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Wungu CDK, Susilo H, Alsagaff MY, Witarto BS, Witarto AP, Pakpahan C, Gusnanto A. Role of klotho and fibroblast growth factor 23 in arterial calcification, thickness, and stiffness: a meta-analysis of observational studies. Sci Rep 2024; 14:5712. [PMID: 38459119 PMCID: PMC10923819 DOI: 10.1038/s41598-024-56377-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
This meta-analysis was conducted to clarify the role of klotho and fibroblast growth factor 23 (FGF-23) in human arterial remodeling across recent studies, in terms of arterial calcification, thickness, and stiffness. A systematic literature search was conducted on five databases for articles up to December 2023. Arterial calcification, thickness, and stiffness were determined using the calcification score and artery affected, carotid intima-media thickness (CIMT), and pulse wave velocity (PWV), respectively. Sixty-two studies with a total of 27,459 individuals were included in this meta-analysis. Most studies involved chronic kidney disease patients. Study designs were mostly cross-sectional with only one case-control and nine cohorts. FGF-23 was positively correlated with arterial calcification (r = 0.446 [0.254-0.611], p < 0.0001 and aOR = 1.36 [1.09-1.69], p = 0.006), CIMT (r = 0.188 [0.02-0.354], p = 0.03), and PWV (r = 0.235 [0.159-0.310], p < 0.00001). By contrast, Klotho was inversely correlated with arterial calcification (r = - 0.388 [- 0.578 to - 0.159], p = 0.001) and CIMT (r = - 0.38 [- 0.53 to - 0.207], p < 0.00001). In conclusion, FGF-23 and Klotho were associated with arterial calcification, thickness, and stiffness, clarifying their role in arterial remodeling processes.
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Affiliation(s)
- Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Division of Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia.
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya, 60115, Indonesia.
| | - Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya, 60115, Indonesia
| | | | - Andro Pramana Witarto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
| | - Cennikon Pakpahan
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
| | - Arief Gusnanto
- School of Mathematics, University of Leeds, Leeds, LS2 9JT, UK
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Mian O, Santi N, Boodhwani M, Beauchesne L, Chan K, Dennie C, Wells GA, Coutinho T. Arterial Age and Early Vascular Aging, But Not Chronological Age, Are Associated With Faster Thoracic Aortic Aneurysm Growth. J Am Heart Assoc 2023; 12:e029466. [PMID: 37581401 PMCID: PMC10492926 DOI: 10.1161/jaha.122.029466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/27/2023] [Indexed: 08/16/2023]
Abstract
Background Aneurysm size is an imperfect risk assessment tool for those with thoracic aortic aneurysm (TAA). Assessing arterial age may help TAA risk stratification, as it better reflects aortic health. We sought to evaluate arterial age as a predictor of faster TAA growth, independently of chronological age. Methods and Results We examined 137 patients with TAA. Arterial age was estimated according to validated equations, using patients' blood pressure and carotid-femoral pulse wave velocity. Aneurysm growth was determined prospectively from available imaging studies. Multivariable linear regression assessed the association of chronological age and arterial age with TAA growth, and multivariable logistic regression assessed associations of chronological and arterial age with the presence of accelerated aneurysm growth (defined as growth>median in the sample). Mean±SD chronological and arterial ages were 62.2±11.3 and 54.2±24.5 years, respectively. Mean baseline TAA size and follow-up time were 45.9±4.0 mm and 4.5±1.9 years, respectively. Median (interquartile range) TAA growth was 0.31 (0.14-0.52) mm/year. Older arterial age (ß±SE for 1 year: 0.004±0.001, P<0.0001) was independently associated with faster TAA growth, while chronological age was not (P=0.083). In logistic regression, each 5-year increase in arterial age was associated with a 23% increase in the odds of accelerated TAA growth (95% CI, 1.085-1.394; P=0.001). Conclusions Arterial age is independently associated with accelerated aneurysm expansion, while chronological age is not. Our results highlight that a noninvasive and inexpensive assessment of arterial age can potentially be useful for TAA risk stratification and disease monitoring as compared with the current clinical standard (chronological age).
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Affiliation(s)
- Owais Mian
- Department of Internal MedicineUniversity of TorontoOntarioCanada
| | - Nicolas Santi
- Division of CardiologyUniversity of TorontoOntarioCanada
| | - Munir Boodhwani
- Division of Cardiac SurgeryUniversity of Ottawa Heart InstituteOntarioCanada
| | - Luc Beauchesne
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
| | - Kwan‐Leung Chan
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
| | - Carole Dennie
- Department of RadiologyThe Ottawa HospitalOntarioCanada
| | - George A. Wells
- School of Epidemiology and Public HealthUniversity of OttawaOntarioCanada
- Cardiovascular Research Methods CentreUniversity of Ottawa Heart InstituteOntarioCanada
| | - Thais Coutinho
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOntarioCanada
- Division of Cardiac Prevention and RehabilitationUniversity of Ottawa Heart InstituteOntarioCanada
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Hajdusianek W, Żórawik A, Poręba R, Gać P. Assessment of aortic stiffness in computed tomography - methodology of radiological examination from 2000 to 2020. Pol J Radiol 2022; 87:e635-e640. [PMID: 36532246 PMCID: PMC9749780 DOI: 10.5114/pjr.2022.121556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION Vascular elasticity may be a predictive factor of various diseases. Although stiffening is thought to be a natural consequence of ageing, it can be accelerated by a number of pathological conditions such as hypertension, diabetes, or renal diseases. Aim of the study was to discuss the methodology used to assess aortic stiffness, with particular emphasis on radiological examination. MATERIAL AND METHODS The PubMed and Google Scholar databases were screened from inception to the year 2000 by 2 independent analysts initially working separately and then comparing their results. RESULTS Assessment of stiffness can be divided into methods not requiring computed tomography scan, such as tonometry of carotid femoral pulse wave velocity, bioelectrical impedance analysis, and cardio ankle vascular index, and methods requiring it, such as multidetector row computed tomography - ECG gated, in which indexes such as aortic distensibility, aortic stiffness, and aortic compliance can be obtained with simultaneous calcification evaluation based on the Agatston score. DISCUSSION Aortic stiffness was corelated with left ventricular afterload, prehypertension, coronary artery plaques, prediction of coronary artery diseases, bone demineralization, chronic obstructive pulmonary diseases, and diabetes mellitus. CONCLUSIONS Being a factor of various severe diseases, aortic stiffness may play an important role in the early detection of patients requiring additional medical care.
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Affiliation(s)
- Wojciech Hajdusianek
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Żórawik
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Paweł Gać
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Wroclaw, Poland
- Centre for Diagnostic Imaging, 4 Military Hospital in Wroclaw, Wroclaw, Poland
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Aydemir D, Salman N, Karimzadehkhouei M, Alaca BE, Turan B, Ulusu NN. Evaluation of the Effects of Aging on the Aorta Stiffness in Relation with Mineral and Trace Element Levels: an Optimized Method via Custom-Built Stretcher Device. Biol Trace Elem Res 2021; 199:2644-2652. [PMID: 32918713 DOI: 10.1007/s12011-020-02380-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/07/2020] [Indexed: 01/03/2023]
Abstract
Aortic stiffness represents the major cause of aging and tightly associated with hypertension, atherosclerosis, cardiovascular diseases, and increased mortality. Mechanical characteristics of the aorta play a vital role in the blood flow, circulation, systolic pressure, and aortic stiffness; however, the correlation of trace element and mineral levels with aortic stiffness has not been studied before. Balance in the trace elements and minerals is vital for the biological functions; however, natural aging may alter this balance. Thus, after measuring aortic stiffness of aged and young rat aortas by a custom-built stretcher device, trace element and mineral levels were evaluated via ICP-MS. Also, biomarkers of aging including blood pressure, arterial pressure glucose, insulin levels, and histochemical parameters were investigated as well. Aortic stiffness, blood glucose, plasma insulin, systolic, diastolic, and mean arterial pressure significantly increased by aging in the aorta of aged rats compared with the young ones. Also, Fe, Al, Co, Ni, Zn, Sr, Na, Mg, and K levels increased in the aged aorta samples compared with the young aorta samples of rats. Increased levels of the indicated elements may be correlated with the development and progression of aortic stiffness and vascular complications. Thus, possible mechanisms correlating aortic stiffness with the imbalance in the trace element and mineral levels should be further investigated.
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Affiliation(s)
- Duygu Aydemir
- School of Medicine, Department of Medical Biochemistry, Koç University, Sariyer, 34450, Istanbul, Turkey
- Koç University Research Center for Translational Medicine (KUTTAM), Sariyer, 34450, Istanbul, Turkey
| | - Naveed Salman
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - Mehrdad Karimzadehkhouei
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - B Erdem Alaca
- Department of Mechanical Engineering, Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
- Surface Science and Technology Center (KUYTAM), Koç University, Rumelifeneri Yolu, Sariyer, 34450, Istanbul, Turkey
| | - Belma Turan
- Faculty of Medicine, Department of Biophysics, Ankara University, 06100, Ankara, Turkey
| | - Nuriye Nuray Ulusu
- School of Medicine, Department of Medical Biochemistry, Koç University, Sariyer, 34450, Istanbul, Turkey.
- Koç University Research Center for Translational Medicine (KUTTAM), Sariyer, 34450, Istanbul, Turkey.
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Ohba H, Ohbayashi N, Fukuda H, Yahara K, Nabika S, Suto Y, Tokuda N, Yoshida K, Nakaoka M, Sakamoto S. Predictors of Reperfusion and 90-day Functional Outcome After Mechanical Thrombectomy for Large Vessel Occlusion Strokes. J Stroke Cerebrovasc Dis 2021; 30:105687. [PMID: 33657521 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/13/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Whether elderly patients with adverse comorbidities or strong vascular meandering benefit from mechanical thrombectomy to the same degree as patients who participated in the pivotal randomized controlled trials on this procedure (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, REVASCAT, DAWN, and DEFUSE 3) remains unknown. We aimed to investigate the predictors of reperfusion and 90-day functional outcome using real-world clinical data, without excluding elderly patients with adverse comorbidities or patients in whom vascular access could not be achieved. MATERIALS AND METHODS We retrospectively reviewed consecutive patients with acute ischemic stroke who underwent or in whom mechanical thrombectomy was attempted at Japanese Red Cross Matsue Hospital from April 2015 to June 2020. RESULTS Altogether, 111 mechanical thrombectomies in 111 patients (average age 77.2 years) were attempted for acute ischemic stroke. Vascular access was not achieved in 8 (7.2%) cases. In the multivariable analysis, age ≥85 years (odd ratio [OR] 0.191, 95% confidence interval [CI] 0.057-0.641, p = 0.007) and presence of adverse comorbidities (OR 0.265, 95% CI 0.090-0.659, p = 0.016) were associated with failed reperfusion. The diffusion-weighted imaging (DWI)-ASPECT score ≥6 (OR 4.650, 95% CI 1.610-13.40, p = 0.005) was associated with good 90-day functional outcomes. Presence of adverse comorbidities was not a predictor, but it had a relatively strong correlation with poor functional outcome. CONCLUSIONS Mechanical thrombectomy in elderly patients should be considered very carefully if they are aged ≥85 years, have low DWI-ASPECT score and have clear evidence of pre-existing adverse comorbidities.
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Affiliation(s)
- Hideo Ohba
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Naohiko Ohbayashi
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Hiroki Fukuda
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Kaita Yahara
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Shinya Nabika
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Yutaka Suto
- Department of Neurology, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Naoki Tokuda
- Department of Neurology, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Kentaro Yoshida
- Department of Neurology, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Mitsuo Nakaoka
- Department of Neurosurgery, Japanese Red Cross Matsue Hospital, Matsue, Japan.
| | - Shigeyuki Sakamoto
- Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
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