along with suggestions of future research questions.
Collapse
|
48
|
Alonso-Domínguez R, Recio-Rodríguez JI, Patino-Alonso MC, Sánchez-Aguadero N, García-Ortiz L, Gómez-Marcos MA. Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study. BMC Cardiovasc Disord 2019; 19:56. [PMID: 30849947 PMCID: PMC6408776 DOI: 10.1186/s12872-019-1039-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 03/01/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Daily aerobic exercise such as healthy walking could have an immediate effect on parameters of arterial stiffness; however, there is little evidence in the diabetic population. Our aim, therefore, is to evaluate the association between healthy walking and acute effects on the parameters of arterial stiffness in subjects with type 2 diabetes. METHODS The Effectiveness of a multifactorial intervention in diabetics study (EMID), is a study based on an application for smartphones, healthy walking and a nutritional workshop in patients with type 2 diabetes in primary care, is a randomized controlled trial of two parallel groups. This is a subanalysis of the intervention group to evaluate the response to the healthy walking according to age and sex, in 89 subjects with type 2 diabetes, aged between 40 and 70 years. The intervention was a 4 km of a healthy walking at low-moderate intensity. To value our aim, the main study variables were measured before and after it. RESULTS The study population had an average age of 65.0 years (61.2-68.1). After the healthy walking, there was a decrease in the parameters of arterial stiffness: Cardio ankle vascular index (CAVI) of - 0.2 (95%CI:-0.4 to - 0.1) and pulse pressure (PP) of the lower extremities of - 3.9 mmHg (95%CI: -5.9 to - 2.0). Furthermore, in the lower extremities there was a decrease in systolic blood pressure of - 5.3 mmHg (95% CI: -7.3 mmHg to - 3.3 mmHg), in diastolic blood pressure of - 1.5 mmHg (95% CI: -2.6 mmHg to - 0.4 mmHg) (p < 0.05 for all). It is observed that males have an OR of 2.981 (IC = 95% 1.095 to 8.119) to achieve a reduction in the CAVI (p < 0.05) and an OR of 2.433 (95%CI: 0.871 to 6.794) in the ankle PP (p > 0.05), compared with females. CONCLUSIONS The findings of this study suggest that daily aerobic exercise at a low to moderate intensity, such as healthy walking, has an immediate beneficial effect on the cardio-ankle vascular index, especially in males. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02991079 .
Collapse
Affiliation(s)
- Rosario Alonso-Domínguez
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain. .,Health Service of Castilla y León (SACyL), Salamanca, Spain. .,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain. .,, Salamanca, Spain.
| | - José I Recio-Rodríguez
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain.,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain.,Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Maria C Patino-Alonso
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain.,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain.,Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain.,Health Service of Castilla y León (SACyL), Salamanca, Spain.,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain
| | - Luis García-Ortiz
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain.,Health Service of Castilla y León (SACyL), Salamanca, Spain.,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain.,Department of Biomedical and diagnostic sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- The Alamedilla Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain.,Health Service of Castilla y León (SACyL), Salamanca, Spain.,Spanish Network for Preventive Activities and Health Promotion (redIAPP), Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
| |
Collapse
|
49
|
Gorshkov AY, Klimushina MV, Boytsov SA, Kots AY, Gumanova NG. Increase in perfused boundary region of endothelial glycocalyx is associated with higher prevalence of ischemic heart disease and lesions of microcirculation and vascular wall. Microcirculation 2019; 25:e12454. [PMID: 29608790 DOI: 10.1111/micc.12454] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 03/26/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE PBR characterizes penetration of red blood cells inside glycocalyx and its thickness can have profound impact on microcirculation and other vascular parameters. The goal of our study was to reliably quantify PBR and assess its potential use as a new marker of cardiovascular pathology. METHODS The study included 208 patients (123 men and 85 women from 40 to 65 years of age) with various grades of cardiovascular SCORE risk index and IHD. PBR was quantified by sidestream dark field capillaroscopy with green light excitation. Cutaneous microcirculation was evaluated with laser Doppler fluorometry. RESULTS Elevated PBR values over 2 mm were associated with morphological and functional lesions of arterial wall and microcirculation and lowered levels of ApoA1 lipoprotein. Moreover, elevated PBR values were associated with 2.07-fold increase in prevalence of cerebral atherosclerosis (P = .015) and 2.42-fold increase in prevalence of IHD (P = .024). Increase in PBR was associated with elevated systolic blood pressure. CONCLUSIONS Thus, PBR can be considered a new highly reproducible and promising marker candidate for non-invasive diagnostics of IHD and cerebral atherosclerosis suggesting important role of microcirculation in development and progression of cardiovascular diseases.
Collapse
Affiliation(s)
- Alexander Y Gorshkov
- National Research Center for Preventive Medicine, Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Marina V Klimushina
- National Research Center for Preventive Medicine, Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Sergei A Boytsov
- National Research Center for Preventive Medicine, Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Alexander Y Kots
- School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Nadezhda G Gumanova
- National Research Center for Preventive Medicine, Ministry of Healthcare of Russian Federation, Moscow, Russia
| |
Collapse
|
50
|
Nishiwaki M, Fujibayashi M, Nanayama C, Ogawa N, Itakura I, Matsumoto N. Increasing levels of daily physical activity for arterial stiffness reduction in older women: a community-based pilot study. J Sports Med Phys Fitness 2018; 58:1701-1709. [DOI: 10.23736/s0022-4707.17.07238-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|