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Yang Y, Feng Y, Ren J, Sun Y. Ankle-Brachial Index, a New Predictor for All-Cause Mortality. Angiology 2024; 75:597. [PMID: 37462238 DOI: 10.1177/00033197231190519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- Yong Yang
- Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng, PR China
| | - Yi Feng
- Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng, PR China
| | - Jian Ren
- Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng, PR China
- Department of Cardiology, Liaocheng Dongchangfu People's Hospital, Liaocheng, PR China
| | - Ying Sun
- Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng, PR China
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Serés-Noriega T, Perea V, Amor AJ. Screening for Subclinical Atherosclerosis and the Prediction of Cardiovascular Events in People with Type 1 Diabetes. J Clin Med 2024; 13:1097. [PMID: 38398409 PMCID: PMC10889212 DOI: 10.3390/jcm13041097] [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: 01/19/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
People with type 1 diabetes (T1D) have a high cardiovascular disease (CVD) risk, which remains the leading cause of death in this population. Despite the improved control of several classic risk factors, particularly better glycaemic control, cardiovascular morbidity and mortality continue to be significantly higher than in the general population. In routine clinical practice, estimating cardiovascular risk (CVR) in people with T1D using scales or equations is often imprecise because much of the evidence comes from pooled samples of people with type 2 diabetes (T2D) and T1D or from extrapolations of studies performed on people with T2D. Given that T1D onsets at a young age, prolonged exposure to the disease and its consequences (e.g., hyperglycaemia, changes in lipid metabolism or inflammation) have a detrimental impact on cardiovascular health. Therefore, it is critical to have tools that allow for the early identification of those individuals with a higher CVR and thus be able to make the most appropriate management decisions in each case. In this sense, atherosclerosis is the prelude to most cardiovascular events. People with diabetes present pathophysiological alterations that facilitate atherosclerosis development and that may imply a greater vulnerability of atheromatous plaques. Screening for subclinical atherosclerosis using various techniques, mainly imaging, has proven valuable in predicting cardiovascular events. Its use enables the reclassification of CVR and, therefore, an individualised adjustment of therapeutic management. However, the available evidence in people with T1D is scarce. This narrative review provides and updated overview of the main non-invasive tests for detecting atherosclerosis plaques and their association with CVD in people with T1D.
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Affiliation(s)
- Tonet Serés-Noriega
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Verónica Perea
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, 08221 Terrassa, Spain
| | - Antonio J. Amor
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, 08036 Barcelona, Spain
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Kamieńska A, Danieluk A, Niwińska MM, Chlabicz S. Arterial Stiffness and Ankle-Brachial Index - Cross-Sectional Study of 259 Primary Care Patients ≥50 Year-Old. Med Sci Monit 2024; 30:e942718. [PMID: 38317385 PMCID: PMC11177718 DOI: 10.12659/msm.942718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Lower-extremity arterial disease (LEAD) is the most common form of peripheral artery disease (PAD), and diagnosis relies on the ankle-brachial index (ABI). The objective of our study was to evaluate the correlation between ABI and arterial stiffness parameters, specifically focusing on PWV. Additionally, we aimed to assess the correlation between PWV and established LEAD risk factors. MATERIAL AND METHODS The study included primary care patients aged ≥50 years. Pulse wave velocity was measured with a Mobil-o-Graph Pulse Wave Analyzer (I.E.M. Germany). Two criteria defined abnormal PWV: 1) universal PWV threshold exceeding 10 m/s (uPWVt) and 2) surpassing an individualized threshold calculated by the device, accounting for sex, age, and blood pressure (iPWVt). RESULTS We assessed PWV in 266 individuals and both PWV and ABI in 259. Overall, 6/259 (2.3%) had a diagnosis of LEAD, 44/259(16.9%) had ABI <0.9, and 97/259 (37.5%) had PWV values above iPWVt. Among patients with Doppler ABI <0.9, 25/44 (56.8%) exhibited elevated iPWVt versus 72/215 (33.5%) in those with ABI ≥0.9 (P=0.003, r=0.18 Spearman's correlation). Among patients with ABI <0.9 19/44 (43.2%) had PWV >iPWVt (P=0.003, r=0.18). We observed significant correlation between elevated PWV (both cutoffs) and hypertension (in both P=0.009, r=0.16) and PWV >uPWVt correlated with the presence of diabetes (P=0.004, r=0.18). CONCLUSIONS Elevated PWV correlates with abnormal ABI and some cardiovascular risk factors in primary care patients aged 50 and above. Use of individualized PWV thresholds, factoring in age, appears to be a preferable approach for assessment of arterial stiffness and early diagnosis of LEAD.
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Wang J, Jing C, Hu X, Cui J, Tang Q, Tu L, Zhao S, Huang J, Guo D, Li Y, Xu J. Assessment of aortic to peripheral vascular stiffness and gradient by segmented upper limb PWV in healthy and hypertensive individuals. Sci Rep 2023; 13:19859. [PMID: 37963909 PMCID: PMC10645764 DOI: 10.1038/s41598-023-46932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/07/2023] [Indexed: 11/16/2023] Open
Abstract
Theoretically pulse wave velocity (PWV) is obtained by calculating the distance between two waveform probes divided by the time difference, and PWV ratio is used to assess the arterial stiffness gradient (SG) from proximal to distal. The aim was to investigate segmental upper-limb PWV (ulPWV) differences and the effects of hypertension and or aging on each ulPWV and SG. The study collected multi-waveform signals and conduction distances from 167 healthy individuals and 92 hypertensive patients. The results showed significant differences between ulPWVs (P < 0.001), with increased and then decreased vascular stiffness along the proximal transmission to the distal peripheral artery and then to the finger. Adjusted for age and sex, ulPWVs in hypertension exceeded that of healthy individuals, with significant differences between groups aged ≥ 50 years (P < 0.05). The hrPWV/rfPWV (heart-radial/radial-finger) was reduced in hypertension and differed significantly between the aged ≥ 50 years (P = 0.015); the ratio of baPWV (brachial-ankle) to ulPWV differed significantly between groups (P < 0.05). Hypertension affected the consistency of rfPWV with hfPWV (heart-finger). The findings suggest that segmented ulPWV is instrumental in providing stiffness corresponding to the physiological structure of the vessel. The superimposition of hypertension and or aging exacerbates peripheral arterial stiffness, as well as alteration in stiffness gradient.
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Affiliation(s)
- Jue Wang
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Congcong Jing
- Department of Endocrinology, Seventh People's Hospital of Shanghai, Shanghai, China
| | - Xiaojuan Hu
- Shanghai Collaborative Innovation Center of TCM Health Services, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ji Cui
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Qingfeng Tang
- The University Key Laboratory of Intelligent Perception and Computing of Anhui Province, Anqing Normal University, Anqing, China
| | - Liping Tu
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Shiju Zhao
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Jinlian Huang
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Dandan Guo
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China
| | - Yongzhi Li
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China.
- China Astronaut Research and Training Center, Astronaut Health Center Laboratory, No. 26, Beiqing Road, Haidian District, Beijing, 100094, China.
| | - Jiatuo Xu
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Pudong New District, Shanghai, 201203, China.
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Huang Y, Zhao L, Cai M, Zhu J, Wang L, Chen X, Zeng Y, Zhang L, Shi J, Guo CF. Arteriosclerosis Assessment Based on Single-Point Fingertip Pulse Monitoring Using a Wearable Iontronic Sensor. Adv Healthc Mater 2023; 12:e2301838. [PMID: 37602671 DOI: 10.1002/adhm.202301838] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/09/2023] [Indexed: 08/22/2023]
Abstract
Arteriosclerosis, which appears as a hardened and narrowed artery with plaque buildup, is the primary cause of various cardiovascular diseases such as stroke. Arteriosclerosis is often evaluated by clinically measuring the pulse wave velocity (PWV) using a two-point approach that requires bulky medical equipment and a skilled operator. Although wearable photoplethysmographic sensors for PWV monitoring are developed in recent years, likewise, this technique is often based on two-point measurement, and the signal can easily be interfered with by natural light. Herein, a single-point strategy is reported based on stable fingertip pulse monitoring using a flexible iontronic pressure sensor for heart-fingertip PWV (hfPWV) measurement. The iontronic sensor exhibits a high pressure-resolution on the order of 0.1 Pa over a wide linearity range, allowing the capture of characteristic peaks of fingertip pulse waves. The forward and reflected waves of the pulse are extracted and the time difference between the two waves is computed for hfPWV measurement using Hiroshi's method. Furthermore, a hfPWV-based model is established for arteriosclerosis evaluation with an accuracy comparable to that of existing clinical criteria, and the validity of the model is verified clinically. The work provides a reliable technique that can be used in wearable arteriosclerosis assessment systems.
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Affiliation(s)
- Yi Huang
- Department of Cardiology, Southern University of Science and Technology Hospital (SUSTech-Hospital), Shenzhen, 518071, China
| | - Lingyu Zhao
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Minkun Cai
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Jiaqi Zhu
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liu Wang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, 230026, China
| | - Xinxing Chen
- Shenzhen Key Laboratory of Biomimetic Robotics and Intelligent Systems, Guangdong Provincial Key Laboratory of Human-Augmentation and Rehabilitation Robotics in Universities, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yumin Zeng
- Department of Sports Center, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Liqing Zhang
- Department of Endocrinology, Southern University of Science and Technology Hospital (SUSTech-hospital), Shenzhen, 518071, China
| | - Jidong Shi
- Shenzhen Key Laboratory of Ultraintense Laser and Advanced Material Technology, Center for Advanced Material Diagnostic Technology, College of Engineering Physics, Shenzhen Technology University, Shenzhen, 518118, China
| | - Chuan Fei Guo
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
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Zheng M, Zhang X, Zhao Q, Chen S, Guo X, Wang C, Jonas JB, Wu S, Guo C. The impact of bilateral brachial-ankle pulse wave velocity difference on cardiovascular disease and all-cause mortality. Front Cardiovasc Med 2023; 10:1234325. [PMID: 37868781 PMCID: PMC10588177 DOI: 10.3389/fcvm.2023.1234325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Background This study aims to investigate the association between an elevated bilateral pulse wave velocity difference (BPWVD) and cardiovascular diseases (CVDs) and all-cause mortality. Methods This study included a total of 38,356 participants. A multivariable Cox proportional hazards regression was used to assess the association between high BPWVD and the increased risk of CVDs and all-cause mortality by calculating hazard ratios (HRs) with 95% confidence intervals. Results A total of 1,213 cases of CVDs were identified over a mean duration of 6.19 years, including 886 cases of cerebral infarction (CI), 105 cases of intracerebral hemorrhage (ICH), and 222 cases of myocardial infarction (MI), along with 1,182 cases of all-cause mortality. The median BPWVD was 42 cm/s (19-80 cm/s). After adjusting for all confounders and baseline brachial-ankle PWV (baPWV), our analysis revealed a significant correlation between a higher risk of CVDs, MI, and all-cause mortality with an increase in BPWVD per standard deviation. HRs (95% confidence interval) were found to be 1.06 (1.01-1.11), 1.11 (1.02-1.21), and 1.07 (1.04-1.10), respectively. Among the participants with higher baPWV on the left side, the HRs (95% confidence interval) were 1.08 (1.02-1.14) for CVDs, 1.27 (1.10-1.46) for incident ICH, 1.16 (1.00-1.24) for incident MI, and 1.10 (1.07-1.15) for all-cause mortality, for per standard deviation increase in BPWVD. Conclusions Our findings reveal a significant correlation between elevated BPWVD and the risks of developing CVDs and all-cause mortality. This highlights the importance of thoroughly evaluating BPWVD as a means of detecting individuals at risk for CVDs and mortality.
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Affiliation(s)
- Mengyi Zheng
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Quanhui Zhao
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Xinying Guo
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chi Wang
- Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Caixia Guo
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Stone K, Veerasingam D, Meyer ML, Heffernan KS, Higgins S, Maria Bruno R, Bueno CA, Döerr M, Schmidt-Trucksäss A, Terentes-Printzios D, Voicehovska J, Climie RE, Park C, Pucci G, Bahls M, Stoner L. Reimagining the Value of Brachial-Ankle Pulse Wave Velocity as a Biomarker of Cardiovascular Disease Risk-A Call to Action on Behalf of VascAgeNet. Hypertension 2023; 80:1980-1992. [PMID: 37470189 PMCID: PMC10510846 DOI: 10.1161/hypertensionaha.123.21314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
This review critiques the literature supporting clinical assessment and management of cardiovascular disease and cardiovascular disease risk stratification with brachial-ankle pulse wave velocity (baPWV). First, we outline what baPWV actually measures-arterial stiffness of both large central elastic arteries and medium-sized muscular peripheral arteries of the lower limb. Second, we argue that baPWV is not a surrogate for carotid-femoral pulse wave velocity. While both measures are dependent on the properties of the aorta, baPWV is also strongly dependent on the muscular arteries of the lower extremities. Increased lower-extremity arterial stiffness amplifies and hastens wave reflections at the level of the aorta, widens pulse pressure, increases afterload, and reduces coronary perfusion. Third, we used an established evaluation framework to identify the value of baPWV as an independent vascular biomarker. There is sufficient evidence to support (1) proof of concept; (2) prospective validation; (3) incremental value; and (4) clinical utility. However, there is limited or no evidence to support (5) clinical outcomes; (6) cost-effectiveness; (8) methodological consensus; or (9) reference values. Fourth, we address future research requirements. The majority of the evaluation criteria, (1) proof of concept, (2) prospective validation, (3) incremental value, (4) clinical utility and (9) reference values, can be supported using existing cohort datasets, whereas the (5) clinical outcomes and (6) cost-effectiveness criteria require prospective investigation. The (8) methodological consensus criteria will require an expert consensus statement. Finally, we finish this review by providing an example of a future clinical practice model.
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Affiliation(s)
- Keeron Stone
- Centre for Cardiovascular Health and Ageing, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom (K.S.)
- National Cardiovascular Research Network, Wales (K.S.)
| | - Dave Veerasingam
- Cardiothoracic Surgery, Galway University Hospital, Ireland (D.V.)
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill (M.L.M.)
| | | | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, PARCC, France (R.M.B.)
- Clinical Pharmacology Unit, AP-HP, Hôpital européen Georges Pompidou, Paris, France (R.M.B.)
| | - Celia Alvarez Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain (C.A.B.)
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay (C.A.B.)
| | - Marcus Döerr
- Department of Internal Medicine B, University Medicine Greifswald, Germany (M.D., M.B.)
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise, and Health (A.S.-T.), University of Basel, Switzerland
- Department of Clinical Research, University Hospital Basel (A.S.-T.), University of Basel, Switzerland
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Greece (D.T.-P.)
| | - Jūlija Voicehovska
- Internal Diseases Department, Riga Stradins University, Latvia (J.V.)
- Nephrology and Renal Replacement Clinics, Riga East University Hospital, Latvia (J.V.)
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania (R.E.C.)
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, London, United Kingdom (C.P.)
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Unit of Internal Medicine, "Santa Maria" Terni Hospital, Italy (G.P.)
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany (M.D., M.B.)
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill (S.H., L.S.)
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill (L.S.)
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (L.S.)
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Miki Y, Tanaka A, Tokuda Y, Tobe A, Shirai Y, Yuhara S, Akita S, Furusawa K, Ishii H, Mutsuga M, Murohara T. Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation. J Cardiovasc Med (Hagerstown) 2023; 24:302-307. [PMID: 36938820 DOI: 10.2459/jcm.0000000000001456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Arterial stiffness indices are used to assess the material properties of the arterial wall and are associated with cardiovascular events. Aortic stenosis (AS) is commonly caused by degenerative calcification and can be associated with increased arterial stiffness. However, the clinical implications of arterial stiffness indices in AS patients before and after treatment are unknown. METHODS This single-center observational study enrolled 150 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) for severe AS. The cardio-ankle vascular index (CAVI) was measured before and after TAVI. The patients were divided into two groups according to the CAVI values before and after TAVI: high CAVI group and low CAVI group. Patient and echocardiographic data and clinical outcomes, including cardiac death and hospitalization for heart failure (HF), were compared. RESULTS The pre- and postprocedural CAVI was 7.90 (6.75-9.30) and 9.65 (8.90-10.65), respectively. In the analyses with preprocedural CAVI, preprocedural echocardiographic aortic valve peak flow velocity was significantly lower in the high CAVI group. No significant differences between the two groups were observed in the occurrence of cardiac death or hospitalization for HF. In the analyses with postprocedural CAVI, B-type natriuretic peptide levels and E/e' ratio after TAVI were significantly higher in the high CAVI group. The composite of cardiac death and hospitalization occurrence for HF was significantly higher in the high CAVI group. CONCLUSION CAVI before TAVI is mainly affected by the AS severity, while CAVI after TAVI is associated with left ventricular diastolic dysfunction and late cardiac events, which may reflect arterial stiffness.
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Affiliation(s)
| | | | - Yoshiyuki Tokuda
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | | | | | - Satoshi Yuhara
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Sho Akita
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | | | - Hideki Ishii
- Department of Cardiology.,Department of Cardiology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masato Mutsuga
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya
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Wang J, Miao R, Chen Z, Wang J, Yuan H, Li J, Huang Z. Age-specific association between non-HDL-C and arterial stiffness in the Chinese population. Front Cardiovasc Med 2022; 9:981028. [PMID: 36225964 PMCID: PMC9548648 DOI: 10.3389/fcvm.2022.981028] [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: 06/29/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background While some epidemiological studies have found correlations between non-high-density lipoprotein cholesterol (non-HDL-C) and arterial stiffness, there are still exist controversial and age-stratified analysis are scarce yet. Methods All individuals in this study were recruited in the Third Xiangya Hospital of Central South University from 2012 to 2016. Arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1,400 cm/s. Association between non-HDL-C and arterial stiffness were explored using Cox proportional-hazards model. We also conducted subanalysis stratified by age. Furthermore, restricted cubic splines were used to model exposure-response relationships in cohort sample. Results This cohort study included 7,276 participants without arterial stiffness at baseline. Over a median follow-up of 1.78 years (IQR, 1.03–2.49), 1,669 participants have identified with incident arterial stiffness. In multivariable-adjusted analyses, higher non-HDL-C concentration was associated with incident arterial stiffness with an adjusted hazard ratio (HR) of 1.09 [95% confidence interval (CI), 1.02–1.17] per 1 mmol/L increase. Compared with the lowest tertile, the HR for arterial stiffness with respect to the highest tertile of non-HDL-C was 1.26 (95% CI, 1.07–1.48). The results were similar in the analysis of young participants (age <60 years). Conclusion Our study identified that non-HDL-C as a potential risk factor of arterial stiffness, especially for younger. The clinical benefits of decreasing non-HDL-C concentration should be further considered in the future.
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Affiliation(s)
- Jie Wang
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Rujia Miao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhiheng Chen
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hong Yuan
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- Department of Rehabilitation, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Jing Li
| | - Zheng Huang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Zheng Huang
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Xu J, Zhou H, Cheng Y, Xiang G. Identifying potential signatures for atherosclerosis in the context of predictive, preventive, and personalized medicine using integrative bioinformatics approaches and machine-learning strategies. EPMA J 2022; 13:433-449. [PMID: 36061826 PMCID: PMC9437201 DOI: 10.1007/s13167-022-00289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
Background Atherosclerosis is a major contributor to morbidity and mortality worldwide. Although several molecular markers associated with atherosclerosis have been developed in recent years, the lack of robust evidence hinders their clinical applications. For these reasons, identification of novel and robust biomarkers will directly contribute to atherosclerosis management in the context of predictive, preventive, and personalized medicine (PPPM). This integrative analysis aimed to identify critical genetic markers of atherosclerosis and further explore the underlying molecular immune mechanism attributing to the altered biomarkers. Methods Gene Expression Omnibus (GEO) series datasets were downloaded from GEO. Firstly, differential expression analysis and functional analysis were conducted. Multiple machine-learning strategies were then employed to screen and determine key genetic markers, and receiver operating characteristic (ROC) analysis was used to assess diagnostic value. Subsequently, cell-type identification by estimating relative subsets of RNA transcript (CIBERSORT) and a single-cell RNA sequencing (scRNA-seq) data were performed to explore relationships between signatures and immune cells. Lastly, we validated the biomarkers' expression in human and mice experiments. Results A total of 611 overlapping differentially expressed genes (DEGs) included 361 upregulated and 250 downregulated genes. Based on the enrichment analysis, DEGs were mapped in terms related to immune cell involvements, immune activating process, and inflaming signals. After using multiple machine-learning strategies, dehydrogenase/reductase 9 (DHRS9) and protein tyrosine phosphatase receptor type J (PTPRJ) were identified as critical biomarkers and presented their high diagnostic accuracy for atherosclerosis. From CIBERSORT analysis, both DHRS9 and PTPRJ were significantly related to diverse immune cells, such as macrophages and mast cells. Further scRNA-seq analysis indicated DHRS9 was specifically upregulated in macrophages of atherosclerotic lesions, which was confirmed in atherosclerotic patients and mice. Conclusions Our findings are the first to report the involvement of DHRS9 in the atherogenesis, and the proatherogenic effect of DHRS9 is mediated by immune mechanism. In addition, we confirm that DHRS9 is localized in macrophages within atherosclerotic plaques. Therefore, upregulated DHRS9 could be a novel potential target for the future predictive diagnostics, targeted prevention, patient stratification, and personalization of medical services in atherosclerosis. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-022-00289-y.
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Affiliation(s)
- Jinling Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 Guangdong China
- Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, 430070 Hubei China
| | - Hui Zhou
- Department of General Surgery, Central South University, The Third Xiangya Hospital, Changsha, 410013 Hunan China
| | - Yangyang Cheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 Guangdong China
- Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, 430070 Hubei China
| | - Guangda Xiang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 Guangdong China
- Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, 430070 Hubei China
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11
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Fang Q, Xiang M, Shi J, Zhou Y, Peng Y, Wang S, Liu C, Hong J, Gu W, Wang W, Zhang Y. Subclinical atherosclerosis associates with diabetic retinopathy incidence: a prospective study. Acta Diabetol 2022; 59:1041-1052. [PMID: 35624320 DOI: 10.1007/s00592-022-01897-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/14/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The prospective correlation between subclinical atherosclerosis and diabetic retinopathy (DR) incidence in Chinese patients with type 2 diabetes mellitus (T2DM) remains elusive. METHODS Prospective data were obtained from 2781 patients with diabetes, among whom 1,964 and 2,180 T2DM patients without any and referable DR at baseline, respectively, were included in the analysis. Multivariate analyses were performed using the Cox proportional hazards model. RESULTS Over a median follow-up of 22.2 months (interquartile range 12.7-27.7), 282 (14.36%) and 125 (5.73%) patients developed any and referable DR, respectively. After adjustment for confounders, each standard deviation (SD) increase in brachial-ankle pulse wave velocity (ba-PWV) was associated with 31% (95% confidence interval 1.15-1.50) and 38% (1.14-1.66) higher risks of incident any and referable DR, respectively. Compared with the lowest ba-PWV quartile, the highest ba-PWV quartile had 135% (1.48-3.72) and 293% (1.83-8.44) higher risks of developing any and referable DR, respectively. Per SD increase of pulse pressure (PP) was associated with 22% (1.09-1.38) and 22% (1.02-1.46) higher risks of incident any and referable DR, respectively. The restricted cubic spline models further indicated a significant linear association of baseline subclinical atherosclerosis with referable DR, and a nonlinear association with any DR. In addition, adding the ba-PWV to the prognostic model for DR incidence improved the C-statistic value, the integrated discrimination improvement value, and the net reclassification improvement value (all P < 0.05). CONCLUSIONS Baseline subclinical atherosclerosis was significantly associated with an increased risk of DR incidence, and elevated ba-PWV independently predicted incident DR in T2DM patients.
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Affiliation(s)
- Qianhua Fang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minqi Xiang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingxia Zhou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Peng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shujie Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cong Liu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Hong
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqiong Gu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yifei Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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Li L, Xie W, Li Q, Hong H. The positive correlation between brachial-ankle pulse wave velocity and aortic diameter in Chinese patients with diabetes. J Clin Hypertens (Greenwich) 2022; 24:1059-1067. [PMID: 35894781 PMCID: PMC9380158 DOI: 10.1111/jch.14548] [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: 04/13/2022] [Revised: 06/16/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
Aortic dilation is associated with an increased risk of cardiovascular diseases. Increased brachial-ankle pulse wave velocity (baPWV) is a hallmark of vascular aging and arterial stiffness, as well as an important risk factor for vascular disease. This study aimed to retrospectively analyze the correlation between baPWV and aortic diameter (AoD) of inpatients with diabetes. A total of 1294 diabetic patients with the detailed medical records were investigated. Arterial stiffness was assessed using baPWV and AoD using echocardiography. The results showed that baPWV and AoD increase with age (p <0.05). Based on multiple linear regression analysis, age, systolic and diastolic blood pressure, left atrial diameter, right ventricle diameter, pulmonary artery diameter, peak velocity of early transmitral blood flow/peak velocity of late transmitral blood flow, and baPWV independently correlated with AoD in patients with diabetes. Additionally, an increased risk of aortic dilation occurred in the highest baPWV quartile compared with the lowest quartile (p <0.001). In conclusion, baPWV is independently and positively associated with AoD. Hence, prospective cohorts or randomized clinical trials will be the next step to further determine whether interventions designed to improve arterial stiffness in patients with diabetes will reduce the risk of aortic dilation.
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Affiliation(s)
- Liping Li
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Wenhui Xie
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Qingqing Li
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Huashan Hong
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Department of Cardiology, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
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13
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Lin CC, Li CI, Liu CS, Lin CH, Yang SY, Li TC. Prediction of all-cause and cardiovascular mortality using ankle-brachial index and brachial-ankle pulse wave velocity in patients with type 2 diabetes. Sci Rep 2022; 12:11053. [PMID: 35773381 PMCID: PMC9247028 DOI: 10.1038/s41598-022-15346-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/22/2022] [Indexed: 12/24/2022] Open
Abstract
Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are used as non-invasive indicators for detecting atherosclerosis and arterial stiffness, two well-known predictors of mortality in patients with type 2 diabetes mellitus (T2DM). ABI and baPWV have independent associations with mortality; however, their joint and interactive effects on mortality have not been assessed in patients with T2DM. This work aims to evaluate the independent, joint, and interactive associations of ABI and baPWV with all-cause and expanded cardiovascular disease (CVD) mortality in patients with T2DM. This observational study included 2160 patients with T2DM enlisted in the Diabetes Care Management Program database of China Medical University Hospital from 2001 to 2016 and then followed their death status until August 2021. Cox proportional hazard models were used to evaluate the independent, joint, and interactive effects of ABI and baPWV on the risk of all-cause and expanded CVD mortality. A total of 474 patient deaths occurred after a mean follow-up of 8.4 years, and 268 of which were attributed to cardiovascular events. Abnormal ABI (≤ 0.9) and highest baPWV quartile were independently associated with increased risks of all-cause [ABI: hazard ratio (HR) 1.67, 95% confidence interval (CI) 1.30–2.11; baPWV: 1.63, 1.16–2.27] and expanded CVD mortality (ABI: 2.21, 1.62–3.02; baPWV: 1.75, 1.09–2.83). The combination of abnormal ABI (≤ 0.9) and highest baPWV quartile was associated with a significantly higher risk of all-cause (4.51, 2.50–8.11) and expanded CVD mortality (9.74, 4.21–22.51) compared with that of the combination of normal ABI and lowest baPWV quartile. Significant interactions were observed between ABI and baPWV in relation to all-cause and expand CVD mortality (both p for interaction < 0.001). Through their independent, joint, and interactive effects, ABI and baPWV are significant parameters that can improve the prediction of all-cause and expanded CVD mortality in patients with T2DM and help identify high-risk patients who may benefit from diabetes care.
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Affiliation(s)
- Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan R.O.C.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan R.O.C.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan R.O.C
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan R.O.C.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan R.O.C
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan R.O.C.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan R.O.C.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan R.O.C
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan R.O.C.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan R.O.C
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung City, 406040, Taiwan R.O.C
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung City, 406040, Taiwan R.O.C.. .,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan R.O.C..
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14
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Kim HM, Rhee TM, Kim HL. Integrated approach of brachial-ankle pulse wave velocity and cardiovascular risk scores for predicting the risk of cardiovascular events. PLoS One 2022; 17:e0267614. [PMID: 35476644 PMCID: PMC9045657 DOI: 10.1371/journal.pone.0267614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) atherosclerotic cardiovascular disease (ASCVD) risk score may be insufficient for accurate prediction of major adverse cardiac events (MACE) in Asians. This study was performed to investigate whether brachial-ankle pulse wave velocity (baPWV) has additional prognostic value to the risk score estimated by the ACC/AHA pooled cohort equations (PCEs). Methods A total of 6,359 patients (3,534 men and 2,825 women) aged 40–79 years without documented cardiovascular disease who underwent baPWV measurement were retrospectively analyzed. Cardiovascular risk scores were calculated using the 2013 ACC/AHA PCEs. Cardiovascular events, including cardiac death, non-fatal myocardial infarction, coronary revascularization and ischemic stroke, were assessed. Results During a median follow-up period of 4.0 years (interquartile range 1.7–6.1 years), cardiovascular events occurred in 129 patients (2.0%). The receiver operating characteristic curve analysis showed that baPWV was stronger in the detection of cardiovascular events than the 2013 ACC/AHA risk score (area under the curve: 0.70 versus 0.62, p<0.001). In the multivariable Cox regression analysis, both baPWV and 2013 ACC/AHA risk score were independently associated with the occurrence of clinical events (p <0.001 for each). The baPWV had incremental prognostic value to the 2013 ACC/AHA risk score in predicting clinical events (global chi-square from 21.23 to 49.51, p<0.001). Conclusion The baPWV appears to be a strong predictor of the risk of cardiovascular events in Koreans. Measuring baPWV in addition to the 2013 ACC/AHA risk score helps identify individuals at risk for MACE aged 40–79 years without previous cardiovascular diseases.
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Affiliation(s)
- Hyue Mee Kim
- Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Tae-Min Rhee
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
- * E-mail:
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15
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Logan JK, Ayers MP. Noninvasive Imaging for the Asymptomatic Patient: How to Use Imaging to Guide Treatment Goals? Med Clin North Am 2022; 106:377-388. [PMID: 35227437 DOI: 10.1016/j.mcna.2021.11.012] [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: 11/24/2022]
Abstract
Imaging subclinical atherosclerosis identifies individuals at higher risk of cardiovascular disease through direct visualization before events occur so that preventative measures can be taken. Coronary artery calcium (CAC) scans are the most widely used and studied to identify subclinical atherosclerosis and are most useful in men older than 40 years and women older than 50 years. Coronary computed tomography angiography has high prognostic value and might be the best modality for assessing subclinical atherosclerosis with incremental increase in predictive value over CAC. Ankle-brachial indexes are specific markers for cardiovascular risk but are a less sensitive tool for risk assessment.
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Affiliation(s)
- Juliette Kathleen Logan
- Division of Cardiovascular Medicine, University of Virginia, Heart and Vascular Center Fontaine, 500 Ray C. Hunt Drive, Charlottesville, VA 22903, USA.
| | - Michael Parker Ayers
- Division of Cardiovascular Medicine, University of Virginia, Heart and Vascular Center Fontaine, 500 Ray C. Hunt Drive, Charlottesville, VA 22903, USA.
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16
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Duan Q, Zhang D, Dong Q, Liao K, Yang Y, Ye L, Ge P, Qin S. Impact of Brachial-Ankle Pulse Wave Velocity on Myocardial Work by Non-invasive Left Ventricular Pressure-Strain in Non-hypertensive and Hypertensive Patients With Preserved Left Ventricular Ejection Fraction. Front Cardiovasc Med 2022; 9:814326. [PMID: 35224047 PMCID: PMC8866308 DOI: 10.3389/fcvm.2022.814326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Data regarding the influence of arterial stiffness on myocardial work (MW) has been scarce. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and MW by non-invasive left ventricular pressure–strain in a population of non-hypertensive and hypertensive individuals. Methods Two hundred and eight participants (104 hypertensive and 104 non-hypertensive individuals) were prospectively enrolled into the study. All participants underwent conventional echocardiography, as well as 2D speckle-tracking echocardiography to assess MW by non-invasive left ventricular pressure–strain and global longitudinal strain (GLS). baPWV measurements were made at the same day as the echocardiography. Then, participants were categorized according to baPWV tertiles. Correlation between baPWV and MW were analyzed. Predicting ability of baPWV for abnormal WM was analyzed using receiver operating characteristic (ROC) curve. Results The median baPWV from the low to high tertile groups were 1286.5 (1197.5–1343.5), 1490.0 (1444.5–1544.0), and 1803.8(1708.3–1972.0) cm/s, respectively. In simple linear regression analysis, baPWV had a significant positive association with global work index (GWI), global constructed work (GCW), and global wasted work (GWW), and a negative association with global work efficiency (GWE). The association remained significant after adjusting for major confounding factors in multiple linear regression analysis. The areas under the ROC curve of baPWV for predicting abnormal GWI, GCW, GWW, and GWE were 0.653, 0.666, 0.725, and 0.688, respectively (all p < 0.05). Conclusions BaPWV is significantly associated with all four components of MW using non-invasive left ventricular pressure-strain method in a mixed population of non-hypertensive and hypertensive individuals.
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Affiliation(s)
- Qin Duan
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
| | - Dongying Zhang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Dong
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kangla Liao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunjin Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liu Ye
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
| | - Ping Ge
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
- *Correspondence: Ping Ge
| | - Shu Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Shu Qin
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17
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Plunde O, Franco-Cereceda A, Bäck M. Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement. Front Cardiovasc Med 2021; 8:754371. [PMID: 34957246 PMCID: PMC8692982 DOI: 10.3389/fcvm.2021.754371] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Valvular and arterial function are tightly intertwined, both in terms of structural changes and hemodynamics. While proximal valvulo-vascular coupling contributes to the cardiovascular consequences of aortic stenosis, less is known on how peripheral arterial stiffness relates to aortic valve disease. Previous studies have shown conflicting results regarding the impact of aortic valve replacement on arterial stiffness. The aim of the present study was therefore to determine predictors of arterial stiffness in patients with and without aortic valve disease undergoing cardiac surgery. Cardio ankle vascular index (CAVI) and carotid femoral pulse wave velocity (cfPWV) were measured to determine arterial stiffness the day before and 3 days after surgery for either ascending aortic or aortic valve disease. Stratification on indication for surgery revealed that CAVI was significantly lower in patients with aortic valve stenosis (n = 45) and aortic valve regurgitation (n=30) compared with those with isolated ascending aortic dilatation (n = 13). After surgery, a significant increased CAVI was observed in aortic stenosis (median 1.34, IQR 0.74-2.26, p < 0.001) and regurgitation (median 1.04, IQR 0.01-1.49, p = 0.003) patients while cfPWV was not significantly changed. Age, diabetes, low body mass index, low pre-operative CAVI, as well as changes in ejection time were independently associated with increased CAVI after surgery. The results of the present study suggest aortic valve disease as cause of underestimation of arterial stiffness when including peripheral segments. We report cardiovascular risk factors and pinpoint the hemodynamic aspect ejection time to be associated with increased CAVI after aortic valve surgery.
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Affiliation(s)
- Oscar Plunde
- Unit of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
- Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Bäck
- Unit of Cardiovascular Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Theme Heart and Vessels, Division of Valvular and Coronary Disease, Karolinska University Hospital, Stockholm, Sweden
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18
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Zhao Y, Huang L, Zhou X, Liu J, Yu J. The early diagnostic value of ankle-brachial index combined with feet electrochemical skin conductance for peripheral artery disease in type 2 diabetes. J Diabetes Investig 2021; 13:525-531. [PMID: 34608767 PMCID: PMC8902391 DOI: 10.1111/jdi.13687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/10/2021] [Accepted: 10/03/2021] [Indexed: 12/24/2022] Open
Abstract
Aims/Introduction In this paper, we focused on exploring the diagnostic and predictive clinical utility of ankle‐brachial index (ABI) in combination with feet electrochemical skin conductance (FESC) for peripheral artery disease (PAD) in Chinese patients with type 2 diabetes mellitus (T2DM). Materials and Methods Overall, 183 Chinese T2DM patients were enrolled in this study. The patients were classified into three groups: Group 1 comprised of uncomplicated type 2 diabetics (n = 36), Group 2 consisted of patients with diabetic peripheral neuropathy (n = 103) whereas Group 3 patients displayed peripheral artery disease (n = 44). All patients underwent Sudoscan test using a Sudoscan (Paris, France) and ABI assessment. Results Multivariate logistic regression models revealed that FESC was an independent risk factor of developing PAD in patients with type 2 diabetes. The AUC for diagnostic, positive predictive and negative predictive value of ABI in combination with FESC for PAD were 0.907, 0.733 and 0.920, respectively. The specificity and sensitivity of ABI in combination with FESC for PAD were 0.914 and 0.750, respectively. Conclusions Ankle‐brachial index in combination with FESC can accurately be used in early diagnosis of PAD.
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Affiliation(s)
- Yun Zhao
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Liji Huang
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiqiao Zhou
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jingshun Liu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiangyi Yu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Li Q, Xie W, Li L, Wang L, You Q, Chen L, Li J, Ke Y, Fang J, Liu L, Hong H. Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning. Front Physiol 2021; 12:714195. [PMID: 34497538 PMCID: PMC8419456 DOI: 10.3389/fphys.2021.714195] [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: 05/26/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023] Open
Abstract
Background Arterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed. Methods Least absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool. Results The predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points. Conclusion The gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.
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Affiliation(s)
- Qingqing Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenhui Xie
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liping Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lijing Wang
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qinyi You
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lu Chen
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Li
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yilang Ke
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jun Fang
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Libin Liu
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huashan Hong
- Fujian Key Laboratory of Vascular Aging, Department of Geriatrics, Department of Cardiology, Department of Cardiac Surgery, Fujian Heart Disease Center, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
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Li Q, Xie W, Li L, Wang L, You Q, Chen L, Li J, Ke Y, Fang J, Liu L, Hong H. Development and Validation of a Prediction Model for Elevated Arterial Stiffness in Chinese Patients With Diabetes Using Machine Learning. Front Physiol 2021. [DOI: 10.3389/fphys.2021.714195
expr 962169460 + 908583142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BackgroundArterial stiffness assessed by pulse wave velocity is a major risk factor for cardiovascular diseases. The incidence of cardiovascular events remains high in diabetics. However, a clinical prediction model for elevated arterial stiffness using machine learning to identify subjects consequently at higher risk remains to be developed.MethodsLeast absolute shrinkage and selection operator and support vector machine-recursive feature elimination were used for feature selection. Four machine learning algorithms were used to construct a prediction model, and their performance was compared based on the area under the receiver operating characteristic curve metric in a discovery dataset (n = 760). The model with the best performance was selected and validated in an independent dataset (n = 912) from the Dryad Digital Repository (https://doi.org/10.5061/dryad.m484p). To apply our model to clinical practice, we built a free and user-friendly web online tool.ResultsThe predictive model includes the predictors: age, systolic blood pressure, diastolic blood pressure, and body mass index. In the discovery cohort, the gradient boosting-based model outperformed other methods in the elevated arterial stiffness prediction. In the validation cohort, the gradient boosting model showed a good discrimination capacity. A cutoff value of 0.46 for the elevated arterial stiffness risk score in the gradient boosting model resulted in a good specificity (0.813 in the discovery data and 0.761 in the validation data) and sensitivity (0.875 and 0.738, respectively) trade-off points.ConclusionThe gradient boosting-based prediction system presents a good classification in elevated arterial stiffness prediction. The web online tool makes our gradient boosting-based model easily accessible for further clinical studies and utilization.
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The Use of Subclinical Atherosclerosis Imaging to Guide Preventive Cardiology Management. Curr Cardiol Rep 2021; 23:61. [PMID: 33961134 DOI: 10.1007/s11886-021-01490-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF THE REVIEW Clinical atherosclerotic cardiovascular disease (ASCVD) requires years to manifest, providing a window of opportunity for preventive cardiovascular management. Subclinical atherosclerosis imaging leverages this long latency period to estimate and improve future ASCVD risk. RECENT FINDINGS Coronary artery calcium (CAC) scoring has the most robust data in the detection of subclinical atherosclerosis. CAC scan significantly enhances cardiovascular risk stratification in addition to traditional risk models. Coronary computed tomography angiography data show similar strengths in subclinical atherosclerosis detection in addition to plaque morphology characterization with inherent limitations. Carotid intima-media thickness and ankle-brachial index are other modalities whose predictive value becomes incremental when added to the aforementioned modalities. When added to traditional risk models, subclinical atherosclerosis imaging modalities personalize future ASCVD risk stratification and assist in the initiation and rate of intensification of preventive therapies. Emerging imaging techniques exist but further research is required for primetime clinical use.
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Nakamizo T, Cologne J, Cordova K, Yamada M, Takahashi T, Misumi M, Fujiwara S, Matsumoto M, Kihara Y, Hida A, Ohishi W. Radiation effects on atherosclerosis in atomic bomb survivors: a cross-sectional study using structural equation modeling. Eur J Epidemiol 2021; 36:401-414. [PMID: 33742296 PMCID: PMC8076141 DOI: 10.1007/s10654-021-00731-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
Past reports indicated that total-body irradiation at low to moderate doses could be responsible for cardiovascular disease risks, but the mechanism remains unclear. The purpose of this study was to investigate the association between radiation exposure and atherosclerosis, an underlying pathology of cardiovascular diseases, in the Japanese atomic bomb survivors. We performed a cross-sectional study measuring 14 clinical-physiological atherosclerosis indicators during clinical exams from 2010 to 2014 in 3274 participants of the Adult Health Study cohort. Multivariable analyses were performed by using a structural equation model with latent factors representing underlying atherosclerotic pathologies: (1) arterial stiffness, (2) calcification, and (3) plaque as measured with indicators chosen a priori on the basis of clinical-physiological knowledge. Radiation was linearly associated with calcification (standardized coefficient per Gy 0.15, 95 % confidence interval: CI [0.070, 0.23]) and plaque (0.11, 95 % CI [0.029, 0.20]), small associations that were comparable to about 2 years of aging per Gy of radiation exposure, but not with arterial stiffness (0.036, 95 % CI [− 0.025, 0.095]). The model fitted better and had narrower confidence intervals than separate ordinary regression models explaining individual indicators independently. The associations were less evident when the dose range was restricted to a maximum of 2 or 1 Gy. By combining individual clinical-physiological indicators that are correlated because of common, underlying atherosclerotic pathologies, we found a small, but significant association of radiation with atherosclerosis.
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Affiliation(s)
- Tomoki Nakamizo
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan.
| | - John Cologne
- Department of Statistics, RERF, Hiroshima, Japan
| | | | | | - Tetsuya Takahashi
- Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan
| | | | - Saeko Fujiwara
- Department of Clinical Studies, RERF, Hiroshima, Japan.,Faculty of Pharmacy, Yasuda Women's University, Hiroshima, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.,Department of Neurology, Sakai City Medical Center, Osaka, Japan
| | - Yasuki Kihara
- Department of Clinical Studies, RERF, Hiroshima, Japan.,Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan.,Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Ayumi Hida
- Department of Clinical Studies, Radiation Effects Research Foundation (RERF), Nagasaki, Japan
| | - Waka Ohishi
- Department of Clinical Studies, RERF, Hiroshima, Japan
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Vater AM, Prantl L, Noll M, Lech L, Jakubietz M, Schmidt K, Kickuth R, Meffert R, Jakubietz R. [Vascular diagnostics before microvascular tissue transfer on the lower extremities : An algorithm]. Unfallchirurg 2021; 125:66-72. [PMID: 33725156 DOI: 10.1007/s00113-021-00988-7] [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] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Microsurgical free flap transfer plays a key role in soft tissue reconstruction of the lower extremities. Through close cooperation between plastic and orthopedic surgery, great progress and success in limb salvage could be achieved over the last decades. The risk for extremity malperfusion is especially high in older patients and after trauma. To maximize the success rate for free flap transfer there is need for interdisciplinary clinical examination and diagnostics. In addition to clinical methods radiological procedures are necessary to evaluate and optimize lower extremity perfusion before surgery.Vascular ultrasound provides important information about the arterial and venous status; however, DSA, CTA and MRA are well-established and exact methods to evaluate arterial inflow. The use of less invasive methods makes it much more feasible, economic and comfortable to perform preoperative selection of patients requiring interventional procedures.In the case of intraluminal stenosis without any option for PTA, a vascular surgeon can be involved at an early stage to evaluate further surgical options. In some cases, similar surgical revascularization and free flap transfer can be performed in a single surgery. The aim of this study is to implement a standardized algorithm for preoperative examination and radiological diagnostics before reconstructive surgery of the lower extremity.
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Affiliation(s)
- Adrian Matthias Vater
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.
| | - Lukas Prantl
- Plastische, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Moritz Noll
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland
| | - Laura Lech
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Michael Jakubietz
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland
| | - Karsten Schmidt
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland
| | - Ralph Kickuth
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Rainer Meffert
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland
| | - Rafael Jakubietz
- Klinik und Poliklinik für Unfall- Hand- Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland
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Effect of Brachial-Ankle Pulse Wave Velocity Combined with Waist-to-Hip Ratio on Cardiac and Cerebrovascular Events. Am J Med Sci 2021; 362:135-142. [PMID: 33621529 DOI: 10.1016/j.amjms.2021.02.014] [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: 04/28/2020] [Revised: 09/05/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Abdominal obesity and brachial-ankle pulse wave velocity (baPWV) are indicators of atherosclerosis. But few studies have shown the relationship between baPWV combined with waist-hip ratio (WHR) and cardiac-cerebrovascular events (CCVEs). METHODS A total of 18944 subjects from Kailuan study were enrolled in this study. Follow-up was conducted three times over 4.82±1.92 years. All the participants were divided into 4 groups according to baPWV and WHR status on baseline: Q1 (normal baPWV, normal WHR), Q2 (normal baPWV, increased WHR), Q3 (increased baPWV, normal WHR) and Q4 (increased baPWV, increased WHR). The incidence and risk factors and further analysis of hypertension subgroups were analyzed. RESULTS During follow-up, 88 myocardial infarctions (MI), 278 cerebral ischemic strokes (CI), 285 strokes and 371 CCVEs occurred, with the cumulative incidence of 0.46%, 1.47%, 1.50%, and 1.96%, respectively. Multivariate Cox regression analysis revealed the risk of CI, stroke and CCVEs was higher in patients with increased baPWV and increased WHR than in the other three groups, followed by the Q3 group (increased baPWV, normal WHR) and Q2 group (normal baPWV, increased WHR) group (all adjusted P<0.01). Further hypertension subgroups analysis showed similar results, but differences were more significant among hypertensive patients. Accordingly, the combination of baPWV and WHR increased the risk of total CCVEs, especially in hypertensive patients. CONCLUSIONS BaPWV and WHR were important risk factors for CCVEs and had synergistic effects. When baPWV increased, WHR may contribute more to the risk of CCVEs in hypertensive patients.
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Sang Y, Cao M, Wu X, Ruan L, Zhang C. Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression. BMC Cardiovasc Disord 2021; 21:34. [PMID: 33441079 PMCID: PMC7807880 DOI: 10.1186/s12872-020-01846-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to identify the most informative measures of serum lipids and their calculated ratios in terms of arterial stiffness progression risk. Methods Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 659 healthy males (47.4 ± 10.7 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. Elevated baPWV was defined as baPWV ≥ 1400 cm/s. Results Over the follow-up period, the mean baPWV value increased from 1340 cm/s to 1410 cm/s, and 331 individuals increased/persisted with high baPWV (outcome 1). Among the 448 subjects who had normal baseline baPWV, 100 incident elevated baPWV occurred (outcome 2). Only baseline logTG (OR 1.64 [95% CI: 1.14–2.37] for outcome 1; 1.89 [1.14–3.17] for outcome 2) and logTG/HDL-C (1.54 [1.15–2.10] for outcome 1; 1.60 [1.05–2.45] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables. Conclusions Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident elevated baPWV, and they performed more effectively than other lipid variables in identifying healthy men at high risk of arterial stiffness progression.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Arita Y, Ogasawara N, Hasegawa S. Correlations Between the Ankle-Brachial Index, Percentage of Mean Arterial Pressure, and Upstroke Time for Endovascular Treatment. Cardiol Res 2020; 11:392-397. [PMID: 33224385 PMCID: PMC7666591 DOI: 10.14740/cr1146] [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: 08/09/2020] [Accepted: 08/22/2020] [Indexed: 01/22/2023] Open
Abstract
Background The ankle-brachial index (ABI), percentage of mean arterial pressure (%MAP), and upstroke time (UT) are indicators to diagnose lower-extremity peripheral artery disease (PAD). However, the respective relationship between these parameters is unknown. In this study, we analyzed the correlations between ABI, %MAP, and UT and examined their clinical usefulness for endovascular treatment (EVT). Methods Sixty-three consecutive subjects who underwent successful EVT for aortoiliac to femoropopliteal artery diseases were analyzed. The ABI, %MAP, and UT were measured using an automated oscillometric device. Results There were significant correlations between the ABI and %MAP (r = -0.425, P < 0.001), the ABI and UT (r = -0.304, P = 0.017), and %MAP and UT (r = 0.368, P = 0.003). In terms of lesion length, there was a significant difference in %MAP after EVT (focal, 42.6%; short, 44.5%; intermediate, 47.1%; long, 49.1%; P = 0.015). There was minimal %MAP improvement in the case of a long lesion length (focal, -8.83%; short, -5.10%; intermediate, -3.00%; long, -1.50%; P = 0.006). Excessive lesion calcification also hindered %MAP improvement (grade 0, -7.16%; grade 1, -5.52%; grade 2, -4.71%; grade 3, -2.80%; grade 4, -1.00%; P = 0.049). Patients who underwent re-EVT (an average of 10.1 months after initial EVT) had minimal %MAP improvement (-2.76% vs. -5.95%, P = 0.035) at the first outpatient visit (an average of 3.3 weeks after EVT). Conclusions In conclusion, the ABI, %MAP, and UT are correlated with each other. If the length of the lesion is long and there is excessive calcification, %MAP improvement is minimal. Moreover, minimal %MAP improvement may be an indicator of future restenosis.
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Affiliation(s)
- Yoh Arita
- Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka, 553-0003, Japan
| | - Nobuyuki Ogasawara
- Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka, 553-0003, Japan
| | - Shinji Hasegawa
- Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka, 553-0003, Japan
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Sun ZJ, Hsiao HJ, Cheng HJ, Chou CY, Lu FH, Yang YC, Wu JS, Chang CJ. Relationship between Kidney Stone Disease and Arterial Stiffness in a Taiwanese Population. J Clin Med 2020; 9:jcm9061693. [PMID: 32498283 PMCID: PMC7355902 DOI: 10.3390/jcm9061693] [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: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022] Open
Abstract
Previous studies examining the association between kidney stone disease (KSD) and arterial stiffness have been limited. Both age and gender have been found to have an impact on KSD, but their influence on the relationship between KSD and increased arterial stiffness is unclear. This study included 6694 subjects from October 2006 to August 2009. The diagnosis of kidney stone was based on the results of ultrasonographic examination. Increased arterial stiffness was defined as right-sided brachial-ankle pulse wave velocity (baPWV) ≥ 14 m/s. Associations between KSD and increased arterial stiffness were analyzed using multiple logistic regression models. KSD was positively related to increased arterial stiffness in both male and female groups (males: odds ratio [OR], 1.306; 95% confidence interval [CI], 1.035–1.649; females: OR, 1.585; 95% CI, 1.038–2.419) after adjusting for confounding factors. Subgroup analysis by age group (<50 and ≥50 years) showed a significant positive relationship only in the groups ≥ 50 years for both genders (males: OR, 1.546; 95% CI, 1.111–2.151; females: OR, 1.783; 95% CI, 1.042–3.054), but not in the groups < 50 years. In conclusion, KSD is associated with a higher risk of increased arterial stiffness in individuals aged ≥ 50 years, but not in those aged < 50 years for both genders.
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Affiliation(s)
- Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
| | - Hsuan-Jung Hsiao
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Chieh-Ying Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, No.345, Zhuangjing Rd., Douliu City, Yunlin 64043, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 70403, Taiwan; (Z.-J.S.); (H.-J.H.); (H.-J.C.); (C.-Y.C.); (F.-H.L.); (Y.-C.Y.)
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No.539, Zhongxiao Rd., East Dist., Chiayi 60002, Taiwan
- Correspondence: (J.-S.W.); (C.-J.C.); Tel.: +886-6-2353535 (J.-S.W.)
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Sang Y, Wu X, Miao J, Cao M, Ruan L, Zhang C. Determinants of Brachial-Ankle Pulse Wave Velocity and Vascular Aging in Healthy Older Subjects. Med Sci Monit 2020; 26:e923112. [PMID: 32445331 PMCID: PMC7260998 DOI: 10.12659/msm.923112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vascular aging is characterized by increasing arterial stiffness as measured by pulse wave velocity. The present study evaluated the factors influencing vascular aging in Chinese healthy older subjects. MATERIAL AND METHODS Disease- and treatment-free aged (≥60 years) participants were recruited from 2014 to 2019. Cardiometabolic risk factors and brachial-ankle pulse wave velocity (baPWV) were assessed. We defined healthy vascular aging (HVA) as the lowest 10% and early vascular aging (EVA) as the highest 10% of the baPWV distribution, after adjustment for age and blood pressure (BP). We fitted linear and logistic regression models to assess the determinants. RESULTS In all, 794 subjects (mean age 66.5±6.8 years, 71.0% male) were recruited; the 10th and 90th percentiles of baPWV were 1278 cm/s and 1955 cm/s, respectively. Age, BP, heart rate, and triglycerides were all positively associated with baPWV, whereas male subjects and body mass index (BMI) were negatively associated with baPWV. The number of participants diagnosed with either HVA or EVA was 80. Logistic regression models showed that sex, BMI, heart rate, and triglycerides were associated with HVA and EVA after adjustment for age, BP, and other confounding factors. CONCLUSIONS Male, high BMI, low heart rate, and low triglycerides are protective factors for vascular aging in the healthy aged population. Management of BMI, heart rate, triglycerides in a reasonable range may help to alleviate the vascular aging process.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Jianping Miao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland)
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Lu Y, Pechlaner R, Cai J, Yuan H, Huang Z, Yang G, Wang J, Chen Z, Kiechl S, Xu Q. Trajectories of Age-Related Arterial Stiffness in Chinese Men and Women. J Am Coll Cardiol 2020; 75:870-880. [DOI: 10.1016/j.jacc.2019.12.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
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Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis. DISEASE MARKERS 2019; 2019:5270159. [PMID: 31781303 PMCID: PMC6874870 DOI: 10.1155/2019/5270159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/22/2019] [Indexed: 01/20/2023]
Abstract
Patients with end-stage renal disease are at an increased risk of cardiovascular diseases and associated mortality. Acoustic cardiography is a technique in which cardiac acoustic data is synchronized with electric information to detect and characterize heart sounds and detect heart failure early. The aim of this study was to investigate acoustic cardiographic parameters before and after hemodialysis (HD) and their correlations with ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and ratio of brachial preejection period to ejection time (bPEP/bET) obtained from an ABI-form device in HD patients. This study enrolled 162 HD patients between October 2016 and April 2018. Demographic, medical, and laboratory data were collected. Acoustic cardiography was performed before and after HD to assess parameters including third heart sound (S3), fourth heart sound (S4), systolic dysfunction index (SDI), electromechanical activation time (EMAT), and left ventricular systolic time (LVST). The mean age of the enrolled patients was 60.4 ± 10.9 years, and 86 (53.1%) patients were male. S4 (p < 0.001) and LVST (p < 0.001) significantly decreased after HD, but EMAT (p < 0.001) increased. Multivariate forward linear regression analysis showed that EMAT/LVST before HD was negatively associated with albumin (unstandardized coefficient β = ‐0.076; p = 0.004) and ABI (unstandardized coefficient β = ‐0.115; p = 0.011) and positively associated with bPEP/bET (unstandardized coefficient β = 0.278; p = 0.003). Screening HD patients with acoustic cardiography may help to identify patients at a high risk of malnutrition, peripheral artery disease, and left ventricular systolic dysfunction.
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 DOI: 10.3389/fcvm.2019.00041/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 05/25/2023] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Kim HL, Kim SH. Pulse Wave Velocity in Atherosclerosis. Front Cardiovasc Med 2019; 6:41. [PMID: 31024934 PMCID: PMC6465321 DOI: 10.3389/fcvm.2019.00041] [Citation(s) in RCA: 201] [Impact Index Per Article: 40.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Early detection of subclinical atherosclerosis is important to reduce patients' cardiovascular risk. However, current diagnostic strategy focusing on traditional risk factors or using risk scoring is not satisfactory. Non-invasive imaging tools also have limitations such as cost, time, radiation hazard, renal toxicity, and requirement for specialized techniques or instruments. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress by arterial stiffening causes endothelial dysfunction, accelerates the formation of atheroma, and stimulates excessive collagen production and deposition in the arterial wall, leading to the progression of atherosclerosis. Pulse wave velocity (PWV), the most widely used measure of arterial stiffness, has emerged as a useful tool for the diagnosis and risk stratification of cardiovascular disease (CVD). The measurement of PWV is simple, non-invasive, and reproducible. There have been many clinical studies and meta-analyses showing the association between PWV and coronary/cerebral/carotid atherosclerosis. More importantly, longitudinal studies have shown that PWV is a significant risk factor for future CVD independent of well-known cardiovascular risk factors. The measurement of PWV may be a useful tool to select subjects at high risk of developing subclinical atherosclerosis or CVD especially in mass screening.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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Zhou S, Zhang Y, Kong Z, Loprinzi PD, Hu Y, Ye J, Liu S, Yu JJ, Zou L. The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050753. [PMID: 30832288 PMCID: PMC6427726 DOI: 10.3390/ijerph16050753] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/23/2019] [Accepted: 02/26/2019] [Indexed: 01/23/2023]
Abstract
Objective: The purpose of this study was to investigate the effects of Tai Chi (TC) on arterial stiffness, physical function of lower-limb, and cognitive ability in adults aged over 60. Methods: This study was a prospective and randomized 12-week intervention trial with three repeated measurements (baseline, 6, and 12 weeks). Sixty healthy adults who met the inclusion criteria were randomly allocated into three training conditions (TC-24, TC-42, and TC-56) matched by gender, with 20 participants (10 males, 10 females) in each of the three groups. We measured the following health outcomes, including markers of atherosclerosis, physical function (leg power, and static and dynamic balance) of lower-limb, and cognitive ability. Results: When all three TC groups (p < 0.05) have showed significant improvements on these outcomes but overall cognitive ability at 6 or 12 weeks training period, TC-56 appears to have superior effects on arterial stiffness and static/dynamic balance in the present study. Conclusions: Study results of the present study add to growing body of evidence regarding therapeutic TC for health promotion and disease prevention in aging population. Future studies should further determine whether TC-42 and TC-56 are beneficial for other non-Chinese populations, with rigorous research design and follow-up assessment.
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Affiliation(s)
- Shengwen Zhou
- Department of Chinese Martial Arts, College of Sport Science, Hunan University of Science and Technology, Yongzhou 425100, China.
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seuoul 08826, Korea.
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China.
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS 36877, USA.
| | - Yang Hu
- Sports Science Research Center, Beijing Sport University, Beijing 100084, China.
| | - Jiajie Ye
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, China.
| | - Shijie Liu
- Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China.
| | - Jane Jie Yu
- Sports and Exercise Psychology Laboratory, Department of Sports, Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Liye Zou
- Lifestyle (Mind-Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China.
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Abstract
Background Brachial–ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) are indices of arterial stiffness, and several studies have used these indices. However, there is no comprehensive review of these parameters in the prognostic significance. Methods The aim of this study was to review the articles exploring the prognostic significance of these parameters. Articles demonstrating independent significance after multivariate analysis on the Cox proportional hazards model were defined as “successful.” The success rate was compared using Fisher’s exact test. In addition, multivariate logistic regression analysis was performed to explore the independent determinants of the success of prognostic prediction. Results The success rate of the baPWV articles (65.7% [46/70]) tended to be higher than that of the CAVI articles (40.0% [6/15]; P=0.083). Multivariate analysis demonstrated that log (number of patients) (OR 11.20, 95% CI 2.45–51.70, P=0.002) and dialysis population (OR 0.28, 95% CI 0.08–0.94, P=0.039) were positive and negative independent determinants of the success of prognostic prediction, respectively. In addition, after redefining two studies as the absence of arteriosclerosis obliterans (ASO) exclusion, baPWV (OR 3.36, 95% CI 0.86–13.20, P=0.083) and the existence of exclusion criteria of ASO (OR 3.08, 95% CI 0.96–9.93, P=0.060) exhibited statistical tendency in the multivariate analysis. Conclusion This study demonstrated that the number of study participants and dialysis population were the independent determinants of the success of prognostic prediction. This study also showed the importance of exclusion criteria of ASO when using these indices. In addition, a prospective large-scale study to confirm the superiority in the prognostic prediction of these indices is warranted.
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Affiliation(s)
- Dai Ato
- Gakujutsu Shien Co., Ltd, Tokyo, Japan,
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