1
|
Gómez-Sánchez L, Tamayo-Morales O, Suárez-Moreno N, Bermejo-Martín JF, Domínguez-Martín A, Martín-Oterino JA, Martín-González JI, González-Calle D, García-García Á, Lugones-Sánchez C, González-Sánchez S, Jiménez-Gómez R, García-Ortiz L, Gómez-Marcos MA, Navarro-Matías E. Relationship between the structure, function and endothelial damage, and vascular ageing and the biopsychological situation in adults diagnosed with persistent COVID (BioICOPER study). A research protocol of a cross-sectional study. Front Physiol 2023; 14:1236430. [PMID: 37772064 PMCID: PMC10523018 DOI: 10.3389/fphys.2023.1236430] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/17/2023] [Indexed: 09/30/2023] Open
Abstract
Background: SARS-CoV-2 infection affects the vascular endothelium, which mediates the inflammatory and thrombotic cascade. Moreover, alterations in the endothelium are related to arterial stiffness, which has been established as a marker of cardiovascular disease. The objective of this study is to analyse how the structure, vascular function, vascular ageing and endothelial damage are related to the biopsychological situation in adults diagnosed with persistent COVID and the differences by gender. Methods: This cross-sectional, descriptive, observational study will be carried out in the Primary Care Research Unit of Salamanca (APISAL) and in the BioSepsis laboratory of the University of Salamanca. The sample will be selected from the persistent COVID monographic office at the Internal Medicine Service of the University Hospital of Salamanca, and from the population of subjects diagnosed with persistent COVID in the clinical history of Primary Care. Through consecutive sampling, the study will include 300 individuals diagnosed with persistent COVID who meet the diagnosis criteria established by the WHO, after they sign the informed consent. Endothelial damage biomarkers will be measured using ELLA-SimplePlexTM technology (Biotechne). Their vascular structure and function will be analysed by measuring the carotid intima-media thickness (Sonosite Micromax); the pulse wave and carotid-femoral pulse wave velocity (cfPWV) will be recorded with Sphygmocor System®. Cardio Ankle Vascular Index (CAVI), brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index will be analysed with Vasera VS-2000®. The integral assessment of the subjects with persistent COVID will be conducted with different scales that evaluate fatigue, sleep, dyspnea, quality of life, attention, nutrition state, and fragility. We will also evaluate their lifestyles (diet, physical activity, smoking habits and alcohol consumption), psychological factors, and cognitive deterioration, which will be gathered through validated questionnaires; moreover, physical activity will be objectively measured using a pedometer for 7 days. Body composition will be measured through impedance using an Inbody 230. Vascular ageing will be calculated with 10 and 90 percentiles of cfPWV and baPWV. Furthermore, we will analyse the presence of vascular injury in the retina, heart, kidneys and brain, as well as cardiovascular risk. Demographic and analytical variables will also be gathered. Discussion: Arterial stiffness reflects the mechanic and functional properties of the arterial wall, showing the changes in arterial pressure, blood flow, and vascular diameter that occur with each heartbeat. SARS-CoV-2 affects the endothelial cells that are infected with this virus, increasing the production of pro-inflammatory cytokines and pro-thrombotic factors, which can cause early vascular ageing and an increase of arterial stiffness. Persistent COVID is a complex heterogeneous disorder that affects the lives of millions of people worldwide. The identifications of potential risk factors to better understand who is at risk of developing persistent COVID is important, since this would enable early and appropriate clinical support. It is unknown whether vascular alterations caused by COVID-19 resolve after acute infection or remain over time, favouring the increase of arterial stiffness and early vascular ageing. Therefore, it is necessary to propose studies that analyse the evolution of persistent COVID in this group of patients, as well as the possible variables that influence it. Clinical Trial registration: ClinicalTrials.gov, identifier NCT05819840.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Hospital de la Paz de Madrid, Servicio de Urgencias, Madrid, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Nuria Suárez-Moreno
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - Jesus F. Bermejo-Martín
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea Domínguez-Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - José A. Martín-Oterino
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Hospital Universitario de Salamanca, Internal Medicine Department, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - José I. Martín-González
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Hospital Universitario de Salamanca, Internal Medicine Department, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - David González-Calle
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
- Hospital Universitario de Salamanca, Cardiology Department, Salamanca, Spain
| | - Ángel García-García
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
- Hospital Universitario de Salamanca, Emergency Department, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Raquel Jiménez-Gómez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Elena Navarro-Matías
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | | |
Collapse
|
2
|
Gómez-Sánchez L, Gómez-Sánchez M, Rodríguez-Sánchez E, Patino-Alonso C, Alonso-Dominguez R, Sanchez-Aguadero N, Lugones-Sánchez C, Llamas-Ramos I, García-Ortiz L, Gómez-Marcos MA. Relationship of Different Anthropometric Indices with Vascular Ageing in an Adult Population without Cardiovascular Disease-EVA Study. J Clin Med 2022; 11:jcm11092671. [PMID: 35566797 PMCID: PMC9105296 DOI: 10.3390/jcm11092671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023] Open
Abstract
The objectives of this study were to analyse the capacity of different anthropometric indices to predict vascular ageing and this association in Spanish adult population without cardiovascular disease. A total of 501 individuals without cardiovascular disease residing in the capital of Salamanca (Spain) were selected (mean age: 55.9 years, 50.3% women), through stratified random sampling by age and sex. Starting from anthropometric measurements such as weight, height, and waist circumference, hip circumference, or biochemical parameters, we could estimate different indices that reflected general obesity, abdominal obesity, and body fat distribution. Arterial stiffness was evaluated by measuring carotid-femoral pulse wave velocity (cf-PWV) using a SphygmoCor® device. Vascular ageing was defined in three steps: Step 1: the participants with vascular injury were classified as early vascular ageing (EVA); Step 2: classification of the participants using the 10 and 90 percentiles of cf-PWV in the study population by age and sex in EVA, healthy vascular ageing (HVA) and normal vascular ageing (NVA); Step 3: re-classification of participants with arterial hypertension or type 2 diabetes mellitus included in HVA as NVA. The total prevalence of HVA and EVA was 8.4% and 21.4%, respectively. All the analysed anthropometric indices, except waist/hip ratio (WHpR), were associated with vascular ageing. Thus, as the values of the different anthropometric indices increase, the probability of being classified with NVA and as EVA increases. The capacity of the anthropometric indices to identify people with HVA showed values of area under the curve (AUC) ≥ 0.60. The capacity to identify people with EVA, in total, showed values of AUC between 0.55 and 0.60. In conclusion, as the values of the anthropometric indices increased, the probability that the subjects presented EVA increased. However, the relationship of the new anthropometric indices with vascular ageing was not stronger than that of traditional parameters. Therefore, BMI and WC can be considered to be the most useful indices in clinical practice to identify people with vascular ageing in the general population.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Carmen Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Statistics Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Natalia Sanchez-Aguadero
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Ines Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37008 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-124465
| | | |
Collapse
|
3
|
Llamas-Ramos I, Llamas-Ramos R, Alonso-Domínguez R, Gómez-Sánchez L, Tamayo-Morales O, Lugones-Sánchez C, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Sedentary Behaviour and Its Relationship with Early Vascular Ageing in the General Spanish Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095450. [PMID: 35564843 PMCID: PMC9101612 DOI: 10.3390/ijerph19095450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022]
Abstract
Sedentary behaviour is associated with a greater predisposition to developing cardiovascular diseases. The aim of the study was to analyse the relationship between sedentary time and early vascular ageing. A total of 501 participants (49.70% men) were recruited through random sampling stratified by age group and sex. Vascular ageing was evaluated considering three criteria: (1) the vascular ageing index (VAI); (2) the carotid−femoral pulse wave velocity (cfPWV) 10th and 90th percentiles of the reference values in the European population by age; and (3) the Framingham’s heart age. The carotid intima−media thickness was measured using a Sonosite Micromaxx ultrasound, the presence of peripheral artery disease was assessed by calculating the ankle−brachial index using a VaSera VS-1500, and the cfPWV was measured with a SphygmoCor® device. Weekly sedentary hours were evaluated through a sitting time questionnaire. The average age of the population was 55.90 ± 14.24 years. The men spent more hours sitting per week (47.6 ± 16.6 vs. 36.8 ± 17.3 h/W), at work (16.7 ± 16.2 vs. 9.73 ± 14.9 h/W), and watching TV (21.6 ± 12.5 vs. 18.7 ± 11.9 h/W). In the logistic regression analysis, the individuals with early vascular aging (EVA), with respect to those with healthy vascular aging (HVA), spent more hours sitting per week (OR = 1.03 vs. OR = 1.02; p < 0.05) and watching TV (OR = 1.03 vs. OR = 1.03; p < 0.05), using the criteria of the European guideline and VAI, and more hours sitting when commuting (OR = 1.04; p < 0.05), using Framingham’s heart age to define EVA. The results of this study indicate that sedentary time is associated with early vascular ageing. Therefore, reducing sedentary time would improve vascular health.
Collapse
Affiliation(s)
- Inés Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- University Hospital of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-663005052
| | - Rocío Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Olaya Tamayo-Morales
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
| |
Collapse
|
4
|
Zócalo Y, Bia D. Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement. Front Physiol 2022; 12:774390. [PMID: 35126173 PMCID: PMC8811372 DOI: 10.3389/fphys.2021.774390] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/22/2021] [Indexed: 12/11/2022] Open
Abstract
Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.
Collapse
|
5
|
The Role of Arterial Stiffness in the Estimation of Cardiovascular Risk in Liver Transplant Recipients. Transplant Direct 2021; 8:e1272. [PMID: 34966842 PMCID: PMC8710317 DOI: 10.1097/txd.0000000000001272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background Long-term cardiovascular (CV) events are a frequent cause of death and disability after liver transplant (LT). Although a more in-depth, risk-adapted control of CV risk factors may result in improved post-LT CV outcomes, an accurate stratification of the CV risk of LT recipients to better implement preventive strategies is lacking. Aortic pulse wave velocity (aPWV) is a surrogate of arterial stiffness that has been suggested as a biomarker of CV risk; it has never been evaluated in adult LT recipients. Methods In a single-center prospective study, we included 122 LT recipients at 12 (n = 39), 60 (n = 45), or 120 (n = 38) mo after LT. aPWV estimation by oscillometry, clinical assessment of CV risk factors, and CV risk estimation by standard clinical scores (systematic coronary risk evaluation and pooled cohort equation) were performed. The incidence of CV events during prospective follow-up was registered. Results aPWV was independently associated with age and the grade of control of blood pressure. After a median follow-up of 35 mo, 15 patients (12%) presented a CV event. Higher aPWV, diabetes, past or present smoking habit, previous CV events, lower eGFR, being in systematic coronary risk evaluation or pooled cohort equation high-risk groups, and higher levels of total cholesterol, LDL-cholesterol, creatinine, and triglycerides were associated with the incidence of CV events at univariate analysis; aPWV, past or present smoking habit, and triglycerides were independent predictors of CV events. Conclusions According to our results, aPWV mirrors CV risk in LT recipients and thus may be a useful CV risk biomarker in this population. Considering these preliminary results, its accuracy in stratifying risk requires confirmation in further studies.
Collapse
|
6
|
Gómez-Sánchez L, Gómez-Sánchez M, Lugones-Sánchez C, Tamayo-Morales O, González-Sánchez S, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Association of Insulin Resistance with Vascular Ageing in a General Caucasian Population: An EVA Study. J Clin Med 2021; 10:jcm10245748. [PMID: 34945044 PMCID: PMC8707603 DOI: 10.3390/jcm10245748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
The data on the relationship between insulin resistance and vascular ageing are limited. The aim of this study was to explore the association of different indices of insulin resistance with vascular ageing in an adult Caucasian population without cardiovascular disease. We selected 501 individuals without cardiovascular disease (mean age: 55.9 years, 50.3% women) through random sampling stratified by sex and age. Arterial stiffness was evaluated by measuring the carotid-to-femoral pulse wave velocity (cfPWV) and brachial-to-ankle pulse wave velocity (baPWV). The participants were classified into three groups according to the degree of vascular ageing: early vascular ageing (EVA), normal vascular ageing (NVA) and healthy vascular ageing (HVA). Insulin resistance was evaluated with the homeostatic model assessment of insulin resistance (HOMA-IR) and another five indices. The prevalence of HVA and EVA was 8.4% and 21.4%, respectively, when using cfPWV, and 7.4% and 19.2%, respectively, when using baPWV. The deterioration of vascular ageing, with both measurements, presented as an increase in all the analysed indices of insulin resistance. In the multiple regression analysis and logistic regression analysis, the indices of insulin resistance showed a positive association with cfPWV and baPWV and with EVA.
Collapse
Affiliation(s)
- Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Olaya Tamayo-Morales
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Susana González-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (C.L.-S.); (O.T.-M.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-124465
| | | |
Collapse
|
7
|
Rico Martín S, Vassilenko V, de Nicolás Jiménez JM, Rey Sánchez P, Serrano A, Martínez Alvarez M, Calderón García JF, Sánchez Muñoz-Torrero JF. Cardio-ankle vascular index (CAVI) measured by a new device: protocol for a validation study. BMJ Open 2020; 10:e038581. [PMID: 33082193 PMCID: PMC7577065 DOI: 10.1136/bmjopen-2020-038581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Cardio-ankle vascular index (CAVI) is a new marker of arterial stiffness (AS) that can assess vascular wall stiffness in the aorta, femoral artery and tibial artery. CAVI is less affected by blood pressure at the time of measurement than the gold standard method (carotid-femoral pulse wave velocity (PWV)). Our group has developed a device called VOPITB (Velocidad Onda de Pulso Índice Tobillo Brazo) that uses the oscillometric method and easily and accurately measures the PWV in the arms and legs separately, allowing new AS indices to be studied. This article describes the research protocol to determine CAVI using VOPITB and to validate the device against a reference device (VaSera VS-1500) and assess its clinical utility. METHODS AND ANALYSES A cross-sectional, descriptive and observational study will be conducted. In all, 120 subjects (a minimum of 40% of subjects from any one gender) will be evaluated. CAVI will be determined from the measurement by VOPITB and VaSera VS-1500. For each subject, the average of the three readings taken with each device will be calculated. The Bland-Altman plot will be used to determine whether any bias exists in the data-that is, a tendency of the size of the difference to vary with the mean. The participants will be divided roughly equally between the following age bands: <30, 30-60 and >60 years. ETHICS AND DISSEMINATION The study has been approved by the ethics committee of the Hospital San Pedro de Alcántara, Cáceres, Spain. The participants will be required to sign an informed consent form before inclusion in the study, in accordance with the Declaration of Helsinki and WHO standards for observational studies. The dissemination plan of the research study results will be through presentations in relevant national and international conferences and scientific publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04303546.
Collapse
Affiliation(s)
- Sergio Rico Martín
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
| | - Valentina Vassilenko
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Laboratory of Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), NOVA School of Science and Technology, NOVA University Lisbon, Caprica, Portugal
| | - Jorge M de Nicolás Jiménez
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Zona Centro Health Center, Extremadura Health Service, Cáceres, Spain
| | - Purificación Rey Sánchez
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
| | - Andreia Serrano
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Laboratory of Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), NOVA School of Science and Technology, NOVA University Lisbon, Caprica, Portugal
| | | | - Julián F Calderón García
- Department of Nursing, Nursing and Occupational Therapy College. Universidad de Extremadura, Caceres, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
| | - Juan F Sánchez Muñoz-Torrero
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, Caceres, Spain
- Department of Internal Medicine, Hospital San Pedro de Alcantara, Caceres, Spain
| |
Collapse
|
8
|
Gómez Sánchez M, Gómez Sánchez L, Patino-Alonso MC, Alonso-Domínguez R, Sánchez-Aguadero N, Lugones-Sánchez C, Rodríguez Sánchez E, García Ortiz L, Gómez-Marcos MA. Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study. Nutrients 2020; 12:nu12041025. [PMID: 32276498 PMCID: PMC7231158 DOI: 10.3390/nu12041025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/18/2022] Open
Abstract
The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex. METHODS We recruited 501 individuals aged 35-75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System® and carotid intima-media thickness by Sonosite Micromax® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population's typical eating habits. RESULTS MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16-0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12-0.86), but not in women (OR = 0.31; 95% CI: 0.04-2.50). CONCLUSION The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men.
Collapse
Affiliation(s)
- Marta Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Leticia Gómez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Maria C Patino-Alonso
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Statistics, University of Salamanca (USAL), IGA Research Group, 37007 Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
| | - Emiliano Rodríguez Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Luis García Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37005 Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Biomedical Research Institute of Salamanca (IBSAL), 37005 Salamanca, Spain; (M.G.S.); (L.G.S.); (M.C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (E.R.S.); (L.G.O.)
- Spanish Network for Preventive Activities and Health Promotion (redIAPP), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain
- Iberian Network on Arterial Structure, Central Hemodynamics and Neurocognition, 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-291-100
| |
Collapse
|