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Lao TT, Annie Hui SY. The obstetric aspects of maternal asthma. Best Pract Res Clin Obstet Gynaecol 2022; 85:57-69. [PMID: 36210285 DOI: 10.1016/j.bpobgyn.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 12/14/2022]
Abstract
Asthma is the commonest chronic medical condition encountered in pregnancy. Poor asthma control and exacerbations are frequently encountered due to treatment non-adherence, pregnancy-related aggravating factors such as increased susceptibility to viral infections, and comorbidities that are commonly associated. Asthma-related inflammatory reactions and placental effects, the effect of medications, and respiratory symptoms and hypoxia are probably to interact to result in an increased adverse obstetric outcomes including miscarriage, foetal congenital anomalies, pregnancy hypertensive disorders, gestational diabetes, preterm labour and birth, antepartum haemorrhage, low birthweight and foetal growth restriction (FGR), caesarean delivery, postpartum haemorrhage (PPH), maternal intensive care admission, and even mortality, while the offspring also has increased long-term morbidity. Interdisciplinary management with frequent assessment by symptoms, spirometry, and biomarkers, together with removal of risk factors such as smoking and appropriate instigation of treatment including short courses of systemic corticosteroid, could ensure optimal and tailored treatment to control symptoms, prevent exacerbations, and ultimately enhancing maternal and perinatal outcomes.
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Affiliation(s)
- Terence T Lao
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
| | - Shuk-Yi Annie Hui
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Bronchial Asthma as a Cardiovascular Risk Factor: A Prospective Observational Study. Biomedicines 2022; 10:biomedicines10102614. [PMID: 36289876 PMCID: PMC9599703 DOI: 10.3390/biomedicines10102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Asthma as a chronic inflammatory disorder has been suggested as a risk factor for endothelial dysfunction (ED), but studies on the association between asthma and cardiovascular disease (CVD) risk are limited. Background: We assessed associations of ED with the severity of asthma, eosinophilic inflammation, lung function, and asthma control. Methods: 52 young asthmatics (median age of 25.22 years) and 45 healthy individuals were included. Demographic, clinical, and laboratory findings were recorded. We evaluated microvascular responsiveness by recording the reactive hyperemia index (RHI) indicating post-occlusive peripheral endothelium-dependent changes in vascular tone using the Itamar Medical EndoPAT2000. VCAM-1, ADMA, high-sensitive CRP (hsCRP), and E-selectin were measured. Results: Asthmatics had considerably lower RHI values (p < 0.001) with a dynamic decreasing trend by asthma severity and higher hsCRP levels (p < 0.001). A substantial increase in hsCRP and E-selectin with asthma severity (p < 0.05) was also observed. We confirmed a higher body mass index (BMI) in asthmatics (p < 0.001), especially in women and in severe asthma. Conclusions: We demonstrated the progression of CVD in asthmatics and the association of the ongoing deterioration of ED with the inflammatory severity, suggesting that the increased risk of CVD in young asthmatics is dependent on disease severity. The underlying mechanisms of risk factors for CVD and disease control require further study.
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Rosenkranz MA, Dean DC, Bendlin BB, Jarjour NN, Esnault S, Zetterberg H, Heslegrave A, Evans MD, Davidson RJ, Busse WW. Neuroimaging and biomarker evidence of neurodegeneration in asthma. J Allergy Clin Immunol 2022; 149:589-598.e6. [PMID: 34536414 PMCID: PMC8821112 DOI: 10.1016/j.jaci.2021.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/19/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidemiologic studies have shown that Alzheimer's disease (AD) and related dementias (ADRD) are seen more frequently with asthma, especially with greater asthma severity or exacerbation frequency. OBJECTIVE To examine the changes in brain structure that may underlie this phenomenon, we examined diffusion-weighted magnetic resonance imaging (dMRI) and blood-based biomarkers of AD (phosphorylated tau 181, p-Tau181), neurodegeneration (neurofilament light chain, NfL), and glial activation (glial fibrillary acidic protein, GFAP). METHODS dMRI data were obtained in 111 individuals with asthma, ranging in disease severity from mild to severe, and 135 healthy controls. Regression analyses were used to test the relationships between asthma severity and neuroimaging measures, as well as AD pathology, neurodegeneration, and glial activation, indexed by plasma p-Tau181, NfL, and GFAP, respectively. Additional relationships were tested with cognitive function. RESULTS Asthma participants had widespread and large-magnitude differences in several dMRI metrics, which were indicative of neuroinflammation and neurodegeneration, and which were robustly associated with GFAP and, to a lesser extent, NfL. The AD biomarker p-Tau181 was only minimally associated with neuroimaging outcomes. Further, asthma severity was associated with deleterious changes in neuroimaging outcomes, which in turn were associated with slower processing speed, a test of cognitive performance. CONCLUSIONS Asthma, particularly when severe, is associated with characteristics of neuroinflammation and neurodegeneration, and may be a potential risk factor for neural injury and cognitive dysfunction. There is a need to determine how asthma may affect brain health and whether treatment directed toward characteristics of asthma associated with these risks can mitigate these effects.
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Affiliation(s)
- Melissa A Rosenkranz
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisc; Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisc.
| | - Douglas C Dean
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisc; Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisc; Waisman Center, University of Wisconsin-Madison, Madison, Wisc
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc; Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, Madison, Wisc
| | - Nizar N Jarjour
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
| | - Stephane Esnault
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | | | - Michael D Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minn
| | - Richard J Davidson
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisc; Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisc; Department of Psychology, University of Wisconsin-Madison, Madison, Wisc
| | - William W Busse
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
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Winder B, Kiechl SJ, Gruber NM, Bernar B, Gande N, Staudt A, Stock K, Hochmayr C, Geiger R, Griesmacher A, Anliker M, Kiechl S, Kiechl-Kohlendorfer U, Knoflach M. The association of allergic asthma and carotid intima-media thickness in adolescence: data of the prospective early vascular ageing (EVA)-Tyrol cohort study. BMC Cardiovasc Disord 2022; 22:11. [PMID: 35042472 PMCID: PMC8764773 DOI: 10.1186/s12872-021-02452-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In recent years, there has been increasing evidence that asthma is associated with atherosclerosis and cardiovascular disease. However, data in children and adolescents are scarce and conflicting. We aimed to assess the impact of asthma with and without an allergic component on the carotid intima-media thickness in a large pediatric population. METHODS The community-based early vascular ageing-Tyrol cohort study was performed between May 2015 and July 2018 in North, East (Austria) and South Tyrol (Italy) and recruited youngster aged 14 years and above. Medical examinations included anthropometric measurements, fasting blood analysis, measurement of the carotid intima-media thickness by high-resolution ultrasound, and a physician guided interview. RESULTS The mean age of the 1506 participants was 17.8 years (standard deviation 0.90). 851 (56.5%) participants were female. 22 subjects had a physician diagnosis of non-allergic asthma, 268 had inhalative allergies confirmed by a positive radio-allergo-sorbent-test and/or prick test, and 58 had allergic asthma. Compared to healthy controls, participants with non-allergic asthma (411.7 vs. 411.7 µm; p = 0.932) or inhalative allergy (420.0 vs. 411.7 µm; p = 0.118) did not have significantly higher carotid intima-media thickness (cIMT). However, participants with allergic asthma had significantly higher cIMT (430.8 vs. 411.7; p = 0.004) compared to those without and this association remained significant after multivariable adjustment for established cardiovascular risk factors. CONCLUSION Allergic asthma in the youth is associated with an increased carotid intima-media thickness. Physicians should therefore be aware of allergic asthma as a potential cardiovascular risk factor in children and adolescents. Trial Registration Number The EVA-Tyrol Study has been retrospectively registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.
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Affiliation(s)
- Bernhard Winder
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innrain 66a, 6020, Innsbruck, Austria
| | - Sophia J Kiechl
- VASCage, Research Centre on Vascular Ageing and Stroke, Innrain 66a, 6020, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Nadja M Gruber
- VASCage, Research Centre on Vascular Ageing and Stroke, Innrain 66a, 6020, Innsbruck, Austria
| | - Benoît Bernar
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
- Department of Pediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Nina Gande
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Anna Staudt
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Katharina Stock
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
- Department of Pediatrics III, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christoph Hochmayr
- Department of Pediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Ralf Geiger
- Department of Pediatrics III, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute of Clinical Chemistry and Laboratory Medicine (ZIMCL), Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Markus Anliker
- Central Institute of Clinical Chemistry and Laboratory Medicine (ZIMCL), Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Stefan Kiechl
- VASCage, Research Centre on Vascular Ageing and Stroke, Innrain 66a, 6020, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | | | - Michael Knoflach
- VASCage, Research Centre on Vascular Ageing and Stroke, Innrain 66a, 6020, Innsbruck, Austria.
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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McNarry MA, Lester L, Ellins EA, Halcox JP, Davies G, Winn CON, Mackintosh KA. Asthma and high-intensity interval training have no effect on clustered cardiometabolic risk or arterial stiffness in adolescents. Eur J Appl Physiol 2021; 121:1967-1978. [PMID: 33778908 PMCID: PMC8192411 DOI: 10.1007/s00421-020-04590-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cardiometabolic risk, including arterial stiffness, is increasing in youth. Those with asthma are suggested to be particularly at risk of cardiovascular disease. Efficient and effective strategies are required to prevent the atherosclerotic process in youth. The purpose of this study was to investigate the effect of 6 months high-intensity interval training (HIIT) on cardiometabolic risk in youth with and without asthma. METHODS 65 adolescents (31 mild asthma; 34 non-asthma) were recruited, 32 (16 asthma) of whom were randomly allocated to receive HIIT three times per week for 6 months. At baseline, mid-intervention, post-intervention and at a 3-month follow-up, anthropometric, metabolic and vascular determinants of cardiometabolic risk were assessed. Following principal component analysis (PCA), linear mixed models were used to assess the influence of asthma, HIIT and their interaction. RESULTS Seven factors were identified which explained 88% of the common variance shared among the parameters. Those with asthma demonstrated lower arterial stiffness factor scores mid-intervention (P = 0.047) and lower cholesterol factor scores post-intervention (P = 0.022) but there was no effect of the intervention, or interaction effects, on any PCA-identified factor, at any time-point. HIIT was associated with a lower low-density lipoprotein and diastolic blood pressure at mid-intervention. DISCUSSION Neither arterial stiffness nor clustered cardiometabolic risk are influenced by HIIT in adolescents with or without asthma, despite important changes in blood lipid and pressure profiles. Blood pressure, augmentation and pulse wave velocity should be considered physiologically distinct constructs and as potential markers of cardiovascular health.
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Affiliation(s)
- M A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK.
| | - L Lester
- School of Human Sciences, University of Western Australia, Perth, 6009, Australia
| | - E A Ellins
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - J P Halcox
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - G Davies
- Swansea University Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - C O N Winn
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK
| | - K A Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Bay Campus, Swansea, SA1 8EN, UK
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Karakaya Z, Cavkaytar Ö, Tosun Ö, Arga M. Subclinical cardiovascular dysfunction in children and adolescents with asthma. J Asthma 2020; 59:451-461. [PMID: 33251886 DOI: 10.1080/02770903.2020.1856866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is close association between asthma and cardiovascular functions as both diseases share common inflammatory pathways. The current study was aimed at investigating the risk factors, associated with endothelial and cardiac functions in children with newly-diagnosed mild-persistent asthma. METHODS A total of 33 steroid-naive asthmatic children [median(interquartile-range); 9.1 years(7.8-13.5)] and 16 healthy controls [11.5 years(9.9-13.6)] were included. Their demographic, clinical and laboratory findings were recorded. Carotid Artery intima-media thickness (CIMT), stiffness, distensibility and strain were measured as atheroclerosis markers. Conventional and tissue Doppler imaging was performed to evaluate ventricular function. RESULTS The patients with asthma had higher CIMT and stiffness and lower strain and distensibility compared to controls (p < 0.001 for all). There was a significant correlation between the duration of asthmatic symptoms and subclinical-atherosclerosis as well as peripheral eosinophil count (p < 0.001, p < 0.05). The patients had lower tricuspid-annular-plane-systolic-excursion (TAPSE), ejection time, and higher isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), and left ventricle myocardial performance index (LVMPI) than the control subjects (p < 0.001 for all). A positive correlation was also observed between the duration of asthmatic-symptoms and cardiac-function parameters. CONCLUSION Children with mild persistent asthma had subclinical atherosclerosis and ventricular dysfunction even in the early stage of disease. Symptom duration was closely associated with both subclinical atherosclerosis and ventricular dysfunction. Myocardial performance index was abnormal in the asthmatic children when assessed by tissue Doppler Imaging even though they had normal ejection fraction in conventional echocardiography. Future prospective studies with larger sample sizes are needed to confirm these findings and to assess the possible protective effect of ICSs in the prevention of subclinical atherosclerosis.
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Affiliation(s)
- Zeynep Karakaya
- Department of Pediatrics, Istanbul Medeniyet University Medical Faculty, İstanbul, Turkey
| | - Özlem Cavkaytar
- Department of Pediatric Allergy and Immunology, Istanbul Medeniyet University Medical Faculty, İstanbul, Turkey
| | - Öykü Tosun
- Department of Pediatric Cardiology, Istanbul Medeniyet University Medical Faculty, İstanbul, Turkey
| | - Mustafa Arga
- Department of Pediatric Allergy and Immunology, Istanbul Medeniyet University Medical Faculty, İstanbul, Turkey
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Hidvégi EV, Jakab AE, Lenkey Z, Bereczki C, Cziráki A, Illyés M. Updated and revised normal values of aortic pulse wave velocity in children and adolescents aged 3-18 years. J Hum Hypertens 2020; 35:604-612. [PMID: 32632146 DOI: 10.1038/s41371-020-0374-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 06/08/2020] [Accepted: 06/25/2020] [Indexed: 11/09/2022]
Abstract
Measurement of aortic pulse wave velocity (PWVao) is recommended for stratifying individual cardiovascular (CV) risk in adults. Diseases in children and adolescents might influence aortic stiffness. It is necessary to exclude overweight (OW), obese (O) subjects, and individuals with increased systolic (SBP) and/or diastolic blood pressure (DBP) from the population, when creating normal values of PWVao in children and adolescents. Body mass index (BMI), SBP/DBP cut-off values have remarkably changed in this population during the last decade. Aims of our study were to expand our previously published PWVao database and to revise it by using the recently determined normal values. PWVao was measured by an occlusive-oscillometric device (Arteriograph, TensioMed Ltd, Budapest, Hungary) in a healthy population aged 3-18 years. 7940 (4374 boys) participants were recruited, 1912 OW/O subjects and 1368 individuals with high SBP/DBP were excluded. Finally, n = 4690 (2599 boys) participants were enrolled. Mean PWVao values increased from 5.4 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in boys and from 5.5 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in girls. Mean PWVao values were significantly lower in our new study, in boys in age groups of 9-16, in girls in age groups of 11-17. This is the largest and widest age-ranged database of PWVao published to date. Due to the change of BMI and SBP/DBP reference values during the last decade, the "old" database of PWVao needed to be revised. As a result of this, normal values of PWVao decreased significantly in both sexes.
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Affiliation(s)
| | - Andrea Emese Jakab
- Department of Pediatrics, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary
| | - Zsófia Lenkey
- Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Csaba Bereczki
- Department of Pediatrics, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary
| | - Attila Cziráki
- Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Miklós Illyés
- Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
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Lee SY, Mac Aogáin M, Fam KD, Chia KL, Binte Mohamed Ali NA, Yap MMC, Yap EPH, Chotirmall SH, Lim CL. Airway microbiome composition correlates with lung function and arterial stiffness in an age-dependent manner. PLoS One 2019; 14:e0225636. [PMID: 31770392 PMCID: PMC6879132 DOI: 10.1371/journal.pone.0225636] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022] Open
Abstract
Objective To investigate age-associated changes in airway microbiome composition and their relationships with lung function and arterial stiffness among genetically matched young and elderly pairs. Methods Twenty-four genetically linked family pairs comprised of younger (≤40 years) and older (≥60 years) healthy participants were recruited (Total n = 48). Lung function and arterial stiffness (carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx)) were assessed. Sputum samples were collected for targeted 16S rRNA gene amplicon sequencing and correlations between microbiome composition, lung function and arterial stiffness were investigated. Results Elderly participants exhibited reductions in lung function (FEV1 (p<0.001), FVC (p<0.001) and percentage FEV1/FVC (p = 0.003)) and a 1.3–3.9-fold increase in arterial stiffness (p<0.001) relative to genetically related younger adults. Elderly adults had a higher relative abundance of Firmicutes (p = 0.035) and lower relative abundance of Proteobacteria (p = 0.014), including specific genera Haemophilus (p = 0.024) and Lautropia (p = 0.020) which were enriched in the younger adults. Alpha diversity was comparable between young and elderly pairs (p>0.05) but was inversely associated with lung function (FEV1%Predicted and FVC %Predicted) in the young (p = 0.006 and p = 0.003) though not the elderly (p = 0.481 and p = 0.696). Conversely, alpha diversity was negatively associated with PWV in the elderly (p = 0.01) but not the young (p = 0.569). Specifically, phylum Firmicutes including the genus Gemella were correlated with lung function (FVC %Predicted) in the young group (p = 0.047 and p = 0.040), while Fusobacteria and Leptotrichia were associated with arterial stiffness (PWV) in the elderly (both p = 0.004). Conclusion Ageing is associated with increased Firmicutes and decreased Proteobacteria representation in the airway microbiome among a healthy Asian cohort. The diversity and composition of the airway microbiome is independently associated with lung function and arterial stiffness in the young and elderly groups respectively. This suggests differential microbial associations with these phenotypes at specific stages of life with potential prognostic implications.
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Affiliation(s)
- Shuen Yee Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Micheál Mac Aogáin
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kai Deng Fam
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kar Ling Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Margaret M. C. Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Eric P. H. Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Chin Leong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- * E-mail:
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9
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Associations between carotid artery longitudinal wall motion and arterial stiffness indicators in young children. Atherosclerosis 2019; 287:64-69. [DOI: 10.1016/j.atherosclerosis.2019.06.895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 01/19/2023]
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Heffernan KS, Columna L, Russo N, Myers BA, Ashby CE, Norris ML, Barreira TV. Brief Report: Physical Activity, Body Mass Index and Arterial Stiffness in Children with Autism Spectrum Disorder: Preliminary Findings. J Autism Dev Disord 2019; 48:625-631. [PMID: 29119519 DOI: 10.1007/s10803-017-3358-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We examined the association between physical activity (PA), body mass index (BMI) and novel measures of subclinical cardiovascular disease (CVD) in 15 children with autism spectrum disorder (ASD) (mean age 7 ± 2 years, 2 girls). PA was objectively assessed using accelerometry as time spent in moderate-vigorous physical activity (MVPA). Arterial stiffness was measured via aortic pulse wave velocity (PWV) and taken as a marker of subclinical CVD risk. MVPA was inversely associated with aortic PWV (r = - 0.46, p < 0.05). BMI percentile was positively associated with aortic PWV (r = 0.61, p < 0.05). Overall findings suggest that reduced PA and higher body mass in children with ASD are associated with increased arterial stiffness which may have a detrimental impact on overall cardiovascular health.
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Affiliation(s)
- Kevin S Heffernan
- Department of Exercise Science, Human Performance Laboratory, Syracuse University, 820 Comstock Ave, Room 201, Syracuse, NY, 13244, USA.
| | - Luis Columna
- Department of Exercise Science, Physical Education, Syracuse University, Syracuse, NY, USA
| | - Natalie Russo
- Department of Psychology, Center for Autism and Electrophysiology Laboratory, Syracuse University, Syracuse, NY, USA
| | - Beth A Myers
- Department of Teaching and Leadership, Taishoff Center for Inclusive Higher Education, Syracuse University, Syracuse, NY, USA
| | - Christine E Ashby
- Department of Teaching and Leadership, Institute on Communication and Inclusion, Syracuse University, Syracuse, NY, USA
| | - Michael L Norris
- Department of Exercise Science, Physical Education, Syracuse University, Syracuse, NY, USA
| | - Tiago V Barreira
- Department of Exercise Science, Human Behavior Measurement Laboratory, Syracuse University, Syracuse, NY, USA
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Huang CJ, Lin HJ, Liao WL, Ceurvels W, Su SY. Diagnosis of traditional Chinese medicine constitution by integrating indices of tongue, acoustic sound, and pulse. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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12
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Sun D, Li X, Heianza Y, Nisa H, Shang X, Rabito F, Kelly T, Harville E, Li S, He J, Bazzano L, Chen W, Qi L. History of Asthma From Childhood and Arterial Stiffness in Asymptomatic Young Adults: The Bogalusa Heart Study. Hypertension 2018; 71:928-936. [PMID: 29632104 PMCID: PMC5898648 DOI: 10.1161/hypertensionaha.118.10916] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/05/2018] [Accepted: 03/05/2018] [Indexed: 12/12/2022]
Abstract
Asthma is related to various cardiovascular risk. Whether a history of asthma from childhood contributes to arterial stiffness in adulthood, a noninvasive surrogate for cardiovascular events, is unknown. Prospective analyses were performed among 1746 Bogalusa Heart Study participants aged 20 to 51 years with data on self-report asthma collected since childhood. Aorta-femoral pulse wave velocity (af-PWV, m/s) was repeatedly assessed among adults ≥aged 18 years. Generalized linear mixed models and generalized linear models were fitted for the repeated measurements of af-PWV and its changes between the last and the first measurements, respectively. After a median follow-up of 11.1 years, participants with a history of asthma from childhood had a higher af-PWV (6.78 versus 6.13; P=0.048) and a greater increase in af-PWV (8.99 versus 2.95; P=0.043) than those without asthma, adjusted for age, sex, race, smoking status, heart rate, body mass index, systolic blood pressure, lipids, and glycemia. In addition, we found significant interactions of asthma with body mass index and systolic blood pressure on af-PWV and its changes (P for interaction <0.01). The associations of asthma with af-PWV and its changes appeared to be stronger among participants who were overweight and obese (body mass index ≥25 kg/m2) or with prehypertension and hypertension (systolic blood pressure ≥120 mm Hg) compared with those with a normal body mass index or systolic blood pressure. Our findings indicate that a history of asthma from childhood is associated with higher af-PWV and greater increases in af-PWV, and such associations are stronger among young adults who are overweight or with elevated blood pressure.
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Affiliation(s)
- Dianjianyi Sun
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Xiang Li
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Yoriko Heianza
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Hoirun Nisa
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Xiaoyun Shang
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Felicia Rabito
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Tanika Kelly
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Emily Harville
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Shengxu Li
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Jiang He
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Lydia Bazzano
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Wei Chen
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.)
| | - Lu Qi
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.).
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Is there a gender-specific association between asthma and carotid intima media thickness in Swiss adolescents? Eur J Pediatr 2018; 177:699-707. [PMID: 29411143 DOI: 10.1007/s00431-018-3107-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/21/2018] [Accepted: 01/23/2018] [Indexed: 01/06/2023]
Abstract
UNLABELLED Respiratory diseases are associated with increased cardiovascular risk in adults, but little is known on the early impact on the vasculature in youth. The SAPALDIA Youth study, the offspring study of the Swiss Study on Air Pollution and Lung and Heart Disease In Adults (SAPALDIA), investigated the association between physician-diagnosed asthma status and common carotid artery intima media thickness (CIMT). Offspring underwent standardized clinical protocols and provided information on early life factors, health, and lifestyle. The association between per subject averages of CIMT and asthma was estimated using mixed linear regression analyses adjusting for main confounders, testing for interaction with gender and age. Of 257 offspring (mean age 15 years, 53% female), 11.5% reported doctor-diagnosed asthma (male 17%, female 7%). Mean CIMT was significantly different by gender (male 0.53 mm (± 0.045), female 0.50 mm (± 0.048); p < 0.001). Interaction was highly significant by gender (p = 0.001) with significantly increased CIMT in asthmatic vs. non-asthmatics boys (difference 0.023 mm, 95% CI 0.003; 0.043), as compared to girls. CONCLUSION Our study suggests an increased risk for early vascular change in adolescent asthmatic boys. Whereas the small number of girls limits the interpretation, the result necessitates further research into sex-specific atherosclerotic burden related to respiratory health in adolescence. What is Known: • Evidence points to a significant impact of adult respiratory disease on cardiovascular health indicators as well as on endpoints. • Inflammation is a key pathway in vascular change across the life course. What is New: • We observe an adverse association between physician-diagnosed asthma and carotid intima media thickness in adolescent boys. • Albeit a limited number of asthmatic girls, we hypothesize the gender typical timing of asthma or a higher male cardiovascular vulnerability as possible explanations for the gender-specific results.
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Longitudinal study of the influence of lung function on vascular health from adolescence to early adulthood in a British multiethnic cohort. J Hypertens 2018; 35:2185-2191. [PMID: 28661960 PMCID: PMC5625963 DOI: 10.1097/hjh.0000000000001455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Vascular and lung function develop and decline over the life course; both predict cardiovascular events and mortality but little is known of how they develop over time. We analysed their relationship in a multiethnic cohort study to test whether lung function from early adolescence to young adulthood affected vascular indices. Methods: ‘DASH’ (http://dash.sphsu.mrc.ac.uk) included 6643 children aged 11–13 years in 2003; a representative 10% sample (n = 665) participated in a pilot follow-up in 2013. Psychosocial, anthropometric, blood pressure (BP), and lung function measures were collected in both surveys; aortic pulse wave velocity (PWV) and augmentation index (AIx) were measured at aged 21–23 years. Relationships between forced expiratory volume Z-scores in 1 s (zFEV1), after global initiative-ethnic adjustments and BP, PWV, and AIx were tested in linear regression and general estimating statistical models. Results: In total, 488 people with complete data were included. At 11–13 years, SBP was positively associated with zFEV1 (coefficient = 1.90, 95% confidence interval 1.11–2.68, P < 0.001); but not at 21–23 years. The 10-year increase in zFEV1 was associated with rise in SBP (1.38, 0.25–1.51, P < 0.05) in mixed effect models adjusted for age, sex, ethnicity, waist to height ratio, employment, reported racism, smoking, and alcohol use but DBP change was unrelated. In fully adjusted models, neither PWV nor central AIx were associated with zFEV1 at 11–13 years or 21–23 years (P > 0.05). Conclusion: Forced expiratory volume change is positively and independently associated with SBP change from adolescence to young adulthood, suggesting earlier lung function plays important roles in SBP development. Vascular indices were unrelated to lung function or its change.
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Affiliation(s)
- Leonardo Roever
- 1 Department of Clinical Research, Federal University of Uberlândia, Brazil
| | - João L O'Connell
- 2 Department of Cardiology, Federal University of Uberlândia, Brazil
| | - Antonio Cp Chagas
- 3 Heart Institute (InCor), HCFMUSP, University of São Paulo Medical School, Brazil.,4 Department of Cardiology, Faculty of Medicine ABC, Brazil
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16
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Bektaş O, Günaydin ZY, Karagöz A, Akgedik R, Bayramoğlu A, Kaya A. The effects of treatment in patients with childhood asthma on the elastic properties of the aorta. Cardiovasc J Afr 2017; 28:165-169. [PMID: 28759088 PMCID: PMC5558130 DOI: 10.5830/cvja-2016-076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/17/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The study aimed to investigate the effects of treatment in patients with childhood asthma on the elastic properties of the aorta and cardiovascular risk. METHODS The study was performed in 66 paediatric patients diagnosed with bronchial asthma (BA). All patients were administered the β2 agonist, salbutamol, for seven days, followed by one month of montelukast and six months of inhaled steroid treatment. All patients underwent conventional transthoracic echocardiographic imaging before and after treatment. Aortic elasticity parameters were considered to be the markers of aortic function. RESULTS Aortic elasticity parameters, including aortic strain (15.2 ± 4.8 and 18.8 ± 9.5%, p = 0.043), aortic distensibility (7.26 ± 4.71 and 9.53 ± 3.50 cm2/dyn, p = 0.010) and aortic stiffness index (3.2 ± 0.6 and 2.8 ± 0.5, p = 0.045 showed significant post-treatment improvement when compared to pre-treatment values. Tricuspid annular plane systolic excursion (TAPSE) was also observed to improve after treatment (1.81 ± 0.38 and 1.98 ± 0.43, p = 0.049). CONCLUSION The study demonstrated that when provided at appropriate doses, medications used in BA may result in an improvement in aortic stiffness.
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Affiliation(s)
- Osman Bektaş
- Department of Cardiology, Faculty of Medicine, Ordu University, Ordu, Turkey
| | | | - Ahmet Karagöz
- Department of Cardiology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Recep Akgedik
- Department of Chest Diseases, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Adil Bayramoğlu
- Department of Cardiology, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Ahmet Kaya
- Department of Cardiology, Faculty of Medicine, Ordu University, Ordu, Turkey
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17
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Vanderschuren MM, Uiterwaal CS, van der Ent CK, Eising JB. Feasibility and characteristics of arterial stiffness measurement in preschool children. Eur J Prev Cardiol 2017; 24:1895-1902. [PMID: 28728487 PMCID: PMC5680906 DOI: 10.1177/2047487317721979] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Arterial stiffness is an important predictor of cardiovascular risk in adult life. Increased arterial stiffness can also be present in children and may be associated with several other cardiovascular risk factors. Until now, however, we know little about measuring arterial stiffness in preschool children. In this study, we assessed the feasibility of measuring arterial stiffness in preschool children and explored possible determinants related to arterial stiffness at this age. Methods We studied 168 healthy children, aged 3.3–4.1 years, who were recruited from a prospective birth cohort. We measured arterial stiffness, expressed in aortic pulse wave velocity and augmentation index, using a non-invasive oscillometric device (Arteriograph). We measured anthropometry and recorded other determinants using a questionnaire. Results In 100 children (59.5%) at least one valid arterial stiffness measurement was obtained. Of these infants, 89 had at least two valid measurements and 73 infants had at least three valid measurements. The mean aortic pulse wave velocity was 5.56 m/s (SD 0.77), and the mean augmentation index of the aorta was 19.7 m/s (SD 7.0). The augmentation index was significantly inversely associated with body height, with a regression coefficient of –0.78 (m/s)/cm (95% confidence interval –1.13 to –0.42). The augmentation index was not significantly associated with age, sex or (birth) weight. Conclusion The feasibility of measuring arterial stiffness in preschool children using the Arteriograph is moderate. We identified height as the most important determinant of the augmentation index in preschool children.
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Affiliation(s)
| | - Cuno Spm Uiterwaal
- 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | | | - Jacobien B Eising
- 1 Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
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18
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Li L, Hu B, Gong S, Yu Y, Yan J. Age and cigarette smoking modulate the relationship between pulmonary function and arterial stiffness in heart failure patients. Medicine (Baltimore) 2017; 96:e6262. [PMID: 28272233 PMCID: PMC5348181 DOI: 10.1097/md.0000000000006262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to assess the relationship between arterial stiffness and pulmonary function in chronic heart failure (CHF).Outpatients previously diagnosed as CHF were enrolled between April 2008 and March 2010, and submitted to arterial stiffness measurement and lung function assessment. Spirometry was performed by measuring forced vital capacity (FVC), the fraction of predicted FVC, forced expiratory volume in 1 second (FEV1), the percentage of predicted FEV1 in 1 second, FEV1 to FVC ratio, and the percentage of predicted FEV1/FVC. Cardio-ankle vascular index (CAVI) was considered for the estimation of arterial stiffness.The 354 patients assessed included 315 nonsmokers, and were 68.2 ± 7.2 years' old. Unadjusted correlation analyses demonstrated CAVI was positively related to age (r = 0.3664, P < 0.0001), and negatively related to body mass index (BMI, r = -0.2040, P = 0.0001), E/A ratio (r = -0.1759, P = 0.0010), and FEV1 (r = -0.2987, P < 0.0001). Stepwise multivariate regression analyses showed age (r = 0.2391, P < 0.0001), BMI (r = -0.2139, P < 0.0001), smoking (r = 0.1211, P = 0.0130), E/A ratio (r = -0.1082, P = 0.0386), and FEV1 (r = -0.2550, P < 0.0001) were independent determinants of CAVI. In addition, there is a significant interaction between CAVI and forced expiratory volume in 1 second (FEV1) in relation to age (Pint < 0.0001) and smoking (Pint = 0.0001). Meanwhile, pulmonary function was not associated with BMI or E/A ratio.These findings demonstrated that reduced pulmonary function is associated with the increased CAVI, and had an interactive effect with age and smoking on CAVI in patients with CHF.
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Affiliation(s)
- Li Li
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Bangchuan Hu
- Intensive Care Unit, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Shijin Gong
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Yihua Yu
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
| | - Jing Yan
- Intensive Care Unit and Zheiiang Provincial Key Laboratory of Geriatrics, Zhejiang Hospital
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Özkan EA, Serin Hİ, Khosroshahi HE, Kılıç M, Ekim M, Beysel P, Geçit UA, Domur E. Arterial Stiffness, Distensibility, and Strain in Asthmatic Children. Med Sci Monit 2016; 22:251-7. [PMID: 26803723 PMCID: PMC4731016 DOI: 10.12659/msm.895502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We hypothesized that since asthma is a chronic inflammatory disease, it could lead to the early development of atherosclerosis in childhood-onset asthma. The aim of this study was to investigate arterial stiffness, distensibility, and strain of different peripheral arteries, the parameters of which can be used to detect atherosclerosis in asthmatic children. MATERIAL/METHODS We studied 22 pediatric patients with asthma and 18 healthy children. Fasting blood glucose and cholesterol levels were evaluated to exclude children with diabetes and hyperlipidemia, which are risk factors for atherosclerosis. Renal, carotid, and brachial arteries diameters were measured. Using the measured data, stiffness, distensibility, and strain of the arteries of all children were calculated. RESULTS Pulse pressure, systolic and diastolic blood pressure, heart rate, cholesterols, and glucose levels of the obese individuals were similar to the controls. In carotid arteries there were no statistical differences regarding stiffness, distensibility, and strain. According to multiple ANCOVA analysis, distensibility and strain of right and left brachial arteries and right renal artery were higher, whereas right renal artery stiffness was lower in asthmatic children than in controls. Approximately one-fifth of the change in the left and right brachial arteries and right renal artery distensibility and strain and a small portion of the change in the right renal artery stiffness were associated with asthma. In contrast, left renal artery distensibility, strain, and stiffness were not associated with asthma. CONCLUSIONS Peripheral arteries had higher distensibility and strain, and lower stiffness in asthmatic children than in controls.
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Affiliation(s)
- Esra Akyüz Özkan
- Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey
- Corresponding Author: Esra Akyüz Özkan, e-mail:
| | | | - Hashem E. Khosroshahi
- Department of Pediatric Cardiology, Bozok University Medical Faculty, Yozgat, Turkey
| | - Mahmut Kılıç
- Department of Public Health, Bozok University Medical Faculty, Yozgat, Turkey
| | - Meral Ekim
- Department of Biochemistry, Bozok University Medical Faculty, Yozgat, Turkey
| | - Perihan Beysel
- Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey
| | - U. Aliye Geçit
- Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey
| | - Esra Domur
- Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey
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Dratva J, Caviezel S, Schaffner E, Bettschart R, Kuenzli N, Schindler C, Schmidt-Trucksäss A, Stolz D, Zemp E, Probst-Hensch N. Infectious diseases are associated with carotid intima media thickness in adolescence. Atherosclerosis 2015; 243:609-15. [PMID: 26545015 DOI: 10.1016/j.atherosclerosis.2015.10.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/04/2015] [Accepted: 10/17/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Inflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence. STUDY DESIGN 288 SAPALDIA offspring (8-21years) underwent a clinical examination in 2010-2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine). Offspring and parents gave information on individuals' and family health, child's vaccination status, infectious diseases and other early life factors. Life-time prevalence of bronchitis, pneumonia, tonsillitis, otitis, mononucleosis, meningitis, appendicitis, and scarlet fever were investigated, separately, and as cumulative infectious disease score. Multilevel adjusted linear regression analysis on the association between subjects' CIMT average and infectious diseases score was performed, stratifying by sex. RESULTS Youth (mean age 14.8 yrs; 53% female) reported on average 1.3 of the listed infectious diseases; 22% boys and 15% girls reported ≥3 infectious diseases (p = 0.136). Two-thirds were vaccinated according to recommendations (boys 56%, girls 61.5%, p = 0.567). Sex-stratified analyses yielded significantly increased CIMT in boys with ≥3 infectious diseases vs. none (0.046 mm, 95%CI 0.024; 0.068). In girls, the effect was of same direction but statistically non-significant (0.011 mm, 95%CI -0.015; 0.036). CONCLUSION The SAPALDIA Youth study complements current evidence on infectious origins of atherosclerosis in adults. The larger effects observed in boys may relate to a higher vulnerability of the vasculature and/or to infectious pathogens. Our data are suggestive of an early impact of childhood infectious diseases on vascular health.
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Affiliation(s)
- Julia Dratva
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland.
| | - Seraina Caviezel
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland; Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Robert Bettschart
- Lungenpraxis Hirslanden Klinik Aarau, Schanzweg 7, CH-5000 Aarau, Switzerland
| | - Nino Kuenzli
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Daiana Stolz
- Universitätsspital, Pneumologie, Basel CH, Petersgraben 4, CH-4031 Basel, Switzerland
| | - Elisabeth Zemp
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
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