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Ho LYW, Kwan RYC, Yuen KM, Leung WC, Tam PN, Tsim NM, Ng SSM. The Effect of Aerobic Exercises on Arterial Stiffness in Older People: A Systematic Review and Meta-Analysis. Gerontologist 2024; 64:gnad123. [PMID: 37656163 DOI: 10.1093/geront/gnad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Aerobic exercise is a cost-effective intervention to improve arterial stiffness, but its effects on older people are unclear; this review aims to determine those effects. RESEARCH DESIGN AND METHODS Five databases were searched for randomized controlled trials of aerobic exercises. Backward and forward citations and clinical trial registries were also reviewed. Data were extracted and synthesized. A random-effects model was used in a meta-analysis. The risk of bias and the certainty of the evidence were also assessed. The protocol of this review was registered (PROSPERO registration number: CRD42022349494). RESULTS Eighteen studies (n = 775) were identified. Aerobic exercises included cycling, walking, swimming, standing core exercise, bench step exercise, aquarobic exercise, jogging, running, upper-limb cycling, and aquatic walking. Postintervention, improvements were seen in the pulse wave velocity (SMD9 = -0.89, 95% confidence interval (CI)-1.57 to -0.22), arterial velocity-pulse index (MD2 = -6.84, 95% CI -9.05 to -4.63), and arterial pressure-volume index (MD2 = -4.97, 95% CI -6.9 to -3.04), but not in the augmentation index, arterial compliance, or beta stiffness index. Exercise lasting >8 weeks but not 4-8 weeks significantly improved pulse wave velocity. Aerobic exercise had a beneficial effect on healthy older people but not on older people with disease. The overall risk of bias was high in 9 of the included studies, with some concerns in the remaining studies. The certainty of the evidence was very low. DISCUSSION AND IMPLICATIONS Aerobic exercises, particularly those lasting >8 weeks, appear to be effective at improving pulse wave velocity in older people postintervention. Future trials with robust designs are needed.
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Affiliation(s)
- Lily Yuen Wah Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
| | - Rick Yiu Cho Kwan
- School of Nursing, Tung Wah College, Hong Kong SAR, People's Republic of China
| | - Ka Man Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
| | - Wai Chun Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
| | - Pui Ni Tam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
| | - Nga Man Tsim
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China
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Zhang L, Sun Z, Yang Y, Mack A, Rodgers M, Aroor A, Jia G, Sowers JR, Hill MA. Endothelial cell serum and glucocorticoid regulated kinase 1 (SGK1) mediates vascular stiffening. Metabolism 2024; 154:155831. [PMID: 38431129 DOI: 10.1016/j.metabol.2024.155831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Excessive dietary salt intake increases vascular stiffness in humans, especially in salt-sensitive populations. While we recently suggested that the endothelial sodium channel (EnNaC) contributes to salt-sensitivity related endothelial cell (EC) and arterial stiffening, mechanistic understanding remains incomplete. This study therefore aimed to explore the role of EC-serum and glucocorticoid regulated kinase 1 (SGK1), as a reported regulator of sodium channels, in EC and arterial stiffening. METHODS AND RESULTS A mouse model of salt sensitivity-associated vascular stiffening was produced by subcutaneous implantation of slow-release deoxycorticosterone acetate (DOCA) pellets, with salt (1 % NaCl, 0.2 % KCl) administered via drinking water. Preliminary data showed that global SGK1 deletion caused significantly decreased blood pressure (BP), EnNaC activity and aortic endothelium stiffness as compared to control mice following DOCA-salt treatment. To probe EC signaling pathways, selective deletion of EC-SGK1 was performed by cross-breeding cadherin 5-Cre mice with sgk1flox/flox mice. DOCA-salt treated control mice had significantly increased BP, EC and aortic stiffness in vivo and ex vivo, which were attenuated by EC-SGK1 deficiency. To demonstrate relevance to humans, human aortic ECs were cultured in the absence or presence of aldosterone and high salt with or without the SGK1 inhibitor, EMD638683 (10uM or 25uM). Treatment with aldosterone and high salt increased intrinsic stiffness of ECs, which was prevented by SGK1 inhibition. Further, the SGK1 inhibitor prevented aldosterone and high salt induced actin polymerization, a key mechanism in cellular stiffening. CONCLUSION EC-SGK1 contributes to salt-sensitivity related EC and aortic stiffening by mechanisms appearing to involve regulation of actin polymerization.
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Affiliation(s)
- Liping Zhang
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Zhe Sun
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Yan Yang
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
| | - Austin Mack
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
| | - Mackenna Rodgers
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
| | - Annayya Aroor
- Department of Medicine, School of Medicine, University of Missouri, Columbia, MO 65211, USA
| | - Guanghong Jia
- Department of Medicine, School of Medicine, University of Missouri, Columbia, MO 65211, USA
| | - James R Sowers
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Michael A Hill
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO 65211, USA.
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Liu Q, Zhang Y, Han B, Wang M, Hu H, Ning J, Hu W, Chen M, Pang Y, Chen Y, Bao L, Niu Y, Zhang R. circRNAs deregulation in exosomes derived from BEAS-2B cells is associated with vascular stiffness induced by PM 2.5. J Environ Sci (China) 2024; 137:527-539. [PMID: 37980036 DOI: 10.1016/j.jes.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 11/20/2023]
Abstract
As an environmental pollutant, ambient fine particulate matter (PM2.5) was linked to cardiovascular diseases. The molecular mechanisms underlying PM2.5-induced extrapulmonary disease has not been elucidated clearly. In this study the ambient PM2.5 exposure mice model we established was to explore adverse effects of vessel and potential mechanisms. Long-term PM2.5 exposure caused reduced lung function and vascular stiffness in mice. And chronic PM2.5 induced migration and epithelial-mesenchymal transition (EMT) phenotype in BEAS-2B cells. After PM2.5 treatment, the circRNAs and mRNAs levels of exosomes released by BEAS-2B cells were detected by competing endogenous RNA (ceRNA) array, which contained 1664 differentially expressed circRNAs (DE-circRNAs) and 308 differentially expressed mRNAs (DE-mRNAs). By bioinformatics analysis on host genes of DE-circRNAs, vascular diseases and some pathways related to vascular diseases including focal adhesion, tight junction and adherens junction were enriched. Then, ceRNA network was constructed, and DE-mRNAs in ceRNA network were conducted functional enrichment analysis by Ingenuity Pathway Analysis, which indicated that hsa_circ_0012627, hsa_circ_0053261 and hsa_circ_0052810 were related to vascular endothelial dysfunction. Furthermore, it was verified experimentally that ExoPM2.5 could induce endothelial dysfunction by increased endothelial permeability and decreased relaxation in vitro. In present study, we investigated in-depth knowledge into the molecule events related to PM2.5 toxicity and pathogenesis of vascular diseases.
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Affiliation(s)
- Qingping Liu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Yaling Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Bin Han
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China; State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Mengruo Wang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Huaifang Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Jie Ning
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Wentao Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Meiyu Chen
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China
| | - Yuanyuan Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lei Bao
- Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, China
| | - Yujie Niu
- Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, China
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, China.
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Phababpha S, Sri-amad R, Huipao N, Sriwannawit P, Roengrit T. Daily Step Count and its Association with Arterial Stiffness Parameters in Older Adults. Ann Geriatr Med Res 2024; 28:101-109. [PMID: 38350695 PMCID: PMC10982445 DOI: 10.4235/agmr.23.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Daily step count is a simple parameter for assessing physical activity. However, the potential advantages of setting daily step goals below the traditional 10,000-step threshold remain unclear. The cross-sectional study aimed to determine the relationship between daily step counts and arterial stiffness outcomes in older individuals. METHODS Forty-eight older adults recorded their daily step counts over a 7-day period using a pedometer. The participants were classified into two groups based on their daily step count: Group 1 (n = 28) consisted of individuals taking fewer than 5000 steps per day, while Group 2 (n = 20) included those who recorded 5,000 to 9,999 steps per day. To evaluate arterial stiffness parameters, we measured pulse wave velocity (PWV), cardio-ankle vascular index (CAVI), and ankle-brachial index (ABI). Hemodynamic and biochemical parameters were also determined. RESULTS Participants who accumulated fewer daily steps exhibited higher PWV compared to each group. An inverse association was observed between average steps per day and PWV. However, no significant differences were found between daily step counts and CAVI or ABI. CONCLUSION Conclusions: As individuals increase their daily step count, they may experience a reduction in arterial stiffness. Consequently, the assessment of daily steps has benefits for enhancing vascular health and overall well-being among older individuals.
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Affiliation(s)
- Suphawadee Phababpha
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Ruchada Sri-amad
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Nawiya Huipao
- Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Porraporn Sriwannawit
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Thapanee Roengrit
- Department of Basic Medical Science, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Ferreira L, Abrantes C, Alves ME, Moreira C, Moreira H. Effects of exercise programs on cardiorespiratory fitness and arterial stiffness on postmenopausal women: A systematic review study. Maturitas 2024; 181:107917. [PMID: 38277884 DOI: 10.1016/j.maturitas.2024.107917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Arterial stiffness is an important marker of cardiovascular disease, with a considerable increase in menopause. The impact of exercise, as a preventive measure, on controlling the progression of cardiovascular disease and arterial dysfunction in middle age remains under investigation. OBJECTIVE This systematic review aims to present the results of studies that examined the effects of different exercise programs (isolated, aerobic, and resistance or combined) on arterial stiffness and cardiorespiratory fitness in postmenopausal women. METHODS Based on PRISMA guidelines, B-On, BioMed, EBSCOhost, MEDLINE, ScienceOpen, PubMed, Science Direct, Scopus, Web of Science, Cochrane library and LILACS databases were searched using specific keywords. RESULTS A final total of 13 manuscripts were included in the qualitative synthesis, involving 700 participants. Four studies used only cardiorespiratory exercise, three only resistance, taekwondo class or flexibility exercise, and six combined exercise programs. Most interventions ranged from 3 to 5 days per week. Carotid-femoral pulse wave velocity showed improvements between 0.22 m/s and 1.56 m/s. In addition, one study showed an improvement of 4.4 ml/kg/min in maximal oxygen consumption. In 7 studies, participation in exercise programs improved arterial stiffness. CONCLUSIONS Combined exercise (aerobic and resistance exercise) and aerobic exercise alone (swimming) improve cardiorespiratory fitness and arterial stiffness in postmenopausal women, particularly pulse wave velocity. The combined exercise program is the most effective, promoting improvements of up to -2.6 m/s in pulse wave velocity in this climacteric phase.
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Affiliation(s)
- Luís Ferreira
- Department of Sports Science, Douro Higher Institute of Educational Sciences, CI-ISCE, 4560-708 Penafiel, Portugal; University of Trás-os-Montes and Alto Douro, 5001-801 Vila-Real, Portugal.
| | - Catarina Abrantes
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, CIDESD, 5001-801 Vila-Real, Portugal
| | - Maria Emília Alves
- Department of Sports Science, Douro Higher Institute of Educational Sciences, CI-ISCE, 4560-708 Penafiel, Portugal; CIAFEL, 4200-450 Porto, Portugal
| | - Carlos Moreira
- University of Trás-os-Montes and Alto Douro, 5001-801 Vila-Real, Portugal
| | - Helena Moreira
- Department of Sports Science, Exercise and Health, University of Trás-os-Montes and Alto Douro, CIDESD, 5001-801 Vila-Real, Portugal; CITAB, 5001-801 Vila Real, Portugal
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Karaś A, Bar A, Pandian K, Jasztal A, Kuryłowicz Z, Kutryb-Zając B, Buczek E, Rocchetti S, Mohaissen T, Jędrzejewska A, Harms AC, Kaczara P, Chłopicki S. Functional deterioration of vascular mitochondrial and glycolytic capacity in the aortic rings of aged mice. GeroScience 2024:10.1007/s11357-024-01091-6. [PMID: 38418756 DOI: 10.1007/s11357-024-01091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
Vascular ageing is associated with increased arterial stiffness and cardiovascular mortality that might be linked to altered vascular energy metabolism. The aim of this study was to establish a Seahorse XFe96 Analyzer-based methodology for the reliable, functional assessment of mitochondrial respiration and glycolysis in single murine aortic rings and to validate this functional assay by characterising alterations in vascular energy metabolism in aged mice. Healthy young and old C57BL/6 mice were used for the analyses. An optimised setup consisting of the Seahorse XFe96 Analyzer and Seahorse Spheroid Microplates was applied for the mitochondrial stress test and the glycolysis stress test on the isolated murine aortic rings, supplemented with analysis of NAD content in the aorta. To confirm the age-dependent stiffness of the vasculature, pulse wave velocity was measured in vivo. In addition, the activity of vascular nitric oxide synthase and vascular wall morphology were analysed ex vivo. The vascular ageing phenotype in old mice was confirmed by increased aortic stiffness, vascular wall remodelling, and nitric oxide synthase activity impairment. The rings of the aorta taken from old mice showed changes in vascular energy metabolism, including impaired spare respiratory capacity, maximal respiration, glycolysis, and glycolytic capacity, as well as a fall in the NAD pool. In conclusion, optimised Seahorse XFe96-based analysis to study energy metabolism in single aortic rings of murine aorta revealed a robust impairment of functional vascular respiratory and glycolytic capacity in old mice linked to NAD deficiency that coincided with age-related aortic wall remodelling and stiffness.
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Affiliation(s)
- Agnieszka Karaś
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
- Doctoral School of Exact and Natural Sciences, Jagiellonian University, Lojasiewicza 11, 30-348, Krakow, Poland
| | - Anna Bar
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
| | - Kanchana Pandian
- Leiden Academic Centre for Drug Research, Leiden University, Einstein Road 55, 2333 CC, Leiden, The Netherlands
| | - Agnieszka Jasztal
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
| | - Zuzanna Kuryłowicz
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
| | - Barbara Kutryb-Zając
- Department of Biochemistry, Medical University of Gdansk, Debniki 1, 80-211, Gdansk, Poland
| | - Elżbieta Buczek
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
- Doctoral School of Exact and Natural Sciences, Jagiellonian University, Lojasiewicza 11, 30-348, Krakow, Poland
| | - Stefano Rocchetti
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
| | - Tasnim Mohaissen
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland
| | - Agata Jędrzejewska
- Department of Biochemistry, Medical University of Gdansk, Debniki 1, 80-211, Gdansk, Poland
| | - Amy C Harms
- Leiden Academic Centre for Drug Research, Leiden University, Einstein Road 55, 2333 CC, Leiden, The Netherlands
| | - Patrycja Kaczara
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland.
| | - Stefan Chłopicki
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Bobrzynskiego 14, 30-348, Krakow, Poland.
- Department of Pharmacology, Jagiellonian University Medical College, Grzegorzecka 16, 31-531, Krakow, Poland.
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Peng H, Zhang H, Xin S, Li H, Liu X, Wang T, Liu J, Zhang Y, Song W. Associations between Erectile Dysfunction and Vascular Parameters: A Systematic Review and Meta-Analysis. World J Mens Health 2024; 42:42.e18. [PMID: 38311372 DOI: 10.5534/wjmh.230192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Erectile dysfunction (ED) is associated with several vascular disorders, but the associations between ED and vascular parameters are still unclear. MATERIALS AND METHODS We analyzed and synthesized a comprehensive range of studies from PubMed, Web of Science, and Scopus regarding the associations between ED and the following measures: ankle-brachial index (ABI), pulse wave velocity (PWV), intima-media thickness (IMT), nitrate-mediated dilation (NMD), flow-mediated dilation (FMD), augmentation index (AI), endothelial progenitor cells (EPCs) and other vascular parameters. Subgroup analysis was conducted according to specific types of parameters. Study quality was assessed by using the Newcastle-Ottawa Scale. Sensitivity analysis was conducted to confirm the robustness of the pooled results. RESULTS Fifty-seven studies with 7,312 individuals were included. Twenty-eight studies were considered to be high-quality. ED patients had a 0.11 mm higher IMT (95% confidence interval [CI]: 0.07, 0.15), a 2.86% lower FMD (95% CI: -3.56, -2.17), a 2.34% lower NMD (95% CI: -3.37, -1.31), a 2.83% higher AI (95% CI: 0.02, 5.63), a 1.11 m/s higher PWV (95% CI: 0.01, 2.21), and a 0.72% lower percentage of EPCs (95% CI: -1.19, -0.24) compared to those without ED. However, ABI was similar between ED patients and non-ED individuals. According to sensitivity analysis, the pooled results were robust. CONCLUSIONS Our study confirmed the associations between ED and several vascular parameters and highlighted the importance of prevention and management of vascular and endothelial dysfunction in ED patients.
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Affiliation(s)
- Hao Peng
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- The Second Clinical School, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hanlin Zhang
- The First Clinical School, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Xin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yucong Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Wen Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Wang S, Shi H, Luo L, He H. Characteristics and correlation of body fat distribution and brachial-ankle pulse wave velocity in adults aged 20-59 years: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:5. [PMID: 38166618 PMCID: PMC10763480 DOI: 10.1186/s12872-023-03597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Fat distribution is closely related to vascular stiffness. This study aimed to investigate age and sex differences in fat distribution and brachial-ankle pulse wave velocity (baPWV), and the association between fat parameters and baPWV. METHODS A total of 10,811 participants aged 20-59 years were recruited. Measures included waist and hip circumference, waist-to-hip ratio (WHR), body mass index (BMI), percentage body fat (PBF), subcutaneous fat area (SFA), visceral fat area (VFA), and baPWV. RESULTS The results confirm that fat accumulates with age and that men tend to carry more abdominal fat than women in the same age group. The findings also indicate that baPWV increases with age and is significantly higher in men than in women in the same age group. In addition, WHR, VFA, and baPWV were more strongly correlated than baPWV and BMI, SFA, and PBF. Finally, the effects of age, PBF, WHR, and VFA on baPWV were greater for the higher quantiles. CONCLUSIONS There are age and sex differences in fat distribution and baPWV. Abdominal obesity is more closely linked to arterial stiffness than overall obesity, and people with higher baPWV are more affected by obesity parameters.
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Affiliation(s)
- Shengya Wang
- Department of Exercise Physiology, Beijing Sport University, Beijing, 100084, China
| | - Haiyan Shi
- Department of Exercise Physiology, Beijing Sport University, Beijing, 100084, China
| | - Laiyuan Luo
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, 100084, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, 100084, China.
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Genovese F, Gonçalves I, Holm Nielsen S, Karsdal MA, Edsfeldt A, Nilsson J, Shore AC, Natali A, Khan F, Shami A. Plasma levels of PRO-C3, a type III collagen synthesis marker, are associated with arterial stiffness and increased risk of cardiovascular death. Atherosclerosis 2024; 388:117420. [PMID: 38128431 DOI: 10.1016/j.atherosclerosis.2023.117420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIMS The N-terminal propeptide of type III collagen (PRO-C3) assay measures a pro-peptide released during type III collagen synthesis, an important feature of arterial stiffening and atherogenesis. There is a clinical need for improved non-invasive, cheap and easily accessible methods for evaluating individuals at risk of cardiovascular disease (CVD). In this study, we investigate the potential of using circulating levels of PRO-C3 to mark the degree of vascular stenosis and risk of cardiovascular events. METHODS Baseline plasma levels of PRO-C3 were measured by ELISA in subjects belonging to the SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (SUMMIT) cohort (N = 1354). Associations between PRO-C3 levels with vascular characteristics, namely stiffness and stenosis, and risk of future cardiovascular events were explored. Subjects were followed up after a median of 35 months (interquartile range 34-36 months), with recorded outcomes cardiovascular death and all-cause mortality. RESULTS We found a correlation between PRO-C3 levels and pulse wave velocity (rho 0.13, p = 0.000009), a measurement of arterial stiffness. Higher PRO-C3 levels were also associated with elevated blood pressure (rho 0.07, p = 0.014), as well as risk of cardiovascular mortality over a three-year follow-up period (OR 1.56, confidence interval 1.008-2.43, p = 0.046). CONCLUSIONS Elevated circulating PRO-C3 levels are associated with arterial stiffness and future cardiovascular death, in the SUMMIT cohort, suggesting a potential value of PRO-C3 as a novel marker for declining vascular health.
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Affiliation(s)
| | - Isabel Gonçalves
- Dept. of Clinical Sciences Malmö, Lund University, Clinical Research Center, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden; Dept. of Cardiology, Malmö, Skåne University Hospital, Lund University, Carl-Bertil Laurells Gata 9, 214 28, Malmö, Sweden
| | - Signe Holm Nielsen
- Nordic Bioscience, Herlev Hovedgade 205-207, 2730, Herlev, Denmark; Biomedicine and Biotechnology, Technical University of Denmark, Søltofts Pl. 221, 2800, Kongens Lyngby, Denmark
| | - Morten A Karsdal
- Nordic Bioscience, Herlev Hovedgade 205-207, 2730, Herlev, Denmark
| | - Andreas Edsfeldt
- Dept. of Clinical Sciences Malmö, Lund University, Clinical Research Center, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden; Dept. of Cardiology, Malmö, Skåne University Hospital, Lund University, Carl-Bertil Laurells Gata 9, 214 28, Malmö, Sweden; Wallenberg Centre for Molecular Medicine, Lund University, Klinikgatan 32, 221 84, Lund, Sweden
| | - Jan Nilsson
- Dept. of Clinical Sciences Malmö, Lund University, Clinical Research Center, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
| | - Angela C Shore
- Diabetes and Vascular Medicine, University of Exeter, Medical School, National Institute for Health Research Exeter Clinical Research Facility, Barrack Road, Exeter, EX2 5AX, UK
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 8, 56100, Pisa, Italy
| | - Faisel Khan
- Division of Systems Medicine, University of Dundee, Dundee, DD1 9SY, UK
| | - Annelie Shami
- Dept. of Clinical Sciences Malmö, Lund University, Clinical Research Center, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden.
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10
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Kim BS, Kim HJ, Shin JH. Association between Estimated Pulse Wave Velocity and Incident Nonalcoholic Fatty Liver Disease in Korean Adults. Pulse (Basel) 2024; 12:1-11. [PMID: 38179088 PMCID: PMC10764092 DOI: 10.1159/000535580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Nonalcoholic fatty liver disease (NAFLD) is associated with vascular dysfunction, one of the signs of which is arterial stiffness. Carotid-femoral pulse wave velocity (PWV), which is considered the gold standard measure of arterial stiffness, can be estimated using two commonly assessed clinical variables: age and blood pressure. This study aimed to evaluate the association between estimated PWV (ePWV) and the prevalence and incidence of NAFLD among Korean adults. Methods This study used data from the Ansan-Ansung cohort study, a subset of the Korean Genome and Epidemiology Study, and included 8,336 adult participants with and without NAFLD at baseline. The participants were subdivided into three tertile groups according to ePWV. Results At baseline, the prevalence of NAFLD was 10.5, 27.5, and 35.0% in the first (lowest), second, and third (highest) tertiles of ePWV, respectively. During the 18-year follow-up period, 2,467 (42.9%) incident cases of NAFLD were identified among 5,755 participants who did not have NAFLD at baseline. After adjustment for clinically relevant variables, participants in the second (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.12-1.40) and third (adjusted HR, 1.42; 95% CI, 1.24-1.64) tertiles of ePWV had a significantly higher risk of incident NAFLD than those in the first tertile. Conclusion Higher ePWV is independently associated with an elevated risk of NAFLD in the general population.
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Affiliation(s)
- Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
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11
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Königstein K, Büschges JC, Schmidt-Trucksäss A, Neuhauser H. Cardiovascular Risk in Childhood is Associated With Carotid Intima-Media Thickness and Stiffness in Adolescents and Young Adults: The KiGGS Cohort. J Adolesc Health 2024; 74:123-129. [PMID: 37815767 DOI: 10.1016/j.jadohealth.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/03/2023] [Accepted: 08/18/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Cardiovascular risk factors are widespread among children and adolescents and may lead to accelerated vascular aging in middle adulthood. However, data are scarce on shorter-term consequences, for example, on associated distinctive vascular properties before age 30 years. This study analyzes the association of childhood exposure to cardiovascular risk factors with carotid properties in adolescents and young adults. METHODS Four thousand thirty one participants from the population-based German Health Interview and Examination Survey for Children and Adolescents cohort (aged 3-17 years) had carotid intima-media thickness (CIMT) and distensibility coefficient (DC) measurements at the second follow-up (aged 14-28 years). The assessment of cardiovascular risk factors at baseline included information about arterial hypertension, obesity, dyslipidemia, and passive smoking. RESULTS Single risk factors and the exposure to multiple cardiovascular risk factors were associated with elevated CIMT and decreased DC. Relative risks for CIMT ≥ 90th centile and/or DC ≤ 10th centile were increased in participants exposed to two (RRCIMT = 1.45 [95% confidence interval 1.11-1.91], p < .05; RRDC = 1.37 [1.02-1.84], p < .05) and ≥ three risk factors (RRCIMT = 1.66 [1.05-2.62], p < .05; RRDC = 1.25 [0.71-2.21], p > .05). DISCUSSION Exposure to multiple cardiovascular risk factors starting in childhood is associated with measurably increased CIMT and carotid stiffness in late adolescence and early adulthood. These findings underline the importance of population-wide preventive measures to promote optimal cardiovascular health.
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Affiliation(s)
- Karsten Königstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
| | - Julia Charlotte Büschges
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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12
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Cheng L, Yue H, Zhang H, Liu Q, Du L, Liu X, Xie J, Shen Y. The influence of microenvironment stiffness on endothelial cell fate: Implication for occurrence and progression of atherosclerosis. Life Sci 2023; 334:122233. [PMID: 37918628 DOI: 10.1016/j.lfs.2023.122233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Atherosclerosis, the primary cause of cardiovascular diseases (CVDs), is characterized by phenotypic changes in fibrous proliferation, chronic inflammation and lipid accumulation mediated by vascular endothelial cells (ECs) and vascular smooth muscle cells (SMCs) which are correlated with the stiffening and ectopic remodeling of local extracellular matrix (ECM). The native residents, ECs and SMCs, are not only affected by various chemical factors including inflammatory mediators and chemokines, but also by a range of physical stimuli, such as shear stress and ECM stiffness, presented in the microenvironmental niche. Especially, ECs, as a semi-selective barrier, can sense mechanical forces, respond quickly to changes in mechanical loading and provide context-specific adaptive responses to restore homeostasis. However, blood arteries undergo stiffening and lose their elasticity with age. Reports have shown that the ECM stiffening could influence EC fate by changing the cell adhesion, spreading, proliferation, cell to cell contact, migration and even communication with SMCs. The cell behaviour changes mediated by ECM stiffening are dependent on the activation of a signaling cascade of mechanoperception and mechanotransduction. Although the substantial evidence directly indicates the importance of ECM stiffening on the native ECs, the understanding about this complex interplay is still largely limited. In this review, we systematically summarize the roles of ECM stiffening on the behaviours of endothelial cells and elucidate the underlying details in biological mechanism, aiming to provide the process of how ECs integrate ECM mechanics and the highlights for bioaffinity of tissue-specific engineered scaffolds.
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Affiliation(s)
- Lin Cheng
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Hongyan Yue
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Huaiyi Zhang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Qiao Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Lingyu Du
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Xiaoheng Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Jing Xie
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yang Shen
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China; JinFeng Laboratory, Chongqing 401329, China.
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13
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Mainas G, Nibali L, Rizzo M. Is subclinical cardiovascular disease linked with periodontal disease in diabetic and non-diabetic subjects? J Diabetes Complications 2023; 37:108580. [PMID: 37572438 DOI: 10.1016/j.jdiacomp.2023.108580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
Periodontal disease leads to a systemic hyper-inflammatory state that might impair other co-morbidities including cardiovascular disease. Evidence-based findings showed that periodontitis may be linked with subclinical signs of cardiovascular diseases such as arterial stiffness. Nevertheless, some contrasting results have been reported over the years. A cross-sectional study regarding the relationship between periodontal disease and subclinical cardiovascular diseases, in non-diabetic and diabetic individuals, has been recently published. Therefore, the aim of this commentary is to give an in-depth on this topic.
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Affiliation(s)
- Giuseppe Mainas
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT London, United Kingdom.
| | - Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT London, United Kingdom
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, School of Medicine, University of Palermo, 90133 Palermo, Italy
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14
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Tamura K, Kanaoka T, Fujiwara N, Hirota K. Esaxerenone for nocturnal hypertension and possible future direction for treatment of hypertension-cardiovascular-kidney comorbidity. Hypertens Res 2023; 46:2059-2061. [PMID: 37328695 DOI: 10.1038/s41440-023-01338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 05/18/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Tomohiko Kanaoka
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naoki Fujiwara
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Keigo Hirota
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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15
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Tanaka A, Shibata H, Imai T, Yoshida H, Miyazono M, Takahashi N, Fukuda D, Okada Y, Teragawa H, Suwa S, Kida K, Moroi M, Taguchi I, Toyoda S, Shimabukuro M, Tanabe K, Tanaka K, Nangaku M, Node K. Rationale and design of an investigator-initiated, multicenter, prospective, placebo-controlled, double-blind, randomized trial to evaluate the effects of finerenone on vascular stiffness and cardiorenal biomarkers in type 2 diabetes and chronic kidney disease (FIVE-STAR). Cardiovasc Diabetol 2023; 22:194. [PMID: 37525257 PMCID: PMC10391880 DOI: 10.1186/s12933-023-01928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The overactivation of mineralocorticoid receptor (MR) plays a key pathological role in the progression of cardiovascular and renal diseases by promoting pro-inflammatory and pro-fibrotic signaling. Recently, it has been found that finerenone, a novel nonsteroidal selective MR antagonist, can robustly improve cardiorenal outcomes in patients with type 2 diabetes (T2D) and a wide spectrum of chronic kidney disease (CKD). However, the mechanisms underlying the cardiorenal benefits of finerenone are poorly understood. Further, whether the clinical benefits are mediated by an improvement in vascular stiffness is not confirmed. Therefore, the current study aims to evaluate the effects of finerenone on vascular stiffness as assessed using cardio ankle vascular index (CAVI) and relevant cardiorenal biomarkers in patients with T2D and CKD. METHODS The Effects of Finerenone on Vascular Stiffness and Cardiorenal Biomarkers in Type 2 Diabetes and Chronic Kidney Disease (FIVE-STAR) is an ongoing, investigator-initiated, multicenter, prospective, placebo-controlled, double-blind, randomized clinical trial in Japan. Its target sample size is 100 subjects. Recruitment will be performed from September 2023 to July 2024. After obtaining informed consent, eligible participants with T2D and CKD (25 mL/min/1.73 m2 ≤ estimated glomerular filtration ratio [eGFR] < 90 mL/min/1.73 m2 and 30 mg/g Cr ≤ urinary albumin-to-creatinine ratio [UACR] < 3500 mg/g Cr) will be equally randomized to receive 24-week treatment with either finerenone (starting dose at 10 mg once daily in participants with a baseline eGFR < 60 mL/min/1.73 m2 or at 20 mg once daily in those with a baseline eGFR ≥ 60 mL/min/1.73 m2) or dose-matched placebo. The primary endpoint is the change from baseline in CAVI at 24 weeks. The secondary endpoints are changes from baseline in UACR at 12 and 24 weeks and relevant serum and urinary biomarkers at 24 weeks. As an exploratory endpoint, proteomic analysis using the Olink® Target 96 panels will be also performed. DISCUSSION FIVE-STAR is the first trial evaluating the therapeutic impact of finerenone on vascular stiffness and relevant cardiorenal biomarkers in patients with T2D and CKD. This study will provide mechanistic insights on the clinical benefits of finerenone based on recent cardiovascular and renal outcome trials. Trial registration Unique Trial Number, NCT05887817 ( https://clinicaltrials.gov/ct2/show/NCT05887817 ) and jRCTs021230011 ( https://jrct.niph.go.jp/latest-detail/jRCTs021230011 ).
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Affiliation(s)
- Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | | | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Oita University, Yufu, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Satoru Suwa
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni-Shi, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Isao Taguchi
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Kengo Tanabe
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Kenichi Tanaka
- Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
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16
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Pewowaruk RJ. Simple Models of Complex Mechanics for Improved Hypertension Care: Learning to De-stiffen Arteries. Artery Res 2023; 29:94-100. [PMID: 37674758 PMCID: PMC10477223 DOI: 10.1007/s44200-023-00037-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/14/2023] [Indexed: 09/08/2023] Open
Abstract
Arteries can stiffen via different mechanisms due to the distending effects of blood pressure, the extracellular (ECM) and vascular smooth muscle cells (VSMC). This short review discusses how these simple models can be applied to the complex biomechanics of arteries to gain physiological insight into why an individual's arteries are stiff and identify new therapeutic strategies. In the Multi-Ethnic Study of Atherosclerosis, the important question of whether arteries stiffen with aging due to load-dependent or structural stiffening was investigated. Structural stiffening was consistently observed with aging, but load-dependent stiffening was highly variable. Importantly, the high load-dependent stiffness was associated with future cardiovascular disease events, but structural stiffness was not. Clinical studies in older, hypertensive adults surprisingly show that decreasing vascular smooth muscle tone can cause clinically significant increases in arterial stiffness. To understand this paradox, the author developed a model simple enough for clinical data but with biologically relevant extracellular matrix (ECM) and vascular smooth muscle cell (VSMC) stiffness parameters. The effect of VSMC tone on arterial stiffness depends on the ECM-VSMC stiffness ratio. Future research is needed to develop a framework that incorporates both the blood pressure dependence of arterial stiffness and the VSMC-ECM interaction on hemodynamics. This could result in personalized arterial stiffness treatments and improved CVD outcomes. The subtitle of this review is "Learning to De-Stiffen Arteries" because our results have so far only shown that we can acutely make arteries stiffer. We are optimistic though that the findings and the analytic techniques covered here will be one of the many steps along the path of the arterial stiffness research community learning how to de-stiffen arteries.
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Affiliation(s)
- Ryan J. Pewowaruk
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI USA
- Department of Medicine Division of Cardiovascular Medicine, University of WI – Madison, Madison, WI USA
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17
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Matias AA, Albin IF, Glickman L, Califano PA, Faller JM, Layec G, Ives SJ. Impact of high intensity interval exercise with and without heat stress on cardiovascular and aerobic performance: a pilot study. BMC Sports Sci Med Rehabil 2023; 15:83. [PMID: 37434243 DOI: 10.1186/s13102-023-00682-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 06/21/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Heat stress during aerobic exercise training may offer an additional stimulus to improve cardiovascular function and performance in a cool-temperate environment. However, there is a paucity of information on the additive effects of high-intensity interval exercise (HIIE) and acute heat stress. We aimed to determine the effects of HIIE in combination with acute heat stress on cardiovascular function and exercise performance. METHODS Twelve active (peak O2 consumption [VO2peak]: 47 ± 8 ml·O2/min/kg) young adults were counterbalanced to six sessions of HIIE in hot (HIIE-H, 30 ± 1 °C, 50 ± 5% relative humidity [RH]) or temperate conditions (HIIE-T, 20 ± 2 °C, 15 ± 10% RH). Resting heart rate (HR), HR variability (HRV), central (cBP) and peripheral blood pressure (pBP), peripheral mean arterial pressure (pMAP), pulse wave velocity (PWV), VO2peak, and 5-km treadmill time-trial were measured pre- and post-training. RESULTS Resting HR and HRV were not significantly different between groups. However, expressed as percent change from baseline, cSBP (HIIE-T: + 0.9 ± 3.6 and HIIE-H: -6.6 ± 3.0%, p = 0.03) and pSBP (HIIE-T: -2.0 ± 4.6 and HIIE-H: -8.4 ± 4.7%, p = 0.04) were lower in the heat group. Post-training PWV was also significantly lower in the heat group (HIIE-T: + 0.4% and HIIE-H: -6.3%, p = 0.03). Time-trial performance improved with training when data from both groups were pooled, and estimated VO2peak was not significantly different between groups (HIIE-T: 0.7% and HIIE-H: 6.0%, p = 0.10, Cohen's d = 1.4). CONCLUSIONS The addition of acute heat stress to HIIE elicited additive adaptations in only cardiovascular function compared to HIIE alone in active young adults in temperate conditions, thus providing evidence for its effectiveness as a strategy to amplify exercise-induced cardiovascular adaptations.
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Affiliation(s)
- Alexs A Matias
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
- Department of Kinesiology, University of Massachusetts at Amherst, Amherst, MA, USA
| | - Isabelle F Albin
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Leah Glickman
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Peter A Califano
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Justin M Faller
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts at Amherst, Amherst, MA, USA
- Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - Stephen J Ives
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA.
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18
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Wang Y, Wang H, Zhou J, Wang J, Wu H, Wu J. Interaction between body mass index and blood pressure on the risk of vascular stiffness : A community-based cross-sectional study and implications for nursing. Int J Nurs Sci 2023; 10:325-331. [PMID: 37545779 PMCID: PMC10401353 DOI: 10.1016/j.ijnss.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Objective This study aimed to analyze associations between body mass index (BMI) and vascular measurements (brachial ankle pulse wave velocity [baPWV] and ankle-brachial index [ABI]), whether blood pressure (BP) was involved in the relationship, and implications for nursing. Methods A cross-sectional study was conducted, including 1,894 middle-aged and older adults who underwent routine health screening at a community medical center in the Zhangjiang community in Shanghai, China. Participants were divided into three groups based on BMI: normal weight (n = 1,202), overweight (n = 480), and obese (n = 212). Multivariate linear regression models and smooth curve fittings were used to evaluate the associations between BMI and indices of vascular stiffness. Mediation analysis examined whether blood pressure mediate the association between BMI and vascular stiffness. Results Multiple linear regression analysis showed that BMI to be significantly and negatively associated with baPWV (β = -0.06 [-0.10, -0.03]) and ABI (β = -0.004 [-0.005, -0.003]), respectively. The interaction test results of systolic blood pressure (SBP) in the relationship between BMI and baPWV were significant (P for interaction = 0.01). After adjusting for age and sex, mediation analyses showed that BMI and baPWV were correlated (β = 0.090, P < 0.001) and mediated by SBP (β = 0.533, P < 0.001) and diastolic blood pressure (DBP) (β = 0.338, P < 0.001). A negative association was found between BMI and ABI (β = -0.135, P < 0.001), which appeared to be partially mediated by SBP (β = 0.124, P < 0.001) and DBP (β = 0.053, P < 0.001). Additional subgroup analysis based on blood pressure levels did not revealed statistically significant mediating effects. Conclusions Our findings showed conflicting associations between BMI and non-invasive vascular measurements of arterial stiffness. BP may have a biological interaction in the relationship between BMI and baPWV. Managing blood pressure and weight through comprehensive clinical care is crucial for preventing stiffness or blockage of vessels in middle-aged and older adults.
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Affiliation(s)
- Yiyan Wang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hao Wang
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Sichuan, China
| | - Jie Zhou
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiaqi Wang
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hengjing Wu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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19
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Saengsin K, Gauvreau K, Prakash A. Comparison of aortic stiffness and hypertension in repaired coarctation patients with a bicuspid versus a tricuspid aortic valve. J Cardiovasc Magn Reson 2023; 25:31. [PMID: 37316842 PMCID: PMC10268521 DOI: 10.1186/s12968-023-00941-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Coarctation of the aorta (COA) is associated with reduced aortic distensibility and systemic hypertension (HTN). 60-85% of COA patients have a bicuspid aortic valve (BAV). It is not known if the presence of a BAV accentuates the aortopathy and HTN in CoA patients. We examined whether patients with COA and a BAV had lower aortic distensibility by CMR, and a higher prevalence of systemic HTN compared with COA patients with a tricuspid aortic valve (TAV). METHODS In successfully repaired COA patients excluding those with residual COA, ascending aorta (AAO) and descending aorta (DAO) distensibility was calculated by CMR. HTN was assessed using standard pediatric and adult criteria. RESULTS Among 215 COA patients (median age 25.3 years), 67% had a BAV, and 33% had a TAV. Median AAO distensibility z-score was lower in the BAV group (- 1.2 versus - 0.7; p = 0.014) but DAO distensibility was similar in BAV and TAV patients. HTN prevalence was similar in BAV (32%) and TAV groups (36%, p = 0.56). On multivariable analysis controlling for confounders, HTN was not associated with BAV but was associated with male gender (p = 0.003) and older age at follow-up (p = 0.004). CONCLUSIONS In young adults with treated COA, those with a BAV had stiffer AAO compared to those with a TAV, but DAO stiffness was similar. HTN was not related to BAV. These results suggest that although the presence of a BAV in COA exacerbates the AAO aortopathy, it does not exacerbate the more generalized vascular dysfunction and associated HTN.
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Affiliation(s)
- Kwannapas Saengsin
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kimberlee Gauvreau
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ashwin Prakash
- Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Kim SJ, Li MH, Noh CI, Kim SH, Lee CH, Yoon JK. Impact of Pulmonary Arterial Elastance on Right Ventricular Mechanics and Exercise Capacity in Repaired Tetralogy of Fallot. Korean Circ J 2023; 53:406-417. [PMID: 37271746 DOI: 10.4070/kcj.2022.0228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/25/2023] [Accepted: 03/01/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. METHODS In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. RESULTS Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO2] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO2 was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. CONCLUSIONS We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.
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Affiliation(s)
- Soo-Jin Kim
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
| | - Mei Hua Li
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
- The Sixth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chung Il Noh
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea.
| | - Seong-Ho Kim
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
| | - Chang-Ha Lee
- Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon, Korea
| | - Ja-Kyoung Yoon
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
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21
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Ren S, Chen Z, Deng X, Fan Y, Sun A. [Primary study on recognition of vascular stiffness based on wavelet scattering neural network]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2023; 40:244-248. [PMID: 37139754 DOI: 10.7507/1001-5515.202207068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Cardiovascular disease is the leading cause of death worldwide, accounting for 48.0% of all deaths in Europe and 34.3% in the United States. Studies have shown that arterial stiffness takes precedence over vascular structural changes and is therefore considered to be an independent predictor of many cardiovascular diseases. At the same time, the characteristics of Korotkoff signal is related to vascular compliance. The purpose of this study is to explore the feasibility of detecting vascular stiffness based on the characteristics of Korotkoff signal. First, the Korotkoff signals of normal and stiff vessels were collected and preprocessed. Then the scattering features of Korotkoff signal were extracted by wavelet scattering network. Next, the long short-term memory (LSTM) network was established as a classification model to classify the normal and stiff vessels according to the scattering features. Finally, the performance of the classification model was evaluated by some parameters, such as accuracy, sensitivity, and specificity. In this study, 97 cases of Korotkoff signal were collected, including 47 cases from normal vessels and 50 cases from stiff vessels, which were divided into training set and test set according to the ratio of 8 : 2. The accuracy, sensitivity and specificity of the final classification model was 86.4%, 92.3% and 77.8%, respectively. At present, non-invasive screening method for vascular stiffness is very limited. The results of this study show that the characteristics of Korotkoff signal are affected by vascular compliance, and it is feasible to use the characteristics of Korotkoff signal to detect vascular stiffness. This study might be providing a new idea for non-invasive detection of vascular stiffness.
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Affiliation(s)
- Shuqi Ren
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - Zengsheng Chen
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - Xiaoyan Deng
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
| | - Anqiang Sun
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, P. R. China
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Cilhoroz BT, Heckel AR, DeBlois JP, Keller A, Sosnoff JJ, Heffernan KS. Arterial stiffness and augmentation index are associated with balance function in young adults. Eur J Appl Physiol 2023; 123:891-899. [PMID: 36564497 DOI: 10.1007/s00421-022-05116-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Arterial stiffness and pulsatile central hemodynamics have been shown to affect various aspects of physical function, such as exercise capacity, gait speed, and motor control. The aim of this study was to examine the potential association between arterial stiffness and balance function in healthy younger men and women. METHODS 112 participants (age = 21 ± 4 years, n = 78 women) underwent measures of arterial stiffness, pulsatile central hemodynamics, balance function and physical fitness in this cross-sectional study. Postural sway was measured in triplicate while participants stood on a foam surface with their eyes closed for 20 s. The average total center of pressure path length from the three trials was used for analysis. Measures of vascular function were estimated using an oscillometric blood pressure device while at rest and included pulse wave velocity (PWV), augmentation index (AIx), and pulse pressure amplification. Measures of physical fitness used as covariates in statistical models included handgrip strength determined from a handgrip dynamometer, lower-body flexibility assessed using a sit-and-reach test, estimated maximal aerobic capacity (VO2max) using heart rate and a step test, and body fat percentage measured from air displacement plethysmography. RESULTS The results from linear regression indicated that after considering sex, mean arterial pressure, body fat, estimated VO2max, handgrip strength, and sit-and-reach, PWV (β = 0.44, p < 0.05) and AIx (β = - 0.25, p < 0.01) were significant predictors of postural sway, explaining 10.2% of the variance. CONCLUSION Vascular function is associated with balance function in young adults independent of physical fitness. Increased arterial stiffness may negatively influence balance, while wave reflections may be protective for balance.
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Affiliation(s)
- Burak T Cilhoroz
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Andrew R Heckel
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Jacob P DeBlois
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Allison Keller
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kevin S Heffernan
- Department of Exercise Science, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, 13244, USA.
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Kim HL, Chung J, Han S, Joh HS, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types. Clin Hypertens 2023; 29:8. [PMID: 36918917 PMCID: PMC10015827 DOI: 10.1186/s40885-022-00233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/21/2022] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Little is known about the characteristics of arterial stiffness in heart failure (HF). This study was performed to compare the degree of arterial stiffness and its association with left ventricular (LV) diastolic function among three groups: control subjects, patients with HF with reduced ejection fraction (HFrEF), and patients with HF with preserved ejection fraction (HFpEF). METHODS A total of 83 patients with HFrEF, 68 patients with HFpEF, and 84 control subjects were analyzed. All HF patients had a history of hospitalization for HF treatment. Brachial-ankle pulse wave velocity (baPWV) measurement and transthoracic echocardiography were performed at the same day in a stable condition. RESULTS The baPWV was significantly higher in patients with both HFrEF and HFpEF compared to control subjects (1,661 ± 390, 1,909 ± 466, and 1,477 ± 296 cm/sec, respectively; P < 0.05 for each). After adjustment of age, baPWV values were similar between patients with HFrEF and HFpEF (P = 0.948). In the multiple linear regression analysis, baPWV was significantly associated with both septal e' velocity (β = -0.360, P = 0.001) and E/e' (β = 0.344, P = 0.001). However, baPWV was not associated with either of the diastolic indices in HFrEF group. The baPWV was associated only with septal e' velocity (β = -0.429, P = 0.002) but not with E/e' in the HFpEF group in the same multivariable analysis. CONCLUSIONS Although arterial stiffness was increased, its association with LV diastolic function was attenuated in HF patients compared to control subjects. The degree of arterial stiffening was similar between HFrEF and HFpEF.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jaehoon Chung
- Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Seokmoon Han
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyun Sung Joh
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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Khang AR, Lee MJ, Yi D, Kang YH. The Ratio of Estimated Glomerular Filtration Rate Based on Cystatin C and Creatinine Reflecting Cardiovascular Risk in Diabetic Patients. Diabetes Metab J 2023:dmj.2022.0177. [PMID: 36872062 DOI: 10.4093/dmj.2022.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/12/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The ratio of estimated glomerular filtration rate (eGFR) based on cystatin C and creatinine (eGFRcystatin C/eGFRcreatinine ratio) is related to accumulating atherosclerosis-promoting proteins and increased mortality in several cohorts. METHODS We assessed whether the eGFRcystatin C/eGFRcreatinine ratio is a predictor of arterial stiffness and sub-clinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, who were followed up during 2008 to 2016. GFR was estimated using an equation based on cystatin C and creatinine. RESULTS A total of 860 patients were stratified according to their eGFRcystatin C/eGFRcreatinine ratio (i.e., <0.9, 0.9-1.1 [a reference group], and >1.1). Intima-media thickness was comparable among the groups; however, presence of carotid plaque was frequent in the <0.9 group (<0.9 group, 38.3%; 0.9-1.1 group, 21.6% vs. >1.1 group, 17.2%, P<0.001). Brachial-ankle pulse wave velocity (baPWV) was faster in the <0.9 group (<0.9 group, 1,656.3±333.0 cm/sec; 0.9-1.1 group, 1,550.5±294.8 cm/sec vs. >1.1 group, 1,494.0±252.2 cm/sec, P<0.001). On comparing the <0.9 group with the 0.9-1.1 group, the multivariate-adjusted odds ratios of prevalence of high baPWV and carotid plaque were 2.54 (P=0.007) and 1.95 (P=0.042), respectively. Cox regression analysis demonstrated near or over 3-fold higher risks of the prevalence of high baPWV and carotid plaque in the <0.9 group without chronic kidney disease (CKD). CONCLUSION We concluded that eGFRcystatin C/eGFRcreatinine ratio <0.9 was related to an increased risk of high baPWV and carotid plaque in T2DM patients, especially, those without CKD. Careful monitoring of cardiovascular disease is needed for T2DM patients with low eGFRcystatin C/eGFRcreatinine ratio.
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Affiliation(s)
- Ah Reum Khang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Min Jin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Dongwon Yi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yang Ho Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Bittencourt JC, Scheinbein GHA, de Oliveira Junior WC, Bassi RL, Moura LB, Correa ALD, de Lima Bernardes RG, Freitas LS, Lemos JC, Gonçalves GKN, Rodrigues-Machado MDG. Arterial stiffness indices, pulse wave velocity and central systolic blood pressure, are able to discriminate between obese and non-obese children. Eur J Pediatr 2023; 182:1403-1415. [PMID: 36680578 PMCID: PMC9862226 DOI: 10.1007/s00431-023-04807-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023]
Abstract
The objectives of this study were to verify, first, if arterial stiffness indices can discriminate between obese and healthy children. Second, to evaluate arterial stiffness index predictors and hemodynamic parameters in obese children. Arterial stiffness indices evaluated were pulse wave velocity (PWV), central systolic blood pressure (SBPc), and central pulse pressure (PPc). A cross-sectional, descriptive, comparative study design was used. The sample consisted of 78 normal-weight children (8.1 ± 1.96 years) and 58 obese children (9.0 ± 1.87 years). PWV, PPc, and SBPc were significantly higher in the group of obese children than in the control group. The ROC curve analysis showed that maximum PWV and SBPc sensitivity and specificity in differentiating obese from non-obese children occurred at 4.09 m/s and 86.17 mmHg, respectively. PPc did not exhibit a discriminatory capacity between the two groups. Peripheral systolic blood pressure (SBPp), peripheral pulse pressure (PPp), and PPc (R2 = 0.98) were predictors of increased PWV. Augmentation pressure, PPp, and reflection coefficient (R2 = 0.873) were predictors of PPc. Age, augmentation index, total vascular resistance, cardiac index, and mean fat percentage (R2 = 0.801) were predictors of SBPc. CONCLUSION This study shows for the first time that PWV > 4.09 m/s and SBPc > 86.17 mmHg are cut-off points associated with a higher risk of obesity. These results indicate that the simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information regarding cardiovascular risk, in addition to increased body mass index. WHAT IS KNOWN • Overweight and obesity are strongly associated with comorbidities que contribute to the development of cardiovascular diseases. WHAT IS NEW • This is the first study to show that PWV and SBPc can discriminate obese from non-obese children. These results show that, in addition to an increased BMI, a simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information on cardiovascular risk.
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Affiliation(s)
- Juliana Cabral Bittencourt
- Faculty of Medical Sciences of Minas Gerais (FCM-MG), Post-Graduate Program in Health Sciences, Belo Horizonte, MG Brazil
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Araújo CRDS, Fernandes J, Caetano DS, Barros AEVDR, de Souza JAF, Machado MDGR, de Aguiar MIR, Brandão SCS, Campos SL, de Andrade ADFD, Brandão DC. Endothelial function, arterial stiffness and heart rate variability of patients with cardiovascular diseases hospitalized due to COVID-19. Heart Lung 2023; 58:210-216. [PMID: 36621104 PMCID: PMC9805900 DOI: 10.1016/j.hrtlng.2022.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND The novel coronavirus disease (COVID-19) may cause vascular (e.g., endothelial dysfunction, and arterial stiffness), cardiac, autonomic (e.g., heart rate variability [HRV]), and systemic inflammatory response via direct viral attack, hypoxia-induced injury, or immunological dysregulation, especially in those patients with pre-existing cardiovascular diseases (CVD). However, to date, no study has shown prevalence of endothelial dysfunction, arterial stiffness and heart rate variability assessed by bedside peripheral arterial tonometry in patients with previous CVD hospitalized in the acute phase of COVID-19. OBJECTIVE This study aimed to assess the prevalence of endothelial dysfunction, arterial stiffness, and altered HRV in patients with CVD hospitalized due to COVID-19. METHODS This cross-sectional study was conducted from July 2020 to February 2021. Included male and female adult patients aged 40 to 60 years with previous CVD and diagnosed with COVID-19. Anthropometric data, comorbidities, and blood tests were analyzed. Endothelial function, arterial stiffness, and HRV were assessed using peripheral arterial tonometry (PAT), and the statistical significance was set at 5%. RESULTS Fourteen (51.8%) patients presented endothelial dysfunction (reactive hyperemia index = 1.2 ± 0.3) and enhancement in the high-frequency component of HRV (p < 0.05). There was a high prevalence of endothelial dysfunction, especially in patients with chronic heart failure (10 (71.4%)). Patients with preserved endothelial function showed a high augmentation index normalized to a heart rate of 75 bpm (p < 0.01), suggesting arterial stiffness. CONCLUSION Patients with CVD hospitalized due to COVID-19 presented endothelial dysfunction assessed using PAT, which could be used as a biomarker for arterial stiffness and altered HRV. The possibility of detecting vascular and autonomic changes during phase II of COVID-19 may help to prevent possible long-term complications.
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Affiliation(s)
| | - Juliana Fernandes
- Department of Physiotherapy. Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | | | | | - Shirley Lima Campos
- Department of Physiotherapy. Federal University of Pernambuco, Recife, Brazil
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Wang YP, Sidibé A, Fortier C, Desjardins MP, Ung RV, Kremer R, Agharazii M, Mac-Way F. Wnt/β-catenin pathway inhibitors, bone metabolism and vascular health in kidney transplant patients. J Nephrol 2023; 36:969-978. [PMID: 36715822 DOI: 10.1007/s40620-022-01563-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/25/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Sclerostin, dickkopf-related protein 1 (DKK1), fibroblast growth factor-23 (FGF23) and α-klotho have been shown to play an important role in bone and vascular disease of chronic kidney disease. We aimed to evaluate the evolution of these bone markers in newly kidney transplanted patients, and whether they are associated with bone metabolism and vascular stiffness. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS This is a longitudinal single-center observational cohort study. Circulating levels of Wnt/β-catenin pathway inhibitors (sclerostin, DKK1, FGF23 and α-klotho), arterial stiffness (carotid-femoral pulse-wave velocity (PWV), carotid-radial PWV, PWV ratio, augmented index) and bone parameters were assessed before (M0), and at 3 (M3) and 6 months (M6) after transplantation. Generalized estimating equations were conducted for comparative analyses between the three time points. We used a marginal structural model for repeated measures for the impact of changes in bone markers on the evolution of arterial stiffness. Multivariate linear regression analyses were performed for the associations between Wnt/β-catenin pathway inhibitors and mineral metabolism parameters. RESULTS We included 79 patients (70% male; median age of 53 (44-60) years old). The levels of sclerostin (2.06 ± 1.18 ng/mL at M0 to 0.88 ± 0.29 ng/mL at M6, p ≤ 0.001), DKK1 (364.0 ± 266.7 pg/mL at M0 to 246.7 ± 149.1 pg/mL at M6, p ≤ 0.001), FGF23 (5595 ± 9603 RU/mL at M0 to 137 ± 215 RU/mL at M6, p ≤ 0.001) and α-klotho (457.6 ± 148.6 pg/mL at M0 to 109.8 ± 120.7 pg/mL at M6, p < 0.05) decreased significantly after kidney transplant. Sclerostin and FGF23 were positively associated with carotid-femoral (standardized β = 0.432, p = 0.037 and standardized β = 0.592, p = 0.005) and carotid-radial PWV (standardized β = 0.259, p = 0.029 and standardized β = 0.242, p = 0.006) throughout the 6 months of follow-up. The nature of the associations between bone markers and bone metabolism parameters varies after kidney transplant. CONCLUSIONS The circulating levels of Wnt/β-catenin pathway inhibitors and α-klotho significantly decrease after kidney transplantation, while sclerostin and FGF23 levels might be associated with improvement of vascular stiffness and blood pressure.
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Affiliation(s)
- Yue-Pei Wang
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Aboubacar Sidibé
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Catherine Fortier
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Marie-Pier Desjardins
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Roth-Visal Ung
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Richard Kremer
- Faculty and Department of Medicine, McGill University Health Center, Royal Victoria Hospital, McGill University, Montréal, Canada
| | - Mohsen Agharazii
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada
| | - Fabrice Mac-Way
- Endocrinology and Nephrology Unit, Faculty and Department of Medicine, CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Université Laval, 10 McMahon, Quebec, QC, G1R 2J6, Canada.
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Ibarrola J, Kim SK, Lu Q, DuPont JJ, Creech A, Sun Z, Hill MA, Jaffe JD, Jaffe IZ. Smooth muscle mineralocorticoid receptor as an epigenetic regulator of vascular ageing. Cardiovasc Res 2023; 118:3386-3400. [PMID: 35020830 PMCID: PMC10060709 DOI: 10.1093/cvr/cvac007] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/07/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS Vascular stiffness increases with age and independently predicts cardiovascular disease risk. Epigenetic changes, including histone modifications, accumulate with age but the global pattern has not been elucidated nor are the regulators known. Smooth muscle cell-mineralocorticoid receptor (SMC-MR) contributes to vascular stiffness in ageing mice. Thus, we investigated the regulatory role of SMC-MR in vascular epigenetics and stiffness. METHODS AND RESULTS Mass spectrometry-based proteomic profiling of all histone modifications completely distinguished 3 from 12-month-old mouse aortas. Histone-H3 lysine-27 (H3K27) methylation (me) significantly decreased in ageing vessels and this was attenuated in SMC-MR-KO littermates. Immunoblotting revealed less H3K27-specific methyltransferase EZH2 with age in MR-intact but not SMC-MR-KO vessels. These ageing changes were examined in primary human aortic (HA)SMC from adult vs. aged donors. MR, H3K27 acetylation (ac), and stiffness gene (connective tissue growth factor, integrin-α5) expression significantly increased, while H3K27me and EZH2 decreased, with age. MR inhibition reversed these ageing changes in HASMC and the decline in stiffness genes was prevented by EZH2 blockade. Atomic force microscopy revealed that MR antagonism decreased intrinsic stiffness and the probability of fibronectin adhesion of aged HASMC. Conversely, ageing induction in young HASMC with H2O2; increased MR, decreased EZH2, enriched H3K27ac and MR at stiffness gene promoters by chromatin immunoprecipitation, and increased stiffness gene expression. In 12-month-old mice, MR antagonism increased aortic EZH2 and H3K27 methylation, increased EZH2 recruitment and decreased H3K27ac at stiffness genes promoters, and prevented ageing-induced vascular stiffness and fibrosis. Finally, in human aortic tissue, age positively correlated with MR and stiffness gene expression and negatively correlated with H3K27me3 while MR and EZH2 are negatively correlated. CONCLUSION These data support a novel vascular ageing model with rising MR in human SMC suppressing EZH2 expression thereby decreasing H3K27me, promoting MR recruitment and H3K27ac at stiffness gene promoters to induce vascular stiffness and suggests new targets for ameliorating ageing-associated vascular disease.
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Affiliation(s)
- Jaime Ibarrola
- Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA
| | - Seung Kyum Kim
- Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA
- Department of Sports Science, Seoul National University of Science and Technology, 232 Gongneung-ro, Nowon-gu, 01811 Republic of Korea, Seoul, South Korea
| | - Qing Lu
- Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA
| | - Jennifer J DuPont
- Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA
| | - Amanda Creech
- Broad Institute, Proteomics Platform, Cambridge, MA 02142, USA
| | - Zhe Sun
- Department of Medical Pharmacology and Physiology, Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65203, USA
| | - Michael A Hill
- Department of Medical Pharmacology and Physiology, Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65203, USA
| | - Jacob D Jaffe
- Broad Institute, Proteomics Platform, Cambridge, MA 02142, USA
| | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA 02111, USA
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Heffernan KS, Charry D, Xu J, Tanaka H, Churilla JR. Estimated pulse wave velocity and incident heart failure and its subtypes: Findings from the multi-ethnic study of atherosclerosis. Am Heart J Plus 2023; 25:100238. [PMID: 36873573 PMCID: PMC9983630 DOI: 10.1016/j.ahjo.2022.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
UNLABELLED Age-associated increase in aortic stiffness, measured as carotid-femoral pulse wave velocity (PWV), is an important effector of cardiac damage and heart failure (HF). Pulse wave velocity estimated from age and blood pressure (ePWV) is emerging as a useful proxy of vascular aging and subsequent cardiovascular disease risk. We examined the association of ePWV with incident HF and its subtypes in a large community sample of 6814 middle-aged and older adults from the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS Participants with an ejection fraction ≤40 % were classified as HF with reduced ejection fraction (HFrEF) while those with an ejection fraction ≥50 % were classified as HF with preserved ejection fraction (HFpEF). Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI). RESULTS Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 339 participants: 165 were classified as HFrEF and 138 as HFpEF. In fully adjusted models, the highest quartile of ePWV was significantly associated with an increased risk of overall HF (HR 4.79, 95 % CI 2.43-9.45) compared with the lowest quartile (reference). When exploring HF subtypes, the highest quartile of ePWV was associated with HFrEF (HR 8.37, 95 % CI 4.24-16.52) and HFpEF (HR 3.94, 95 % CI 1.39-11.17). CONCLUSIONS Higher ePWV values were associated with higher rates of incident HF and its subtypes in a large, diverse cohort of men and women.
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Affiliation(s)
- Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, 820 Comstock Ave, The Women's Building Suite 100, Syracuse, NY 13244, USA
| | - Daniela Charry
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA
| | - Jing Xu
- Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive/Bldg 39, Jacksonville, FL 32224-2673, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA
| | - James R. Churilla
- Department of Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, 1UNF Drive/Bldg 39, Jacksonville, FL 32224-2673, USA
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Patra PK, Banday AZ, Asghar A, Nisar R, Das RR, Reddy P, Bhattarai D. Vascular dysfunction in juvenile idiopathic arthritis: a systematic review and meta-analysis. Rheumatol Int 2023; 43:33-45. [PMID: 36469106 DOI: 10.1007/s00296-022-05255-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
We performed a systematic review and meta-analysis of studies evaluating vascular function in patients with JIA. Relevant literature published from 1st January 1965 to 1st March 2022 was searched systematically utilizing PubMed, Web of Science, and Embase databases. Observational studies were included-patients with JIA (classified according to the International League of Associations for Rheumatology criteria) were included as cases (study population) and age/sex-matched healthy participants as controls (comparator group). Outcome measures were differences in non-invasive parameters of vascular function. Online Population, Intervention, Comparison, Outcomes Portal was used for deduplication of studies and data extraction. Review Manager, Comprehensive Meta-analysis, and Meta-Essential softwares were used for data synthesis/analysis (encompassing data pooling and evaluation of heterogeneity and publication bias). Newcastle-Ottawa Scale and GRADEpro GDT software were utilized to assess study quality and certainty of evidence, respectively. Of 338 citations, 17 observational studies with 1423 participants (cases = 757, controls = 666) were included. Carotid intima-media thickness (CIMT) was higher [mean difference (MD) 0.02 mm {95% confidence interval (CI) 0.01-0.04}, p = 0.0006, I2 = 69%] in patients with JIA. Besides, decreased flow-mediated dilatation (FMD) [MD - 2.18% {95%CI - 3.69- - 0.68}, p = 0.004, I2 = 73%] was also observed. Results of studies assessing pulse wave velocity or arterial stiffness could not be pooled due to significant methodological variations. A 'very low' certainty of evidence suggests the presence of vascular dysfunction in JIA. Future longitudinal studies are required to determine whether altered CIMT and FMD in patients with JIA translate to an enhanced risk of (adverse) clinical cardiovascular events. PROSPERO (CRD42022323752).
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Affiliation(s)
- Pratap Kumar Patra
- Department of Pediatrics, Allergy Immunology Unit, All India Institute of Medical Sciences (AIIMS), Patna, 801105, India.
| | - Aaqib Zaffar Banday
- Rheumatology Division, Kashmir Clinics Group, Balgarden, Srinagar, India
- Clinical Immunology and Rheumatology Division, Department of Pediatrics, Khyber Medical Institute, Nowpora, Srinagar, India
| | | | - Rahila Nisar
- Department of Microbiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Pakkiresh Reddy
- Department of Pediatrics, Allergy Immunology Unit, All India Institute of Medical Sciences (AIIMS), Patna, 801105, India
| | - Dharmagat Bhattarai
- Advanced Center for Immunology and Rheumatology, Om Hospital and Research Center, Katmandu, Nepal
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Ma X, Zhu Z, Wang Y, Shen B, Jiang X, Liu W, Wu Y, Zou C, Luan Y, Gao H, Huang H. Quantifying carotid stiffness in a pre-hypertensive population with ultrafast ultrasound imaging. Ultrasonography 2023; 42:89-99. [PMID: 36588181 PMCID: PMC9816694 DOI: 10.14366/usg.22039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/09/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE The aim of this study was to assess carotid stiffening in a pre-hypertensive (PHT) population using ultrafast pulse wave velocity (ufPWV). METHODS This study retrospectively enrolled 626 individuals who underwent clinical interviews, serum tests, and assessments of the systolic blood pressure (SBP), diastolic blood pressure (DBP), carotid intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS), and pulse wave velocity-end of systole (PWV-ES) between January 2017 and December 2021. The patients were divided into three groups according to their blood pressure (BP)-normal BP (NBP): SBP <130 mmHg and DBP <80 mmHg (n=215); PHT: 130 mmHg≤SBP<140 mmHg and/or 80 mmHg≤DBP<90 mmHg (n=119); hypertensive (HT): SBP ≥140 mmHg and/or DBP ≥90 mmHg (n=292). Correlation analyses and comparisons were performed among the groups and in the cIMT subgroups (cIMT ≥0.050 cm and <0.050 cm). RESULTS cIMT and PWV-ES significantly differed among the BP groups (P<0.05). The BP groups had similar PWV-BS when cIMT <0.050 cm or cIMT ≥0.050 cm (all P>0.05). However, the NBP group had a notably lower PWV-ES than the PHT (P<0.001 and P=0.024) and HT (all P<0.001) groups in both cIMT categories, while the PWV-ES in the PHT group were not significantly lower than in the HT group (all P>0.05). CONCLUSION Carotid morphological and biomechanical properties in the PHT group differed from those in the NBP group. ufPWV could be used for an early evaluation of carotid stiffening linked to pre-hypertension.
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Affiliation(s)
- Xuehui Ma
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Zhengqiu Zhu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yinping Wang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Bixiao Shen
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xuezhong Jiang
- Department of Ultrasound, Jiangsu Province Geriatric Hospital, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjun Liu
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Chong Zou
- Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China,Center of Good Clinical Practice, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yun Luan
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Gao
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Huang
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China,Correspondence to: Hui Huang, MD, Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155# Hanzhong Road, Nanjing 210029, China Tel. +86-25-8661-7141 Fax. +86-25-8661-7141 E-mail:
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Michalski AC, Ferreira AS, Midgley AW, Costa VAB, Fonseca GF, da Silva NSL, Borges J, Billinger SA, Cunha FA. Mixed circuit training acutely reduces arterial stiffness in patients with chronic stroke: a crossover randomized controlled trial. Eur J Appl Physiol 2023; 123:121-34. [PMID: 36205814 DOI: 10.1007/s00421-022-05061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/30/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Investigate whether a single bout of mixed circuit training (MCT) can elicit changes in arterial stiffness in patients with chronic stroke. Second, to assess the between-day reproducibility of post-MCT arterial stiffness measurements. METHODS Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and two bouts of MCT on separate days in a randomized counterbalanced order. The MCT involved 3 sets of 15 repetition maximum for 10 exercises, with each set separated by 45-s of walking. Brachial-radial pulse wave velocity (br-PWV), radial artery compliance (AC) and reflection index (RI1,2) were assessed 10 min before and 60 min after CTL and MCT. Ambulatory arterial stiffness index (AASI) was calculated from 24-h recovery ambulatory blood pressure monitoring. RESULTS Compared to CTL, after 60 min of recovery from the 1st and 2nd bouts of MCT, lower values were observed for br-PWV (mean diff = - 3.9 and - 3.7 m/s, respectively, P < 0.01; ICC2,1 = 0.75) and RI1,2 (mean diff = - 16.1 and - 16.0%, respectively, P < 0.05; ICC2,1 = 0.83) concomitant with higher AC (mean diff = 1.2 and 1.0 × 10-6 cm5/dyna, respectively, P < 0.01; ICC2,1 = 0.40). The 24-h AASI was reduced after bouts of MCT vs. CTL (1st and 2nd bouts of MCT vs. CTL: mean diff = - 0.32 and - 0.29 units, respectively, P < 0.001; ICC2,1 = 0.64). CONCLUSION A single bout of MCT reduces arterial stiffness during laboratory (60 min) and ambulatory (24 h) recovery phases in patients with chronic stroke with moderate-to-high reproducibility. TRIAL REGISTRATION Ensaiosclinicos.gov.br identifier RBR-5dn5zd.
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Kim KD, Kim H, Cho S, Lee SH, Joh JH. Ultrasound Elastography to Differentiate the Thrombus and Plaque in Peripheral Arterial Diseases. Vasc Specialist Int 2022; 38:34. [PMID: 36575112 PMCID: PMC9794493 DOI: 10.5758/vsi.220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose Arterial stiffness and steno-occlusion of the lower-extremity can result from many vascular lesions, including acute thromboembolisms, soft plaques, calcified plaques, or inflammatory disease. Ultrasound (US) elastography measures the tissue deformation response to compression and displays tissue stiffness. This study aimed to evaluate the characteristics of arterial lesions in the lower extremities using US elastography. Materials and Methods We retrospectively analyzed the data of 20 patients who visited our institute for arterial disease treatment between May 2016 and November 2017. An US examination with B-mode and strain elastography (SE) was performed of four different lesion types at 45 sites: acute and subacute thromboembolisms, soft plaques, calcified plaques, and thromboangiitis obliterans lesions (TAOs). During SE, stress was externally applied by the operator using the transducer. Strain ratio (SR) was calculated as the fraction of the average strain in the reference area divided by the average strain in the lesion. The SR was compared among different lesion types, with the accompanying vein as the reference region of interest. Results The strain was highest in the soft plaques (0.63%±0.23%), followed by the TAOs (0.45%±0.11%), calcified plaques (0.44%±0.13%), and acute thromboembolisms (0.34%±0.23%), which were statistically significant (P=0.026). However, the mean SR was highest for the calcified plaques (2.33%±0.80%), followed by the TAOs (1.63%±0.40%), acute thromboembolisms (1.60%±0.48%), and soft plaques (1.51±0.39), and which were statistically significant (P=0.013). Conclusion Despite several limitations, vascular elastography may be useful for differentiating between lesion types in peripheral arterial disease.
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Affiliation(s)
- Ki Duk Kim
- Department of Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyangkyoung Kim
- Department of Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sungsin Cho
- Department of Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung Hwan Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jin Hyun Joh
- Department of Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea,Corresponding author: Jin Hyun Joh, Department of Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea, Tel: 82-2-440-6261, Fax: 82-2-440-6296, E-mail: , https://orcid.org/0000-0002-8533-6755
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Pewowaruk RJ, Hein AJ, Carlsson CM, Korcarz CE, Gepner AD. Effects of nitroglycerin-induced vasodilation on elastic and muscular artery stiffness in older Veterans. Hypertens Res 2022; 45:1997-2007. [PMID: 35840750 PMCID: PMC10896453 DOI: 10.1038/s41440-022-00981-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/01/2022] [Accepted: 06/05/2022] [Indexed: 11/09/2022]
Abstract
Vascular smooth muscle tone may play an important role in the physiology of increased arterial stiffness that occurs with aging. This study evaluated the impact of smooth muscle tone on arterial stiffness in older individuals following nitroglycerin-induced vasodilation in elastic and muscular arteries. Forty older Veterans (≥60 years old) without known cardiovascular disease were included in this study. Twenty Veterans were included as hypertensive participants (70.8 ± 6.6 years, 10 females), and 20 were included as normotensive controls (72.0 ± 9.3 years, 8 females). Nitroglycerin (NTG)-induced changes in arterial stiffness were measured locally with vascular ultrasound in the carotid and brachial arteries and regionally by carotid-femoral pulse wave velocity (cfPWV) with tonometry. With NTG treatment, both hypertensive participants and normotensive controls Veterans showed increased carotid PWV (6.4 ± 1.3 m/s to 7.2 ± 1.4 m/s, Δ 0.8 ± 1.1 m/s, p = 0.007) and cfPWV (8.6 ± 1.9 m/s to 9.5 ± 2.4 m/s, Δ 0.9 ± 2.3 m/s, p = 0.020) but did not show changes in brachial PWV (11.2 ± 2.4 m/s to 11.1 ± 2.2 m/s, Δ -0.2 ± 2.5 m/s, p = 0.72). The carotid artery was dilated more in control participants than hypertensive Veterans (Δ 0.54 ± 0.19 mm vs. 0.42 ± 0.12 mm, p = 0.022). Brachial artery dilation was similar between the two groups (Δ 0.55 ± 0.26 mm vs. 0.51 ± 0.20 mm, p = 0.46). In older Veterans without known cardiovascular disease, NTG-induced vasodilation increased elastic artery stiffness but did not change muscular artery stiffness. Increased central arterial stiffness and a decrease in the arterial stiffness gradient could offset some of the benefits of lowering blood pressure in older patients who are prescribed vasodilators as an antihypertensive therapy. Elastic artery stiffening with vasodilation warrants further investigation, as it may be important for antihypertensive medication selection and influence CVD development.
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Affiliation(s)
- Ryan J Pewowaruk
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Amy J Hein
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Cynthia M Carlsson
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Medicine - Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Claudia E Korcarz
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Adam D Gepner
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Kawabata T, Kubozono T, Ojima S, Kawasoe S, Akasaki Y, Salim AA, Ikeda Y, Miyata M, Takenaka T, Ohishi M. Insufficient blood pressure control is independently associated with increased arterial stiffness. Hypertens Res 2022; 45:1861-8. [PMID: 36192630 DOI: 10.1038/s41440-022-01039-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 02/07/2023]
Abstract
Hypertension is a risk factor for atherosclerosis. Achieving the therapeutic target value of blood pressure (BP) prevents the onset of cardiovascular events; however, it is not clear how antihypertensive drug use and BP control status relate to arterial stiffness. The purpose of this study is to investigate the relationship between BP control status with or without antihypertensive drugs and arterial stiffness. Nine hundred eighty individuals (mean age: 68 ± 11 years) who participated in a community-based cohort study were enrolled. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). Higher BP was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Participants were divided into four groups: normal, non higher BP without antihypertensive drugs (n = 421); untreated, higher BP without antihypertensive drugs (n = 174); good control, non higher BP with antihypertensive drugs (n = 209); and poor control, higher BP with antihypertensive drugs (n = 176). In multivariable logistic analysis adjusted for age, sex, dyslipidemia and diabetes mellitus medication use, obesity, smoking, alcohol drinking, and heart rate at the CAVI measurement for a high CAVI-using a borderline cutoff value of 8.0-the other three groups were significantly associated with a high CAVI when compared with the normal group. By contrast, multivariable logistic analysis of a high CAVI using an abnormal cutoff value of 9.0 demonstrated that the poor control and untreated groups were significantly associated with a high CAVI, whereas the good control group was not. In conclusion, even with antihypertensive drugs, poor BP control is independently associated with a high CAVI.
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Song Q, Ling Q, Bai J, Zhang H, Bu P, Chen F, Wu S, Zhang W, Chen M, Cai J. Influence of baseline arterial stiffness on effects of intensive compared with standard blood pressure control: a post hoc analysis of the STEP trial. BMC Med 2022; 20:358. [PMID: 36261812 PMCID: PMC9583479 DOI: 10.1186/s12916-022-02556-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The benefits and risks of intensive versus standard systolic blood pressure (SBP) treatment in older patients with arterial stiffness (AS) remains unclear. This study aims to investigate the interaction between the baseline AS and SBP treatments on cardiovascular outcomes. METHODS In this post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial, we involved 6865 participants with complete data regarding baseline brachial-ankle pulse wave velocity (baPWV). Patients were categorized by baseline AS status (AS, baPWV ≥ 1800 cm/s; non-AS, baPWV < 1800 cm/s). The primary outcome was a composite of cardiovascular events. The secondary outcomes were stroke, acute coronary syndrome (ACS), major cardiovascular events (MACE), and all-cause death. Cox regression was used to calculate hazard ratios for the outcomes. RESULTS During a mean follow-up of 2.69 years, a total of 248 primary outcome events and 81 all-cause deaths occurred. The hazard ratios for the primary outcome were 0.76 (95% confidence interval (CI), 0.54-1.09) and 0.63 (95% CI, 0.43-0.92) in the AS and non-AS groups, respectively (P for interaction = 0.43), and that for stroke was 0.58 (95% CI, 0.33-1.02) and 0.48 (95% CI, 0.23-0.99) in the AS and non-AS groups, respectively (P for interaction = 0.68). Effects of intensive SBP treatment on safety outcomes and all-cause death were also similar in the two groups (P for interaction > 0.05 for all). CONCLUSIONS In the STEP trial, the beneficial effects of intensive SBP treatment were similar among those in the AS group and the non-AS group at baseline. TRIAL REGISTRATION STEP ClinicalTrials.gov number, NCT03015311. Registered 2 January 2017.
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Affiliation(s)
- Qirui Song
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Qianhui Ling
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Jingjing Bai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Hongwei Zhang
- The Hospital of Shunyi District Beijing, Beijing, 101300, China
| | - Peili Bu
- Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Fang Chen
- The First People's Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Shouling Wu
- Kailuan General Hospital, Tangshan, 063000, Hebei, China
| | - Weili Zhang
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Gongtinanlu Rd. 8, Chaoyang District, Beijing, 100020, China.
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China.
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Bruno RM, Pépin JL, Empana JP, Yang RY, Vercamer V, Jouhaud P, Escourrou P, Boutouyrie P. Home monitoring of arterial pulse-wave velocity during COVID-19 total or partial lockdown using connected smart scales . Eur Heart J Digit Health 2022; 3:362-372. [PMID: 36712157 PMCID: PMC9384477 DOI: 10.1093/ehjdh/ztac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 11/19/2022]
Abstract
Aims To investigate the impact of coronavirus disease 2019 lockdown on trajectories of arterial pulse-wave velocity in a large population of users of connected smart scales that provide reliable measurements of pulse-wave velocity. Methods and results Pulse-wave velocity recordings obtained by Withings Heart Health & Body Composition Wi-Fi Smart Scale users before and during lockdown were analysed. We compared two demonstrative countries: France, where strict lockdown rules were enforced (n = 26 196) and Germany, where lockdown was partial (n = 26 847). Subgroup analysis was conducted in users of activity trackers and home blood pressure monitors. Linear growth curve modelling and trajectory clustering analyses were performed. During lockdown, a significant reduction in vascular stiffness, weight, blood pressure, and physical activity was observed in the overall population. Pulse-wave velocity reduction was greater in France than in Germany, corresponding to 5.2 month reduction in vascular age. In the French population, three clusters of stiffness trajectories were identified: decreasing (21.1%), stable (60.6%), and increasing pulse-wave velocity clusters (18.2%). Decreasing and increasing clusters both had higher pulse-wave velocity and vascular age before lockdown compared with the stable cluster. Only the decreasing cluster showed a significant weight reduction (-400 g), whereas living alone was associated with increasing pulse-wave velocity cluster. No clusters were identified in the German population. Conclusions During total lockdown in France, a reduction in pulse-wave velocity in a significant proportion of French users of connected smart bathroom scales occurred. The impact on long-term cardiovascular health remains to be established.
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Affiliation(s)
- Rosa Maria Bruno
- Corresponding author. Tel: +33 1 5398 7967, Fax: +33 1 5609 3991,
| | - Jean Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France,EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | | | | | | | | | - Pierre Escourrou
- Centre Interdisciplnaire du Sommeil, 20 rue St SaënsParis 15, France,Université Paris Saclay, Paris, France
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France,Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, F-75015 Paris, France
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da Silva RSN, da Silva DS, Waclawovsky G, Schaun MI. Effects of aerobic, resistance, and combined training on endothelial function and arterial stiffness in older adults: study protocol for a systematic review and meta-analysis. Syst Rev 2022; 11:171. [PMID: 35964075 PMCID: PMC9375352 DOI: 10.1186/s13643-022-02036-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Aging is an independent risk factor for cardiovascular events. It promotes vascular dysfunction which is associated with risk factors for cardiovascular diseases (CVDs). Exercise can modulate vascular function parameters, but little is known about the effects of different modalities of training (aerobic, resistance, and combined) on endothelial function and arterial stiffness in older adults. METHODS This systematic review study will include randomized controlled trials (RCTs) selected from the electronic databases MEDLINE (PubMed), Cochrane, LILACS, EMBASE, and Web of Science. We will follow the PRISMA guidelines and PICOS framework. Studies involving both male and female older adults (≥60 years old) with or without comorbidities undergoing aerobic, resistance, and/or combined training compared to a control group (no exercise) will be eligible. We will use the Cochrane Risk of Bias 2 (RoB 2) tool to evaluate the quality of individual studies and GRADE to assess the strength of evidence. Statistical analyses will be conducted with RStudio for Windows (v1.3.959) using R package meta. DISCUSSION A systematic review and meta-analysis involving data from studies of older adults would deepen our understanding of vascular adaptations to exercise training in this population. It could provide new insights into how health providers can improve patient management and prevention of cardiovascular events in older adults. SYSTEMATIC REVIEW REGISTRATION PROSPERO 42021275451.
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Affiliation(s)
- Raphael S N da Silva
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Diego S da Silva
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Gustavo Waclawovsky
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Maximiliano I Schaun
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil.
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Hinrichs T, Portegijs E, Rantanen T, Infanger D, Schmidt-Trucksäss A, Karavirta L. Association between arterial stiffness and walking capacity in older adults. Exp Gerontol 2022; 167:111925. [PMID: 35963452 DOI: 10.1016/j.exger.2022.111925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/08/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Arterial stiffening - a process that is largely due to intimal thickening, collagen disposition or elastin fragmentation - significantly contributes to cardiovascular events and mortality. There is also some evidence that it may negatively affect physical function. This study aimed to evaluate whether arterial stiffness was associated with measures of walking capacity in a large, population-based sample of highly aged older adults. METHODS A population-based sample of 910 community-dwelling adults (aged 75, 80, or 85 years) were investigated in a cross-sectional observational study. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, was estimated based on the oscillometric recording of pulse waves at the brachial artery site. Walking capacity was assessed by 10-meter habitual walking speed, 10-meter maximum walking speed, and six-minute walk distance. We used multiple linear regression models to examine possible associations between PWV and parameters of walking capacity, and we adjusted the models for sex, age, socioeconomic status, anthropometry, physician-diagnosed diseases, prescription medication, smoking history, physical activity, and mean arterial pressure. Continuous variables were modelled using restricted cubic splines to account for potential nonlinear associations. RESULTS Mean (standard deviation) 10-meter habitual walking speed, 10-meter maximum walking speed, and six-minute walk distance were 1.3 (0.2) m/s, 1.7 (0.4) m/s, and 413 (85) m, respectively. The fully adjusted regression models revealed no evidence for associations between PWV and parameters of walking capacity (all p-values >0.05). CONCLUSION Our results did not confirm previous findings suggesting a potential negative association between arterial stiffness and walking capacity in old age. Longitudinal studies, potentially taking additional confounders into account, are needed to disentangle the complex relationship between the two factors.
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Affiliation(s)
- Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Erja Portegijs
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Denis Infanger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Laura Karavirta
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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Chongthammakun V, Pan AY, Earing MG, Damluji AA, Goot BH, Cava JR, Gerardin JF. The association between cardiac magnetic resonance-derived aortic stiffness parameters and aortic dilation in young adults with bicuspid aortic valve: With and without coarctation of aorta. Am Heart J Plus 2022; 20:100194. [PMID: 38560418 PMCID: PMC10978397 DOI: 10.1016/j.ahjo.2022.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 04/04/2024]
Abstract
Background Bicuspid aortic valve (BAV) is associated with progressive aortic dilation. Studies in aortopathies have shown a correlation between increased aortic stiffness and aortic dilation. We aimed to evaluate aortic stiffness measures as predictors of progressive aortic dilation by cardiac magnetic resonance (CMR) in BAV patients. Methods This is a retrospective study of 49 patients with BAV (median age 21.1 years at first CMR visit) with ≥2 CMR at the Wisconsin Adult Congenital Heart Disease Program (WAtCH). Circumferential aortic strain, distensibility, and β-stiffness index were obtained from CMR-derived aortic root cine imaging, and aortic dimensions were measured at aortic root and ascending aorta. A linear mixed-model and logistic regression were used to identify important predictors of progressive aortic dilation. Results Over a median of 3.8 years follow-up, the annual growth rates of aortic root and ascending aorta dimensions were 0.25 and 0.16 mm/year, respectively. Aortic strain and distensibility decreased while β-stiffness index increased with age. Aortic root strain and distensibility were associated with progressive dilation of the ascending aorta. Baseline aortic root diameter was an independent predictor of >1 mm/year growth rate of the aortic root (adjusted OR 1.34, 95 % CI 1.03-1.74, p = 0.028). Most patients (61 %) had coexisting coarctation of aorta. Despite the higher prevalence of hypertension in patients with aortic coarctation, hypertension or coarctation had no effect on baseline aorta dimensions, stiffness, or progressive aortic dilation. Conclusion Some CMR-derived aortic stiffness parameters correlated with progressive aortic dilation in BAV and should be further investigated in larger and older BAV cohorts.
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Affiliation(s)
- Vasutakarn Chongthammakun
- Adult Congenital Heart Disease Program, Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States of America
- Herma Heart Institute, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Amy Y. Pan
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Michael G. Earing
- Sections of Cardiology and Pediatric Cardiology, University of Chicago, Chicago, IL, United States of America
| | - Abdulla A. Damluji
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA, United States of America
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Benjamin H. Goot
- Herma Heart Institute, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Joseph R. Cava
- Herma Heart Institute, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Jennifer F. Gerardin
- Herma Heart Institute, Medical College of Wisconsin, Milwaukee, WI, United States of America
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Koppula A, Asif AR, Barra RR, Sridharan KS. Feasibility of home-based tracking of insulin resistance from vascular stiffness estimated from the photoplethysmographic finger pulse waveform. Physiol Meas 2022; 43. [PMID: 35512706 DOI: 10.1088/1361-6579/ac6d3f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/05/2022] [Indexed: 11/12/2022]
Abstract
In this study, we explored the utility of post-prandial vascular stiffness as a surrogate measure for the estimation of insulin resistance (IR), which is a pre-diabetic condition. A cohort of 51 healthy young adults of varying Body mass index values (BMI) were studied by fasting plasma values of insulin and glucose; fasting and post-meal finger photoplethysmography (PPG), and electrocardiogram (ECG). Insulin resistance was estimated by Homeostatic model assessment-Insulin resistance 2 (HOMA-IR2) using fasting plasma insulin and glucose. Vascular stiffness was estimated by reciprocal of pulse arrival time (rPAT) from ECG and finger PPG at five time points from fasting to 2-hours post oral glucose ingestion. We examined if insulin resistance is correlated with meal induced vascular stiffness changes supporting the feasibility of using finger PPG for the estimation of insulin resistance. HOMA-IR2 was found to be positively correlated with early rise (0- to 30- minutes post meal) and delayed fall (30- to 120-minutes) of rPAT. Correlation persisted even after the effect of BMI has been partialled out in sub-group analysis. We conclude that finger PPG based pulse waveform and single lead ECG has the potential to be used as a non-invasive method for the assessment of insulin resistance. As both signals viz., ECG and PPG can be easily acquired using wearable and other low-cost sensing systems, the present study can serve as a pointer for the development of accessible methods of monitoring and longitudinal tracking of insulin resistance in health and pathophysiological states.
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Affiliation(s)
- Aditya Koppula
- Biomedical Engineering, Indian Institute of Technology Hyderabad, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana state, India, Hyderabad, 502205, INDIA
| | - Abdur Rehman Asif
- Biochemistry, Apollo Institute of Medical Sciences and Research, Road.No.92, Film nagar, Apollo health city campus, Jubilee Hills, Hyderabad, Telangana, 500096, INDIA
| | - Ram Reddy Barra
- Physiology, Apollo Institute of Medical Sciences and Research, Apollo health city campus, Road.No.92, Jubilee hills, Hyderabad, India, Hyderabad, Telangana, 500090, INDIA
| | - Kousik Sarathy Sridharan
- Biomedical Engineering, Indian Institute of Technology Hyderabad, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana state, India, Hyderabad, Telangana, 502285, INDIA
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Debourdeau E, Gardes G, Nocca D, Carriere I, Chiquet C, Villain M, Roubille C, Du Cailar G, Sardinoux M, Daien V, Fesler P. Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study. Obes Surg 2022; 32:1-10. [PMID: 35469081 DOI: 10.1007/s11695-022-06064-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Obesity is associated with increased cardiovascular risk. Bariatric surgery (BS) improves the clinical and metabolic profile. Retinal caliber changes could precede cardiovascular events. Different studies have shown an improvement in retinal caliber after BS. The aim of this study was to examine retinal caliber and other cardiovascular target organ damage before and after BS. MATERIALS AND METHODS Monocentric, prospective cohort study at the Montpellier University Hospital. Biologic features, vessel stiffness, echocardiograph variables, and retinal caliber at baseline and 6 and 12 months were assessed in consecutive patients with class 2 or 3 obesity undergoing BS. A mixed linear model adjusted for age and sex was used. RESULTS We included 88 patients (75 women). The mean (SD) age was 43 years (11) and mean (SD) baseline weight 117 (21) Kg. Mean changes in the first year after BS were - 5.1 µm in central retinal vein equivalent (CRVE) (p < 0.0001), + 0.02 in arteriole-to-venule ratio (AVR) (p < 0.0001), - 1.4 mmol/L in glycemia (p < 0.0001), - 1.0 mg/L in natural logarithm of C-reactive protein (p < 0.0001), and - 54.0 g in left ventricular mass (p = 0.0005). We observed no significant improvement in arterial stiffness markers. Predictors of improvement in CRVE were high baseline weight (p = 0.030), male sex (p = 0.025), and no diabetes history (p Dynamic links between variations = 0.047). CONCLUSION The retinal microvascular phenotype improved during the first year after bariatric surgery, with decreased CRVE and increased AVR. Factors associated with retinal microvascular plasticity were male sex, high baseline weight, and absence of diabetes. Longitudinal assessment of retinal vascular calibers may offer new insights into the pathophysiology of subclinical vascular processes.
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Affiliation(s)
- Eloi Debourdeau
- Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France. .,Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France.
| | - Gabriel Gardes
- Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France
| | - David Nocca
- Digestive Surgery Division A, CHU de Montpellier, F-34000, Montpellier, France
| | - Isabelle Carriere
- Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France
| | - Christophe Chiquet
- Department of Ophthalmology, Grenoble Alpes University Hospital, 38048, Grenoble, France
| | - Max Villain
- Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34000, Montpellier, France
| | - Guilhem Du Cailar
- Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France
| | - Mathieu Sardinoux
- Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France
| | - Vincent Daien
- Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France.,The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, 2000, Australia
| | - Pierre Fesler
- Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34000, Montpellier, France
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Park JH, Seo E, Choi W, Lee SJ. Ultrasound deep learning for monitoring of flow-vessel dynamics in murine carotid artery. Ultrasonics 2022; 120:106636. [PMID: 34826686 DOI: 10.1016/j.ultras.2021.106636] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 10/09/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Several arterial diseases are closely related with mechanical properties of the blood vessel and interactions of flow-vessel dynamics such as mean flow velocity, wall shear stress (WSS) and vascular strain. However, there is an opportunity to improve the measurement accuracy of vascular properties and hemodynamics by adopting deep learning-based ultrasound imaging for flow-vessel dynamics (DL-UFV). In this study, the DL-UFV is proposed by devising an integrated neural network for super-resolved localization and vessel wall segmentation, and it is also combined with tissue motion estimation and flow measurement techniques such as speckle image velocimetry and speckle tracking velocimetry for measuring velocity field information of blood flow. Performance of the DL-UFV is verified by comparing with other conventional techniques in tissue-mimicking phantoms. After the performance verification, in vivo feasibility is demonstrated in the murine carotid artery with different pathologies: aging and diabetes mellitus (DM). The mutual comparison of flow-vessel dynamics and histological analyses shows correlations between the immunoreactive region and abnormal flow-vessel dynamics interactions. The DL-UFV improves biases in measurements of velocity, WSS, and strain with up to 4.6-fold, 15.1-fold, and 22.2-fold in the tissue-mimicking phantom, respectively. Mean flow velocities and WSS values of the DM group decrease by 30% and 20% of those of the control group, respectively. Mean flow velocities and WSS values of the aging group (34.11 cm/s and 13.17 dyne/cm2) are slightly smaller than those of the control group (36.22 cm/s and 14.25 dyne/cm2). However, the strain values of the aging and DM groups are much smaller than those of the control group (p < 0.05). This study shows that the DL-UFV performs better than the conventional ultrasound-based flow and strain measurement techniques for measuring vascular stiffness and complicated flow-vessel dynamics. Furthermore, the DL-UFV demonstrates its excellent performance in the analysis of the hemodynamic and hemorheological effects of DM and aging on the flow and vascular characteristics. This work provides useful hemodynamic information, including mean flow velocity, WSS and strain with high-resolution for diagnosing the pathogenesis of arterial diseases. This information can be used for monitoring progression and regression of atherosclerotic diseases in clinical practice.
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Affiliation(s)
- Jun Hong Park
- Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Eunseok Seo
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77, Cheongam-ro, Nam-gu, Pohang 37679, Republic of Korea
| | - Woorak Choi
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77, Cheongam-ro, Nam-gu, Pohang 37679, Republic of Korea
| | - Sang Joon Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77, Cheongam-ro, Nam-gu, Pohang 37679, Republic of Korea.
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Tagawa K, Choi Y, Takahashi A, Maeda S. Body height determines carotid stiffness following resistance exercise in young Japanese men. Am J Physiol Regul Integr Comp Physiol 2022; 322:R309-R318. [PMID: 35107029 DOI: 10.1152/ajpregu.00215.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Height is inversely associated with an increase in arterial stiffness after habitual resistance exercise (RE). Considering that RE is performed during exercise prescriptions, the association between height and the acute effects of RE on arterial stiffness should be clarified. We investigated the effects of height on arterial stiffness following transient RE. Thirty-nine young Japanese men were studied under parallel experimental conditions (sham control [seated rest] and RE [5 sets of 10 repetitions at 75% of one-repetition maximum]), which were randomly ordered on two separate days. The subjects were divided into tertiles of height (each group, n = 13). The β-stiffness index (index of arterial stiffness), assessed by carotid pulse pressure and distension, was measured in all subjects. A significant interaction between time, height, and RE was found for the β-stiffness index (P = 0.01). RE significantly increased the β-stiffness index in the lower height group (P < 0.001), but not in the middle and higher height groups. Height was negatively associated with an increase in β-stiffness index following RE, even after controlling the confounders, including exercise volume and changes in heart rate and carotid pulse pressure (P = 0.003). The mediation analysis demonstrated a mediating effect of carotid distension on the relationship between height and changes in the β-stiffness index. These results suggest that short height individuals have increased arterial stiffness following RE due to decreased mechanical distension, rather than through the widening of pulsatile pressure.
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Affiliation(s)
- Kaname Tagawa
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Miyagi University of Education, Sendai, Japan
| | - Youngju Choi
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.,Institute of Sport and Art Convergence, Inha University, Incheon, Korea
| | - Akari Takahashi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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Rossi-Monteiro EM, Sefair LR, Lima MC, Nascimento MFL, Mendes-Pinto D, Anschuetz L, Rodrigues-Machado MG. Pediatric obstructive sleep-disordered breathing is associated with arterial stiffness. Eur J Pediatr 2022; 181:725-734. [PMID: 34557975 DOI: 10.1007/s00431-021-04238-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 01/14/2023]
Abstract
The association between obstructive sleep-disordered breathing (oSDB) and arterial stiffness, an independent predictor of cardiovascular outcomes, is not well established in children. This study compared cardiovascular parameters between healthy and oSDB children and aimed to identify predictors of arterial stiffness indices in children with oSDB. Cross-sectional study realized in a tertiary hospital from June 2018 to January 2020. Forty-eight children (3 to 10 years old) with clinical diagnosis of oSDB and indication for adenotonsillectomy and 24 controls were evaluated. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main arterial stiffness indices assessed were augmentation index and pulse wave velocity, both derived from the aortic pulse wave. In the oSDB group, the questionnaires Obstructive Sleep Apnea-18 (OSA-18) and Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) were applied. The oSDB group had higher values of reflection coefficient (p = 0.044) and augmentation index (p = 0.003) than the control group. Stepwise multiple regression analysis revealed that age, female sex, reflection coefficient, and systolic volume were independent predictors of augmentation index. Higher pulse wave velocity values were associated with worse quality of life assessed by PedsQL 4.0 questionnaire. There was no association with OSA-18. The vascular and hemodynamic parameters were similar in both groups.Conclusion: Children with oSDB have increased augmentation index, an independent predictor of cardiovascular outcomes. The early identification of subclinical cardiovascular changes reinforces the importance of treating the disease, as well as changing lifestyle habits, to prevent complications in adulthood. What is Known: • The association between oSDB and cardiovascular risk in adults is well described in the literature. • Children with oSDB, regardless of their weight or sex, have higher PWV values when compared to non-snoring children. What is New: • Children with oSDB have augmented arterial stiffness, evidenced by the increase in AIx@75, measured non-invasively by brachial artery oscillometry with a portable device. • Low quality of life and therefore a high disease burden in children with oSDB may be a risk factor for arterial stiffness.
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Affiliation(s)
- Eduardo Machado Rossi-Monteiro
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, MG, Belo Horizonte, Brazil.,Department of Otorhinolaryngology, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | | | - Marcos Correia Lima
- Department of Otorhinolaryngology, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | | | - Daniel Mendes-Pinto
- Department of Vascular Surgery, Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | - Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Maria Glória Rodrigues-Machado
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais - FCM-MG, MG, Belo Horizonte, Brazil.
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Kaya M, Balasubramanian V, Li JKJ. Inadequacy of Augmentation Index for Monitoring Arterial Stiffness: Comparison with Arterial Compliance and Other Hemodynamic Variables. Cardiovasc Eng Technol 2022; 13:590-602. [PMID: 35102522 DOI: 10.1007/s13239-021-00605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/14/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE Augmentation Index (AIx) is used clinically for monitoring both wave reflections and arterial stiffness, which when increased is a risk factor of cardiovascular mortality and morbidity. We hypothesize that AIx is not solely related to vascular stiffness as described by arterial compliance and other hemodynamic parameters since AIx underestimates wave reflections. METHODS Aortic pressure and flow datasets (n = 42) from mongrel dogs were obtained from our experiments and Mendeley Data under various conditions. Arterial compliances based on the Windkessel model (Ct), the stroke volume (SV) to pulse pressure (PP) ratio (Cv = SV/PP), and at inflection pressure point (CPi) were computed. Other relevant hemodynamic factors are also computed. RESULTS AIx was poorly associated with arterial stiffness calculated from Ct (r = 0.299, p = 0.058) or CPi (r = 0.203, p = 0.203), even when adjusted for heart rates. Ct and Cv were monotonically associated. Alterations in inflection pressure (Pi) did not follow the changes in pulse pressure (PP) (r = 0.475, p = 0.002), and Pi was quantitatively similar to systolic pressure (r = 0.940, p < 0.001). CONCLUSION AIx is neither linearly correlated with arterial stiffness, nor with arterial compliance and several cardiac and arterial parameters have to be considered when AIx is calculated.
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Affiliation(s)
- Mehmet Kaya
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA.
| | - Vignesh Balasubramanian
- Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL, 32901, USA
| | - John K-J Li
- Department of Biomedical Engineering and Robert Wood Johnson Medical School, Rutgers University, 599 Taylor Road, Piscataway, NJ, 08854, USA
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El Fol A, Ammar W, Sharaf Y, Youssef G. The central arterial stiffness parameters in decompensated versus compensated states of heart failure: a paired comparative cohort study. Egypt Heart J 2022; 74:2. [PMID: 34978636 PMCID: PMC8724513 DOI: 10.1186/s43044-021-00236-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Arterial stiffness is strongly linked to the pathogenesis of heart failure and the development of acute decompensation in patients with stable chronic heart failure. This study aimed to compare arterial stiffness indices in patients with heart failure with reduced ejection fraction (HFrEF) during the acute decompensated state, and three months later after hospital discharge during the compensated state. Results One hundred patients with acute decompensated HFrEF (NYHA class III and IV) and left ventricular ejection fraction ≤ 35% were included in the study. During the initial and follow-up visits, all patients underwent full medical history taking, clinical examination, transthoracic echocardiography, and non-invasive pulse wave analysis by the Mobil-O-Graph 24-h device for measurement of arterial stiffness. The mean age was 51.6 ± 6.1 years and 80% of the participants were males. There was a significant reduction of the central arterial stiffness indices in patients with HFrEF during the compensated state compared to the decompensated state. During the decompensated state, patients presented with NYHA FC IV (n = 64) showed higher AI (24.5 ± 10.0 vs. 16.8 ± 8.6, p < 0.001) and pulse wave velocity (9.2 ± 1.3 vs. 8.5 ± 1.2, p = 0.021) than patients with NYHA FC III, and despite the relatively smaller number of females, they showed higher stiffness indices than males. Conclusions Central arterial stiffness indices in patients with HFrEF were significantly lower in the compensated state than in the decompensated state. Patients with NYHA FC IV and female patients showed higher stiffness indices in their decompensated state of heart failure.
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Affiliation(s)
- Ahmed El Fol
- Cardiovascular Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Waleed Ammar
- Cardiovascular Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasser Sharaf
- Cardiovascular Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ghada Youssef
- Cardiovascular Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Heffernan K, Stoner L, Meyer ML, Keifer A, Bates L, Lassalle PP, Hanson ED, Horiuchi M, Michos ED, Kucharska-Newton A, Matsushita K, Hughes TM, Tanaka H. Associations between estimated and measured carotid-femoral pulse wave velocity in older Black and White adults: the atherosclerosis risk in communities (ARIC) study. J Cardiovasc Aging 2022; 2:7. [PMID: 36816983 PMCID: PMC9934460 DOI: 10.20517/jca.2021.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean arterial pressure. Association and agreement between the two measurements were determined using Pearson's correlation coefficient (r), standard error of estimate (SEE), and Bland-Altman analysis. Associations between traditional risk factors with ePWV and cfPWV were evaluated using linear mixed regression models. We observed weak correlations between ePWV and cfPWV within White adults (r = 0.36) and Black adults (r = 0.31). The mean bias for Bland-Altman analysis was low at -0.17 m/s (95%CI: -0.25 to -0.09). However, the inspection of the Bland-Altman plots indicated systematic bias (P < 0.001), which was consistent across race strata. The SEE, or typical absolute error, was 2.8 m/s suggesting high variability across measures. In models adjusted for sex, prevalent diabetes, the number of prevalent cardiovascular diseases, and medication count, both cfPWV and ePWV were positively associated with heart rate, triglycerides, and fasting glucose, and negatively associated with body mass index (BMI) and smoking status in White adults (P < 0.05). cfPWV and ePWV were not associated with heart rate, triglycerides, and fasting glucose in Black adults, while both measures were negatively associated with BMI in Black adults. Conclusions Findings suggest a weak association between ePWV and cfPWV in older White and Black adults from ARIC. There were similar weak associations between CVD risk factors with ePWV and cfPWV in White adults with subtle differences in associations in Black adults.
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Affiliation(s)
- Kevin Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY 13244, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Michelle L. Meyer
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Adam Keifer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lauren Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Patricia Pagan Lassalle
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Erik D. Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Masahiro Horiuchi
- Department of Human Environmental Science, Mount Fuji Research Institute, Yamanashi 403-0005, Japan
| | - Erin D. Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Anna Kucharska-Newton
- Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.,Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY 40536, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Timothy M. Hughes
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
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Alonso-Domínguez R, Sánchez-Aguadero N, Patino-Alonso MC, Agudo-Conde C, de Cabo-Laso Á, Gómez-Sánchez M, Gómez-Sánchez L, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Association between measurements of arterial stiffness and target organ damage in a general Spanish population. Ann Med 2021; 53:345-356. [PMID: 33533280 PMCID: PMC7877984 DOI: 10.1080/07853890.2021.1881812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/21/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Little is known about the relationship between arterial stiffness and cardiovascular target organ damage (TOD) in the general population. The aim was to analyse the relationship between different measurements of arterial stiffness and TOD, in a general Spanish population without a history of cardiovascular event. MATERIALS AND METHODS Transversal descriptive study. Through stratified random sampling, a total of 501 individuals were included. Carotid-femoral pulse wave velocity (cf-PWV) was measured using a SphygmoCor System®, the cardio-ankle vascular index (CAVI) was determined with aVasera VS-1500® and brachial-ankle pulse wave velocity (ba-PWV)was calculated through a validated equation. RESULTS The average age was 55.84 ± 14.26.The percentage of vascular TOD, left ventricular hypertrophy (LVH) and renal TOD was higher in men (p < .001). A positive correlation was obtained between carotid intima-media thickness (c-IMT) and the measurements of vascular function. In the model 1 of the logistic regression analysis, cf-PWV was associated with vascular TOD (OR = 1.15, p = .040), ba-PWV was associated with vascular TOD (OR = 1.20, p = .010) and LVH (OR = 1.12, p = .047). CONCLUSIONS The different measurements of arterial stiffness are highly associated with each other. Moreover, cf-PWV and ba-PWV were associated with vascular TOD, and ba-PWV with LVH, although they disappear when adjusting for cardiovascular risk factors. Key Messages There is a strong correlation between the different measurements of vascular structure and function. Carotid-femoral and brachial-ankle pulse wave velocity were positively associated with vascular target organ damage, the latter was also positively associated with left ventricular hypertrophy. This associations disappear when adjusting for cardiovascular risk factors.
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Affiliation(s)
- Rosario Alonso-Domínguez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - María C. Patino-Alonso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Ángela de Cabo-Laso
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Marta Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castile and Leon (SACyL), Salamanca, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Portugal and Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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Cabral LLP, Freire YA, Browne RAV, Macêdo GAD, Câmara M, Schwade D, Farias-Junior LF, Paulo-Pereira R, Silva RM, Lemos TMAM, Barreira TV, Costa EC. Associations of steps per day and peak cadence with arterial stiffness in older adults. Exp Gerontol 2022; 157:111628. [PMID: 34798157 DOI: 10.1016/j.exger.2021.111628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/24/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is evidence showing an inverse association between steps/day and arterial stiffness in adults. However, the relationship of steps/day and peak cadence with arterial stiffness is poorly understood in older adults. This study aimed to investigate the association between steps/day and peak cadence with arterial stiffness in older adults. METHODS This cross-sectional study included 222 community-dwelling older adults (66 ± 5 years; 81.5% females; 70.3% with hypertension). Arterial stiffness was measured by aortic pulse wave velocity (aPWV). Steps/day and peak cadence were assessed by accelerometry. The participants were categorized according to the number of steps/day: sedentary <5000; low active 5000-7499; active 7500-9999; highly active 10,000+. Peak cadence was defined as the average of steps/day of the highest 30 min (not necessarily consecutive) for all valid days. Generalized linear models were used for data analyses. RESULTS The active (β = -0.34 m/s, 95% CI -0.60, -0.08) and highly active (β = -0.51 m/s, 95% CI -0.83, -0.20) groups had lower aPWV compared to the sedentary group. No significant difference was found between the low active group and the sedentary group (β = -0.21 m/s, 95% CI -0.46, 0.05). Every increment of 1000 steps/day was associated with a decrease of 0.05 m/s in the aPWV (95% CI -0.08, -0.02). Every increment of 10 steps/min in peak 30-min cadence was associated with a decrease of 0.05 m/s in aPWV (95% CI -0.09, -0.01). CONCLUSIONS Our findings show that easy-to-use proxies of the volume (steps/day) and intensity (peak cadence) of ambulatory behavior are inversely associated with arterial stiffness in older adults. The inverse association of steps/day and peak cadence with arterial stiffness is dose-response.
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