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de Souza Sartori JF, Dos Santos ML, Stollmeier A, Julio Cerci R, Aguiar Moreira C, Zeghbi Cochenski Borba V. Coronary calcium score in patients with post-surgical hypoparathyroidism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2024; 68:e230053. [PMID: 38578437 PMCID: PMC11081047 DOI: 10.20945/2359-4292-2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/02/2023] [Indexed: 04/06/2024]
Abstract
Objective This study aimed to evaluate the cardiovascular risk of patients with post-surgical hypoparathyroidism through coronary calcium score (CACS) evaluation andcardiovascular risk calculators. Subjects and methods Patients with post-surgical hypoparathyroidism (HG = 29) were compared to a control group (CG = 29), matched by sex and age. Demographic and clinical data were captured by a questionnaire or patient files. Both groups performed a thoracic-computed tomography to evaluate the CACS and the cardiovascular risk was calculated by two risk calculators. Results In the HG, the supplementation of calcium varied between 500 to 2,000 mg/day and the mean calcitriol was 0.5 ± 0.29 mcg/day. The mean serum calcium and phosphorus were 8.32 ± 0.68 and 4.92 ± 0.87 mg/dL, respectively, and in the range recommended for hypoparathyroidism. The Brazilian Society of Cardiology's risk calculator showed a difference among groups, with no patient in the HG with low risk, but the CACS was similar. A positive CACS in the HG was associated with obesity and high BMI but not with calcium and/or vitamin D supplementation. Conclusion In conclusion, patients with hypoparathyroidism did not show increased CACS, and it was not related to supplementation.
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Affiliation(s)
| | | | - Aline Stollmeier
- Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil
| | | | - Carolina Aguiar Moreira
- Departamento de Medicina, Divisão de Endocrinologia, Universidade Federal do Paraná, Curitiba, PR, Brasil
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2
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Polonine S, de Santa Rosa RG, Farias MLF, Garcia MI, Gomes CP, Gottlieb I, Madeira M. Hyperphosphatemia is associated with cardiac valve calcification in chronic hypoparathyroidism. J Endocrinol Invest 2022; 45:1359-1366. [PMID: 35235195 DOI: 10.1007/s40618-022-01770-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/16/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the association between metabolic abnormalities and cardiovascular risk factors in patients with chronic hypoparathyroidism (HPP). PATIENTS AND METHODS Patients 18 years and older, glomerular filtration > 30 mL/min/1.73 m2 and no documented coronary artery disease were selected. Serum calcium, phosphorus, glucose, lipids, PTH, 25(OH)D and FGF23 were measured. Cardiovascular risk was estimated by the European Society of Cardiology (ESC) calculator. Transthoracic echocardiogram and carotid ultrasound were performed to detect carotid plaques (CP), carotid intima-media thickness (IMT), cardiac valve calcification (CVC), and left ventricular hypertrophy (LVH). RESULTS Thirty-seven patients (94.6% female), aged 56.0 ± 13.5 years and HPP duration 7.0 (4.0; 11.3) years, were included. Fifteen were classified as low cardiovascular risk, 9 as intermediate risk, 9 as high risk and none as very high risk. The prevalence of CP, CVC and LVH was 24.3%, 24.3% and 13.5%, respectively. IMT values were within normal ranges in all cohort. FGF23 were not associated with CP, IMT, CVC or LVH. After logistic regression, phosphorus was the only significant metabolic variable impacting CVC in univariate analysis (OR 2.795; 95% CI 1.132-6.905; p = 0.026), as well as in the multivariate analysis (OR 3.572; 95% CI 1.094-11.665; p = 0.035). Analysis by ROC curve showed serum phosphorus > 5.05 mg/dL (AUC 0.748; CI 0.584-0.877; p = 0.05) as the best cutoff point associated with valve heart calcification (sensitivity 78%; negative predictive value 91.3%). CONCLUSION Hyperphosphatemia was associated with CVC in HPP patients. Further studies are needed to investigate whether the control of hyperphosphatemia may reduce cardiovascular risk in this population.
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Affiliation(s)
- S Polonine
- Division of Endocrinology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil.
| | - R G de Santa Rosa
- Division of Nephrology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil
| | - M L F Farias
- Division of Endocrinology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil
| | - M I Garcia
- Division of Cardiology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil
| | - C P Gomes
- Division of Nephrology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil
| | - I Gottlieb
- Casa de Saúde São José, Rua Macedo Sobrinho 21, Rio de Janeiro, RJ, 22271-080, Brazil
| | - M Madeira
- Division of Endocrinology, Clementino Fraga Filho Hospital, UFRJ, Avenida Professor Rodolpho Paulo Rocco 255, Rio de Janeiro, RJ, 21941-913, Brazil
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Cirakoglu OF, Karadeniz AG, Akyüz AR, Aydın C, Şahin S, Erkan H. Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study. Angiology 2021; 72:754-761. [PMID: 33663258 DOI: 10.1177/0003319721998853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ayşe Gül Karadeniz
- Department of Radiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ali Riza Akyüz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Cihan Aydın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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Lorente-Poch L, Rifà-Terricabras S, Sancho JJ, Torselli-Valladares D, González-Ortiz S, Sitges-Serra A. Prevalence of basal ganglia and carotid artery calcifications in patients with permanent hypoparathyroidism after total thyroidectomy. Endocr Connect 2020; 9:955-962. [PMID: 33032262 PMCID: PMC7576655 DOI: 10.1530/ec-20-0387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Permanent hypoparathyroidism is an uncommon disease resulting most frequently from neck surgery. It has been associated with visceral calcifications but few studies have specifically this in patients with post-surgical hypoparathyroidism. The aim of the present study was to assess the prevalence of basal ganglia and carotid artery calcifications in patients with long-term post-thyroidectomy hypoparathyroidism compared with a control population. DESIGN Case-control study. METHODS A cross-sectional review comparing 29 consecutive patients with permanent postoperative hypoparathyroidism followed-up in a tertiary reference unit for Endocrine Surgery with a contemporary control group of 501 patients who had an emergency brain CT scan. Clinical variables and prevalence of basal ganglia and carotid artery calcifications were recorded. RESULTS From a cohort of 46 patients diagnosed with permanent hypoparathyroidism, 29 were included in the study. The mean duration of disease was 9.2 ± 7 years. Age, diabetes, hypertension, smoking and dyslipidemia were similarly distributed in case and control groups. The prevalence of carotid artery and basal ganglia calcifications was 4 and 20 times more frequent in patients with permanent hypoparathyroidism, respectively. After propensity score matching of the 28 the female patients, 68 controls were matched for age and presence of cardiovascular factors. Cases showed a four-fold prevalence of basal ganglia calcifications, whereas that of carotid calcifications was similar between cases and controls. CONCLUSION A high prevalence of basal ganglia calcifications was observed in patients with post-surgical permanent hypoparathyroidism. It remains unclear whether carotid artery calcification may also be increased.
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Affiliation(s)
- Leyre Lorente-Poch
- Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
- Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Correspondence should be addressed to L Lorente-Poch:
| | | | - Juan José Sancho
- Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
- Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Antonio Sitges-Serra
- Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain
- Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain
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Pamuk N, Akkan T, Dağdeviren M, Koca AO, Beyan E, Ertuğrul DT, Altay M. Central and peripheral blood pressures and arterial stiffness increase in hypoparathyroidism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:374-382. [PMID: 32267362 PMCID: PMC10522079 DOI: 10.20945/2359-3997000000234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/26/2019] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to evaluate whether arterial stiffness is affected in the patients with hypoparathyroidism through pulse wave analysis (PWA). Subjects and methods Sixty-three patients diagnosed with hypoparathyroidism and sixty volunteers were evaluated for the study. When 21 patients were excluded in the hypoparathyroidism group due to exclusion criteria, the research continued with 42 patients and 60 volunteers who are similar to the patients in terms of age, gender and body mass index (BMI). Fasting plasma glucose after 10 hours of fasting, creatinine, thyroid stimulating hormone (TSH), free thyroxine (fT4), albumin, calcium, phosphorus, magnesium, 25-OH vitamin D, parathormone (PTH) and urine calcium results in 24-hour urine for the patients in the hypoparathyroidism group were recorded. Evaluation of arterial stiffness was performed by Mobil-O-Graph 24h PWA device. Results Systolic blood pressure (SBP) (p = 0.01), diastolic blood pressure (DBP) (p = 0.005), mean blood pressure (p = 0.009), central SBP (p = 0.004), central DBP (p = 0.01) and pulse wave velocity (PWV) (p = 0.02) were found higher in the hypoparathyroidism group. A positive correlation was detected between phosphorus level and SBP [(p = 0.03. r = 0.327)], central SBP [(p = 0.04, r = 0.324)] and PWV [(p = 0.003, r = 0.449)]. We detected that age and serum phosphorus levels were independent predictor variables for PWV (B = 0.014, p < 0.001 and B = 0.035, p < 0.001, respectively). Conclusion We detected that hypoparathyroidism causes an increase in blood pressure and arterial stiffness. The most significant determinant factors were detected as advanced age and hyperphosphatemia. The patients diagnosed with hypoparathyroidism should be closely monitored and treatment planning should include to prevent the patients from hyperphosphatemia.
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Affiliation(s)
- Naim Pamuk
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Internal MedicineAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Tolga Akkan
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Murat Dağdeviren
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Arzu Or Koca
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Esin Beyan
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Internal MedicineAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Derun Taner Ertuğrul
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mustafa Altay
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Underbjerg L, Sikjaer T, Rejnmark L. Cardiovascular findings in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism: A cohort study. Clin Endocrinol (Oxf) 2019; 90:592-600. [PMID: 30589959 DOI: 10.1111/cen.13927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE As only sparse data are available on indices of cardiovascular health among patients with nonsurgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP), we aimed to compare the cardiovascular profile between these groups of patients. METHODS A total of 56 patients with Ns-HypoPT and 30 with PHP were included and underwent a clinical examination including blood sampling and measurements of arterial stiffness, pulse wave velocity (PWV) and blood pressure (BP). Arterial stiffness and PWV were measured using AtCor SphygmoCor-XCEL (Atcor Medical Pty Ltd, Sydney, NSW, Australia). RESULTS Patients with Ns-HypoPT had an average age of 47 ± 17 years (68% females) and PHP patients 36 ± 13 years (80% females). Over 70% in both groups were genetically screened. Groups did not differ in terms of a history of cardiovascular disease, smoking status, use of calcium and vitamin D supplements or treatment with cholesterol-lowering or antihypertensive drugs. Compared with Ns-HypoPT, PHP patients had significantly lower levels of high-density lipoproteins (HDL) cholesterol and average glucose from HbA1c (Pboth = 0.01). PWV was significantly higher among patients with Ns-HypoPT (Pcrude = 0.02), even after adjustment for mean arterial pressure, body mass index, age and gender (Padjusted < 0.01). Heart rate was significantly higher in Ns-HypoPT compared with PHP (P = 0.03). Office BP and 24-hour ambulatory BP did not differ between groups (P > 0.05). CONCLUSION Patients with Ns-HypoPT have compared with PHP a higher arterial stiffness and heart rate. This has been associated with an increased risk of cardiovascular disease. Our data suggest that resistance to PTH is present in the cardiovascular system in PHP.
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Affiliation(s)
- Line Underbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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7
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Icen YK, Koc AS, Sumbul HE. Coronary Artery Disease Severity Is Associated With Abdominal Aortic Intima–Media Thickness in Patients With Non-ST-Segment Elevation Myocardial Infarction. Angiology 2018; 70:561-566. [DOI: 10.1177/0003319718794833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yahya Kemal Icen
- Cardiology Department, Health Sciences University, Adana Health Practice and Research Center, Adana, Turkey
| | - Ayse Selcan Koc
- Radiology Department, Health Sciences University, Adana Health Practice and Research Center, Adana, Turkey
| | - Hilmi Erdem Sumbul
- Internal Medicine Department, Health Sciences University, Adana Health Practice and Research Center, Adana, Turkey
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B-Mode ultrasound assessment of intima-media thickness of common carotid, internal carotid, brachial, femoral arteries and abdominal aorta in patients with cardiovascular risk factor. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.421768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Koc AS, Sumbul HE. Increased aortic intima-media thickness may be used to detect macrovascular complications in adult type II diabetes mellitus patients. Cardiovasc Ultrasound 2018; 16:8. [PMID: 29891012 PMCID: PMC5996542 DOI: 10.1186/s12947-018-0127-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background Carotid intima media thickness (C-IMT) and aortic IMT (A-IMT) increase in adult and pediatric patients with diabetes mellitus (DM), respectively. In both age groups IMT is used for early detection of macrovascular complications. In adult DM patients, A-IMT is still not a routine examination and is not used frequently. We aimed to determine whether there is an increase in A-IMT values measured from abdominal aorta besides traditional C-IMT in patients with type II DM and to determine parameters closely related to A-IMT in the same patient group. Methods We included 114 type II DM patients and 100 healthy control subjects similar in age and sex in our study. Bilateral C-IMT and A-IMT values were measured by B-mode ultrasonography (USG) in addition to anamnesis, physical examination and routine examinations of all patients. Results When the clinical, demographic and laboratory data of patients with and without DM were compared, there was a high level of glucose and HbA1c and low hemoglobin levels in the DM patient group. All other parameters were found to be similar between the two groups. When the B-mode USG findings were examined, it was found that C-IMT and A-IMT were increased in patients with DM, with the A-IMT increase being more prominent. A-IMT values were found to be strongly and positively correlated with age, systolic blood pressure, blood urea nitrogen, DM onset time and HbA1c levels, and a negatively and significantly correlated with hemoglobin levels (p < 0.05, for each). In the regression model, the parameters correlating most closely with A-IMT were DM diagnosis onset time, HbA1c and hemoglobin levels (p = 0.001 and β = 0.353, p = 0.014 and β = 0.247 and p < 0.001 and β = − 0.406). Conclusions As in pediatric DM patients also in adult DM patients A-IMT can easily be measured with new model USG devices. A-IMT must be measured during abdominal USG which is routine in adult DM patients. A-IMT is an easy, reproducible and non-invasive parameter that may be used in the diagnosis of macrovascular complications of adult type II DM.
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Affiliation(s)
- Ayse Selcan Koc
- Department of Radiology, University of Health Sciences - Adana Health Practices and Research Center, Adana, Turkey.
| | - Hilmi Erdem Sumbul
- Department of Internal Medicine, University of Health Sciences - Adana Health Practices and Research Center, Adana, Turkey
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10
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Koc AS, Gorgulu FF, Donmez Y, Icen YK. There is a significant relationship between morning blood pressure surge and increased abdominal aortic intima-media thickness in hypertensive patients. J Med Ultrason (2001) 2018. [PMID: 29536281 DOI: 10.1007/s10396-018-0877-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE There are limited data about increased aortic intima-media thickness (A-IMT) in the presence of subclinical target organ damage in hypertensive (HT) patients. In this study, we aimed to determine the frequency of increased A-IMT, the parameters determining increased A-IMT, and the relationship between increased A-IMT and other vascular IMT measurements. MATERIALS AND METHODS We prospectively included 265 patients (mean age 54.1 ± 10.6 years, male/female 91/174) with essential HT. Physical examination of all patients was performed. Laboratory data and antihypertensive treatments were recorded. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) was performed. Bilateral carotid, brachial, and femoral artery and abdominal A-IMT values were measured by B-mode ultrasonography (USG). Patients were categorized into two main groups: patients with increased A-IMT (≥ 3 mm) or normal A-IMT (< 3 mm). RESULTS Increased A-IMT was detected in 55 patients (20.8%). There was a close relationship between increased A-IMT and advanced age, presence of coronary artery disease, high morning blood pressure surge (MBPS), and bilateral carotid and femoral IMT. Parameters associated with increased A-IMT in univariate analysis were assessed by regression analysis. Left femoral IMT and MBPS were independently associated with increased A-IMT. In the regression model, each 5-mmHg elevation in MBPS increased the risk of increased A-IMT by 34.2%. The cutoff value of MBPS obtained by the ROC curve analysis was 32 mmHg for the prediction of increased A-IMT (sensitivity 76.3%, specificity 63.5%). The area under the curve was 0.784 (95% CI 0.720-0.847, p < 0.001). CONCLUSION Abdominal A-IMT increased at a significant rate in patients with HT. An independent association was found between MBPS and A-IMT, which can both be easily detected by ABPM and B-mode USG. The high MBPS level was considered to be a simple and inexpensive method for detecting subclinical target organ damage. A-IMT measurement should also be a part of abdominal USG, which is a routine examination in HT patients.
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Affiliation(s)
- Ayse Selcan Koc
- Department of Radiology, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey.
| | - Ferıde Fatma Gorgulu
- Department of Radiology, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey
| | - Yurdaer Donmez
- Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey
| | - Yahya Kemal Icen
- Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey
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11
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Petrini J, Ring M, Franco-Cereceda A, Caidahl K, Eriksson MJ. Aortic versus carotid intima-media thickness and impact of aortic valve disease. Clin Physiol Funct Imaging 2018; 38:895-902. [PMID: 29345099 DOI: 10.1111/cpf.12502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/13/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Intima-media thickness is a marker for atherosclerosis but is also influenced by shear stress and flow. We evaluated the relation between intima-media thickness of the descending aorta (AoIMT) and the common carotid artery (CIMT) in patients with and without severe aortic valve disease (sAVD). METHODS A total of 310 patients (233 with sAVD, 77 without) were examined with regard to AoIMT and CIMT using transesophageal echocardiography and carotid ultrasound, respectively, before valvular and/or aortic surgery. Digitally stored B-mode images were used for semiautomatic AoIMT and CIMT measurements. RESULTS There were no significant differences in patients with or without sAVD with regard to AoIMT (1·35 ± 0·31 vs. 1·35 ± 0·33 mm) or CIMT (0·80 ± 0·15 vs. 0·78 ± 0·16 mm). The correlations between AoIMT and CIMT were r = 0·29 in patients with and r = 0·51 in patients without sAVD, and the difference between these correlations was significant (P<0·05). In multivariate regression, age was the main determinant for AoIMT and CIMT in both groups, further in sAVD, the aortic mean pressure gradient (Pmean ) was a determinant of AoIMT, but not of CIMT. CONCLUSIONS The correlation between CIMT and AoIMT is weaker in patients with sAVD compared to those without sAVD. Pmean is also a significant predictor of AoIMT, but not of CIMT. This implies that, in addition to the atherosclerotic process, turbulent aortic flow or altered blood flow helicity created by large stroke volumes and diastolic flow reversal or high-velocity jets, affect the intima-media of the descending aorta and common carotid artery differently.
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Affiliation(s)
- Johan Petrini
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Södersjukhuset, Stockholm, Sweden
| | - Margareta Ring
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria J Eriksson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
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12
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Agarwal P, Prakash M, Singhal M, Bhadada SK, Gupta Y, Khandelwal N. To assess vascular calcification in the patients of hypoparathyroidism using multidetector computed tomography scan. Indian J Endocrinol Metab 2015; 19:785-790. [PMID: 26693429 PMCID: PMC4673807 DOI: 10.4103/2230-8210.167545] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Our pilot data showed an increased intima media thickness in the patients with sporadic idiopathic hypoparathyroidism (SIH). Alteration in homeostasis of calcium, phosphate, and parathyroid hormone (PTH) may predispose to increase the risk of cardiovascular morbidity and mortality. The data on objective assessment of this increased risk is however lacking. OBJECTIVE To assess the effect of altered calcium, phosphate, and PTH homeostasis in the patients with SIH on coronary calcium score (a marker of increase vascular risk) by multidetector computed tomography scan (MDCT). METHODS In this case-control study, we measured coronary CT calcium score in 30 patients of SIH and compared with 40 age and sex matched healthy subjects. Correlation of coronary calcium score with biochemical parameters was evaluated. RESULTS Three of the 30 cases (10%) with SIH were found to have coronary artery calcification (CAC) of varying degree, whereas none of the control showed CAC (P = 0.07). The patients with CAC had significantly lower serum calcium levels (albumin corrected), as compared to the patients without CAC. Inverse correlation of CAC was found with serum calcium levels. No correlation was found with other biochemical parameters. CONCLUSION The vascular risk is increased in the patients with SIH as assessed by coronary calcium score measured by MDCT. Low serum calcium levels might be a predisposing factor for this increased risk.
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Affiliation(s)
- Pooja Agarwal
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mahesh Prakash
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manphool Singhal
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Yashdeep Gupta
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Niranjan Khandelwal
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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