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Roy M, Guo X, Wang Q, Stäb D, Jin N, Lim RP, Ooi A, Chakraborty S. Patient-specific prediction of arterial wall elasticity using medical image-informed in-silico simulations. Comput Biol Med 2025; 188:109849. [PMID: 39978097 DOI: 10.1016/j.compbiomed.2025.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 10/13/2024] [Revised: 01/20/2025] [Accepted: 02/10/2025] [Indexed: 02/22/2025]
Abstract
Limitations in clinical cardiovascular research have driven the development of advanced simulations for patient-specific insights into arterial elasticity. However, uncertainties in model inputs, data resolution, and parameter estimation can compromise accuracy. Our research aimed to provide reliable estimates of the arterial wall elasticity non-invasively, where direct clinical measurement is difficult. By integrating patient-specific imaging with a simplified flow simulation model and uncertainty quantification, we sought to improve the reliability of these predictions as compared to the state-of-the-art. In a proof-of-concept study, we developed a simple area-averaged model of arterial hemodynamics, using Magnetic Resonance Angiogram (MRA)-derived geometries and input parameters based on the age, cuff blood pressure, and phase-contrast MRI data in five human subjects. This resulted in an in-silico model estimating the pressure and flow variations across the arterial-branches. Statistical uncertainties in the hemodynamic parameter predictions were quantified using non-intrusive Polynomial Chaos. Additionally, we developed a model to estimate the arterial elasticity by interlacing the results from fluid-structure interaction simulation for arterial hemodynamics with patient-specific clinical data. We found that the arterial elasticity values derived from our model, when used to predict the flowrates, closely matched the flow characteristics obtained from the patient-specific 4D flow MRI. The findings also showed zero or minimal positive/negative bias in our simulations, with no noticeable systematic error in predicting arterial elasticity values. Our results evidenced that accurate prediction of arterial wall elasticity is possible through use of an efficient simulation technique supplemented with clinically attainable imaging data. This has potential to predict cardiovascular-risk and guide individual patient management.
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Affiliation(s)
- Manideep Roy
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Xiaojing Guo
- Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Qingdi Wang
- Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia; Department of Biomedical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Daniel Stäb
- MR Research Collaborations, Siemens Healthcare Pty Limited, Melbourne, VIC, 3153, Australia
| | - Ning Jin
- Siemens Medical Solutions Inc. Malvern, PA, 19355, USA
| | - Ruth P Lim
- Departments of Radiology and Surgery, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, 3010, Australia; Department of Radiology, Austin Health, Heidelberg VIC, 3084, Australia
| | - Andrew Ooi
- Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Suman Chakraborty
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India; Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India.
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Olansen J, Yin M, Molino J, Carruthers T, Jenkins D, Karniadakis G, Aaron RK. Peripheral arterial pathology and osteoarthritis of the knee: US examination of arterial wall stiffness, thickness, and flow characteristics. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100537. [PMID: 39559250 PMCID: PMC11570950 DOI: 10.1016/j.ocarto.2024.100537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 10/16/2024] [Accepted: 10/21/2024] [Indexed: 11/20/2024] Open
Abstract
Background Osteoarthritis (OA) is a widespread chronic joint disorder characterized by the degeneration of articular cartilage, extensive bone remodeling, ligamentous fibrosis, and synovial inflammation impacting millions. Shared factors like phenotypic similarities, hypofibrinolysis, and inflammation constitute similarities in pathophysiology and clinical manifestations between OA and peripheral vascular disease (PVD). This study investigated peripheral arterial flow characteristics, vascular wall thickness, and stiffness in knee OA to clarify a potential association with early atherosclerosis. Methods The OA cohort consisted of 35 knees with a mean age of 69 years. The control cohort consisted of 58 knees with a mean age of 68 years. Subjects underwent arterial ultrasound scanning of the common femoral, superficial femoral, and popliteal arteries. Data measured included peak systolic volumetric flow, intima-media thickness, systolic and diastolic vessel diameter, and simultaneous EKG and flow curves. Structural and functional vascular data were quantified using the incremental Young's modulus, pulse wave velocity (PWV), and distensibility. Results Significantly elevated arterial volumetric flow, measures of arterial stiffness, and intima-media wall thickness were observed in those with OA compared to those without. PWV as calculated by the Bramwell-Hill equation were found to be significantly greater in all three vessels of patients with OA. Conclusions This study supports the association between peripheral arterial pathology and knee OA, consistent with shared clinical and phenotypic traits. The observed characteristics of early vascular pathology suggest potential pathophysiologic linkages between OA and PVD. This foundational framework provides avenues for mechanistic studies exploring the relationship between these two disease processes.
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Affiliation(s)
- Jon Olansen
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Minglang Yin
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Janine Molino
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Thomas Carruthers
- Division of Vascular Surgery, Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Derek Jenkins
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - George Karniadakis
- Division of Applied Mathematics, Brown University, Providence, RI 02912, USA
| | - Roy K. Aaron
- Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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Wang S, Wang X, Chen J, Wang M, Zhang C. Identification of key genes and biological pathways associated with vascular aging in diabetes based on bioinformatics and machine learning. Aging (Albany NY) 2024; 16:9369-9385. [PMID: 38809515 PMCID: PMC11210242 DOI: 10.18632/aging.205870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 12/19/2023] [Accepted: 04/09/2024] [Indexed: 05/30/2024]
Abstract
Vascular aging exacerbates diabetes-associated vascular damage, a major cause of microvascular and macrovascular complications. This study aimed to elucidate key genes and pathways underlying vascular aging in diabetes using integrated bioinformatics and machine learning approaches. Gene expression datasets related to vascular smooth muscle cell (VSMC) senescence and diabetic vascular aging were analyzed. Differential expression analysis identified 428 genes associated with VSMC senescence. Functional enrichment revealed their involvement in cellular senescence, ECM-receptor interaction, PI3K-Akt and AGE-RAGE signaling pathways. Further analysis of diabetic vascular aging datasets revealed 52 differentially expressed genes, enriched in AMPK signaling, AGE-RAGE signaling, cellular senescence, and VEGF signaling pathways. Machine learning algorithms, including LASSO regression and SVM-RFE, pinpointed six key genes: TFB1M, FOXRED2, LY75, DALRD3, PI4K2B, and NDOR1. Immune cell infiltration analysis demonstrated correlations between diabetic vascular aging, the identified key genes, and infiltration levels of plasma cells, M1 macrophages, CD8+ T cells, eosinophils, and regulatory T cells. In conclusion, this study identified six pivotal genes (TFB1M, FOXRED2, LY75, DALRD3, PI4K2B, and NDOR1) closely associated with diabetic vascular aging through integrative bioinformatics and machine learning approaches. These genes are linked to alterations in the immune microenvironment during diabetic vascular aging. This study provides a reference and basis for molecular mechanism research, biomarker mining, and diagnosis and treatment evaluation of diabetes-related vascular aging.
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Affiliation(s)
- Sha Wang
- Department of Endocrinology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Xia Wang
- Department of Endocrinology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Jing Chen
- Department of Endocrinology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Min Wang
- Department of Endocrinology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Chi Zhang
- Department of Endocrinology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
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Goksu K, Vural A, Kahraman AN, Aslan IK. Evaluation of common carotid artery wall stiffness by shear wave elastography in smokers and non-smokers. Tob Induc Dis 2024; 22:TID-22-49. [PMID: 38463751 PMCID: PMC10921918 DOI: 10.18332/tid/185300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 09/30/2023] [Revised: 12/27/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Smoking is one of the most important preventable causes of cardiovascular diseases. Vascular disease caused by smoking is associated with vascular endothelial damage, platelet aggregation, and adhesion. In our study, we examined the effect of chronic smoking on vessel wall stiffness in smokers and control group by measuring carotid artery wall stiffness by shear wave ultrasonography. METHODS Sixty-two smokers of similar ages and genders, and 67 people who never smoked in the last ten years were included as the control group in this cross-sectional study. Arterial wall stiffness over the common carotid arteries of all participants was measured by shear wave elastography (SWE). In addition, each patient's blood pressure, fasting blood glucose, body mass index (BMI), HDL and LDL cholesterol measurements were recorded. RESULTS Arterial wall stiffness values in smokers were found to be statistically significantly higher than in non-smokers. The mean of SWE measurements of the smokers was 47.3 ± 6.2 kPa, and that of the control group was 42.9 ± 4 kPa. The mean values of HDL and LDL of the smokers were 46.9 ± 5.6 mg/dL and 147.3 ± 9.3 mg/dL, respectively, and those of the control group were 50.3 ± 5.1 mg/dL and 136.9 ± 5.9 mg/dL. The LDL cholesterol values were statistically significantly higher in smokers compared to the control group, and HDL cholesterol values were statistically significantly lower in smokers. CONCLUSIONS In our study, the arterial wall stiffness values measured by the SWE technique were higher in smokers than non-smokers.
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Affiliation(s)
- Kamber Goksu
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Ahmet Vural
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Ahmet N. Kahraman
- Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Isil K. Aslan
- Department of Neurology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
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Bernar B, Gande N, Stock AK, Staudt A, Pechlaner R, Hochmayr C, Kaltseis K, Winder B, Kiechl SJJ, Broessner G, Geiger R, Kiechl S, Kiechl-Kohlendorfer U, Knoflach M. Early Vascular Ageing in adolescents with migraine with aura: a community-based study. BMC Cardiovasc Disord 2023; 23:384. [PMID: 37528337 PMCID: PMC10394858 DOI: 10.1186/s12872-023-03409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 03/26/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation point into the direction of an abnormal vasoreactivity that also extends to the extracranial vasculature. METHODS In the Early Vascular Ageing Tyrol study, a community-based non-randomized controlled trial conducted in 45 schools and companies in Tyrol (Austria) and South-Tyrol (Italy) between May 2015 and September 2018 aiming to increase cardiovascular health in adolescents, headache syndromes were classified according to the International Classification of Headache Disorders in a face-to-face interview. Carotid-femoral pulse-wave-velocity was measured by applanation tonometry and carotid intima-media-thickness by high-resolution ultrasound of the distal common carotid arteries. Differences in pulse-wave-velocity and carotid intima-media-thickness in youngsters with migraine with aura were compared respectively to those without headache and with other headaches by multivariable linear regression analysis. RESULTS Of the 2102 study participants 1589 were aged 14 to 19 (mean 16.8) years and had complete data. 43 (2.7%) reported migraine with aura and 737 (46.4%) other headaches. Mean pulse-wave-velocity was 6.17 m/s (± 0.85) for migraine with aura, 6.06 m/s (± 0.82) for all other headaches and 6.15 (0.95) m/s for participants without headaches. Carotid intima-media-thickness was 411.3 µm (± 43.5) for migraine with aura, 410.9 µm (± 46.0) for all other headaches and 421.6 µm (± 48.4) for participants without headaches. In multivariable linear regression analysis, we found no differences in carotid-femoral pulse-wave-velocity or carotid intima-media-thickness in young subjects with migraine with aura, all other headaches, or no headaches. CONCLUSIONS In line with previous large-scale studies in adults, we could not demonstrate relevant associations of migraine with aura with markers of arterial stiffness or subclinical atherosclerosis making early vascular ageing an unlikely pathophysiological link between migraine with aura and cardiovascular diseases. TRIAL REGISTRATION First registered on ClinicalTrials.gov 29/04/2019 (NCT03929692).
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Affiliation(s)
- Benoît Bernar
- Department of Pediatrics, Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Nina Gande
- Department of Pediatrics, Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Katharina Stock
- Department of Pediatrics, Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
- Department of Pediatrics, Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Staudt
- Department of Pediatrics, Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Christoph Hochmayr
- Department of Pediatrics, Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kaltseis
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Bernhard Winder
- Department of Pediatrics, Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
- Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Sophia Julia J Kiechl
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
- Department of Neurology, Hochzirl-Natters Hospital, Zirl, Austria
| | - Gregor Broessner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Ralf Geiger
- Department of Pediatrics, Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | | | - Michael Knoflach
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria.
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria.
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Damay VA, Setiawan, Lesmana R, Akbar MR, Lukito AA, Tarawan VM, Martha JW, Nugroho J, Sugiharto S. Aerobic Exercise versus Electronic Cigarette in Vascular Aging Process: First Histological Insight. Int J Vasc Med 2023; 2023:8874599. [PMID: 37533734 PMCID: PMC10393525 DOI: 10.1155/2023/8874599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 06/11/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023] Open
Abstract
Smoking is related to vascular aging. However, the hazardous effect of e-cigarette is often debatable, with limited studies available. In contrast, moderate-intensity aerobic exercise is well known to decrease aortic stiffness. We provide novel research to determine the effect of e-cigarette and aerobic moderate-intensity exercise on the aortic structure of Wistar rats. A total of 26 male Wistar rats (Rattus norvegicus) 8 weeks aged, 200-250 g b.w., were randomly divided into 4 groups, namely, K0 (normal rats), K1 (rats were given moderate-intensity aerobic exercise by animal treadmill 20 m/30 min), K2 (rats were given e-cigarette with 6 mg nicotine, 40% propylene glycol, and 60% vegetable glycerine 30 min for 5 days/week), and K3 (rats were given e-cigarette and moderate-intensity aerobic exercise). After exposure for 6 weeks, all animals were sacrificed to isolate the aorta for histopathological analysis with hematoxylin-eosin stain to evaluate the elastic fiber layer and intimal-medial thickness. The Verhoeff-Van Gieson staining was done for quantification elastic lamina fragmentation. Our study found that the e-cigarette group had the highest elastic lamina fragmentation among groups (8.14 ± 2.85). The exercise only group showed the lowest elastic lamina fragmentation (2.50 ± 1.87). Fragmentation in the e-cigarette and exercise group was higher than in the exercise only group (5.83 ± 0.753 vs. 2.50 ± 1.87, p = 0.002). There is a significant difference of NO serum between four groups. The result of post hoc analysis using LSD showed that there is a significant difference of NO serum between K0 and K2, K0 and K3, K1 and K2, and K1 and K3. Therefore, our research demonstrated that the most injury of aorta elastic lamina was in the group that was exposed to e-cigarette that leads to vascular aging while exercise is not yet proven to reverse this effect.
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Affiliation(s)
- Vito A. Damay
- Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Setiawan
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Ronny Lesmana
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Muhammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Antonia Anna Lukito
- Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Vita M. Tarawan
- Department of Biomedical Sciences, Universitas Padjadjaran, Bandung, Indonesia
| | - Januar W. Martha
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - J. Nugroho
- Department of Cardiology and Vascular Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sony Sugiharto
- Department of Anatomical Pathology, Universitas Tarumanegara, Jakarta, Indonesia
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Scalia A, Ghafari C, Navarre W, Delmotte P, Phillips R, Carlier S. High Fidelity Pressure Wires Provide Accurate Validation of Non-Invasive Central Blood Pressure and Pulse Wave Velocity Measurements. Biomedicines 2023; 11:1235. [PMID: 37189852 PMCID: PMC10135723 DOI: 10.3390/biomedicines11041235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 03/01/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Central blood pressure (cBP) is known to be a better predictor of the damage caused by hypertension in comparison with peripheral blood pressure. During cardiac catheterization, we measured cBP in the ascending aorta with a fluid-filled guiding catheter (FF) in 75 patients and with a high-fidelity micromanometer tipped wire (FFR) in 20 patients. The wire was withdrawn into the brachial artery and aorto-brachial pulse wave velocity (abPWV) was calculated from the length of the pullback and the time delay between the ascending aorta and the brachial artery pulse waves by gating to the R-wave of the ECG for both measurements. In 23 patients, a cuff was inflated around the calf and an aorta-tibial pulse wave velocity (atPWV) was calculated from the distance between the cuff around the leg and the axillary notch and the time delay between the ascending aorta and the tibial pulse waves. Brachial BP was measured non-invasively and cBP was estimated using a new suprasystolic oscillometric technology. The mean differences between invasively measured cBP by FFR and non-invasive estimation were -0.4 ± 5.7 mmHg and by FF 5.4 ± 9.4 mmHg in 52 patients. Diastolic and mean cBP were both overestimated by oscillometry, with mean differences of -8.9 ± 5.5 mmHg and -6.4 ± 5.1 mmHg compared with the FFR and -10.6 ± 6.3 mmHg and -5.9 ± 6.2 mmHg with the FF. Non-invasive systolic cBP compared accurately with the high-fidelity FFR measurements, demonstrating a low bias (≤5 mmHg) and high precision (SD ≤ 8 mmHg). These criteria were not met when using the FF measurements. Invasively derived average Ao-brachial abPWV was 7.0 ± 1.4 m/s and that of Ao-tibial atPWV was 9.1 ± 1.8 m/s. Non-invasively estimated PWV based on the reflected wave transit time did not correlate with abPWV or with atPWV. In conclusion, we demonstrate the advantages of a novel method of validation for non-invasive cBP monitoring devices using acknowledged gold standard FFR wire transducers and the possibility to easily measure PWV during coronary angiography with the impact of cardiovascular risk factors.
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Affiliation(s)
- Alessandro Scalia
- Department of Cardiology, Centre Hospitalier Universitaire Ambroise Paré, 7000 Mons, Belgium
- Department of Cardiology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMONS), 7000 Mons, Belgium
| | - Chadi Ghafari
- Department of Cardiology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMONS), 7000 Mons, Belgium
| | - Wivine Navarre
- Faculty of Medicine, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
| | - Philippe Delmotte
- Department of Cardiology, Centre Hospitalier Universitaire Ambroise Paré, 7000 Mons, Belgium
| | - Rob Phillips
- The School of Medicine, The University of Queensland, Brisbane 4072, Australia
| | - Stéphane Carlier
- Department of Cardiology, Centre Hospitalier Universitaire Ambroise Paré, 7000 Mons, Belgium
- Department of Cardiology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMONS), 7000 Mons, Belgium
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Alansare AB, Stoner L, Aljuhani OE, Gibbs BB. Utility of Estimated Pulse Wave Velocity for Tracking the Arterial Response to Prolonged Sitting. J Cardiovasc Dev Dis 2022; 9:411. [PMID: 36547408 PMCID: PMC9785284 DOI: 10.3390/jcdd9120411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 10/18/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Arterial stiffness, measured by pulse wave velocity (PWV), is a purported mechanism linking sedentary behavior to cardiovascular disease. This secondary analysis compared associations between measured carotid−femoral PWV (cfPWV) and carotid−radial (crPWV) responses to an acute bout of prolonged sitting with mathematically estimated cfPWV (ePWV). Methods: Overweight/obese adults with elevated blood pressure were enrolled (n = 25; 42 ± 12 yrs; 64% males). Participants performed an 8 h simulated workday of mostly sitting. cfPWV and crPWV were measured while supine in the morning, midday, and afternoon. ePWV was calculated at the same timepoints using age and seated mean arterial pressure (MAP). Pearson correlation coefficients associated ePWV with cfPWV and crPWV. Generalized linear models separately examined the effects of time on cfPWV, crPWV, and ePWV. Results: ePWV significantly associated with cfPWV and crPWV (r = 0.69 and 0.55, respectively; p < 0.05) in the morning (baseline). cfPWV significantly increased over time (β = 0.52 ± 0.20 and 0.48 ± 0.21 with and without MAP adjustment, respectively; p < 0.05). In contrast, ePWV and crPWV did not significantly increase overtime (β = 0.14 ± 0.09 and 0.25 ± 0.23, respectively; p > 0.05). Conclusions: Our results suggest that, although ePWV is associated with cfPWV and crPWV at a fixed timepoint, ePWV responds differently to prolonged sitting and likely does not capture the same acute vascular responses.
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Affiliation(s)
- Abdullah Bandar Alansare
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, King Khalid Rd, Riyadh 80200, Saudi Arabia
| | - Lee Stoner
- Department of Sport and Exercise, University of North Carolina, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Osama Eid Aljuhani
- Department of Physical Education, College of Sport Sciences and Physical Activity, King Saud University, King Khalid Rd, Riyadh 80200, Saudi Arabia
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
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Larios-Cárdenas M, González-Radillo OI, Trujillo-Quirós J, Cardona-Müller D, Barocio-Pantoja M, Cardona-Muñoz EG, Grover-Páez F. Tadalafil Improves Haemodynamics and Arterial Stiffness but Not Flow- Mediated Dilation in Grade 1 Obesity. A Single-dose, Placebo-controlled Clinical Trial. Curr Vasc Pharmacol 2022; 20:527-533. [PMID: 36043781 DOI: 10.2174/1570161120666220827154417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/14/2022] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Obesity, a major health issue worldwide, is associated with increased cardiovascular risk, endothelial dysfunction, and arterial stiffness. Tadalafil has been demonstrated to improve vascular parameters. AIM To evaluate the effect of a single 20 mg dose of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers. METHODS A randomized, double-blind, placebo-controlled study was conducted on 80 participants (41 assigned to placebo and 39 to tadalafil) with grade 1 obesity, to evaluate the acute effect of a single dose of 20 mg of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers. RESULTS Tadalafil did not modify flow-mediated dilation. However, it significantly lowered systolic blood pressure (SBP) (130.6±17.1 vs. 125.0±12.7 mmHg, p=0.011), diastolic blood pressure (82.7±18.2 vs. 76.5±11.8 mmHg, p≤0.001), central systolic blood pressure (116.33±19.16 vs. 109.90±15.05 mmHg, p=0.001), the augmentation index (69.1±17.1 vs. 65.7±14.4, p=0.012), and brachial-ankle pulse wave velocity (1229.7±218.4 vs. 1164.0±181.7, p=0.001). CONCLUSION A single dose of tadalafil did not modify flow-mediated dilation in patients with grade 1 obesity but improved blood pressure and brachial-ankle pulse wave velocity.
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Affiliation(s)
- Mariana Larios-Cárdenas
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Oscar I González-Radillo
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Jhonatan Trujillo-Quirós
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - David Cardona-Müller
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Marycruz Barocio-Pantoja
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Ernesto G Cardona-Muñoz
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Fernando Grover-Páez
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
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10
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A patient-specific image-based approach to estimate pulmonary artery stiffness based on vessel constitutive model. Med Eng Phys 2022; 107:103851. [DOI: 10.1016/j.medengphy.2022.103851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 04/09/2021] [Revised: 06/28/2022] [Accepted: 07/10/2022] [Indexed: 11/21/2022]
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11
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Klonizakis M, Gumber A, McIntosh E, Brose LS. Medium- and longer-term cardiovascular effects of e-cigarettes in adults making a stop-smoking attempt: a randomized controlled trial. BMC Med 2022; 20:276. [PMID: 35971150 PMCID: PMC9380327 DOI: 10.1186/s12916-022-02451-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 01/14/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Smoking is a major risk factor for cardiovascular disease and smoking cessation reduces excess risk. E-cigarettes are popular for smoking cessation but there is little evidence on their cardiovascular health effect. Our objective was to compare the medium- and longer-term cardiovascular effects in smokers attempting to quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). METHODS This was a single-center, pragmatic three-arm randomized (1:1:1) controlled trial, which recruited adult smokers (≥ 10 cigarettes/day), who were willing to attempt to stop smoking with support (n = 248). Participants were randomized to receive behavioral support with either (a) e-cigarettes with 18 mg/ml nicotine, (b) e-cigarettes without nicotine, and (c) NRT. Flow-mediated dilation (%FMD) and peak cutaneous vascular conductance (CVCmax) responses to acetylcholine (ACh) and sodium nitroprusside (SNP), mean arterial pressure (MAP), and other outcomes were recorded at baseline, 3, and 6 months after stopping smoking. Data were analyzed using generalized estimating equations (GEE). RESULTS At 3- and 6-month follow-up, %FMD showed an improvement over baseline in all three groups (e.g., p < 0.0001 at 6 months). Similarly, ACh, SNP, and MAP improved significantly over baseline in all groups both at 3 and 6 months (e.g., ACh: p = 0.004, at 6 months). CONCLUSIONS Smokers attempting to quit experienced positive cardiovascular impact after both a 3- and 6-month period. None of the groups (i.e., nicotine-containing and nicotine-free e-cigarettes or NRT) offered superior cardiovascular benefits to the others. TRIAL REGISTRATION ClinicalTrials.gov NCT03061253 . Registered on 17 February 2017.
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Affiliation(s)
- Markos Klonizakis
- Lifestyle Exercise and Nutrition Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, S10 2BP, UK.
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK.
| | - Anil Gumber
- Lifestyle Exercise and Nutrition Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, S10 2BP, UK
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Emma McIntosh
- Lifestyle Exercise and Nutrition Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Leonie S Brose
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- SPECTRUM Research Consortium, Edinburgh, UK
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12
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Advanced Glycation End Products and Diabetes Mellitus: Mechanisms and Perspectives. Biomolecules 2022; 12:biom12040542. [PMID: 35454131 PMCID: PMC9030615 DOI: 10.3390/biom12040542] [Citation(s) in RCA: 274] [Impact Index Per Article: 91.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/15/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 02/06/2023] Open
Abstract
Persistent hyperglycemic state in type 2 diabetes mellitus leads to the initiation and progression of non-enzymatic glycation reaction with proteins and lipids and nucleic acids. Glycation reaction leads to the generation of a heterogeneous group of chemical moieties known as advanced glycated end products (AGEs), which play a central role in the pathophysiology of diabetic complications. The engagement of AGEs with its chief cellular receptor, RAGE, activates a myriad of signaling pathways such as MAPK/ERK, TGF-β, JNK, and NF-κB, leading to enhanced oxidative stress and inflammation. The downstream consequences of the AGEs/RAGE axis involve compromised insulin signaling, perturbation of metabolic homeostasis, RAGE-induced pancreatic beta cell toxicity, and epigenetic modifications. The AGEs/RAGE signaling instigated modulation of gene transcription is profoundly associated with the progression of type 2 diabetes mellitus and pathogenesis of diabetic complications. In this review, we will summarize the exogenous and endogenous sources of AGEs, their role in metabolic dysfunction, and current understandings of AGEs/RAGE signaling cascade. The focus of this review is to recapitulate the role of the AGEs/RAGE axis in the pathogenesis of type 2 diabetes mellitus and its associated complications. Furthermore, we present an overview of future perspectives to offer new therapeutic interventions to intervene with the AGEs/RAGE signaling pathway and to slow down the progression of diabetes-related complications.
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13
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Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial. BIOLOGY 2021; 10:biology10111208. [PMID: 34827200 PMCID: PMC8614829 DOI: 10.3390/biology10111208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Academic Contribution Register] [Received: 10/18/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022]
Abstract
Simple Summary E-cigarettes are popular for smoking cessation but knowledge of their effect on cardiovascular health is limited. We compared the short-term cardiovascular effects in 248 smokers who quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). All participants received behavioural support. We assessed the cardiovascular effects of these stop smoking methods 3 days following quit date. Our work suggests that e-cigarettes offer similar vascular health benefits to that of NRT. This happens at a very early stage in the stop smoking process (3 days). Abstract Smoking increases cardiovascular disease (CVD) risk by leading to endothelial injury. E-cigarettes remain a popular way to stop smoking. Evidence on their effect on cardiovascular health is growing but remains limited, particularly in the short-term. The main objective of this study was to compare short-term cardiovascular effects in smokers who quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). This was a single-centre (Sheffield, UK) pragmatic three-arm randomised controlled trial which recruited adult smokers (≥10 cigarettes per day), who were willing to attempt to stop smoking with support (n = 248). Participants were randomised to receive either: (a) behavioral support and e-cigarettes with 18 mg/mL nicotine (n = 84); (b) behavioral support and e-cigarettes without nicotine (n = 82); (c) behavioral support and NRT (n = 82). Flow Mediated Dilation (%FMD), peak cutaneous vascular conductance responses to acetylcholine (ACh) and sodium nitroprusside (SNP) and mean arterial pressure (MAP) were recorded at baseline and three days after stopping smoking. General Linear Models were used to compare changes between groups and changes from follow-up. Adjusting for baseline, at follow-up, all outcomes (for the 208 participants that completed the 3-day assessments) with the exception of SNP had improved significantly over baseline and there were no differences between groups (%FMD F = 1.03, p = 0.360, df = 2,207; ACh F = 0.172, p = 0.84, df = 2,207; SNP F = 0.382, p = 0.68, df = 2,207; MAP F = 0.176, p = 0.84, df = 2,207). For smokers ≥20 cigarettes per day, benefits were also pronounced. Smoking cessation showed positive cardiovascular impact even after a 3-day period and the effects did not differ between nicotine-containing e-cigarettes, nicotine-free e-cigarettes and NRT.
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14
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Bhat OM, Yuan X, Kukreja RC, Li PL. Regulatory role of mammalian target of rapamycin signaling in exosome secretion and osteogenic changes in smooth muscle cells lacking acid ceramidase gene. FASEB J 2021; 35:e21732. [PMID: 34143450 DOI: 10.1096/fj.202100385r] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 03/04/2021] [Revised: 05/22/2021] [Accepted: 06/01/2021] [Indexed: 12/28/2022]
Abstract
Acid ceramidase (murine gene code: Asah1) (50 kDa) belongs to N-terminal nucleophile hydrolase family. This enzyme is located in the lysosome, which mediates conversion of ceramide (CER) into sphingosine and free fatty acids at acidic pH. CER plays an important role in intracellular sphingolipid metabolism and its increase causes inflammation. The mammalian target of rapamycin complex 1 (mTORC1) signaling on late endosomes (LEs)/lysosomes may control cargo selection, membrane biogenesis, and exosome secretion, which may be fine controlled by lysosomal sphingolipids such as CER. This lysosomal-CER-mTOR signaling may be a crucial molecular mechanism responsible for development of arterial medial calcification (AMC). Torin-1 (5 mg/kg/day), an mTOR inhibitor, significantly decreased aortic medial calcification accompanied with decreased expression of osteogenic markers like osteopontin (OSP) and runt-related transcription factor 2 (RUNX2) and upregulation of smooth muscle 22α (SM22-α) in mice receiving high dose of Vitamin D (500 000 IU/kg/day). Asah1fl/fl /SMCre mice had markedly increased co-localization of mTORC1 with lysosome-associated membrane protein-1 (Lamp-1) (lysosome marker) and decreased co-localization of vacuolar protein sorting-associated protein 16 (VPS16) (a multivesicular bodies [MVBs] marker) with Lamp-1, suggesting mTOR activation caused reduced MVBs interaction with lysosomes. Torin-1 significantly reduced the co-localization of mTOR vs Lamp-1, increased lysosome-MVB interaction which was associated with reduced accumulation of CD63 and annexin 2 (exosome markers) in the coronary arterial wall of mice. Using coronary artery smooth muscle cells (CASMCs), Pi -stimulation significantly increased p-mTOR expression in Asah1fl/fl /SMCre CASMCs as compared to WT/WT cells associated with increased calcium deposition and mineralization. Torin-1 blocked Pi -induced calcium deposition and mineralization. siRNA mTOR and Torin-1 significantly reduce co-localization of mTORC1 with Lamp-1, increased VPS16 vs Lamp-1 co-localization in Pi -stimulated CASMCs, associated with decreased exosome release. Functionally, Torin-1 significantly reduces arterial stiffening as shown by restoration from increased pulse wave velocity and decreased elastin breaks. These results suggest that lysosomal CER-mTOR signaling may play a critical role for the control of lysosome-MVB interaction, exosome secretion and arterial stiffening during AMC.
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Affiliation(s)
- Owais M Bhat
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Xinxu Yuan
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Rakesh C Kukreja
- VCU Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Pin-Lan Li
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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15
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Sri-Amad R, Huipao N, Prasertsri P, Roengrit T. Aortic Pulse Wave Velocity, Ankle-Brachial Index, and Malondialdehyde in Older Adults with or without Metabolic Syndrome. Pulse (Basel) 2020; 8:31-39. [PMID: 32999876 DOI: 10.1159/000505838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
Metabolic syndrome is an important health problem associated with both subclinical atherosclerosis and an increased risk of cardiovascular disease and it leads to an elevated total mortality. Aortic pulse wave velocity (aPWV) is widely used for noninvasive assessment of arterial stiffness. Ankle-brachial index (ABI) predicts peripheral arterial disease (PAD) of the lower extremities. In addition, malondialdehyde (MDA) is thought to be involved in the development of arterial stiffness. The present study aimed to: (1) compare aPWV, ABI, and MDA between participants with MetS and those without MetS and (2) investigate the correlation of aPWV and ABI with the components of MetS and MDA. A total of 48 Thai elderly subjects were divided into 2 groups (MetS and non-MetS) according to the parameters set by the International Diabetes Federation (IDF). aPWV and ABI were measured using the VaSera VS-1500 system (Fukuda Denshi Co., Tokyo, Japan). MDA was determined by spectrophotometry. aPWV and MDA were significantly higher in the MetS group compared to the participants in the non-MetS group (9.33 ± 2.72 vs. 7.95 ± 1.37 m/s, p = 0.03, and 0.74 ± 0.71 vs. 0.45 ± 0.20 μmol, p = 0.02, respectively). However, ABI did not differ between the groups. Analysis of the risk factors of aPWV in each group revealed that there were no statistical associations between the components of MetS and MDA and aPWV in both the MetS and the non-MetS groups. A high aPWV is more prevalent among patients with MetS than among those without MetS. Monitoring of aPWV might help to explore potential detection of vascular damage in the elderly.
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Affiliation(s)
- Ruchada Sri-Amad
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Nawiya Huipao
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
| | - Piyapong Prasertsri
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand.,Exercise and Nutrition Sciences and Innovation Research Unit, Burapha University, Chonburi, Thailand
| | - Thapanee Roengrit
- Department of Physiology, Faculty of Science, Prince of Songkla University, Songkhla, Thailand
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16
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van de Kuit A, Benjamens S, Sotomayor CG, Rijkse E, Berger SP, Moers C, Bakker SJ, Minnee RC, Yakar D, Pol RA. Postoperative Ultrasound in Kidney Transplant Recipients: Association Between Intrarenal Resistance Index and Cardiovascular Events. Transplant Direct 2020; 6:e581. [PMID: 33134505 PMCID: PMC7581034 DOI: 10.1097/txd.0000000000001034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 05/06/2020] [Revised: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 01/09/2023] Open
Abstract
UNLABELLED Doppler ultrasound, including intrarenal resistance index (RI) measurement, is a widely used modality to assess kidney transplantation (KTx) vascularization. The aim of this study is to gain insight in the associations between early postoperative RI measurements and cardiovascular events (CVEs), all-cause mortality, and death-censored graft survival. METHODS From 2015 to 2017, a prospective cohort study was conducted in patients in which RI measurement was performed immediately after KTx. The RI was calculated as (peak systolic velocity-end-diastolic velocity)/peak systolic velocity. End points were CVEs, all-cause mortality, and graft failure. Kaplan-Meier analyses (logrank test) were used for differences in end points. Univariate and multivariate associations were investigated by means of Cox regression analyses. RESULTS RI cutoff of 0.70 was used. We included 339 recipients, of which 271 (80%) had an RI ≤ 0.70 and 68 (20%) had an RI > 0.70. CVEs were observed in 27 (8%) patients, 27 (8%) patients died, and 17 (5%) patients had graft failure during a median follow-up of 37 months (interquartile range, 33-43). Kaplan-Meier analyses and univariate Cox regression indicated a significant association with overall CVE-free survival (hazard ratios [HR], 2.79; P = 0.011; logrank test, P = 0.008) and all-cause mortality (HR, 2.59; P = 0.017; logrank test, P = 0.013) for patients with an RI above and below 0.70. An independent association was shown between an RI > 0.70 and CVE-free survival (HR, 2.48; P = 0.042) when deceased donation was not included in the model. CONCLUSIONS In the early postoperative period, a high RI showed to be associated with CVEs after adjustment for cardiovascular risk factors, whereas no independent association was found with overall survival and graft failure. For the interpretation of RI measurements after KTx surgery, patients' cardiovascular state should be taken into consideration.
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Affiliation(s)
- Anouk van de Kuit
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stan Benjamens
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Camilo G. Sotomayor
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elsaline Rijkse
- Department of HPB and Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Stefan P. Berger
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cyril Moers
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J.L. Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert C. Minnee
- Department of HPB and Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Derya Yakar
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert A. Pol
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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17
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Mutzenbach JS, Machegger L, Moscote-Salazar LR, Killer-Oberpfalzer M, Müller-Thies-Broussalis E, Pikija S. Carotid Calcium Volume and Stenosis after Stent Implantation. J Stroke Cerebrovasc Dis 2020; 29:104862. [PMID: 32689638 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 01/18/2020] [Revised: 03/21/2020] [Accepted: 04/02/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Internal carotid artery (ICA) stenosis could be treated with stent placement. It was hypothesized that calcium amount could be predictive of vessel stenosis after stent placement. We utilised computed tomography (CT) angiography to quantify volume of calcium material in bulbar ICA. MATERIALS AND METHODS 28 patients with 31 treated ICA stenosis were collected and analysed using CT angiography-based calcium volume measurement. The Casper stent system (CSS) was used exclusively. Prospective data on emergent carotid stenosis were collected using serial ultrasound controls over a 12-month period. RESULTS Median age was 76 years (interquartile range (IQR) 67.5-77.8) and the majority were men (71.4%). Plaque median calcium volume was 0.142 cm3 (IQR 0.030 - 0.227) and median average Hounsfield Units (HU) were 561.0 (414.5-675.0). We detected positive linear relationship between average HU and ICA calcium volume. Furthermore, weak positive correlation was observed between calcium volume and residual stenosis as seen on post-interventional angiography, (correlation coefficient R = 0.38, p=0.035). Stronger positive correlation emerged between plaques' average HU and residual stenosis (R = 0.42, p=0.018). Angiographic stenosis showed univariate association with late stenosis as detected 12 months after CAS. CONCLUSION Calcium burden could be associated with residual stenosis after CSS placement. Larger studies are needed to confirm our preliminary data.
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Affiliation(s)
| | - Lukas Machegger
- Division of neuroradiology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
| | - Luis Rafael Moscote-Salazar
- Research Institute for Neurointervention, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
| | - Monika Killer-Oberpfalzer
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Research Institute for Neurointervention, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
| | - Erasmia Müller-Thies-Broussalis
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria; Research Institute for Neurointervention, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
| | - Slaven Pikija
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
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18
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Machin DR, Auduong Y, Gogulamudi VR, Liu Y, Islam MT, Lesniewski LA, Donato AJ. Lifelong SIRT-1 overexpression attenuates large artery stiffening with advancing age. Aging (Albany NY) 2020; 12:11314-11324. [PMID: 32564006 PMCID: PMC7343505 DOI: 10.18632/aging.103322] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/25/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
Advanced age is accompanied by aortic stiffening that is associated with decreased vascular expression of sirtuin-1 (SIRT-1). Interventions that increase SIRT-1 expression also lower age-related aortic stiffness. Therefore, we sought to determine if lifelong SIRT-1 overexpression would attenuate age-related aortic stiffening. Aortic pulse wave velocity (PWV) was assessed from 3-24 months in SIRT-1 transgenic overexpressing (SIRTTG) and wild-type (WT) mice. To determine the role of aortic structural changes on aortic stiffening, histological assessment of aortic wall characteristics was performed. Across the age range (3-24 mo), PWV was 8-17% lower in SIRTTG vs. WT (P<0.05). Moreover, the slope of age-related aortic stiffening was lower in SIRTTG vs. WT (2.1±0.2 vs. 3.8±0.3 cm/sec/mo, respectively). Aortic elastin decreased with advancing age in WT (P<0.05 old vs. young WT), but was maintained in SIRTTG mice (P>0.05). There was an age-related increase in aortic collagen, advanced glycation end products, and calcification in WT (P<0.05 old vs. young WT). However, this did not occur in SIRTTG (P>0.05). These findings indicate that lifelong SIRT-1 overexpression attenuates age-related aortic stiffening. These functional data are complemented by histological assessment, demonstrating that the deleterious changes to the aortic wall that normally occur with advancing age are prevented in SIRTTG mice.
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Affiliation(s)
- Daniel R. Machin
- University of Utah, Department of Internal Medicine, Salt Lake City, UT 84132, USA
| | - Yauling Auduong
- University of Utah, Department of Internal Medicine, Salt Lake City, UT 84132, USA
| | | | - Yu Liu
- University of Utah, Department of Internal Medicine, Salt Lake City, UT 84132, USA
| | - Md. Torikul Islam
- University of Utah, Department of Nutrition and Integrative Physiology, Salt Lake City, UT 84112, USA
| | - Lisa A. Lesniewski
- University of Utah, Department of Internal Medicine, Salt Lake City, UT 84132, USA
- University of Utah, Department of Nutrition and Integrative Physiology, Salt Lake City, UT 84112, USA
- VA Salt Lake City, GRECC, Salt Lake City, UT 84148, USA
| | - Anthony J. Donato
- University of Utah, Department of Internal Medicine, Salt Lake City, UT 84132, USA
- University of Utah, Department of Nutrition and Integrative Physiology, Salt Lake City, UT 84112, USA
- University of Utah, Department of Biochemistry, Salt Lake City, UT 84132, USA
- VA Salt Lake City, GRECC, Salt Lake City, UT 84148, USA
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19
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Awal HB, Nandula SR, Domingues CC, Dore FJ, Kundu N, Brichacek B, Fakhri M, Elzarki A, Ahmadi N, Safai S, Fosso M, Amdur RL, Sen S. Linagliptin, when compared to placebo, improves CD34+ve endothelial progenitor cells in type 2 diabetes subjects with chronic kidney disease taking metformin and/or insulin: a randomized controlled trial. Cardiovasc Diabetol 2020; 19:72. [PMID: 32493344 PMCID: PMC7271387 DOI: 10.1186/s12933-020-01046-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 03/22/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Endothelial Progenitor cells (EPCs) has been shown to be dysfunctional in both type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) leading to poor regeneration of endothelium and renal perfusion. EPCs have been shown to be a robust cardiovascular disease (CVD) risk indicator. Cellular mechanisms of DPP4 inhibitors such as linagliptin (LG) on CVD risk, in patients with T2DM with established CKD has not been established. Linagliptin, a DPP4 inhibitor when added to insulin, metformin or both may improve endothelial dysfunction in a diabetic kidney disease (DKD) population. METHODS 31 subjects taking metformin and/or Insulin were enrolled in this 12 weeks, double blind, randomized placebo matched trial, with 5 mg LG compared to placebo. Type 2 diabetes subjects (30-70 years old), HbA1c of 6.5-10%, CKD Stage 1-3 were included. CD34+ cell number, migratory function, gene expression along with vascular parameters such as arterial stiffness, biochemistry, resting energy expenditure and body composition were measured. Data were collected at week 0, 6 and 12. A mixed model regression analysis was done with p value < 0.05 considered significant. RESULTS A double positive CD34/CD184 cell count had a statistically significant increase (p < 0.02) as determined by flow cytometry in LG group where CD184 is SDF1a cell surface receptor. Though mRNA differences in CD34+ve was more pronounced CD34- cell mRNA analysis showed increase in antioxidants (superoxide dismutase 2 or SOD2, Catalase and Glutathione Peroxidase or GPX) and prominent endothelial markers (PECAM1, VEGF-A, vWF and NOS3). Arterial stiffness measures such as augmentation Index (AI) (p < 0.04) and pulse wave analysis (PWV) were improved (reduced in stiffness) in LG group. A reduction in LDL: HDL ratio was noted in treatment group (p < 0.04). Urinary exosome protein examining podocyte health (podocalyxin, Wilms tumor and nephrin) showed reduction or improvement. CONCLUSIONS In DKD subjects, Linagliptin promotes an increase in CXCR4 expression on CD34 + progenitor cells with a concomitant improvement in vascular and renal parameters at 12 weeks. Trial Registration Number NCT02467478 Date of Registration: 06/08/2015.
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MESH Headings
- Adult
- Aged
- Antigens, CD34/blood
- Biomarkers/blood
- Cells, Cultured
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/drug therapy
- Diabetic Nephropathies/blood
- Diabetic Nephropathies/diagnosis
- Diabetic Nephropathies/drug therapy
- Dipeptidyl-Peptidase IV Inhibitors/adverse effects
- Dipeptidyl-Peptidase IV Inhibitors/therapeutic use
- District of Columbia
- Double-Blind Method
- Drug Therapy, Combination
- Endothelial Progenitor Cells/drug effects
- Endothelial Progenitor Cells/metabolism
- Endothelial Progenitor Cells/pathology
- Female
- Humans
- Hypoglycemic Agents/adverse effects
- Hypoglycemic Agents/therapeutic use
- Insulin/adverse effects
- Insulin/therapeutic use
- Linagliptin/adverse effects
- Linagliptin/therapeutic use
- Male
- Metformin/adverse effects
- Metformin/therapeutic use
- Middle Aged
- Pilot Projects
- Receptors, CXCR4/blood
- Renal Insufficiency, Chronic/blood
- Renal Insufficiency, Chronic/diagnosis
- Renal Insufficiency, Chronic/drug therapy
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Hassan B. Awal
- The GW Medical Faculty Associates, 2300 M Street NW, Washington, DC 20037 USA
| | - Seshagiri Rao Nandula
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Cleyton C. Domingues
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Fiona J. Dore
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Nabanita Kundu
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Beda Brichacek
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Mona Fakhri
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Adrian Elzarki
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Neeki Ahmadi
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Shauna Safai
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
| | - Magan Fosso
- The GW Medical Faculty Associates, 2300 M Street NW, Washington, DC 20037 USA
| | - Richard L. Amdur
- The GW Medical Faculty Associates, 2300 M Street NW, Washington, DC 20037 USA
| | - Sabyasachi Sen
- The GW Medical Faculty Associates, 2300 M Street NW, Washington, DC 20037 USA
- Department of Medicine, The George Washington University, 2300 I St NW, SMHS Room 462, Washington, DC 20052 USA
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Lee SH, Pekas EJ, Lee S, Headid RJ, Park SY. The Impact of Aspirin Intake on Lactate Dehydrogenase, Arterial Stiffness, and Oxidative Stress During High-Intensity Exercise: A Pilot Study. J Hum Kinet 2020; 72:101-113. [PMID: 32269652 PMCID: PMC7126265 DOI: 10.2478/hukin-2019-0101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 01/01/2023] Open
Abstract
Aspirin is a common nonsteroidal anti-inflammatory drug used to reduce fever, pain, and inflammation. However, aspirin's anti-inflammatory properties may also prevent increased levels of blood lactate dehydrogenase, vascular arterial stiffness and oxidative stress induced by high-intensity exercise. The purpose of this study was to investigate the effects of 4 weeks of aspirin supplementation on lactate dehydrogenase activity, lactate, arterial stiffness, and antioxidant capacity during high-intensity exercise in Taekwondo athletes. Participants were randomly divided into two groups: aspirin supplementation (n = 10) and placebo-control (n = 10). Blood levels of lactate dehydrogenase (LDH) enzyme activity and lactate were assessed to examine muscle damage and carotid-to-radial pulse wave velocity and the augmentation index were measured to examine arterial stiffness. Blood levels of superoxide dismutase, malondialdehyde, and glutathione peroxidase were assessed to determine antioxidant capacity and levels of oxidative stress. There were significant group × time interactions for enzyme activity of LDH (Δ-60 ± 24.36 U/L) and carotid-to-radial pulse wave velocity (Δ-1.33 ± 0.54 m/s), which significantly decreased (p < 0.05) following aspirin supplementation compared to placebo-control. Superoxide dismutase (Δ359 ± 110 U/gHb) and glutathione peroxidase (Δ28.2 ± 10.1 U/gHb) significantly decreased while malondialdehyde (0Δ3.0 ± 0.1 mmol/mL) significantly increased (p < 0.05) in the placebo-control group compared to the supplementation group. However, there were no changes in lactate concentration levels or augmentation index. These results reveal that low-dose aspirin supplementation would be a useful supplementation therapy to prevent high-intensity exercise training-induced increases in oxidative damage, inflammation, skeletal muscle fatigue, and arterial stiffness in elite Taekwondo athletes.
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Affiliation(s)
- Sang Ho Lee
- Department of Taekwondo Mission, Kosin University, Busan, South Korea
| | - Elizabeth J. Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Seungyong Lee
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ronald J. Headid
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
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Durand MJ, Beckert AK, Peterson CY, Ludwig KA, Ridolfi TJ, Lauer KK, Freed JK. You Are Only as Frail as Your Arteries: Prehabilitation of Elderly Surgical Patients. CURRENT ANESTHESIOLOGY REPORTS 2019. [DOI: 10.1007/s40140-019-00357-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 12/20/2022]
Abstract
Abstract
Purpose of Review
To discuss the concept of prehabilitation for the elderly frail surgical patient as well as strategies to improve preoperative functional capacity and vascular function to decrease postoperative complications.
Recent Findings
Frailty is associated with poor surgical outcomes yet there is no consensus on how frailty should be measured or mitigated in the preoperative period. Prehabilitation, or improving functional capacity prior to surgery typically through exercise, has been shown to be an effective strategy to decrease preoperative frailty and improves surgical outcomes. Use of remote ischemic preconditioning (RIPC) may serve as an alternative to exercise in this fragile patient population.
Summary
Prehabilitation programs using strategies targeted at improving vascular function may decrease frailty in the preoperative period and improve surgical outcomes in the elderly population.
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22
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van Velzen MHN, Niehof SP, Mik EG, Loeve AJ. Measuring pulse wave velocity with a novel, simple sensor on the finger tip: a feasibility study in healthy volunteers. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab3ad8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/11/2022]
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23
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Szucs B, Szucs C, Petrekanits M, Varga JT. Molecular Characteristics and Treatment of Endothelial Dysfunction in Patients with COPD: A Review Article. Int J Mol Sci 2019; 20:E4329. [PMID: 31487864 PMCID: PMC6770145 DOI: 10.3390/ijms20184329] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 07/26/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 12/22/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) show systemic consequences, such as chronic systemic inflammation leading to changes in the airway, airway penetrability, and endothelial function. Endothelial dysfunction is characterized by a list of alterations of endothelium towards reduced vasodilation, proinflammatory state, detachment and apoptosis of endothelial cells, and development of atherosclerosis. COPD-induced endothelial dysfunction is associated with elevated cardiovascular risk. The increment of physical activities such as pulmonary rehabilitation (PR) training have a significant effect on COPD, thus, PR can be an integrative part of COPD treatment. In this narrative review the focus is on the function of endothelial inflammatory mediators [cytokines, chemokines, and cellular proteases] and pulmonary endothelial cells and endothelial dysfunction in COPD as well as the effects of dysfunction of the endothelium may play in COPD-related pulmonary hypertension. The relationship between smoking and endothelial dysfunction is also discussed. The connection between different pulmonary rehabilitation programs, arterial stiffness and pulse wave velocity (PWV) is presented. Endothelial dysfunction is a significant prognostic factor of COPD, which can be characterized by PWV. We discuss future considerations, like training programs, as an important part of the treatment that has a favorable impact on the endothelial function.
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Affiliation(s)
- Botond Szucs
- PharmaFlight Research and Training Center, H-4030 Debrecen, Hungary
| | - Csilla Szucs
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Debrecen, Debrecen H-4032, Hungary
| | - Mate Petrekanits
- Institute of Exercise Physiology and Sport Medicine, University of Physical Education, H-1123 Budapest, Hungary
| | - Janos T Varga
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, H-1121 Budapest, Hungary.
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24
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Wang Y, Li H, Guo Y, Lee WN. Bidirectional Ultrasound Elastographic Imaging Framework for Non-invasive Assessment of the Non-linear Behavior of a Physiologically Pressurized Artery. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1184-1196. [PMID: 30876671 DOI: 10.1016/j.ultrasmedbio.2019.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Received: 06/18/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
Studies of non-destructive bidirectional ultrasound assessment of non-linear mechanical behavior of the artery are scarce in the literature. We hereby propose derivation of a strain-shear modulus relationship as a new graphical diagnostic index using an ultrasound elastographic imaging framework, which encompasses our in-house bidirectional vascular guided wave imaging (VGWI) and ultrasound strain imaging (USI). This framework is used to assess arterial non-linearity in two orthogonal (i.e., longitudinal and circumferential) directions in the absence of non-invasive pressure measurement. Bidirectional VGWI estimates longitudinal (μL) and transverse (μT) shear moduli, whereas USI estimates radial strain (ɛr). Vessel-mimicking phantoms (with and without longitudinal pre-stretch) and in vitro porcine aortas under static and/or dynamic physiologic intraluminal pressure loads were examined. ɛr was found to be a suitable alternative to intraluminal pressure for representation of cyclic loading on the artery wall. Results revealed that μT values of all samples examined increased non-linearly with εr magnitude and more drastically than μL, whereas μL values of only the pre-stretched phantoms and aortas increased with ɛr magnitude. As a new graphical representation of arterial non-linearity and function, strain-shear modulus loops derived by the proposed framework over two consecutive dynamic loading cycles differentiated sample pre-conditions and corroborated direction-dependent non-linear mechanical behaviors of the aorta with high estimation repeatability.
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Affiliation(s)
- Yahua Wang
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - He Li
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Yuexin Guo
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, University of Hong Kong, Hong Kong; Medical Engineering Programme, University of Hong Kong, Hong Kong.
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25
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Demirel A, Baykara M, Koca TT, Berk E, Gençay ÖA. Comparison of vascular arterial stiffness parameters of adolescent wrestlers with healthy subjects: Is heavy training harmful for wrestlers? J Back Musculoskelet Rehabil 2019; 32:155-160. [PMID: 30248031 DOI: 10.3233/bmr-171083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Indexed: 02/04/2023]
Abstract
BACKROUND The effect of different exercise modalities on the vascular structure has been the subject of clinical trials but there is not enough data about wrestlers. OBJECTIVE This study aimed to compare the arterial stiffness parameters in adolescent wrestlers with those of age-matched sedentary controls to show the effects of long and heavy training. METHODS This study was carried out as a case-control study. Thirty three (N= 33) elite male adolescent wrestlers (12-18 years) and 35 age and sex-matched control subjects (P= 0.438) with a sedentary lifestyle were included the study. The data was obtained by using sonography and a sphygmomanometer. Systolic and diastolic diameters and intima media thickness (IMT) measurements were performed from the carotid arteries of the subjects. The arterial tension was measured in the same session, and arterial stiffness parameters were calculated using specific formulas. RESULTS The mean age range was 15.9 ± 0.9 years and 16.0 ± 0.8 years for the wrestlers and control subjects, respectively (P= 0.43). Statistically, the Body Mass Index (BMI) was significantly higher in wrestlers (mean = 23.7 ± 4.0 kg/m2; P= 0.00). The groups had no difference in height (P= 0.80) and weight (P= 0.05). The systolic blood pressure (SBP) was significantly higher in wrestlers (mean = 120 ± 13.4 mmHg; P= 0.00); the pulse was significantly lower in wrestlers (mean = 69.61 ± 17.2 beats/min; P= 0.00); the IMT was significantly lower in wrestlers (IMT mean = 0.288 ± 0.1 mm; P= 0.01); the diastolic wall stress (DWS) was significantly higher in wrestlers (DWS mean = 933.64 ± 298.0 mmHg; P= 0.03) than controls. No significant differences were found in the elastic modulus (P= 0.11), compliance (P= 0.86), and distensibility (P= 0.86) parameters between the groups. CONCLUSION Bradycardia is an expected condition for athletes. SBP and DWS were found to be high in wrestlers, suggesting that arterial tissue is more susceptible to stress. The low IMT indicates the protective effect of regular exercise against atherosclerosis. It is known that regular exercise is good for the vascular structure while heavy exercise puts a load on the vascular structure. The fact that the elastic modulus, compliance, and distensibility do not differ between the groups suggests that structural changes in the adolescents have no effect on the vascular wall.
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Affiliation(s)
- Adnan Demirel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Murat Baykara
- Department of Radiology, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Tuba Tülay Koca
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ejder Berk
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ökkeş Alparslan Gençay
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
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De Bruyne T, Steenput B, Roth L, De Meyer GRY, Santos CND, Valentová K, Dambrova M, Hermans N. Dietary Polyphenols Targeting Arterial Stiffness: Interplay of Contributing Mechanisms and Gut Microbiome-Related Metabolism. Nutrients 2019; 11:E578. [PMID: 30857217 PMCID: PMC6471395 DOI: 10.3390/nu11030578] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/01/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/15/2022] Open
Abstract
Increased arterial stiffness is a degenerative vascular process, progressing with age that leads to a reduced capability of arteries to expand and contract in response to pressure changes. This progressive degeneration mainly affects the extracellular matrix of elastic arteries and causes loss of vascular elasticity. Recent studies point to significant interference of dietary polyphenols with mechanisms involved in the pathophysiology and progression of arterial stiffness. This review summarizes data from epidemiological and interventional studies on the effect of polyphenols on vascular stiffness as an illustration of current research and addresses possible etiological factors targeted by polyphenols, including pathways of vascular functionality, oxidative status, inflammation, glycation, and autophagy. Effects can either be inflicted directly by the dietary polyphenols or indirectly by metabolites originated from the host or microbial metabolic processes. The composition of the gut microbiome, therefore, determines the resulting metabolome and, as a consequence, the observed activity. On the other hand, polyphenols also influence the intestinal microbial composition, and therefore the metabolites available for interaction with relevant targets. As such, targeting the gut microbiome is another potential treatment option for arterial stiffness.
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Affiliation(s)
- Tess De Bruyne
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Bieke Steenput
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, 2610 Antwerpen, Belgium.
| | - Claudia Nunes Dos Santos
- Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2780-901 Oeiras, Portugal.
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Av. da República, 2780-157 Oeiras, Portugal.
- CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Kateřina Valentová
- Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 142 20 Prague, Czech Republic.
| | - Maija Dambrova
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, LV-1006 Riga, Latvia.
| | - Nina Hermans
- Laboratory of Natural Products and Food-Research and Analysis (NatuRA), University of Antwerp, 2610 Antwerpen, Belgium.
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27
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Saeedi P, Shavandi A, Skidmore PML. What Do We Know about Diet and Markers of Cardiovascular Health in Children: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E548. [PMID: 30769798 PMCID: PMC6406429 DOI: 10.3390/ijerph16040548] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Academic Contribution Register] [Received: 02/02/2019] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 02/07/2023]
Abstract
Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur in children, evidence shows that the manifestation of CVD risk factors begins in childhood, preceding clinical complications of CVD in adulthood. Dietary intake is a modifiable risk factor that has been shown to make a substantial contribution to the risk of CVD in adulthood. However, less is known about the association between dietary intake and markers of cardiovascular health in children. This review summarises the current evidence on the relationship between dietary intake and markers of cardiovascular health including traditional CVD risk factors, physical fitness, and indices of arterial stiffness and wave reflection in children. Original research published in English, between January 2008 and December 2018 fulfilling the objective of this review were screened and included. Findings show that adaptation of a healthy lifestyle early in life can be beneficial for reducing the risk of CVD later in life. Furthermore, keeping arterial stiffness low from a young age could be a potential CVD prevention strategy. However, limited studies are available on diet-arterial stiffness relationship in children, and future research is required to better understand this association to aid the development and implementation of evidence-based strategies for preventing CVD-related complications later in life.
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Affiliation(s)
- Pouya Saeedi
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
| | - Amin Shavandi
- BioMatter Unit-Biomass Transformation Lab (BTL), École interfacultaire de Bioingénieurs (EIB), Université Libre de Bruxelles, Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium.
| | - Paula M L Skidmore
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- Department of Medicine, University of Otago, Christchurch 8140, New Zealand.
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28
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Crouch AC, Castle PE, FitzGerald LN, Scheven UM, Greve JM. Assessing structural and functional response of murine vasculature to acute β-adrenergic stimulation in vivo during hypothermic and hyperthermic conditions. Int J Hyperthermia 2019; 36:1137-1146. [PMID: 31744344 PMCID: PMC6874305 DOI: 10.1080/02656736.2019.1684577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 07/08/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022] Open
Abstract
Background: Because of the importance of adrenoreceptors in regulating the cardiovascular (CV) system and the role of the CV system in thermoregulation, understanding the response to these two stressors is of interest. The purpose of this study was to assess changes of arterial geometry and function in vivo during thermal and β-adrenergic stress induced in mice and quantified by MRI.Methods: Male mice were anesthetized and imaged at 7 T. Anatomical and functional data were acquired from the neck (carotid artery), torso (suprarenal and infrarenal aorta and iliac artery) and periphery (femoral artery). Intravenous dobutamine (tail vein catheter, 40 µg/kg/min, 0.12 mL/h) was used as β-adrenergic stressor. Baseline and dobutamine data were acquired at minimally hypothermic (35 °C) and minimally hyperthermic (38 °C) core temperatures. Cross-sectional vessel area and maximum cyclic strain were measured across the cardiac cycle.Results: Vascular response varied by location and by core temperature. For minimally hypothermic conditions (35 °C), average, maximum and minimum areas decreased with dobutamine only at the suprarenal aorta (avg: -17.9%, max: -13.5%, min: -21.4%). For minimally hyperthermic conditions (38 °C), vessel areas decreased between baseline and dobutamine at the carotid (avg: -19.6%, max: -15.5%, min: -19.3%) and suprarenal aorta (avg: -24.2%, max: -17.4%, min: -17.3%); whereas, only the minimum vessel area decreased for the iliac artery (min: -14.4%). Maximum cyclic strain increased between baseline and dobutamine at the iliac artery for both conditions and at the suprarenal aorta at hyperthermic conditions.Conclusions: At hypothermic conditions, the vessel area response to dobutamine is diminished compared to hyperthermic conditions where the vessel area response mimics normothermic dobutamine conditions. The varied response emphasizes the need to monitor and control body temperature during medical conditions or treatments that may be accompanied by hypothermia, especially when vasoactive agents are used.
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Affiliation(s)
| | - Paige E. Castle
- Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | | | | | - Joan M. Greve
- Biomedical Engineering, University of Michigan, Ann Arbor, MI
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29
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Magalhães JE, Barros IMLD, Pedrosa RP, Sampaio Rocha-Filho PA. Migraine and Markers of Carotid Atherosclerosis in Middle-Aged Women: A Cross-Sectional Study. Headache 2018; 59:77-85. [PMID: 30516278 DOI: 10.1111/head.13460] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Accepted: 08/01/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study evaluated the association between migraine and the markers of carotid artery disease. BACKGROUND Migraine increases the risk of cardiovascular events, but its relationship with vascular dysfunction is unclear. METHODS In this cross-sectional study, middle-aged women with no known cardiovascular diseases underwent clinical, neurological, and laboratory evaluations; pulse wave velocity (PWV) assessment; and carotid artery ultrasonography. We divided the participants based on the presence of migraine and, further, based on the type of migraine. Associations between migraine and carotid thickening (intima-media thickness >0.9 mm), carotid plaques, or arterial stiffening (PWV >10 m/s) were evaluated using a multiple regression analysis. RESULTS The study comprised 112/277 (40%) women with migraine, of whom 46/277 (17%) reported having an aura. Compared to the non-migraineurs, the migraine with aura group had an increased risk of diffuse carotid thickening (3/46 [6.8%] vs 2/165 [1.3%], adjusted OR = 7.12, 95% CI 1.05-48.49). Migraine without aura was associated with a low risk of carotid plaques (3/66 [4.7%] vs 26/165 [16.7%], adjusted OR = 0.28, 95% CI 0.08-0.99) and arterial stiffening (21/66 [34.4%] vs 82/165 [51.2%], adjusted OR = 0.39, 95% CI 0.19-0.79). There were no correlations between migraine characteristics and arterial stiffness or carotid thickness measurements. CONCLUSION Migraine with aura is associated with an increased risk of carotid thickening, and migraine without aura is associated with a low risk of carotid plaques and arterial stiffening.
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Affiliation(s)
- João Eudes Magalhães
- Division of Neurology, Hospital Universitário Oswaldo Cruz of the Universidade de Pernambuco, Recife, Brazil.,Postgraduate program in Neuropsychiatry and Behavioral Sciences of the Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Rodrigo Pinto Pedrosa
- Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco of the Universidade de Pernambuco, Recife, Brazil
| | - Pedro Augusto Sampaio Rocha-Filho
- Division of Neurology, Hospital Universitário Oswaldo Cruz of the Universidade de Pernambuco, Recife, Brazil.,Department of Neuropsychiatry of the Universidade Federal de Pernambuco, Recife, Brazil.,Postgraduate program in Neuropsychiatry and Behavioral Sciences of the Universidade Federal de Pernambuco, Recife, Brazil
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Takahashi I, Cologne J, Haruta D, Yamada M, Takahashi T, Misumi M, Fujiwara S, Matsumoto M, Kihara Y, Hida A, Ohishi W. Association Between Prevalence of Peripheral Artery Disease and Radiation Exposure in the Atomic Bomb Survivors. J Am Heart Assoc 2018; 7:e008921. [PMID: 30486720 PMCID: PMC6405541 DOI: 10.1161/jaha.118.008921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 03/19/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022]
Abstract
Background Past reports suggested that total-body irradiation at 0.5 to 1.0 Gy could be responsible for atherosclerosis. Peripheral artery disease ( PAD ) is a manifestation of systematic atherosclerosis. Whether the consequences of a low-to-moderate dose of radiation include increased risk of PAD remains to be determined. The purpose of this study was to examine the association between radiation exposure and prevalence of PAD among Japanese atomic bomb survivors. Methods and Results Radiation exposure from the atomic bombing was assessed in 3476 participants (41.1% men, mean age 74.8 years with SD 6.4 years) with a cross-sectional survey in 2010 to 2014. Left- and right-side ankle-brachial indexes and upstroke time ( UT ) were obtained using oscillometric VP -2000. PAD was defined as an ankle-brachial index of 1.0 or less or a prior history related to revascularization. UT was considered a sensitive marker of early-stage PAD . Association between radiation exposure and PAD or UT was assessed using multivariable regression analyses with adjustment for potential confounding factors. Of 3476 participants, 79 (2.3%) were identified as having prevalent PAD . Multivariate logistic regression analysis indicated that radiation dose was unrelated to PAD prevalence (odds ratio, 0.83; 95% confidence interval [0.57-1.21]). UT appeared to increase with radiation dose, but the increase was not statistically significant (1.09 ms/Gy; 95% confidence interval [-0.17 to 2.36]). Conclusions We found no clear association of radiation dose with PAD , but it remains to be determined whether UT is associated with radiation dose.
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Affiliation(s)
- Ikuno Takahashi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - John Cologne
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Daisuke Haruta
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Michiko Yamada
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
| | - Munechika Misumi
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Saeko Fujiwara
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
- Hiroshima Atomic‐bomb Casualty CouncilHiroshimaJapan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
- Japan Community Health care OrganizationHoshigaoka Medical CenterOsakaJapan
| | - Yasuki Kihara
- Department of Cardiovascular MedicineHiroshima UniversityHiroshimaJapan
| | - Ayumi Hida
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Waka Ohishi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
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Szucs B, Petrekanits M, Varga J. Effectiveness of a 4-week rehabilitation program on endothelial function, blood vessel elasticity in patients with chronic obstructive pulmonary disease. J Thorac Dis 2018; 10:6482-6490. [PMID: 30746192 DOI: 10.21037/jtd.2018.10.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 12/13/2022]
Abstract
Background Chronic obstructive pulmonary disease (COPD) may have considerable cardiovascular risk. Physical activity has a paramount role in COPD treatment. Our aim was to evaluate the applicability of arteriograph in COPD and measure the effectiveness of pulmonary rehabilitation on endothelial function. Methods A total of 40 patients with COPD (FEV1: 45.43±20.20%pred, BMI: 27.99±6.98 kg/m2, male: female was 21:19, age: 65.47±7.39 years) participated in a 4-week rehabilitation program. We used a patented, invasively validated Arteriograph. Blood pressure, pulse, augmentation index (AIX), pulse wave velocity (PWV), diastolic area index (DAI) were registered with functional measurements in pulmonary rehabilitation. Results Pulmonary rehabilitation was effective in 6 minutes walking distance (6MWD: 335.32±110.43 vs. 398.32±126.21 m), maximal inspiratory pressure (MIP: 57.72±22.69 vs. 63.63±18.01 cmH2O), chest wall expansion (CWE: 2.84±1.26 vs. 4.00±1.76 cm), breath holding time (BHT: 25.77±10.63 to 29.21±11.60 sec) and grip strength (GS: 24.87±11.88 vs. 27.03±11.43 kg) (P<0.05). Improvement in quality of life was monitored by COPD assessment test marker (CAT: 17.00±8.49 vs. 11.89±7.31, P<0.05). Systolic (133.38±22.15 vs. 126.48±20.22 mmHg) and diastolic blood pressure (76.95±14.37 vs. 75.4±12.7 mmHg) showed a reduction tendency. Pulse also decreased (76.95±14.37 vs. 72.53±13.65 bpm). AIX levels showed slight improvement (3.54±35.59% vs. 2.93±30.79%); 23 patients peripheral circulation progressed. The PWV data showed abnormal elasticity with minimal change (11.74±2.13 vs. 11.4±2.73 m/s); although 20 patients showed improvement. DAI detected slightly diminished coronary circulation with moderate improvement (43.32±6.81 vs. 47.1±7.01 m/s). Conclusions Elevated arterial stiffness, high PWV turned the COPD patients to the high/very high-risk cluster. Rehabilitation resulted significant improvement in MIP, CWE, BHT, 6MWD, CAT with mild, but favorable changes in blood pressure, pulse, AIX, PWV. As a consequence of the four weeks rehabilitation period overall quality of life improved and cardiovascular risk showed a reduction tendency in COPD.
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Affiliation(s)
- Botond Szucs
- PharmaFlight Research and Training Center, Debrecen, Hungary.,Institute of Exercise Physiology and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Mate Petrekanits
- PharmaFlight Research and Training Center, Debrecen, Hungary.,Institute of Exercise Physiology and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Janos Varga
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary
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Hildreth KL, Schwartz RS, Vande Griend J, Kohrt WM, Blatchford PJ, Moreau KL. Effects of testosterone and progressive resistance exercise on vascular function in older men. J Appl Physiol (1985) 2018; 125:1693-1701. [PMID: 30188798 PMCID: PMC7474250 DOI: 10.1152/japplphysiol.00165.2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/16/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 11/22/2022] Open
Abstract
The cardiovascular effects of testosterone (T) are controversial. Low T has been associated with accelerated vascular aging, characterized by large elastic artery stiffening (decreased compliance), intimal-medial thickening (IMT), and endothelial dysfunction. Endurance exercise improves vascular function, but resistance training may increase arterial stiffness. We sought to determine whether T supplementation improved markers of vascular aging in men with low-normal T and whether T supplementation prevented arterial stiffness with resistance exercise. We studied 160 community-dwelling older men (66 ± 5 yr) with low-normal baseline total T levels (200-350 ng/dl). Participants were randomized to transdermal T gel targeting either a lower (400-550 ng/dl) or higher (600-1,000 ng/dl) T range or to placebo gel and to either progressive resistance training (PRT) or to no exercise for 12 mo. Carotid artery stiffness (arterial compliance) and carotid IMT were measured at baseline, 6 mo, and 12 mo. Endothelial function (brachial artery flow-mediated dilation) was measured in a subset (n = 86). Changes in carotid artery compliance, IMT, and endothelial function with either the lower or higher range of T supplementation were not different from placebo at 6 or 12 mo. There were no differences between PRT and no PRT groups, alone or with T supplementation, in changes in any of the vascular measures at either time point. Supplementation of T and PRT in older men with low-normal levels do not appear to improve or harm vascular function.NEW & NOTEWORTHY Increased promotion and prescription of testosterone (T) to aging men has raised concerns about potential adverse cardiovascular effects. We show that in older men with T levels in the low-normal range, 12 mo of T supplementation with or without resistance exercise did not improve or harm vascular function.
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Affiliation(s)
- Kerry L Hildreth
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Robert S Schwartz
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver, Colorado
| | - Joseph Vande Griend
- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
| | - Wendy M Kohrt
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver, Colorado
| | - Patrick J Blatchford
- Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver, Colorado
- Colorado Biostatistical Consortium, Colorado School of Public Health, University of Colorado Denver
| | - Kerrie L Moreau
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Veterans Affairs Eastern Colorado Geriatric Research, Education and Clinical Center, Denver, Colorado
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Czaja B, Závodszky G, Azizi Tarksalooyeh V, Hoekstra AG. Cell-resolved blood flow simulations of saccular aneurysms: effects of pulsatility and aspect ratio. J R Soc Interface 2018; 15:rsif.2018.0485. [PMID: 30257923 DOI: 10.1098/rsif.2018.0485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 06/28/2018] [Accepted: 08/28/2018] [Indexed: 11/12/2022] Open
Abstract
We study the effect of pulsatile flow on the transport of red blood cells (RBCs) and platelets into aneurysm geometries with varying dome-to-neck aspect ratios (AR). We use a validated two-dimensional lattice Boltzmann model for blood plasma with a discrete element method for both RBCs and platelets coupled by the immersed boundary method. Flow velocities and vessel diameters were matched with measurements of cerebral perforating arteries and flow was driven by a synthetic heartbeat curve typical for such vessel sizes. We observe a flow regime change as the aspect ratio increases from a momentum-driven regime in the small aspect ratio to a shear-driven regime in the larger aspect ratios. In the small aspect ratio case, we see the development of a re-circulation zone that exhibits a layering of high (greater than or equal to 7 s) and low (less than 7 s) residence cells. In the shear-driven regime, we see high and low residence cells well mixed, with an increasing population of cells that are trapped inside the aneurysm as the aspect ratio increases. In all cases, we observe aneurysms that are platelet-rich and red blood cell-poor when compared with their respective parental vessel populations. Pulsatility also plays a role in the small aspect ratio as we observe a smaller population of older trapped cells along the aneurysm wall in the pulsatile case when compared with a steady flow case. Pulsatility does not have a significant effect in shear-driven regime aspect ratios.
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Affiliation(s)
- B Czaja
- Computational Science Lab, University of Amsterdam, Amsterdam, The Netherlands
| | - G Závodszky
- Computational Science Lab, University of Amsterdam, Amsterdam, The Netherlands.,Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | | | - A G Hoekstra
- Computational Science Lab, University of Amsterdam, Amsterdam, The Netherlands.,ITMO University, St Petersburg, Russia
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Abstract
Advancing age promotes cardiovascular disease (CVD), the leading cause of death in the United States and many developed nations. Two major age-related arterial phenotypes, large elastic artery stiffening and endothelial dysfunction, are independent predictors of future CVD diagnosis and likely are responsible for the development of CVD in older adults. Not limited to traditional CVD, these age-related changes in the vasculature also contribute to other age-related diseases that influence mammalian health span and potential life span. This review explores mechanisms that influence age-related large elastic artery stiffening and endothelial dysfunction at the tissue level via inflammation and oxidative stress and at the cellular level via Klotho and energy-sensing pathways (AMPK [AMP-activated protein kinase], SIRT [sirtuins], and mTOR [mammalian target of rapamycin]). We also discuss how long-term calorie restriction-a health span- and life span-extending intervention-can prevent many of these age-related vascular phenotypes through the prevention of deleterious alterations in these mechanisms. Lastly, we discuss emerging novel mechanisms of vascular aging, including senescence and genomic instability within cells of the vasculature. As the population of older adults steadily expands, elucidating the cellular and molecular mechanisms of vascular dysfunction with age is critical to better direct appropriate and measured strategies that use pharmacological and lifestyle interventions to reduce risk of CVD within this population.
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Affiliation(s)
- Anthony J. Donato
- University of Utah, Department of Internal Medicine, Division of Geriatrics, Salt Lake City, Utah
- Veterans Affairs Medical Center-Salt Lake City, Geriatrics Research Education and Clinical Center, Salt Lake City, Utah
| | - Daniel R. Machin
- University of Utah, Department of Internal Medicine, Division of Geriatrics, Salt Lake City, Utah
- Veterans Affairs Medical Center-Salt Lake City, Geriatrics Research Education and Clinical Center, Salt Lake City, Utah
| | - Lisa A. Lesniewski
- University of Utah, Department of Internal Medicine, Division of Geriatrics, Salt Lake City, Utah
- Veterans Affairs Medical Center-Salt Lake City, Geriatrics Research Education and Clinical Center, Salt Lake City, Utah
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Gogulamudi VR, Cai J, Lesniewski LA. Reversing age-associated arterial dysfunction: insight from preclinical models. J Appl Physiol (1985) 2018; 125:1860-1870. [PMID: 29745797 DOI: 10.1152/japplphysiol.00086.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 01/16/2023] Open
Abstract
Cardiovascular diseases (CVDs) remain the leading causes of death in the United States, and advancing age is a primary risk factor. Impaired endothelium-dependent dilation and increased stiffening of the arteries with aging are independent predictors of CVD. Increased tissue and systemic oxidative stress and inflammation underlie this age-associated arterial dysfunction. Calorie restriction (CR) is the most powerful intervention known to increase life span and improve age-related phenotypes, including arterial dysfunction. However, the translatability of long-term CR to clinical populations is limited, stimulating interest in the pursuit of pharmacological CR mimetics to reproduce the beneficial effects of CR. The energy-sensing pathways, mammalian target of rapamycin, AMPK, and sirtuin-1 have all been implicated in the beneficial effects of CR on longevity and/or physiological function and, as such, have emerged as potential targets for therapeutic intervention as CR mimetics. Although manipulation of each of these pathways has CR-like benefits on arterial function, the magnitude and/or mechanisms can be disparate from that of CR. Nevertheless, targeting these pathways in older individuals may provide some benefits against arterial dysfunction and CVD. The goal of this review is to provide a brief discussion of the mechanisms and pathways underlying age-associated dysfunction in large arteries, explain how these are impacted by CR, and to present the available evidence, suggesting that targets for energy-sensing pathways may act as vascular CR mimetics.
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Affiliation(s)
| | - Jinjin Cai
- Department of Internal Medicine-Division of Geriatrics, University of Utah , Salt Lake City, Utah
| | - Lisa A Lesniewski
- Department of Internal Medicine-Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Geriatrics Research Education and Clinical Center, Veteran's Affairs Medical Center-Salt Lake City, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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Nascimento DDC, da Silva CR, Valduga R, Saraiva B, de Sousa Neto IV, Vieira A, Funghetto SS, Silva AO, Oliveira SDC, Pereira GB, Willardson JM, Prestes J. Blood pressure response to resistance training in hypertensive and normotensive older women. Clin Interv Aging 2018; 13:541-553. [PMID: 29674845 PMCID: PMC5898885 DOI: 10.2147/cia.s157479] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The purpose of the present study was to identify the variability of blood pressure response to a 10-week resistance training (RT) program in hypertensive and normotensive elderly women. PARTICIPANTS AND METHODS Twenty-seven untrained hypertensive and 12 normotensive elderly women participated in the present study. A whole-body RT program was performed on two nonconsecutive days per week for 10 weeks. The responsiveness of resting systolic blood pressure (SBP) was determined based on the percent decline between the pre- and post-training time points T1 and T4. The term responders were used to describe subjects who exhibited a percent SBP decline ≥-2.58% and the term nonresponders for subjects who exhibited a percent SBP decline <-2.58%, respectively. RESULTS Both the responders and nonresponders in the hypertensive group presented significant changes in SBP (-7.83 ± 5.70 mmHg vs 3.78 ± 7.42 mmHg), respectively. Moreover, the responders and nonresponders in the normotensive group presented significant changes in SBP as well (-8.58 ± 5.52 mmHg vs 5.71 ± 3.84 mmHg). CONCLUSION SBP presents a heterogeneous response to a controlled RT program in hypertensive and normotensive elderly women. A different modality of training and additional therapies should be used for nonresponders in order to decrease resting SBP.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
- Centro Universitário do Distrito Federal (UDF), Brasília, Brazil
| | - Cristiane Rocha da Silva
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
| | - Renato Valduga
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
- Centro Universitário Unieuro, Brasília, Brazil
| | - Bruno Saraiva
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
| | | | | | | | | | - Samuel da Cunha Oliveira
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
| | - Guilherme Borges Pereira
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
| | - Jeffrey M Willardson
- Health and Human Performance Department, Rocky Mountain College, Billings, MT, USA
| | - Jonato Prestes
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil
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The influence of NAFLD on the risk of atherosclerosis and cardiovascular diseases. Clin Exp Hepatol 2018; 4:1-6. [PMID: 29594192 PMCID: PMC5865905 DOI: 10.5114/ceh.2018.73155] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 07/31/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries and is associated with obesity, dyslipidaemia, diabetes, and metabolic syndrome. Atherosclerosis and cardiovascular diseases are also highly prevalent in this group of patients, due to the presence of shared risk factors. The incidences of coronary artery calcification, hypertension, aortic valve sclerosis, diastolic dysfunction, atherosclerotic plaques, and increased carotid intima-media thickness were more common in patients with NAFLD than in those without. The present paper reviews the medical literature concerning the association between NAFLD and cardiovascular events.
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38
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van Velzen MHN, Loeve AJ, Mik EG, Niehof SP. Design and Functional Testing of a Novel Blood Pulse Wave Velocity Sensor. J Med Device 2017. [DOI: 10.1115/1.4038308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 01/23/2023] Open
Abstract
The multiphotodiode array (MPA) is a novel transmission photoplethysmography (PPG) sensor to measure pulse wave velocity (PWV) in the finger. To validate the MPA, a setup was built to generate a red laser dot traveling over the MPA with known and constant scanning velocities. These scanning velocities were chosen to include speeds at least twice as high as those found in the normal range of PWV in healthy populations and were set at 12.9, 25.8, 36, or 46.7 m/s. The aim of this study was to verify the functionality of the MPA: performing local noninvasive PWV measurements. To illustrate the applicability of the MPA in clinical practice, an in vivo pilot study was conducted using the flow-mediated dilation (FMD) technique. The in vitro accuracy of the MPA was ±0.2%, 0.3%, 0.5%, and 0.6% at the applied scanning velocities. The MPA can measure PWVs with a maximum deviation of 3.0%. The in vivo pilot study showed a PWV before the FMD of 1.1±0.2 m/s. These results suggest that this novel MPA can reliably and accurately measure PWV within clinically relevant ranges and even well beyond.
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Affiliation(s)
- Marit H. N. van Velzen
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, Erasmus University Medical Center Rotterdam, 's-Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands e-mail:
| | - Arjo J. Loeve
- Department of Biomechanical Engineering, Faculty 3mE, Delft University of Technology, Mekelweg 2, Delft 2628 CD, The Netherlands e-mail:
| | - Egbert G. Mik
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, Erasmus University Medical Center Rotterdam, 's-Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands e-mail:
| | - Sjoerd P. Niehof
- Department of Anesthesiology, Laboratory of Experimental Anesthesiology, Erasmus University Medical Center Rotterdam, 's-Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands e-mail:
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Dobson GP, Arsyad A, Letson HL. The Adenosine Hypothesis Revisited: Modulation of Coupling between Myocardial Perfusion and Arterial Compliance. Front Physiol 2017; 8:824. [PMID: 29104545 PMCID: PMC5654924 DOI: 10.3389/fphys.2017.00824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 07/04/2017] [Accepted: 10/06/2017] [Indexed: 12/25/2022] Open
Abstract
For over four decades the thoracic aortic ring model has become one of the most widely used methods to study vascular reactivity and electromechanical coupling. A question that is rarely asked, however, is what function does a drug-mediated relaxation (or contraction) in this model serve in the intact system? The physiological significance of adenosine relaxation in rings isolated from large elastic conduit arteries from a wide range of species remains largely unknown. We propose that adenosine relaxation increases aortic compliance in acute stress states and facilitates ventricular-arterial (VA) coupling, and thereby links compliance and coronary artery perfusion to myocardial energy metabolism. In 1963 Berne argued that adenosine acts as a local negative feedback regulator between oxygen supply and demand in the heart during hypoxic/ischemic stress. The adenosine VA coupling hypothesis extends and enhances Berne's "adenosine hypothesis" from a local regulatory scheme in the heart to include conduit arterial function. In multicellular organisms, evolution may have selected adenosine, nitric oxide, and other vascular mediators, to modulate VA coupling for optimal transfer of oxygen (and nutrients) from the lung, heart, large conduit arteries, arterioles and capillaries to respiring mitochondria. Finally, a discussion of the potential clinical significance of adenosine modulation of VA coupling is extended to vascular aging and disease, including hypertension, diabetes, obesity, coronary artery disease and heart failure.
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Affiliation(s)
- Geoffrey P Dobson
- Heart, Trauma and Sepsis Research Laboratory, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Aryadi Arsyad
- Physiology Department, Medical Faculty, Hasanuddin University, Makassar, Indonesia
| | - Hayley L Letson
- Heart, Trauma and Sepsis Research Laboratory, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
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Ecobici M, Voiculescu M. Importance of arterial stiffness in predicting cardiovascular events. ACTA ACUST UNITED AC 2017; 55:8-13. [PMID: 27490029 DOI: 10.1515/rjim-2016-0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 06/03/2016] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Cardiovascular events represent an important cause of morbidity and mortality in the entire population. Arterial stiffness is currently considered one of the most important risk factors for the development of cardiovascular events. The gold-standard for evaluating arterial stiffness is pulse wave velocity (PWV). Recent studies have demonstrated that PWV is an independent risk factor regarding the development of cardiovascular events, especially in certain categories of patients. MATERIAL AND METHODS The development of cardiovascular events was assessed in 174 patients admitted in the Center of Internal Medicine, Fundeni Clinical Institute, between January 2011 - May 2012. Arterial stiffness was evaluated by measuring PWV using the Sphygmocor system (AtCor, Australia), which is based on the principle of applanation tonometry. The patients were monitored for the development of cardiovascular events (ischemic heart disease, heart failure, stroke, acute myocardial infarction) and for death of cardiovascular cause, over a median period of 51.5 months (43-60 months). RESULTS Of the 174 patients, 81 (46.6%) were women and 93 (53.4%) were men. Mean age was 55.96 years. 93 of the 174 patients had chronic kidney failure in different stages (47.3% in stage V). Regarding PWV in the patient group, we obtained a mean score of 9.382. We observed a significant difference regarding the PWV level only for acute myocardial infarction and death between patients who developed these events and those who did not. CONCLUSIONS Our study demonstrates that PWV increase can be positively associated with the occurrence of cardiovascular events, particularly in certain groups of patients.
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Lastra G, Manrique C, Jia G, Aroor AR, Hayden MR, Barron BJ, Niles B, Padilla J, Sowers JR. Xanthine oxidase inhibition protects against Western diet-induced aortic stiffness and impaired vasorelaxation in female mice. Am J Physiol Regul Integr Comp Physiol 2017; 313:R67-R77. [PMID: 28539355 DOI: 10.1152/ajpregu.00483.2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 11/09/2016] [Revised: 04/25/2017] [Accepted: 05/16/2017] [Indexed: 12/21/2022]
Abstract
Consumption of a high-fat, high-fructose diet [Western diet (WD)] promotes vascular stiffness, a critical factor in the development of cardiovascular disease (CVD). Obese and diabetic women exhibit greater arterial stiffness than men, which contributes to the increased incidence of CVD in these women. Furthermore, high-fructose diets result in elevated plasma concentrations of uric acid via xanthine oxidase (XO) activation, and uric acid elevation is also associated with increased vascular stiffness. However, the mechanisms by which increased xanthine oxidase activity and uric acid contribute to vascular stiffness in obese females remain to be fully uncovered. Accordingly, we examined the impact of XO inhibition on endothelial function and vascular stiffness in female C57BL/6J mice fed a WD or regular chow for 16 wk. WD feeding resulted in increased arterial stiffness, measured by atomic force microscopy in aortic explants (16.19 ± 1.72 vs. 5.21 ± 0.54 kPa, P < 0.05), as well as abnormal aortic endothelium-dependent and -independent vasorelaxation. XO inhibition with allopurinol (widely utilized in the clinical setting) substantially improved vascular relaxation and attenuated stiffness (16.9 ± 0.50 vs. 3.44 ± 0.50 kPa, P < 0.05) while simultaneously lowering serum uric acid levels (0.55 ± 0.98 vs. 0.21 ± 0.04 mg/dL, P < 0.05). In addition, allopurinol improved WD-induced markers of fibrosis and oxidative stress in aortic tissue, as analyzed by immunohistochemistry and transmission electronic microscopy. Collectively, these results demonstrate that XO inhibition protects against WD-induced vascular oxidative stress, fibrosis, impaired vasorelaxation, and aortic stiffness in females. Furthermore, excessive oxidative stress resulting from XO activation appears to play a key role in mediating vascular dysfunction induced by chronic exposure to WD consumption in females.
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Affiliation(s)
- Guido Lastra
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri; .,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Camila Manrique
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Guanghong Jia
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Annayya R Aroor
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Melvin R Hayden
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Brady J Barron
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Brett Niles
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Child Health, University of Missouri, Columbia, Missouri; and
| | - James R Sowers
- Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, Missouri.,University of Missouri, School of Medicine, Research Service Harry S. Truman Memorial Veterans Hospital, University of Missouri, Columbia, Missouri.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
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Kilicgedik A, Ç Efe S, Gürbüz AS, Acar E, Yılmaz MF, Erdoğan A, Kahveci G, Izgi IA, Kirma C. Left Atrial Mechanical Function and Aortic Stiffness in Middle-aged Patients with the First Episode of Atrial Fibrillation. Chin Med J (Engl) 2017; 130:143-148. [PMID: 28091404 PMCID: PMC5282669 DOI: 10.4103/0366-6999.197979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 12/04/2022] Open
Abstract
Background: In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial (LA) mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with the first episode of nonvalvular atrial fibrillation (AF). Methods: This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Koşuyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1st month (mostly in the first 2 weeks) following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results: Pulse wave analysis showed no significant differences between the AF patients and healthy controls with respect to PWV (10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s; P = 0.370), augmentation pressure (9.6 ± 7.4 mmHg vs. 9.1 ± 5.7 mmHg; P = 0.740), and aortic pulse pressure (AoPP; 40.4 ± 14.0 mmHg vs. 42.1 ± 7.6 mmHg, P = 0.550). The first LA positive peak of strain was inversely related to the augmentation pressure (r = −0.30; P = 0.02) and aortic systolic pressure (r = −0.26, P = 0.04). Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement (45.1 ± 14.1 mmHg) showed a significant increase compared with AoPP at the first measurement (39.0 ± 10.6 mmHg, P = 0.028), which was also higher than that of healthy controls (42.1 ± 7.6 mmHg, P = 0.000). Conclusion: The association between aortic stiffness with reduced atrial strain and the key role of AoPP in the development of AF should be considered when treating nonvalvular AF patients with normal LA sizes.
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Affiliation(s)
- Alev Kilicgedik
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Suleyman Ç Efe
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Ahmet S Gürbüz
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Emrah Acar
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Mehmet F Yılmaz
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Aslan Erdoğan
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Gökhan Kahveci
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Ibrahim A Izgi
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
| | - Cevat Kirma
- Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital, Kartal, Istanbul 34846, Turkey
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Abstract
Hypertension is the second most common cause of chronic kidney disease (CKD) and is a potentiator of kidney failure when accompanying disease. CKD is a common cause of resistant hypertension. Nephropathy progression has dramatically slowed over the past 3 decades from an average of 8 to between 2-3 mL/min per year regardless of diabetes status. The incidence of very high albuminuria as well as progression from high albuminuria very high albuminuria has substantially decreased over the past 3 decades. This improvement relates to better blood pressure control using agents that slow nephropathy as well as better glycemic and cholesterol control.
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Affiliation(s)
- Hillel Sternlicht
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, ASH Comprehensive Hypertension Center, The University of Chicago Medicine, 5841 South Maryland Avenue, MC 1027, Chicago, IL 60637, USA
| | - George L Bakris
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, ASH Comprehensive Hypertension Center, The University of Chicago Medicine, 5841 South Maryland Avenue, MC 1027, Chicago, IL 60637, USA.
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Mikolasevic I, Milic S, Turk Wensveen T, Grgic I, Jakopcic I, Stimac D, Wensveen F, Orlic L. Nonalcoholic fatty liver disease - A multisystem disease? World J Gastroenterol 2016; 22:9488-9505. [PMID: 27920470 PMCID: PMC5116593 DOI: 10.3748/wjg.v22.i43.9488] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 06/28/2016] [Revised: 08/30/2016] [Accepted: 10/19/2016] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome (MetS). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of MetS. However, accumulating evidence indicates that the effects of NAFLD extend beyond the liver and are negatively associated with a range of chronic diseases, most notably cardiovascular disease (CVD), diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). It is becoming increasingly clear that these diseases are the result of the same underlying pathophysiological processes associated with MetS, such as insulin resistance, chronic systemic inflammation and dyslipidemia. As a result, they have been shown to be independent reciprocal risk factors. In addition, recent data have shown that NAFLD actively contributes to aggravation of the pathophysiology of CVD, T2DM, and CKD, as well as several other pathologies. Thus, NAFLD is a direct cause of many chronic diseases associated with MetS, and better detection and treatment of fatty liver disease is therefore urgently needed. As non-invasive screening methods for liver disease become increasingly available, detection and treatment of NAFLD in patients with MetS should therefore be considered by both (sub-) specialists and primary care physicians.
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Yeboah K, Antwi DA, Gyan B, Govoni V, Mills CE, Cruickshank JK, Amoah AGB. Arterial stiffness in hypertensive and type 2 diabetes patients in Ghana: comparison of the cardio-ankle vascular index and central aortic techniques. BMC Endocr Disord 2016; 16:53. [PMID: 27680212 PMCID: PMC5041289 DOI: 10.1186/s12902-016-0135-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 03/22/2016] [Accepted: 09/21/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Diabetes and hypertension increase arterial stiffness and cardiovascular events in all societies studied so far; sub-Saharan African studies are sparse. We investigated factors affecting arterial function in Ghanaians with diabetes, hypertension, both or neither. METHOD Testing the hypothesis that arterial stiffness would progressively increase from controls to multiply affected patients, 270 participants were stratified into those with diabetes or hypertension only, with both, or without either. Cardio-ankle vascular index (CAVI), heart-ankle pulse wave velocity (haPWV), aortic PWV (PWVao) by Arteriograph, aortic and brachial blood pressures (BP), were measured. RESULTS In patients with both diabetes and hypertension compared with either alone, values were higher of CAVI (mean ± SD, 8.3 ± 1.2 vs 7.5 ± 1.1 and 7.4 ± 1.1 units; p < 0.05), PWVao (9.1 ± 1.4 vs 8.7 ± 1.9 and 8.1 ± 0.9 m/s; p < 0.05) and haPWV (8.5 ± 1 vs 7.9 ± 1 and 7.2 ± 0.7 m/s; p < 0.05) respectively. In multivariate analysis, age, having diabetes or hypertension and BMI were independently associated with CAVI in all participants (β = 0.49, 0.2, 0.17 and -0.2 units; p < 0.01, respectively). Independent determinants of PWVao were heart rate, systolic BP and age (β = 0.42, 0.27 and 0.22; p < 0.01), and for haPWV were systolic BP, age, BMI, diabetes and hypertension status (β = 0.46, 0.32, -0.2, 0.2 and 0.11; p < 0.01). CONCLUSION In this sub-Saharan setting with lesser atherosclerosis than the western world, arterial stiffness is significantly greater in patients with coexistent diabetes and hypertension but did not differ between those with either diabetes or hypertension only. Simple, reproducibly measured PWV/CAVI may offer effective and efficient targets for intervention.
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Affiliation(s)
- Kwame Yeboah
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana.
| | - Daniel A Antwi
- Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, P.O. Box KB 143, Accra, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Virginia Govoni
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Charlotte E Mills
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - J Kennedy Cruickshank
- Cardiovascular Medicine Group, Division of Diabetes and Nutrition, King's College and King's Health Partners, London, UK
| | - Albert G B Amoah
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
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Maksuti E, Westerhof N, Westerhof BE, Broomé M, Stergiopulos N. Contribution of the Arterial System and the Heart to Blood Pressure during Normal Aging - A Simulation Study. PLoS One 2016; 11:e0157493. [PMID: 27341106 PMCID: PMC4920393 DOI: 10.1371/journal.pone.0157493] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 03/14/2016] [Accepted: 05/30/2016] [Indexed: 11/18/2022] Open
Abstract
During aging, systolic blood pressure continuously increases over time, whereas diastolic pressure first increases and then slightly decreases after middle age. These pressure changes are usually explained by changes of the arterial system alone (increase in arterial stiffness and vascular resistance). However, we hypothesise that the heart contributes to the age-related blood pressure progression as well. In the present study we quantified the blood pressure changes in normal aging by using a Windkessel model for the arterial system and the time-varying elastance model for the heart, and compared the simulation results with data from the Framingham Heart Study. Parameters representing arterial changes (resistance and stiffness) during aging were based on literature values, whereas parameters representing cardiac changes were computed through physiological rules (compensated hypertrophy and preservation of end-diastolic volume). When taking into account arterial changes only, the systolic and diastolic pressure did not agree well with the population data. Between 20 and 80 years, systolic pressure increased from 100 to 122 mmHg, and diastolic pressure decreased from 76 to 55 mmHg. When taking cardiac adaptations into account as well, systolic and diastolic pressure increased from 100 to 151 mmHg and decreased from 76 to 69 mmHg, respectively. Our results show that not only the arterial system, but also the heart, contributes to the changes in blood pressure during aging. The changes in arterial properties initiate a systolic pressure increase, which in turn initiates a cardiac remodelling process that further augments systolic pressure and mitigates the decrease in diastolic pressure.
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Affiliation(s)
- Elira Maksuti
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
- Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Nico Westerhof
- Departments of Physiology and Pulmonary Diseases, ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands
| | - Berend E. Westerhof
- Edwards Lifesciences BMEYE, Critical Care Noninvasive, Amsterdam, The Netherlands
- Heart Failure Research Center, Laboratory for Clinical Cardiovascular Physiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Michael Broomé
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
- ECMO Department, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Nikos Stergiopulos
- Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Bioengineering, Swiss Federal Institute of Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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47
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Relationship Between Echocardiographically Evaluated Aortic Stiffness and Prolidase Activity in Aortic Tissue of Patients with Critical Coronary Artery Disease. Arch Med Res 2016; 47:200-6. [DOI: 10.1016/j.arcmed.2016.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 03/15/2016] [Accepted: 06/28/2016] [Indexed: 11/18/2022]
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48
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BATTISTA CHRISTINA, BIA DANIEL, GERMÁN YANINAZÓCALO, ARMENTANO RICARDOL, HAIDER MANSOORA, OLUFSEN METTES. WAVE PROPAGATION IN A 1D FLUID DYNAMICS MODEL USING PRESSURE-AREA MEASUREMENTS FROM OVINE ARTERIES. J MECH MED BIOL 2016. [DOI: 10.1142/s021951941650007x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/18/2022]
Abstract
This study considers a 1D fluid dynamics arterial network model with 14 vessels developed to assimilate ex vivo 0D temporal data for pressure-area dynamics in individual vessel segments from 11 male Merino sheep. A 0D model was used to estimate vessel wall parameters in a two-parameter elastic model and a four-parameter Kelvin viscoelastic model. This was done using nonlinear optimization minimizing the least squares error between model predictions and measured cross-sectional areas. Subsequently, estimated values for elastic stiffness and unstressed area were related to construct a nonlinear relationship. This relation was used in the network model. A 1D single vessel model of the aorta was then developed and used to estimate the inflow profile and parameters for total resistance and compliance for the downstream network and to demonstrate effects of incorporating viscoelasticity in the arterial wall. Lastly, the extent to which vessel wall parameters estimated from ex vivo data can be used to realistically simulate pressure and area in a vessel network was evaluated. Elastic wall parameters in the network simulations were found to yield pressure-area relationships across all vessel locations and sheep that were in ranges comparable to those in the ex vivo data.
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Affiliation(s)
- CHRISTINA BATTISTA
- Department of Mathematics, North Carolina State University, 2311 Stinson Drive Raleigh, North Carolina 27695, USA
| | - DANIEL BIA
- Department of Physiology, Universidad de la Republica, Montevideo, Uruguay
| | | | | | - MANSOOR A. HAIDER
- Department of Mathematics, North Carolina State University, 2311 Stinson Drive Raleigh, North Carolina 27695, USA
| | - METTE S. OLUFSEN
- Department of Mathematics, North Carolina State University, 2311 Stinson Drive Raleigh, North Carolina 27695, USA
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49
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Evaluation of cardiovascular risk in patients with Parkinson disease under levodopa treatment. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:75-80. [PMID: 26918017 PMCID: PMC4753016 DOI: 10.11909/j.issn.1671-5411.2016.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Academic Contribution Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Levodopa is the indispensable choice of medial therapy in patients with Parkinson disease (PD). Since L-dopa treatment was shown to increase serum homocysteine levels, a well-known risk factor for cardiovascular disorders, the patients with PD under L-dopa treatment will be at increased risk for future cardiovascular events. The objective of this study is to evaluate cardiovascular risk in patients with PD under levodopa treatment. METHODS The study population consisted of 65 patients with idiopathic PD under L-dopa treatment. The control group included 32 age and gender matched individuals who had no cognitive decline. Echocardiographic measurements, serum homocysteine levels and elastic parameters of the aorta were compared between the patients with PD and controls. RESULTS As an expected feature of L-dopa therapy, the Parkinson group had significantly higher homocystein levels (15.1 ± 3.9 µmol/L vs. 11.5 ± 3.2 µmol/L, P = 0.02). Aortic distensibility was significantly lower in the patients with PD when compared to controls (4.8 ± 1.5 dyn/cm(2) vs. 6.2 ± 1.9 dyn/cm(2), P = 0.016). Additionally, the patients with PD had higher aortic strain and aortic stiffness index (13.4% ± 6.4% vs. 7.4% ± 3.6%, P < 0.001 and 7.3 ± 1.5 vs. 4.9 ± 1.9, P < 0.001 respectively). Furthermore, serum homocysteine levels were found to be positively correlated with aortic stiffness index and there was a negative correlation between aortic distensibility and levels of serum homocysteine (r = 0.674, P < 0.001; r = -0.602, P < 0.001, respectively). CONCLUSIONS The patients with PD under L-dopa treatment have increased aortic stiffness and impaired diastolic function compared to healthy individuals. Elevated serum homocysteine levels may be a possible pathophysiological mechanism.
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50
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Maksuti E, Widman E, Larsson D, Urban MW, Larsson M, Bjällmark A. Arterial Stiffness Estimation by Shear Wave Elastography: Validation in Phantoms with Mechanical Testing. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:308-21. [PMID: 26454623 DOI: 10.1016/j.ultrasmedbio.2015.08.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Received: 03/13/2015] [Revised: 07/07/2015] [Accepted: 08/17/2015] [Indexed: 05/26/2023]
Abstract
Arterial stiffness is an independent risk factor found to correlate with a wide range of cardiovascular diseases. It has been suggested that shear wave elastography (SWE) can be used to quantitatively measure local arterial shear modulus, but an accuracy assessment of the technique for arterial applications has not yet been performed. In this study, the influence of confined geometry on shear modulus estimation, by both group and phase velocity analysis, was assessed, and the accuracy of SWE in comparison with mechanical testing was measured in nine pressurized arterial phantoms. The results indicated that group velocity with an infinite medium assumption estimated shear modulus values incorrectly in comparison with mechanical testing in arterial phantoms (6.7 ± 0.0 kPa from group velocity and 30.5 ± 0.4 kPa from mechanical testing). To the contrary, SWE measurements based on phase velocity analysis (30.6 ± 3.2 kPa) were in good agreement with mechanical testing, with a relative error between the two techniques of 8.8 ± 6.0% in the shear modulus range evaluated (40-100 kPa). SWE by phase velocity analysis was validated to accurately measure stiffness in arterial phantoms.
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Affiliation(s)
- Elira Maksuti
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden.
| | - Erik Widman
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - David Larsson
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Matthew W Urban
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Matilda Larsson
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Anna Bjällmark
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
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