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Yang Y, Feng H, Tang Y, Wang Z, Qiu P, Huang X, Chang L, Zhang J, Chen YE, Mizrak D, Yang B. Bioengineered vascular grafts with a pathogenic TGFBR1 variant model aneurysm formation in vivo and reveal underlying collagen defects. Sci Transl Med 2024; 16:eadg6298. [PMID: 38718134 DOI: 10.1126/scitranslmed.adg6298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/17/2024] [Indexed: 05/30/2024]
Abstract
Thoracic aortic aneurysm (TAA) is a life-threatening vascular disease frequently associated with underlying genetic causes. An inadequate understanding of human TAA pathogenesis highlights the need for better disease models. Here, we established a functional human TAA model in an animal host by combining human induced pluripotent stem cells (hiPSCs), bioengineered vascular grafts (BVGs), and gene editing. We generated BVGs from isogenic control hiPSC-derived vascular smooth muscle cells (SMCs) and mutant SMCs gene-edited to carry a Loeys-Dietz syndrome (LDS)-associated pathogenic variant (TGFBR1A230T). We also generated hiPSC-derived BVGs using cells from a patient with LDS (PatientA230T/+) and using genetically corrected cells (Patient+/+). Control and experimental BVGs were then implanted into the common carotid arteries of nude rats. The TGFBR1A230T variant led to impaired mechanical properties of BVGs, resulting in lower burst pressure and suture retention strength. BVGs carrying the variant dilated over time in vivo, resembling human TAA formation. Spatial transcriptomics profiling revealed defective expression of extracellular matrix (ECM) formation genes in PatientA230T/+ BVGs compared with Patient+/+ BVGs. Histological analysis and protein assays validated quantitative and qualitative ECM defects in PatientA230T/+ BVGs and patient tissue, including decreased collagen hydroxylation. SMC organization was also impaired in PatientA230T/+ BVGs as confirmed by vascular contraction testing. Silencing of collagen-modifying enzymes with small interfering RNAs reduced collagen proline hydroxylation in SMC-derived tissue constructs. These studies demonstrated the utility of BVGs to model human TAA formation in an animal host and highlighted the role of reduced collagen modifying enzyme activity in human TAA formation.
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MESH Headings
- Animals
- Humans
- Receptor, Transforming Growth Factor-beta Type I/metabolism
- Receptor, Transforming Growth Factor-beta Type I/genetics
- Induced Pluripotent Stem Cells/metabolism
- Collagen/metabolism
- Blood Vessel Prosthesis
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/metabolism
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Rats, Nude
- Disease Models, Animal
- Rats
- Bioengineering
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Gene Editing
- Loeys-Dietz Syndrome/genetics
- Loeys-Dietz Syndrome/pathology
- Male
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Affiliation(s)
- Ying Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Hao Feng
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
- Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Ying Tang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
- Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Zhenguo Wang
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ping Qiu
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Xihua Huang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lin Chang
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jifeng Zhang
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Yuqing Eugene Chen
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Dogukan Mizrak
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Bo Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
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Cerebral Arterial Asymmetries in the Neonate: Insight into the Pathogenesis of Stroke. Symmetry (Basel) 2022. [DOI: 10.3390/sym14030456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Neonatal and adult strokes are more common in the left than in the right cerebral hemisphere in the middle cerebral arterial territory, and adult extracranial and intracranial vessels are systematically left-dominant. The aim of the research reported here was to determine whether the asymmetric vascular ground plan found in adults was present in healthy term neonates (n = 97). A new transcranial Doppler ultrasonography dual-view scanning protocol, with concurrent B-flow and pulsed wave imaging, acquired multivariate data on the neonatal middle cerebral arterial structure and function. This study documents for the first-time systematic asymmetries in the middle cerebral artery origin and distal trunk of healthy term neonates and identifies commensurately asymmetric hemodynamic vulnerabilities. A systematic leftward arterial dominance was found in the arterial caliber and cortically directed blood flow. The endothelial wall shear stress was also asymmetric across the midline and varied according to vessels’ geometry. We conclude that the arterial structure and blood supply in the brain are laterally asymmetric in newborns. Unfavorable shearing forces, which are a by-product of the arterial asymmetries described here, might contribute to a greater risk of cerebrovascular pathology in the left hemisphere.
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Ma R, Xie Q, Li Y, Chen Z, Ren M, Chen H, Li H, Li J, Wang J. Animal models of cerebral ischemia: A review. Biomed Pharmacother 2020; 131:110686. [PMID: 32937247 DOI: 10.1016/j.biopha.2020.110686] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/09/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
Stroke seriously threatens human health because of its characteristics of high morbidity, disability, recurrence, and mortality, thus representing a heavy financial and mental burden to affected families and society. Many preclinical effective drugs end in clinical-translation failure. Animal models are an important approach for studying diseases and drug effects, and play a central role in biomedical research. Some details about animal models of cerebral ischemia have not been published, such as left-/right-sided lesions or permanent cerebral ischemia/cerebral ischemia-reperfusion. In this review, ischemia in the left- and right-hemisphere in patients with clinical stroke and preclinical studies were compared for the first time, as were the mechanisms of permanent cerebral ischemia and cerebral ischemia-reperfusion in different phases of the disease. The results showed that stroke in the left hemisphere was more common in clinical patients, and that most patients with stroke failed to achieve successful recanalization. Significant differences were detected between permanent cerebral ischemia and cerebral ischemia-reperfusion models in the early, subacute, and recovery phases. Therefore, it is recommended that, with the exception of the determined experimental purpose or drug mechanism, left-sided permanent cerebral ischemia animal models should be prioritized, as they would be more in line with the clinical scenario and would promote clinical translation. In addition, other details regarding the preoperative management, surgical procedures, and postoperative care of these animals are provided, to help establish a precise, effective, and reproducible model of cerebral ischemia model and establish a reference for researchers in this field.
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Affiliation(s)
- Rong Ma
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Qian Xie
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yong Li
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Zhuoping Chen
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Mihong Ren
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Hai Chen
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Hongyan Li
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jinxiu Li
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jian Wang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Low A, Mak E, Malpetti M, Chouliaras L, Nicastro N, Su L, Holland N, Rittman T, Rodríguez PV, Passamonti L, Bevan-Jones WR, Jones PS, Rowe JB, O'Brien JT. Asymmetrical atrophy of thalamic subnuclei in Alzheimer's disease and amyloid-positive mild cognitive impairment is associated with key clinical features. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:690-699. [PMID: 31667328 PMCID: PMC6811895 DOI: 10.1016/j.dadm.2019.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Although widespread cortical asymmetries have been identified in Alzheimer's disease (AD), thalamic asymmetries and their relevance to clinical severity in AD remain unclear. Methods Lateralization indices were computed for individual thalamic subnuclei of 65 participants (33 healthy controls, 14 amyloid-positive patients with mild cognitive impairment, and 18 patients with AD dementia). We compared lateralization indices across diagnostic groups and correlated them with clinical measures. Results Although overall asymmetry of the thalamus did not differ between groups, greater leftward lateralization of atrophy in the ventral nuclei was demonstrated in AD, compared with controls and amyloid-positive mild cognitive impairment. Increased posterior ventrolateral and ventromedial nuclei asymmetry were associated with worse cognitive dysfunction, informant-reported neuropsychiatric symptoms, and functional ability. Discussion Leftward ventral thalamic atrophy was associated with disease severity in AD. Our findings suggest the clinically relevant involvement of thalamic nuclei in the pathophysiology of AD.
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Affiliation(s)
- Audrey Low
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Maura Malpetti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Nicolas Nicastro
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Negin Holland
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - W Richard Bevan-Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Pp Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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Rafati M, Havaee E, Moladoust H, Sehhati M. Appraisal of different ultrasonography indices in patients with carotid artery atherosclerosis. EXCLI JOURNAL 2017; 16:727-741. [PMID: 28827988 PMCID: PMC5547385 DOI: 10.17179/excli2017-232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/03/2017] [Indexed: 12/20/2022]
Abstract
In this study a semi-automated image-processing based method was designed in which the parameters such as intima-media thickness (IMT), resistive index (RI), pulsatility index (PI), dicrotic notch index (DNI), and mean wavelet entropy (MWE) were evaluated in B-mode and Doppler ultrasound in patients presenting with carotid artery atherosclerosis. In a cross-sectional design, 144 men were divided into four groups of control, mild, moderate and severe stenosis subjects. In all individuals, far wall IMT, RI, PI, DNI, and MWE of the left common carotid artery (CCA) were extracted using the proposed method. Our findings showed that the maximum far wall IMT, RI, PI, DNI in the CCA were significantly different in the patients with mild, moderate, and severe stenosis compared to control group (p-value < 0.05), however, there were no significant differences in MWE among the four groups (p-value > 0.05). The proposed method can help physicians to better identify patients at risk of cardiovascular diseases.
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Affiliation(s)
- Mehravar Rafati
- Department of Medical Physics and Radiology, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Elham Havaee
- Department of Medical Physics and Radiology, Faculty of Paramedicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hassan Moladoust
- Cardiovascular Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Sehhati
- Department of Biomedical Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Machado-Silva W, Henriques AD, Souza GD, Gomes L, Ferreira AP, Brito CJ, Córdova C, Moraes CF, Nóbrega OT. Serum Immune Mediators Independently Associate with Atherosclerosis in the Left (But Not Right) Carotid Territory of Older Individuals. J Stroke Cerebrovasc Dis 2016; 25:2851-2858. [PMID: 27554076 DOI: 10.1016/j.jstrokecerebrovasdis.2016.07.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/26/2016] [Accepted: 07/30/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIM Disturbance in the carotid arteries strongly predicts cerebrovascular events and correlates with a systemic inflammatory milieu. We investigated the relationship of a profile of 10 circulating inflammatory mediators with measures of carotid intima-media thickness (cIMT) in elderly subjects, taking traditional risk factors into account. METHODS Clinical inspection for present and past chronic conditions and events, as well as biochemical and anthropometric measurements, was performed for patients in ambulatory setting. Scores of cIMT were obtained bilaterally in the distal common carotid artery wall. Serum concentrations of cytokines were assessed by bead-based, multiplexed flow cytometry immunoassays. RESULTS Correlation analysis between log-transformed cytokines levels implicated the mediators interleukin-1β (IL1β), IL6, IL8, IL10, and tumor necrosis factor-α (TNFα) (P ≤ .005) with scores of the left cIMT. Stepwise multivariate regression showed that TNFα, IL1β, and IL6 levels accounted for most of the variance in the cIMT scores. Comparison of cytokine levels across increasing tertiles of the left cIMT reproduced the positive association with TNFα and IL1β levels. CONCLUSION Five out of ten immune mediators independently correlated with cIMT of older subjects in a territory-sensitive manner. This possible contribution of immune mediators to an atherosclerotic process probably relates to the inflammaging process.
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Affiliation(s)
| | | | - Gleim Dias Souza
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | - Lucy Gomes
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | | | | | - Cláudio Córdova
- Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
| | - Clayton Franco Moraes
- Universidade de Brasília (UnB), Brasília, Distrito Federal, Brazil; Universidade Católica de Brasília (UCB-DF), Taguatinga, Distrito Federal, Brazil
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Jansen van Vuuren A, Saling MM, Ameen O, Naidoo N, Solms M. Hand preference is selectively related to common and internal carotid arterial asymmetry. Laterality 2016; 22:377-398. [PMID: 27380444 DOI: 10.1080/1357650x.2016.1205596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study documents relationships between handedness and carotid arterial asymmetries. The article is divided into two sections, considering first geometric (n = 195) and then haemodynamic (n = 228) asymmetries. In the geometric study, diameters, lengths, and angles of the common carotid arteries in left and right-handed participants were measured using computed tomography angiography scans. Resistance to blood flow was calculated according to Poiseuille's formula. In the haemodynamic study, peak systolic and end-diastolic velocity, vessel diameter, and volume flow rate of the common, internal, and external carotid arteries were measured in left and right-handed participants, using Doppler ultrasonography. The findings reveal for the first time that the extracranial arteries supplying the cerebral hemispheres are asymmetrical in a direction that increases blood flow to the hemisphere dominant for handedness. Significant handedness interactions were identified in arterial length, diameter, resistance to blood flow, velocity and flow volume rate (p < .001). Arterial resistance and volume flow rates significantly predicted hand preference and proficiency. Our findings reveal a vascular correlate of handedness, but causality cannot be determined from this study alone. These asymmetries appear to be independent of aortic arch anomalies, suggesting a top-down, possibly demand-driven, pattern of development.
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Affiliation(s)
| | - Michael M Saling
- b Melbourne School of Psychological Sciences, University of Melbourne , Parkville , VIC , Australia.,c Florey Institute of Neurosciences and Mental Health , Melbourne , Australia
| | - Ozyar Ameen
- a Department of Psychology , University of Cape Town , Rondebosch , South Africa
| | - Nadraj Naidoo
- a Department of Psychology , University of Cape Town , Rondebosch , South Africa
| | - Mark Solms
- a Department of Psychology , University of Cape Town , Rondebosch , South Africa
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Selamet Tierney ES, Gauvreau K, Jaff MR, Gal D, Nourse SE, Trevey S, O'Neill S, Baker A, Newburger JW, Colan SD. Carotid artery intima-media thickness measurements in the youth: reproducibility and technical considerations. J Am Soc Echocardiogr 2014; 28:309-16. [PMID: 25459501 DOI: 10.1016/j.echo.2014.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Carotid artery intima-media thickness (CIMT), a marker of atherosclerosis, is increased in youth at risk for future cardiovascular disease. Some pediatric studies have used CIMT as a primary outcome in clinical trials, yet data are limited on the standardization of methodology in children. The goal of this study was to evaluate reproducibility of CIMT measurements using two different measurement techniques. METHODS Carotid artery ultrasound studies of children and adolescents obtained as a component of a research study in Kawasaki syndrome were retrospectively analyzed. The CIMTs of both common carotid arteries (CCAs) were measured by one of two sonographers at the time in the cardiac cycle when resolution subjectively was determined to be optimal (Opt-CIMT). These sonographers blindly remeasured a random sample of studies of their own and each other's, using the same method. Another observer made CIMT measurements using exclusively frames on the R wave (R-CIMT). A fourth observer independently measured a random sample of studies twice with the R-CIMT method. RESULTS Carotid artery images from 184 subjects (mean age, 14.7 ± 2.2 years) were analyzed. The intraclass correlation coefficient for interobserver variability was 0.86 (95% confidence interval [CI], 0.69-0.94) compared with 0.85 (95% CI, 0.65-0.93) for the right and 0.86 (95% CI, 0.67-0.94) versus 0.95 (95% CI, 0.87-0.98) for the left CCA for Opt-CIMT and R-CIMT, respectively. R-CIMT was significantly thicker than Opt-CIMT (right CCA, 0.439 ± 0.030 vs 0.428 ± 0.024 mm, P < .001; left CCA, 0.446 ± 0.030 vs 0.434 ± 0.025 mm, P < .001). CONCLUSION Pediatric CIMT measurements have excellent reproducibility when the same methodology is applied but vary significantly throughout the cardiac cycle. This report highlights the need to standardize CIMT measurements in the youth and supports the use of electrocardiographic timing, as recommended in adults, in pediatric longitudinal studies.
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Affiliation(s)
- Elif Seda Selamet Tierney
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California.
| | - Kimberlee Gauvreau
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Michael R Jaff
- Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dana Gal
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Susan E Nourse
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California
| | - Shari Trevey
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Stephen O'Neill
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Annette Baker
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Jane W Newburger
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Steven D Colan
- Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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9
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Lupattelli G, De Vuono S, Boni M, Helou R, Raffaele Mannarino M, Rita Roscini A, Alaeddin A, Pirro M, Vaudo G. Insulin resistance and not BMI is the major determinant of early vascular impairment in patients with morbid obesity. J Atheroscler Thromb 2013; 20:924-33. [PMID: 23903296 DOI: 10.5551/jat.18663] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Several factors contribute to the development of atherogenesis in patients with obesity. The aim of our study was to evaluate the different roles of insulin resistance, strictly correlated to visceral adiposity, and the body mass index (BMI), an estimate of overall adiposity, on early vascular impairment in patients with morbid obesity. METHODS We enrolled 65 morbidly obese subjects (BMI 44.6 ± 7 kg/m(2)) who were free of previous cardiovascular events and 28 nonobese subjects (control group) in a cross-sectional study. The presence of glycemia and insulinemia, the levels of lipids and liver parameter and the ultrasonographic assessment of the flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) and visceral fat area (VFA) were evaluated in all subjects. RESULTS In the obese patients with a median HOMA value of ≥ 3.5, the FMD was significantly lower (p < .05) and the left carotid maximum-IMT was significantly higher (p < .05) than those observed in the group with lower HOMA values. No vascular differences were found between the two groups that were subdivided according to the BMI median value. Both the left max-IMT and FMD exhibited a significant correlation with HOMA-IR ("ρ" .292, p=0.02 , "ρ"-.292, p=0.02 respectively) but not with BMI. According to a multivariate analysis, the VFA was an independent predictor of a reduced FMD (β - .541, p.002; p of the model .002), while age (β .611 p < .0001) and HOMA-IR (β .399 p < .001) were independent predictors of the left max-IMT (p of the model .002). CONCLUSIONS The HOMA-IR, which is strictly related to visceral fat and is an index of metabolic impairment, and not BMI, which reflects of global adiposity, can be used to identify early vascular impairment in patients with morbid obesity.
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Affiliation(s)
- Graziana Lupattelli
- Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia
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10
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Segmental analysis of carotid arterial strain using speckle-tracking. J Am Soc Echocardiogr 2011; 24:1276-1284.e5. [PMID: 21907541 DOI: 10.1016/j.echo.2011.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Increased arterial stiffness has been shown to be associated with aging and cardiovascular risk factors. Speckle-tracking algorithms are being used to measure myocardial strain. The aims of this study were to evaluate whether speckle-tracking could be used to measure carotid arterial strain (CAS) reproducibly in healthy volunteers and to determine if CAS was lesser in individuals with diabetes. METHODS Bilateral electrocardiographically gated ultrasound scans of the distal common carotid arteries (three cardiac cycles; 14-MHz linear probe; mean frame rate, 78.7 ± 8.9 frames/sec) were performed twice (2-4 days apart) on 10 healthy volunteers to test repeatability. Differences in CAS between healthy subjects (n = 20) and patients with diabetes (n = 21) were examined. Peak CAS was measured in each of six equal segments, and averages of all segments (i.e., the global average), of the three segments nearest the probe, and of the three segments farthest from the probe (i.e., the far wall average) were obtained. RESULTS Global CAS (intraclass correlation coefficient = 0.40) and far wall average (intraclass correlation coefficient = 0.63) had the greatest test-retest reliability. Global and far wall averaged CAS values were lower in patients with diabetes (4.29% [SE, 0.27%] and 4.30% [SE, 0.44%], respectively) than in controls (5.48% [SE, 0.29%], P = .001, and 5.58% [SE, 0.44%], P = .003, respectively). This difference persisted after adjustment for age, gender, race, and hemodynamic parameters. CONCLUSIONS Speckle-tracking to measure CAS is feasible and modestly reliable. Patients with diabetes had lower CAS obtained with speckle-tracking compared with healthy controls.
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Tajik P, Meijer R, Duivenvoorden R, Peters SAE, Kastelein JJ, Visseren FJ, Crouse JR, Palmer MK, Raichlen JS, Grobbee DE, Bots ML. Asymmetrical distribution of atherosclerosis in the carotid artery: identical patterns across age, race, and gender. Eur J Prev Cardiol 2011; 19:687-97. [PMID: 21613319 DOI: 10.1177/1741826711410821] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Small autopsy studies and clinical practice indicated that carotid atherosclerosis develops in an asymmetrical helical pattern coinciding with regions of low shear stress. We investigated the distribution of carotid atherosclerosis as determined by maximum carotid intima-media thickness (CIMT), to assess if we could confirm this atherosclerotic configuration across various populations with different cardiovascular risk. METHODS AND RESULTS We used the individual baseline CIMT data from 3364 subjects from four recent international multicentre randomized controlled trials in which the carotid artery was systematically examined using the same ultrasound protocol and method to quantify CIMT. For each subject, circumferential information on the maximum CIMT of the left and right carotid arteries was obtained for the common carotid, bifurcation, and internal carotid artery segments. In each segment (common, bifurcation, internal), mixed modelling was used to study the differences in CIMT between angles, sides, gender, age, race, and studies. Each segment showed a different circumferential CIMT pattern. In all segments there were statistically significant differences between maximum CIMT across circumferential angles (p < 0.001); on average CIMT was highest in the posteromedial wall of the bifurcation and internal carotid segments and in the anterolateral wall of the common carotid segment. This asymmetric circumferential pattern was found to be identical in men and women, in young and old age, in different race groups, and across the studies. CONCLUSIONS We confirmed the asymmetrical helix-like distribution of atherosclerosis in the carotid arteries and expand the evidence by showing that the atherosclerotic configuration is similar across populations with different vascular risks and across gender, age, and race. This has implications for future design of carotid ultrasound studies, as the angle of insonation is an important predictor of maximum CIMT.
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Affiliation(s)
- Parvin Tajik
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Latha R, Daisy P. Influence of Terminalia bellerica Roxb. Fruit Extracts on Biochemical
Parameters in Streptozotocin Diabetic Rats. INT J PHARMACOL 2010. [DOI: 10.3923/ijp.2010.89.96] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cherbuin N, Réglade-Meslin C, Kumar R, Sachdev P, Anstey KJ. Mild Cognitive Disorders are Associated with Different Patterns of Brain asymmetry than Normal Aging: The PATH through Life Study. Front Psychiatry 2010; 1:11. [PMID: 21423423 PMCID: PMC3059654 DOI: 10.3389/fpsyt.2010.00011] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 04/07/2010] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Defining how brain structures differ in pre-clinical dementia is important to better understand the pathological processes involved and to inform clinical practice. The aim of this study was to identify significant brain correlates (volume and asymmetry in volume) of mild cognitive disorders when compared to normal controls in a large community-based sample of young-old individuals who were assessed for cognitive impairment. METHODS Cortical and sub-cortical volumes were measured using a semi-automated method in 398 participants aged 64-70 years who were selected from a larger randomly sampled cohort and who agreed to undergo an MRI scan. Diagnoses were reached based on established protocols for MCI and a more inclusive category of any Mild Cognitive Disorder (any-MCD: which includes AAMI, AACD, OCD, MNC, CDR, MCI). Logistic regression analyses were used to assess the relationship between volume and asymmetry of theoretically relevant cerebral structures (predictors) and MCI or any-MCD while controlling for age, sex, and intra-cranial volume. RESULTS The main correlates of cognitive impairment assessed in multivariate analyses were hippocampal asymmetry (more to left, MCI: OR 0.83, 95%CI 0.71-0.96, p = 0.013; MCD: OR 0.86, 95%CI 0.77-0.97, p = 0.011), lateral ventricle asymmetry (more to left, MCI: OR 0.95, 95%CI 0.91-0.99, p = 0.009; MCD: OR 0.95, 95%CI 0.92-0.98, p = 0.004), and cerebellar cortex asymmetry (more to right, MCI: OR 1.51, 95%CI 1.13-2.01, p = 0.005). CONCLUSIONS In this population-based cohort stronger associations were found between asymmetry measures, rather than raw volumes in cerebral structures, and mild cognitive disorders.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Mental Health Research, Australian National University Canberra, ACT, Australia
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