1
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Shokoples BG, Berillo O, Comeau K, Chen HY, Higaki A, Caillon A, Ferreira NS, Engert JC, Thanassoulis G, Paradis P, Schiffrin EL. P2RX7 gene knockout or antagonism reduces angiotensin II-induced hypertension, vascular injury and immune cell activation. J Hypertens 2023; 41:1701-1712. [PMID: 37796207 DOI: 10.1097/hjh.0000000000003520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Extracellular ATP is elevated in hypertensive mice and humans and may trigger immune activation through the purinergic receptor P2X7 (P2RX7) causing interleukin-1β production and T-cell activation and memory T-cell development. Furthermore, P2RX7 single nucleotide polymorphisms (SNP) are associated with hypertension. We hypothesized that P2RX7 activation contributes to hypertension and cardiovascular injury by promoting immune activation. METHODS Male wild-type and P2rx7-/- mice were infused or not with angiotensin II (AngII) for 14 days. A second group of AngII-infused wild-type mice were co-infused with the P2RX7 antagonist AZ10606120 or vehicle. BP was monitored by telemetry. Cardiac and mesenteric artery function and remodeling were assessed using ultrasound and pressure myography, respectively. T cells were profiled in thoracic aorta/perivascular adipose tissue by flow cytometry. Associations between SNPs within 50 kb of P2RX7 transcription, and BP or hypertension were modeled in 384 653 UK Biobank participants. RESULTS P2rx7 inactivation attenuated AngII-induced SBP elevation, and mesenteric artery dysfunction and remodeling. This was associated with decreased perivascular infiltration of activated and effector memory T-cell subsets. Surprisingly, P2rx7 knockout exaggerated AngII-induced cardiac dysfunction and remodeling. Treatment with a P2RX7 antagonist reduced BP elevation, preserved mesenteric artery function and reduced activated and effector memory T cell perivascular infiltration without adversely affecting cardiac function and remodeling in AngII-infused mice. Three P2RX7 SNPs were associated with increased odds of DBP elevation. CONCLUSION P2RX7 may represent a target for attenuating BP elevation and associated vascular damage by decreasing immune activation.
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Affiliation(s)
- Brandon G Shokoples
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - Olga Berillo
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - Kevin Comeau
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - Hao Yu Chen
- Preventive and Genomic Cardiology, McGill University Health Centre Research Institute
| | - Akinori Higaki
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - Antoine Caillon
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - Nathanne S Ferreira
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
| | - James C Engert
- Preventive and Genomic Cardiology, McGill University Health Centre Research Institute
- Department of Medicine, McGill University, Montreal, Canada
| | - George Thanassoulis
- Preventive and Genomic Cardiology, McGill University Health Centre Research Institute
- Department of Medicine, McGill University, Montreal, Canada
| | - Pierre Paradis
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
- Department of Medicine, McGill University, Montreal, Canada
| | - Ernesto L Schiffrin
- Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research
- Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital
- Department of Medicine, McGill University, Montreal, Canada
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2
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Onofrei VA, Zamfir CL, Anisie E, Ceasovschih A, Constantin M, Mitu F, Adam CA, Grigorescu ED, Petroaie AD, Timofte D. Determinants of Arterial Stiffness in Patients with Morbid Obesity. The Role of Echocardiography and Carotid Ultrasound Imaging. Medicina (B Aires) 2023; 59:medicina59030428. [PMID: 36984428 PMCID: PMC10053097 DOI: 10.3390/medicina59030428] [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: 01/30/2023] [Revised: 02/11/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Background and objective: Morbid obesity is accompanied by an increased cardiovascular (CV) risk, which justifies a multidisciplinary, integrative approach. Arterial stiffness has a well-defined additional role in refining individual CV risk. Given that echocardiography and carotid ultrasound are usual methods for CV risk characterization, we aimed to identify the imaging parameters with a predictive value for early-onset arterial stiffness. Material and methods: We conducted a study in which 50 patients (divided into two equal groups with morbid obesity and without obesity), age and gender matched, untreated for cardiovascular risk factors, were addressed to bariatric surgery or non-inflammatory benign pathology surgery. Before the surgical procedures, we evaluated demographics, anthropometric data and biochemical parameters including adipokines (chemerin, adiponectin). Arterial stiffness was evaluated using the Medexpert ArteriographTM TL2 device. Transthoracic echocardiography and carotid ultrasound were also performed. We also analyzed adipocyte size and vascular wall thickness in intraoperative biopsies. Results: Left ventricle (LV) mass index (p = 0.2851), LV ejection fraction (LVEF) (p = 0.0073), epicardial adipose tissue thickness (p = 0.0001) as echocardiographic parameters and carotid intima–media thickness (p = 0.0033), relative wall thickness (p = 0.0295), wall to lumen thickness ratio (p = 0.0930) and carotid cross-sectional area (p = 0.0042) as ultrasound parameters were significant measures in our groups and were assessed in relation to adipocyte size, blood vessel wall thickness and adipokines serum levels. Statistical analysis revealed directly proportional relationships between LV mass index (p = 0.008), carotid systolic thickness of the media (p = 0.009), diastolic thickness of the media (p = 0.007), cross-sectional area (p = 0.001) and blood vessel wall thickness. Carotid relative wall thickness positively correlates with adipocyte size (p = 0.023). In patients with morbid obesity, chemerin and adiponectin/chemerin ratio positively correlates with carotid intima–media thickness (p = 0.050), systolic thickness of the media (p = 0.015) and diastolic thickness of the media (p = 0.001). The multiple linear regression models revealed the role of epicardial adipose tissue thickness and carotid cross-sectional area in predicting adipocyte size which in turn is an independent factor for arterial stiffness parameters such as pulse wave velocity, subendocardial viability ratio and aortic augmentation index. Conclusions: Our results suggest that epicardial adipose tissue thickness, carotid intima–media thickness, relative wall thickness and carotid cross-sectional area might be useful imaging parameters for early prediction of arterial stiffness in patients with morbid obesity.
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Affiliation(s)
- Viviana Aursulesei Onofrei
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
- “St. Spiridon” Clinical Emergency Hospital, Independence Boulevard No. 1, 700111 Iasi, Romania
- Correspondence: (V.A.O.); (C.A.A.)
| | - Carmen Lacramioara Zamfir
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
| | - Ecaterina Anisie
- “St. Spiridon” Clinical Emergency Hospital, Independence Boulevard No. 1, 700111 Iasi, Romania
| | - Alexandr Ceasovschih
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
- “St. Spiridon” Clinical Emergency Hospital, Independence Boulevard No. 1, 700111 Iasi, Romania
| | - Mihai Constantin
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
| | - Florin Mitu
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania
- Academy of Medical Sciences, Ion C. Brătianu Boulevard No 1, 030167 Bucharest, Romania
- Academy of Romanian Scientists, Professor Dr. Doc. Dimitrie Mangeron Boulevard No. 433, 700050 Iasi, Romania
| | - Cristina Andreea Adam
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania
- Correspondence: (V.A.O.); (C.A.A.)
| | - Elena-Daniela Grigorescu
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
| | - Antoneta Dacia Petroaie
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
| | - Daniel Timofte
- Department of Medical Specialties I and II, Morpho-Functional Sciences I and Preventive Medicine and Interdisciplinary, “Grigore T. Popa” University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania
- “St. Spiridon” Clinical Emergency Hospital, Independence Boulevard No. 1, 700111 Iasi, Romania
- Academy of Medical Sciences, Ion C. Brătianu Boulevard No 1, 030167 Bucharest, Romania
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Boutouyrie P, Climie RE, Bruno RM. Type 2 Diabetes Mellitus, Interaction Between Left Ventricle and Large Arteries. Am J Hypertens 2022; 35:388-390. [PMID: 35088827 DOI: 10.1093/ajh/hpac007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pierre Boutouyrie
- Pharmacologie HEGP, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM U970, 20 rue Leblanc 75015 PARIS, France
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Rosa-Maria Bruno
- Pharmacologie HEGP, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM U970, 20 rue Leblanc 75015 PARIS, France
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Gong L, Liu Y. Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations. Int J Sports Med 2022; 43:996-1012. [PMID: 35468651 PMCID: PMC9622304 DOI: 10.1055/a-1795-2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The purpose was to analyze the effects of exercise training (ET) on arterial
stiffness in all-age overweight or obese individuals. Sixty-one trials were
included with ET improving flow-mediated dilation (FMD), pulse wave velocity
(PWV), and intima-media thickness (IMT). In the subgroup analysis: (i) ET
improved FMD in overweight or obese children and adolescents with a large effect
size (SMD=0.83, 95% CI 0.42–1.25). PWV was decreased
after ET regardless of age. IMT was decreased by ET in participants younger than
60, (ii) ET improved FMD, PWV, and IMT in participants whose BMI were smaller
than 30 kg/m
2
, but ET only improved PWV of
participants whose BMI were larger than 30 kg/m
2
.
(iii) AE improved FMD, PWV, and IMT. High-intensity interval training (HIIT)
decreased IMT. (iv) The increase of FMD only happened when training duration was
longer than eight weeks. However, ET decreased PWV when the training duration
was no longer than 12 weeks. IMT was decreased when the training duration was
longer than eight weeks. ET instigated an improvement in endothelial function
and arterial stiffness in overweight or obese populations, but depending on the
different characteristics of exercise intervention and participants’
demographics.
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Affiliation(s)
- Lijing Gong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China
| | - Yujia Liu
- Physical education, Jiangsu Normal University, Xuzhou, China
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Qin Z, Liu D, You X, Duan Q, Zhao Y. Evaluating Impact of Pulse Pressure on Indexes of Myocardial Work by Speckle-Tracking Echocardiography in Normotensive, Prehypertensive and Newly Diagnosed Hypertensive Patients. Int J Gen Med 2022; 15:1933-1943. [PMID: 35228817 PMCID: PMC8882027 DOI: 10.2147/ijgm.s351628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background The impact of pulse pressure (PP) on indexes of myocardial work (MWIs). This study aims to explore the potential association of high PP with myocardial work (MW). Hypothesis PP had an association with four indexes of MW in a mixed population of normotensive, prehypertensive and newly diagnosed hypertensive individuals. Methods The study was a single-center, cross-sectional, observational study. A total of 204 participants (66 normotensive, 35 prehypertensive and 103 newly diagnosed hypertensive individuals) were evaluated by speckle-tracking echocardiography (STE) and blood pressure measurement. According to the PP tertiles, the participants were divided into three groups: Group I (<44 mmHg, n=67), Group II (44–52 mmHg, n=68) and Group III (≥52 mmHg, n=69). Results In Group II and Group III, the proportion of males was higher than that in Group I (median 46 vs 30 (P=0.002)). With increasing PP, the three indexes of MW, namely, GWI, GCW and GWW, increased, and the differences among the three groups were statistically significant (P<0.001). PP was positively related to GWI, GCW and GWW and negatively correlated with GWE. After adjusting for E/e’, LVMI, LAVI and GLS, PP was still significantly correlated with the four MW indexes (both P<0.001). Conclusion PP had a strong association with four indexes of MW in a mixed population of normotensive, prehypertensive and newly diagnosed hypertensive individuals. The evaluation of PP and MWIs might be valuable for identifying very early diastolic impairment of the heart.
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Affiliation(s)
- Zheng Qin
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Dawei Liu
- Department of Cardiovascular Medicine, The Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People’s Republic of China
| | - Xiaojun You
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Qin Duan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Correspondence: Qin Duan, Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email
| | - Yu Zhao
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Yu Zhao, Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email
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6
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Dimitroulas T, Anyfanti P, Bekiari E, Angeloudi E, Pagkopoulou E, Kitas G. Arterial stiffness in rheumatoid arthritis: Current knowledge and future perspectivess. INDIAN JOURNAL OF RHEUMATOLOGY 2022. [DOI: 10.4103/injr.injr_254_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Vatner SF, Zhang J, Vyzas C, Mishra K, Graham RM, Vatner DE. Vascular Stiffness in Aging and Disease. Front Physiol 2021; 12:762437. [PMID: 34950048 PMCID: PMC8688960 DOI: 10.3389/fphys.2021.762437] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/26/2021] [Indexed: 01/01/2023] Open
Abstract
The goal of this review is to provide further understanding of increased vascular stiffness with aging, and how it contributes to the adverse effects of major human diseases. Differences in stiffness down the aortic tree are discussed, a topic requiring further research, because most prior work only examined one location in the aorta. It is also important to understand the divergent effects of increased aortic stiffness between males and females, principally due to the protective role of female sex hormones prior to menopause. Another goal is to review human and non-human primate data and contrast them with data in rodents. This is particularly important for understanding sex differences in vascular stiffness with aging as well as the changes in vascular stiffness before and after menopause in females, as this is controversial. This area of research necessitates studies in humans and non-human primates, since rodents do not go through menopause. The most important mechanism studied as a cause of age-related increases in vascular stiffness is an alteration in the vascular extracellular matrix resulting from an increase in collagen and decrease in elastin. However, there are other mechanisms mediating increased vascular stiffness, such as collagen and elastin disarray, calcium deposition, endothelial dysfunction, and the number of vascular smooth muscle cells (VSMCs). Populations with increased longevity, who live in areas called “Blue Zones,” are also discussed as they provide additional insights into mechanisms that protect against age-related increases in vascular stiffness. Such increases in vascular stiffness are important in mediating the adverse effects of major cardiovascular diseases, including atherosclerosis, hypertension and diabetes, but require further research into their mechanisms and treatment.
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Affiliation(s)
- Stephen F Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Jie Zhang
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Christina Vyzas
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Kalee Mishra
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Robert M Graham
- Victor Chang Cardiac Research Institute, University of New South Wales, Darlinghurst, NSW, Australia
| | - Dorothy E Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
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8
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Laurent S, Chatellier G, Azizi M, Calvet D, Choukroun G, Danchin N, Delsart P, Girerd X, Gosse P, Khettab H, London G, Mourad JJ, Pannier B, Pereira H, Stephan D, Valensi P, Cunha P, Narkiewicz K, Bruno RM, Boutouyrie P. SPARTE Study: Normalization of Arterial Stiffness and Cardiovascular Events in Patients With Hypertension at Medium to Very High Risk. Hypertension 2021; 78:983-995. [PMID: 34455813 PMCID: PMC8415523 DOI: 10.1161/hypertensionaha.121.17579] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Supplemental Digital Content is available in the text. The SPARTE study (Strategy for Preventing cardiovascular and renal events based on ARTErial stiffness; URL: https://www.clinicaltrials.gov; Unique identifier: NCT02617238) is a multicenter open-label randomized controlled trial with blinded end point evaluation, undertaken at 25 French research centers in university hospitals. Patients with primary hypertension were randomly assigned (1:1) to a therapeutic strategy targeting the normalization of carotid-femoral pulse wave velocity (PWV) measured every 6 months (PWV group, n=264) versus a classical therapeutic strategy only implementing the European Guidelines for Hypertension Treatment (conventional group, n=272). In the PWV group, the therapeutic strategy used preferably a combination of ACE (angiotensin-converting enzyme) inhibitor or angiotensin receptor blocker and calcium channel blockers, as well as maximal recommended doses of ACE inhibitors and angiotensin receptor blockers. The primary outcome was a combined end point including particularly stroke and coronary events. Secondary outcomes included the time-course changes in brachial office blood pressure (BP), ambulatory BP, PWV, and treatments. After a median follow-up of 48.3 months, there was no significant between-group difference in primary outcome (hazard ratio, 0.74 [95% CI, 0.40–1.38], P=0.35). In the PWV group, combinations of renin-angiotensin-system blockers and calcium channel blockers were prescribed at higher dosage (P=0.028), office and ambulatory systolic blood pressure and diastolic blood pressure decreased more (P<0.001 and P<0.01, respectively), and PWV increased less (P=0.0003) than in the conventional group. The SPARTE study lacked sufficient statistical power to demonstrate its primary outcome. However, it demonstrated that a PWV-driven treatment for hypertension enables to further reduce office and ambulatory systolic blood pressure and diastolic blood pressure and prevent vascular aging in patients with hypertension at medium-to-very-high risk, compared with strict application of guidelines.
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Affiliation(s)
- Stephane Laurent
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.)
| | - Gilles Chatellier
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Clinical Research Unit, INSERM U970, Paris (G. Chatellier, H.P.)
| | - Michel Azizi
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Hypertension Department and DMU CARTE, Paris, France (M.A.).,INSERM, CIC1418, Paris, France (M.A.)
| | - David Calvet
- Neurology department, GHU Paris Psychiatrie Neurosciences, Sainte-Anne Hospital (D.C.).,INSERM UMR 1266, FHU NeuroVasc, Paris, France (D.C.)
| | - Gabriel Choukroun
- Nephrology Dialysis Transplantation Department, CHU Amiens, France (G. Choukroun).,MP3CV Research Unit, University Picardie Jules Verne, France (G. Choukroun)
| | - Nicolas Danchin
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Cardiology Department, Georges Pompidou Hospital, Paris, France (N.D.)
| | | | - Xavier Girerd
- ICAN, Sorbonne University, Assistance-Publique Hopitaux de Paris, Paris, France (X.G.)
| | - Philippe Gosse
- Cardiology Department, Saint Andre Hospital, CHU Bordeaux, France (P.G.)
| | - Hakim Khettab
- Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
| | - Gerard London
- Department of Nephrology, Manhes Hospital, Fleury Merogis, France(G.L.)
| | | | - Bruno Pannier
- Department of Internal Medicine, Manhes Hospital, Fleury Merogis, France (B.P.)
| | - Helena Pereira
- Clinical Research Unit, INSERM U970, Paris (G. Chatellier, H.P.)
| | - Dominique Stephan
- University of Strasbourg, France (D.S.).,UMR 1260, INSERM-University of Strasbourg, France (D.S.)
| | - Paul Valensi
- Unit of Endocrinology-Diabetology-Nutrition, Assistance-Publique Hopitaux de Paris, Jean Verdier Hospital, University Sorbonne Paris Cite, Bondy, France (P.V.)
| | - Pedro Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Guimaraes, Portugal (P.C.).,Life and Health Research Institute (ICVS/3B's), Minho University, Portugal (P.C.)
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Debinki, Gdansk, Poland (K.N.)
| | - Rosa-Maria Bruno
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
| | - Pierre Boutouyrie
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
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Laurent S, Boutouyrie P. Arterial Stiffness and Hypertension in the Elderly. Front Cardiovasc Med 2020; 7:544302. [PMID: 33330638 PMCID: PMC7673379 DOI: 10.3389/fcvm.2020.544302] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Abstract
Hypertension prevalence increases with age. Age and high blood pressure are the two main determinants of arterial stiffness. In elderly hypertensives, large arteries stiffen and systolic and pulse pressures increase, due to wave reflections. A major reason for measuring arterial stiffness in clinical practice in elderly hypertensive patients comes from the repeated demonstration that arterial stiffness and wave reflections have a predictive value for CV events. A large body of evidence has been published during the last two decades, concerning the epidemiology, pathophysiology, and pharmacology of large arteries in hypertension in various settings of age. Particularly, two expert consensus documents have reviewed the methodological agreements for measuring arterial stiffness. The concepts of Early Vascular Aging (EVA) and Supernormal Vascular Aging (SUPERNOVA) help to better understand on which determinants of arterial stiffness it is possible to act, in order to limit target organ damage and cardiovascular complications. This review will address the issues of the cellular and molecular mechanisms of arterial stiffening in elderly hypertensives, the consequences of arterial stiffening on central systolic and pulse (systolic minus diastolic, PP) pressures and target organs, the methodology for measuring arterial stiffness, central pulse pressure and wave reflection, the epidemiological determinants of arterial stiffening in elderly hypertensives, the pharmacology of arterial destiffening, and how the concepts of EVA and SUPERNOVA apply to the detection of organ damage and prevention of CV complications.
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Affiliation(s)
- Stéphane Laurent
- Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
- PARCC-INSERM U970, Paris, France
- Department of Pharmacology and Hôpital Européen Georges Pompidou, Paris, France
| | - Pierre Boutouyrie
- Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
- PARCC-INSERM U970, Paris, France
- Department of Pharmacology and Hôpital Européen Georges Pompidou, Paris, France
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Flahault A, Oliveira Fernandes R, De Meulemeester J, Ravizzoni Dartora D, Cloutier A, Gyger G, El-Jalbout R, Bigras JL, Luu TM, Nuyt AM. Arterial Structure and Stiffness Are Altered in Young Adults Born Preterm. Arterioscler Thromb Vasc Biol 2020; 40:2548-2556. [PMID: 32847389 DOI: 10.1161/atvbaha.120.315099] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Preterm birth has been associated with changes in arterial structure and function. Association with complications occurring during the neonatal period, including bronchopulmonary dysplasia, on vascular outcomes in adulthood is unknown. Approach and Results: We evaluated a cohort of 86 adults born preterm (below 30 weeks of gestation), compared to 85 adults born term, at a mean age of 23 years. We performed ultrasonographic assessment of the dimensions of the ascending aorta, carotid and brachial arteries, and estimated flow-mediated dilation, carotid-femoral pulse wave velocity, augmentation index corrected for heart rate, and carotid intima-media thickness. All analyses were performed with and without adjustment for potential confounding variables, including height, sex, and body mass index. Ascending aorta diameter in diastole was smaller in the preterm group, but carotid and brachial arteries were similar. Carotid and brachial strain, a marker of arterial distensibility, was smaller in the preterm group, while carotid-femoral pulse wave velocity, was similar between groups, indicating similar aortic stiffness. Carotid intima-media thickness, endothelial function flow-mediated dilation, blood nitrite, and nitrate levels were similar between groups. Individuals with bronchopulmonary dysplasia had lower brachial artery strain suggesting long-term association of this neonatal complication with vascular structure. Diastolic blood pressure was higher in the preterm group and was associated with decreased brachial and carotid distensibility. CONCLUSIONS Young adults born preterm display alterations in arterial distensibility that are associated with a history of bronchopulmonary dysplasia.
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Affiliation(s)
- Adrien Flahault
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Rafael Oliveira Fernandes
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Julie De Meulemeester
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada.,Department of Pediatrics, Ghent University Hospital, Belgium (J.D.M.)
| | - Daniela Ravizzoni Dartora
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Anik Cloutier
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Geneviève Gyger
- Department of Medicine, Faculty of Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada (G.G.)
| | - Ramy El-Jalbout
- Department of Radiology (R.E.-J.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Jean-Luc Bigras
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
| | - Anne Monique Nuyt
- Department of Pediatrics (A.F., R.O.F., J.D.M., D.R.D., A.C., J.-L.B., T.M.L., A.M.N.), Faculty of Medicine, Sainte-Justine University Hospital and Research Center, Université de Montréal, Quebec, Canada
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11
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Berillo O, Huo KG, Fraulob-Aquino JC, Richer C, Briet M, Boutouyrie P, Lipman ML, Sinnett D, Paradis P, Schiffrin EL. Circulating let-7g-5p and miR-191-5p Are Independent Predictors of Chronic Kidney Disease in Hypertensive Patients. Am J Hypertens 2020; 33:505-513. [PMID: 32115655 DOI: 10.1093/ajh/hpaa031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/15/2019] [Accepted: 02/25/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hypertension (HTN) is associated with target organ damage such as cardiac, vascular, and kidney injury. Several studies have investigated circulating microRNAs (miRNAs) as biomarkers of cardiovascular disease, but few have examined them as biomarker of target organ damage in HTN. We aimed to identify circulating miRNAs that could serve as biomarkers of HTN-induced target organ damage using an unbiased approach. METHODS AND RESULTS Fifteen normotensive subjects, 16 patients with HTN, 15 with HTN associated with other features of the metabolic syndrome (MetS), and 16 with HTN or chronic kidney disease (CKD) were studied. Circulating RNA extracted from platelet-poor plasma was used for small RNA sequencing. Differentially expressed (DE) genes were identified with a threshold of false discovery rate <0.1. DE miRNAs were identified uniquely associated with HTN, MetS, or CKD. However, only 2 downregulated DE miRNAs (let-7g-5p and miR-191-5p) could be validated by reverse transcription-quantitative PCR. Let-7g-5p was associated with large vessel stiffening, miR-191-5p with MetS, and both miRNAs with estimated glomerular filtration rate (eGFR) and neutrophil and lymphocyte fraction or number and neutrophil-to-lymphocyte ratio. Using the whole population, stepwise multiple linear regression generated a model showing that let-7g-5p, miR-191-5p, and urinary albumin/creatinine ratio predicted eGFR with an adjusted R2 of 0.46 (P = 8.5e-7). CONCLUSIONS We identified decreased circulating let-7g-5p and miR-191-5p as independent biomarkers of CKD among patients with HTN, which could have pathophysiological and therapeutic implications.
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Affiliation(s)
- Olga Berillo
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Ku-Geng Huo
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Júlio C Fraulob-Aquino
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Chantal Richer
- Division of Hematology-Oncology, Research Center, CHU Sainte-Justine, Montréal, Canada
| | - Marie Briet
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
- INSERM U1083, CNRS UMR 6214, Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d’Angers, Université d’Angers, Angers, France
| | - Pierre Boutouyrie
- Department of Pharmacology, Université Paris-Descartes, INSERM U970 and Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Mark L Lipman
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
- Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Canada
| | - Daniel Sinnett
- Division of Hematology-Oncology, Research Center, CHU Sainte-Justine, Montréal, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Pierre Paradis
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Ernesto L Schiffrin
- Vascular and Hypertension Research Unit, Lady Davis Institute for Medical Research, Montréal, Canada
- Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Canada
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12
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The Role of Vascular Smooth Muscle Cells in Arterial Remodeling: Focus on Calcification-Related Processes. Int J Mol Sci 2019; 20:ijms20225694. [PMID: 31739395 PMCID: PMC6888164 DOI: 10.3390/ijms20225694] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/31/2019] [Accepted: 11/08/2019] [Indexed: 12/22/2022] Open
Abstract
Arterial remodeling refers to the structural and functional changes of the vessel wall that occur in response to disease, injury, or aging. Vascular smooth muscle cells (VSMC) play a pivotal role in regulating the remodeling processes of the vessel wall. Phenotypic switching of VSMC involves oxidative stress-induced extracellular vesicle release, driving calcification processes. The VSMC phenotype is relevant to plaque initiation, development and stability, whereas, in the media, the VSMC phenotype is important in maintaining tissue elasticity, wall stress homeostasis and vessel stiffness. Clinically, assessment of arterial remodeling is a challenge; particularly distinguishing intimal and medial involvement, and their contributions to vessel wall remodeling. The limitations pertain to imaging resolution and sensitivity, so methodological development is focused on improving those. Moreover, the integration of data across the microscopic (i.e., cell-tissue) and macroscopic (i.e., vessel-system) scale for correct interpretation is innately challenging, because of the multiple biophysical and biochemical factors involved. In the present review, we describe the arterial remodeling processes that govern arterial stiffening, atherosclerosis and calcification, with a particular focus on VSMC phenotypic switching. Additionally, we review clinically applicable methodologies to assess arterial remodeling and the latest developments in these, seeking to unravel the ubiquitous corroborator of vascular pathology that calcification appears to be.
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13
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Ouyang A, Olver TD, Emter CA, Fleenor BS. Chronic exercise training prevents coronary artery stiffening in aortic-banded miniswine: role of perivascular adipose-derived advanced glycation end products. J Appl Physiol (1985) 2019; 127:816-827. [PMID: 31295062 DOI: 10.1152/japplphysiol.00146.2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Heart failure (HF) is associated with increased large conduit artery stiffness and afterload resulting in stiffening of the coronary arteries. Perivascular adipose tissue (PVAT) and advanced glycation end products (AGE) both promote arterial stiffness, yet the mechanisms by which coronary PVAT promotes arterial stiffness and the efficacy of exercise to prevent coronary stiffness are unknown. We hypothesized that both chronic continuous and interval exercise training would prevent coronary PVAT-mediated AGE secretion and arterial stiffness. Yucatan miniature swine were divided into four groups: control-sedentary (CON), aortic banded sedentary-heart failure (HF), aortic banded HF-continuous exercise trained (HF+CONT), and aortic banded HF-interval exercise trained (HF+IT). The left circumflex and right coronary arteries underwent ex vivo mechanical testing, and arterial AGE, elastin, and collagen were assessed. Coronary elastin elastic modulus (EEM) and elastin protein were lower and AGE was increased with HF compared with CON, which was prevented by both HF+CONT and HF+IT. Mouse aortic segments treated with swine coronary PVAT conditioned medium had lower EEM and elastin content and greater AGE secretion and arterial AGE accumulation in HF compared with CON, which was prevented by both HF+CONT and HF+IT. Aminoguanidine (AMG), an AGE inhibitor, prevented the reduction in EEM, arterial elastin content, and AGE accumulation in mouse aortic segments treated with PVAT conditioned medium in the HF group. Our data demonstrate efficacy for chronic continuous and interval exercise to prevent coronary artery stiffness via inhibition of PVAT-derived AGE secretion in a preclinical miniswine model of pressure overload-induced HF.NEW & NOTEWORTHY Our findings show that chronic continuous and interval exercise training regimens prevent coronary artery stiffness associated with inhibition of perivascular adipose tissue-derived advanced glycation end products in a translational pressure overload-induced heart failure model potentially providing an effective therapeutic option for heart failure patients.
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Affiliation(s)
- An Ouyang
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - T Dylan Olver
- Department of Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Bradley S Fleenor
- Human Performance Laboratory, School of Kinesiology, Ball State University, Muncie, Indiana
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14
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Larstorp ACK, Stokke IM, Kjeldsen SE, Hecht Olsen M, Okin PM, Devereux RB, Wachtell K. Antihypertensive therapy prevents new-onset atrial fibrillation in patients with isolated systolic hypertension: the LIFE study. Blood Press 2019; 28:317-326. [PMID: 31259628 DOI: 10.1080/08037051.2019.1633905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: Atrial fibrillation (AF) is associated with increased cardiovascular risk and the incidence increases with age, hypertension and left ventricular hypertrophy (LVH). Reducing in-treatment systolic blood pressure (SBP) prevents new-onset AF but has previously not been studied in patients with isolated systolic hypertension (ISH). We aimed to investigate the effect on preventing new-onset AF by decreased in-treatment SBP in patients with ISH compared to patients with non-ISH. Methods and results: Double-blind, randomized, parallel-group study of 1320 patients with ISH and electrocardiographic (ECG) LVH, included among the 9193 patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Annual ECGs were Minnesota coded centrally, and new-onset AF was evaluated in 1248 ISH patients and compared with 7583 non-ISH patients during mean 4.8 ± 0.9 years follow-up. Cox regression analyses were used to assess the effect of reduced in-treatment SBP. New-onset AF occurred in 61 (4.9%) ISH patients and 292 (3.9%) non-ISH patients. In multivariate analysis lower in-treatment SBP was associated with 17% risk reduction (p = 0.008) for new-onset AF in ISH patients and 9% risk reduction (p = 0.006) in non-ISH patients per 10 mmHg decrease in in-treatment SBP, independent of treatment modality, baseline risk factors, baseline SBP and in-treatment heart rate and ECG-LVH. There was a significant interaction (p = 0.041) in favor of SBP reduction and AF prevention in ISH vs. non-ISH patients. Conclusion: Our data suggest that the effect of in-treatment SBP reduction in preventing new-onset AF is stronger in ISH compared to non-ISH patients with hypertension and ECG-LVH. However, the principal findings were the same in ISH and non-ISH patients.
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Affiliation(s)
- Anne C K Larstorp
- Departments of Medical Biochemistry and Cardiology, Oslo University Hospital, University of Oslo , Oslo , Norway
| | - Ildri M Stokke
- Departments of Medical Biochemistry and Cardiology, Oslo University Hospital, University of Oslo , Oslo , Norway
| | - Sverre E Kjeldsen
- Departments of Medical Biochemistry and Cardiology, Oslo University Hospital, University of Oslo , Oslo , Norway
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital, and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital , Odense , Denmark
| | - Peter M Okin
- Greenberg Division of Cardiology, Weill Cornell Medicine , New York , NY , USA
| | - Richard B Devereux
- Greenberg Division of Cardiology, Weill Cornell Medicine , New York , NY , USA
| | - Kristian Wachtell
- Departments of Medical Biochemistry and Cardiology, Oslo University Hospital, University of Oslo , Oslo , Norway
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15
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Fujisue K, Tokitsu T, Yamamoto E, Sueta D, Takae M, Nishihara T, Oike F, Usuku H, Ito M, Motozato K, Kanazawa H, Araki S, Arima Y, Takashio S, Izumiya Y, Suzuki S, Sakamoto K, Kaikita K, Tsujita K. Prognostic significance of polyvascular disease in heart failure with preserved left ventricular ejection fraction. Medicine (Baltimore) 2019; 98:e15959. [PMID: 31305390 PMCID: PMC6641821 DOI: 10.1097/md.0000000000015959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The prognostic significance of systemic atherothrombosis in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the relation between the presence of polyvascular disease (PVD) and cardiovascular outcomes in HFpEF patients.A total of 510 consecutive HFpEF patients were prospectively observed for up to 1500 days or until occurrence of cardiovascular events. PVD was defined as ≥2 coexistence of coronary artery disease, peripheral arterial disease, and cerebrovascular disease.Overall, 124 cardiovascular events were observed during follow-up (median: 1430 days). Kaplan-Meier curve showed HFpEF with PVD (n = 84) experienced more cardiovascular events than did those without PVD patients (44.0% vs 20.4%, log-rank: P < .001). Multivariable Cox proportional hazards analysis with significant factors from univariate analysis showed the presence of PVD (hazard ratio [HR]: 2.875, 95% [CI]: 1.894-4.365, P < .001), previous HF hospitalization (HR: 1.578, 95% CI: 1.031-2.414, P = .036), hemoglobin (HR: 0.889, 95% CI: 0.805-0.983, P = .021), serum sodium (HR: 0.946, 95% CI 0.896-1.000, P = .048), ln-BNP (per 1.0, HR: 1.255, 95% CI: 1.055-1.494, P = .010), and E/e' (HR: 1.047, 95% CI: 1.020-1.075, P < .001) significantly predicted future cardiovascular events. Multivariable Cox hazard analysis with 4 established factors (age, BNP, diabetes mellitus, and previous HF hospitalization) from the I-PRESERVE (Irbesartan in HFpEF) study showed PVD was independently associated with cardiovascular events in HFpEF patients (HR: 2.562, 95% CI: 1.715-3.827, P < .001).The presence of PVD is significantly associated with cardiovascular events in HFpEF, suggesting the importance of screening PVD in HFpEF.
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Affiliation(s)
- Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Takanori Tokitsu
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Masafumi Takae
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Taiki Nishihara
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Miwa Ito
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Kota Motozato
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Hisanori Kanazawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Satoshi Araki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Satoru Suzuki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences and Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
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Pessinaba S, Atti YDM, Afassinou YM, Pio M, Kaziga W, Géraldo R, Atta B, Kpélafia M, Simwétaré MF, Dossim P, Baragou S, Damorou F. [Prevalence and determinants of the increased carotid intima-media thickness in a population of 1203 black African hypertensive]. Ann Cardiol Angeiol (Paris) 2019; 68:162-167. [PMID: 30290917 DOI: 10.1016/j.ancard.2018.08.032] [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: 06/02/2017] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate the prevalence and determinants of increased carotid intima-media thickness (IMT) in a population of black hypertensive patients and it influence of on the assessment of their overall cardiovascular risk. PATIENTS AND METHODS This was a 16-month, cross-sectional study conducted in the outpatient unit of the cardiology department of the Campus teaching hospital of Lome, and included 1203 hypertensive patients, both sexes, aged 35 years and more. Each patient benefited from a carotid IMT measure. Carotid IMT was increased if it was>0.9mm and the plaque was defined as a carotid IMT>1.2mm. RESULTS The mean age of our patients was 53.3±10.4 years with a sex ratio of 1.6 in favor of women. The duration of hypertension was less than 5 years in 56.7% and hypertension was grade 1 in 47.7% of cases. The mean carotid IMT was 0.89mm±0.20. The prevalence of the increased carotid IMT was 45.8% and that of an atheroma plaque was 15.8%. Carotid IMT was correlated with age (P˂0.0001), duration of arterial hypertension (P=0.01), history of stroke (P˂0.0001), and presence of left ventricular hypertrophy to cardiac ultrasound (P=0.01). The overall cardiovascular risk was modified after taking into account the carotid IMT. An increase in cardiovascular risk was observed in 30.5% of hypertensive patients. CONCLUSION Increased carotid intima-media thickness is frequent in Togolese hypertension. The determining factors are age, duration of arterial hypertension, left ventricular hypertrophy and stroke. The systematic measurement of the carotid intima-media thickness would better evaluate the overall cardiovascular risk for our patients.
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Affiliation(s)
- S Pessinaba
- Service de cardiologie, CHU Campus Lomé, Togo.
| | - Y D M Atti
- Service de cardiologie, CHU Campus Lomé, Togo
| | | | - M Pio
- Service de cardiologie, CHU Sylvanus Olympio, Togo
| | - W Kaziga
- Service de cardiologie, CHU Campus Lomé, Togo
| | - R Géraldo
- Service de cardiologie, CHU Campus Lomé, Togo
| | - B Atta
- Service de cardiologie, CHU Sylvanus Olympio, Togo
| | - M Kpélafia
- Service de cardiologie, CHU Campus Lomé, Togo
| | | | - P Dossim
- Service de cardiologie, CHU Campus Lomé, Togo
| | - S Baragou
- Service de cardiologie, CHU Sylvanus Olympio, Togo
| | - F Damorou
- Service de cardiologie, CHU Campus Lomé, Togo
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17
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Owaki Y, Watanabe K, Iwasaki A, Saitou T, Matsushita H, Wakatsuki A. Placental hypoplasia and maternal organic vascular disorder in pregnant women with gestational hypertension and preeclampsia. J Matern Fetal Neonatal Med 2019; 34:353-359. [PMID: 30983440 DOI: 10.1080/14767058.2019.1608175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed to investigate the etiology and pathology of preeclampsia (PE), a two-stage disorder involving uteroplacental dysfunction resulting from abnormal implantation and placentation, and gestational hypertension (GH), for which maternal organic vascular disorder is often an underlying factor.Methods: We assessed concentrations of oxygen free radicals (d-ROMs), maternal angiogenic factor (PlGF), and antiangiogenic factor (sFlt-1), placental hypoxic changes, oxidative DNA damage, and maternal organic vascular disorders in 23 women with PE (PE group), 13 with GH (GH group), and 16 with uncomplicated pregnancies (normal group). Intima-media thickness (IMT) of the carotid artery was assessed as a proxy for maternal organ vascular disorder. Immunohistochemical analysis was performed to measure the proportion of placental trophoblast cell nuclei staining positive for hypoxia-inducible factor-1α (HIF-1α), which reflects hypoxic changes, and 8-hydroxy-2'-deoxyguanosine (8-OHdG), which reflects oxidative DNA damage.Results: Maternal serum d-ROM concentrations were significantly increased in both GH and PE groups relative to the normal group. Maternal serum d-ROM concentrations were significantly increased in both GH and PE groups relative to the normal group. Maternal serum sFlt-1 concentrations, ratio of sFlt-1/PlGF, and proportions of HIF-1α-positive nuclei and 8-OHdG-positive nuclei were significantly higher in the PE group compared to GH and normal groups. IMT was significantly greater in GH and PE groups compared to the normal group, and was higher in the GH group compared to the PE group.Conclusions: Our findings suggest that placental hypoxic changes and oxidative DNA damage are severe in patients with PE and accompanied by an increase in antiangiogenic factors. Moreover, maternal organ vascular disorder was more severe in patients with GH compared to those with PE, as assessed by IMT.Key message: PE is a two-stage disorder that involves uteroplacental dysfunction, and organic vascular disorder underlies GH.
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Affiliation(s)
- Yuki Owaki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kazushi Watanabe
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ai Iwasaki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takuya Saitou
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroshi Matsushita
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
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18
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Tsioufis C, Konstantinidis D, Nikolakopoulos I, Vemmou E, Kalos T, Georgiopoulos G, Vogiatzakis N, Ifantis A, Konstantinou K, Gennimata V, Tousoulis D. Biomarkers of Atrial Fibrillation in Hypertension. Curr Med Chem 2019; 26:888-897. [DOI: 10.2174/0929867324666171006155516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/05/2017] [Accepted: 12/30/2017] [Indexed: 12/20/2022]
Abstract
Background:
Atrial fibrillation (AF) is the most frequently encountered cardiac
arrhythmia globally and substantially increases the risk for thromboembolic disease.
Albeit, 20% of all cases of AF remain undiagnosed. On the other hand, hypertension amplifies
the risk for both AF occurrences through hemodynamic and non-hemodynamic
mechanisms and cerebrovascular ischemia. Under this prism, prompt diagnosis of undetected
AF in hypertensive patients is of pivotal importance.
Method:
We conducted a review of the literature for studies with biomarkers that could
be used in AF diagnosis as well as in predicting the transition of paroxysmal AF to sustained
AF, especially in hypertensive patients.
Results:
Potential biomarkers for AF can be broadly categorized into electrophysiological,
morphological and molecular markers that reflect the underlying mechanisms of adverse
atrial remodeling. We focused on P-wave duration and dispersion as electrophysiological
markers, and left atrial (LA) and LA appendage size, atrial fibrosis, left ventricular
hypertrophy and aortic stiffness as structural biomarkers, respectively. The heterogeneous
group of molecular biomarkers of AF encompasses products of the neurohormonal
cascade, including NT-pro BNP, BNP, MR-pro ANP, polymorphisms of the ACE and
convertases such as corin and furin. In addition, soluble biomarkers of inflammation (i.e.
CRP, IL-6) and fibrosis (i.e. TGF-1 and matrix metalloproteinases) were assessed for predicting
AF.
Conclusion:
The reviewed individual biomarkers might be a valuable addition to current
diagnostic tools but the ideal candidate is expected to combine multiple indices of atrial
remodeling in order to effectively detect both AF and adverse characteristics of high risk
patients with hypertension.
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Affiliation(s)
- Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitris Konstantinidis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Ilias Nikolakopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Evi Vemmou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Theodoros Kalos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Georgios Georgiopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Nikolaos Vogiatzakis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Aris Ifantis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinou Konstantinou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Vasiliki Gennimata
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Differential impact of local and regional aortic stiffness on left ventricular remodeling: a cardiovascular magnetic resonance study. J Hypertens 2019; 36:552-559. [PMID: 29334490 DOI: 10.1097/hjh.0000000000001597] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Left ventricular (LV) remodeling and aortic stiffness have independent predictive value for all causes and cardiovascular mortality. Because elastic properties of the arterial wall vary along the aortic pathway, we hypothesized that local and regional aortic stiffness could differently impact on LV remodeling. METHODS AND RESULTS Regional aortic stiffness was determined from carotid-femoral pulse wave velocity (cfPWV) measured by aplanation tonometry. Aortic arch pulse wave velocity was measured by phase contrast cardiovascular magnetic resonance (CMR). Local stiffness was calculated in the ascending aorta pulse wave velocity (aaPWV) and descending aorta pulse wave velocity using central pulse pressure measurement, cine CMR acquisition, and surface change estimation. CMR LV remodeling was expressed as LV mass to end-diastolic volume ratio.We evaluated 146 study participants (41 ± 15 years) free of overt cardiovascular disease. In stepwise multivariate regression analysis, cfPWV and aaPWV were significantly and independently correlated to mass to end-diastolic volume ratio (partial R = 0.07 and R = 0.10, respectively, all P < 0.005) after adjustment for age, sex, BMI, brachial mean blood pressure, and central pulse pressure. Descending aorta pulse wave velocity was correlated with mass to end-diastolic volume ratio to a lower extent (R = 0.04, P = 0.0115) and aortic arch pulse wave velocity was not independently associated with mass to end-diastolic volume ratio. CfPWV and aaPWV were both independently associated with mass to end-diastolic volume ratio, explaining 5 and 8% of mass to end-diastolic volume ratio variance, respectively. CONCLUSION In study participants free of overt cardiovascular disease, stiffness of the ascending aorta representing the local proximal aortic function face to the LV and of the downstream aortic pathway assessed by cfPWV reflecting more advanced alterations of material properties involving the entire aorta, are independent determinants of LV remodeling after adjustment to age, BMI, mean blood pressure, and sex.
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20
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Do treatment-induced changes in arterial stiffness affect left ventricular structure? A meta-analysis. J Hypertens 2019; 37:253-263. [DOI: 10.1097/hjh.0000000000001918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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21
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Takahashi T, Shishido T, Watanabe K, Sugai T, Toshima T, Kinoshita D, Yokoyama M, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Miyamoto T, Watanabe T, Shibata Y, Konta T, Ueno Y, Kato T, Kayama T, Kubota I, Watanabe M. Ventricular wall stress and silent myocardial damage are associated with pulse pressure in the general population. J Clin Hypertens (Greenwich) 2018; 20:1319-1326. [PMID: 30035383 DOI: 10.1111/jch.13349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/20/2018] [Accepted: 06/07/2018] [Indexed: 11/30/2022]
Abstract
Pulse pressure (PP) is a risk factor for cardiovascular diseases and is associated with increased afterload and myocardial oxygen demand. Brain natriuretic peptide (BNP) and heart-type fatty acid-binding protein (H-FABP) are known as biomarkers indicating ventricular wall stress and silent myocardial damage. However, the association between PP and ventricular wall stress and silent myocardial damage in the general population is unclear. The authors enrolled 3504 patients who participated in a community-based annual health check. Serum levels of BNP and H-FABP were measured as markers of ventricular wall stress and silent myocardial damage. Patients were divided into four groups according to the quartiles of PP. Patients in the highest PP group showed higher serum BNP and H-FABP levels than that of the other groups. Multivariate logistic analysis showed that high PP was independently associated with ventricular wall stress and silent myocardial damage on the basis of BNP and H-FABP levels. Compared with systolic blood pressure, diastolic blood pressure, and mean blood pressure, PP was superior in predicting ventricular wall stress and silent myocardial damage evaluated according to BNP and H-FABP levels, which was reflected by the receiver operating characteristic analysis. Screening of healthy patients revealed that high PP was related to high BNP and H-FABP levels, suggesting that an asymptomatic general population with high PP may be exposed to ventricular wall stress and myocardial damage and might be susceptible to silent heart failure.
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Affiliation(s)
- Tetsuya Takahashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Tetsuro Shishido
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Ken Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takayuki Sugai
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Taku Toshima
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Daisuke Kinoshita
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Miyuki Yokoyama
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Harutoshi Tamura
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Satoshi Nishiyama
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Hiroki Takahashi
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takanori Arimoto
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Takuya Miyamoto
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Yoko Shibata
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuneo Konta
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Yoshiyuki Ueno
- Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan
| | - Takeo Kato
- Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan
| | - Takamasa Kayama
- Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan
| | - Isao Kubota
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
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Ng KYB, Simpson NAB, Cade JE, Greenwood DC, Mcardle HJ, Ciantar E, Alwan NA. Is infant arterial stiffness associated with maternal blood pressure in pregnancy? Findings from a UK birth cohort (Baby VIP study). PLoS One 2018; 13:e0200159. [PMID: 30001353 PMCID: PMC6042719 DOI: 10.1371/journal.pone.0200159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/20/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In adults, arterial stiffness measured by pulse wave velocity (PWV) is regarded as a predictor of cardiovascular disease. Infant vascular development depends on factors related to pregnancy, including maternal blood pressure (BP). This study assessed the association between maternal BP in pregnancy and infant brachio-femoral PWV at age 2-6 weeks. METHODS The Baby Vascular health and Iron in Pregnancy (Baby VIP) study is a birth cohort which measured PWV and heart rate (HR) in 284 babies in Leeds, UK, at 2-6 weeks after birth. Maternal BP measurements at 12 and 36 weeks gestation was collected from antenatal clinical records. Multivariable linear regression models assessed associations between maternal systolic and diastolic BPs, and BP change from booking to 36 weeks, with infant PWV adjusting for covariables at both mother and baby level. RESULTS There was no evidence of an association between infant PWV and maternal systolic BP at booking (adjusted regression coefficient -0.01 m/s per 10mmHg, 95% CI -0.11, 0.14, p = 0.84) or at 36 weeks (adjusted regression coefficient 0.00 m/s per 10mmHg, 95% CI -0.12, 0.11, p = 0.95). Change between 12 and 36 weeks gestation of more than 30 mmHg in systolic BP or 15 mmHg in diastolic BP was also not associated with infant PWV. There was an inverse relationship between infant HR and infant PWV (regression coefficient -0.14 m/s per 10 bpm, 95% CI -0.22, -0.05, p<0.01). CONCLUSIONS This study has shown no evidence of association between infant PWV at 2-6 weeks of age and maternal BP in early or late pregnancy. Infant HR was inversely associated with infant PWV. Further studies are required to determine the predictors of infant PWV as well as the importance and long term implications of PWV measurements in infants.
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Affiliation(s)
- Ka Ying Bonnie Ng
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Department of Obstetrics and Gynaecology, Princess Anne Hospital,Southampton, United Kingdom
| | - Nigel A. B. Simpson
- Department of Women’s and Children’s Health, University of Leeds, Leeds, United Kingdom
| | - Janet E. Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Darren C. Greenwood
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Harry J. Mcardle
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Etienne Ciantar
- Department of Women’s and Children’s Health, University of Leeds, Leeds, United Kingdom
| | - Nisreen A. Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
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23
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Pääkkö TJW, Perkiömäki JS, Kesäniemi YA, Ylitalo AS, Lumme JA, Huikuri HV, Ukkola OH. Increasing ambulatory pulse pressure predicts the development of left ventricular hypertrophy during long-term follow-up. J Hum Hypertens 2018; 32:180-189. [PMID: 29416118 DOI: 10.1038/s41371-018-0034-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/09/2017] [Accepted: 12/12/2017] [Indexed: 01/19/2023]
Abstract
Ambulatory blood pressure (ABP) has been shown to have an association with left ventricular hypertrophy (LVH). We evaluated the association between ABP characteristics and the development of LVH during long-term follow-up (20 years) in 420 middle-aged subjects from OPERA cohort. ABP measurements (ABPM) were recorded and echocardiographic examinations were performed at baseline and revisit. Anthropometrics were measured and laboratory analyses performed at visit. The questionnaire presented to all participants elicited detailed information about their habits. Left ventricular mass index (LVMI) was calculated according to Troys method. Baseline LVMI was a significant independent predictor of LVMI change (p < 0.001). None of the baseline continuous ABPM predicted the change in LVMI. A greater increase in daytime and night-time systolic blood pressure (BP) (p from 0.006 to 0.048) and 24 h, daytime and night-time pulse pressure (PP) (p from 0.005 to 0.034) predicted a greater increase in LVMI. Especially the increase in night-time SBP (p = 0.006) and PP (p = 0.005) predicted a greater increase in LVMI. We also considered circadian BP profiles among subjects, whose ABPM at baseline and echocardiographic measurements both at baseline and follow-up were available. Diastolic non-dippers were observed to show a greater increase in LVMI compared to diastolic dippers (10.6 ± 33.0 g/m2 vs. 7.0 ± 28.8 g/m2, p = 0.032), when baseline LVMI and in-office DBP were taken account. These findings suggest that an increasing ambulatory PP increases and a diastolic non-dipping status may increase the risk for the development of LVH during later life course.
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Affiliation(s)
- Tero J W Pääkkö
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | - Juha S Perkiömäki
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | | | - Antti S Ylitalo
- Lappi Central Hospital, Rovaniemi, University of Oulu, Oulu, Finland
| | - Jarmo A Lumme
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Heikki V Huikuri
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Olavi H Ukkola
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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24
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Pääkkö TJW, Renko RJ, Perkiömäki JS, Kesäniemi YA, Ylitalo AS, Lumme JA, Huikuri HV, Ruskoaho H, Vuolteenaho O, Ukkola OH. Ambulatory Pulse Pressure Predicts the Development of Left Ventricular Diastolic Dysfunction in Over 20 Years of Follow-up. Am J Hypertens 2017; 30:985-992. [PMID: 28911024 DOI: 10.1093/ajh/hpx087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 05/03/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Ambulatory blood pressure (ABP) has been shown to have an association with left ventricular diastolic dysfunction (LVDD) in cross-sectional assessments. We evaluated the association between ABP measurement (ABPM) and the development of LVDD during over 20 years of follow up in 414 middle-aged subjects from OPERA cohort. METHODS ABPM, clinical, and anthropometric measurements were performed in baseline. Echocardiographic measurements were performed at baseline and during follow-up and E/E' ≥15 was considered indicating significant LVDD. RESULTS Several baseline clinical characteristics (age, female gender, short stature, body mass index, prevalence of diabetes, in-office systolic BP (SBP), in-office pulse pressure (PP), N-terminal pro-atrial natriuretic peptide, and the use of antihypertensive therapy) were associated with the development of LVDD. Baseline 24-hour mean, daytime mean or nighttime mean SBP or diastolic BP were not associated with the development of LVDD, neither were different circadian BP profiles. Instead 24-hour mean, daytime mean and nighttime mean PP showed significant association with the development of LVDD (P from <0.001 to 0.001) even after adjustment with significant baseline clinical characteristics (P from 0.001 to 0.016). CONCLUSION These findings suggest that ambulatory PP has an independent predictive value in the development of LVDD during over 20 years of follow-up.
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Affiliation(s)
- Tero J W Pääkkö
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Reko J Renko
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha S Perkiömäki
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | | | - Antti S Ylitalo
- Lappi Central Hospital, Rovaniemi, University of Oulu, Oulu, Finland
| | - Jarmo A Lumme
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Heikki V Huikuri
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Heikki Ruskoaho
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Olli Vuolteenaho
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Olavi H Ukkola
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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25
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Schillaci G, Battista F, D'Abbondanza M, Pucci G. The impact of the cardio-ankle vascular index on left ventricular structure and function. Eur Heart J Suppl 2017. [DOI: 10.1093/eurheartj/suw062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Korneva VA, Kuznetsova TY. Assessment of arterial wall stiffness by 24-hour blood pressure monitoring. TERAPEVT ARKH 2016. [DOI: 10.17116/terarkh2016889119-124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Arterial wall stiffness is an early marker of cardiovascular diseases. The gold standard for assessment of the stiffness of large vessels is presently pulse wave velocity (PWV). Work is in progress on the study of the reference values of PWV in people of different genders and ages. 24-hour blood pressure (BP) monitoring is not only a procedure that can estimate diurnal BP variability, but also monitor the indicators of vascular wall stiffness in a number of cases over a 24-hour period. The given review highlights the pathophysiology of arterial stiffness, methods for its assessment, and the aspects of use in therapeutic practice.
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27
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Kim HL, Kim MA, Shim WJ, Oh S, Kim M, Park SM, Kim YH, Na JO, Shin MS, Yoon HJ, Shin GJ, Cho Y, Kim SE, Hong KS, Cho KI. Sex Difference in the Association Between Brachial Pulse Pressure and Coronary Artery Disease: The Korean Women's Chest Pain Registry (KoROSE). J Clin Hypertens (Greenwich) 2016; 19:38-44. [PMID: 27364854 DOI: 10.1111/jch.12862] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/27/2022]
Abstract
This study was performed to investigate the association between brachial pulse pressure (PP) and the presence/extent of obstructive coronary artery disease (CAD) in men and women. Study data were obtained from a nation-wide registry composed of 632 patients (173 men and 459 women, 58.1±10.5 years) with suspected CAD who underwent invasive coronary angiography. PP was higher in patients with obstructive CAD (≥50% stenosis) than those without CAD in both sexes (P=.032 in men; P<.001 in women). However, PP increased proportionally with the increasing number of obstructed coronary arteries in women (P<.001) but not in men (P=.070). Multiple logistic-regression analyses demonstrated that higher PP (≥50.5 mm Hg) was an independent factor for determining obstructive CAD even after controlling for potential confounders in women (odds ratio, 2.83; 95% confidence interval, 1.40-5.73; P=.004). These results were consistent in 173 selected women matched with 173 men based on age and CAD severity. In conclusion, the association between brachial PP and obstructive CAD was more pronounced in women than in men. Brachial PP can be a simple and useful indicator of CAD especially in women.
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Affiliation(s)
- Hack-Lyoung Kim
- Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myung-A Kim
- Seoul National University Boramae Medical Center, Seoul, Korea
| | | | - Sohee Oh
- Seoul National University Boramae Medical Center, Seoul, Korea
| | - Mina Kim
- Korea University Anam Hospital, Seoul, Korea
| | | | | | - Jin Oh Na
- Korea University Anam Hospital, Seoul, Korea
| | - Mi Seung Shin
- Gachon Medical School Gil Medical Center, Incheon, Korea
| | - Hyun Ju Yoon
- Chonnam National University Hospital, Gwangju, Korea
| | - Gil Ja Shin
- Ewha Womans University Hospital, Seoul, Korea
| | | | - Sung-Eun Kim
- Hanllym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Kyung-Soon Hong
- Hanllym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
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28
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Campo A, Heuten H, Goovaerts I, Ennekens G, Vrints C, Dirckx J. A non-contact approach for PWV detection: application in a clinical setting. Physiol Meas 2016; 37:990-1003. [PMID: 27244585 DOI: 10.1088/0967-3334/37/7/990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A need for screening methods for arteriosclerosis led to the development of several approaches to measure pulse wave velocity (PWV) being indicative of arterial stiffness. Carotid-femoral PWV (cfPWV) can be measured between common carotid artery (CCA) and femoral artery (FA) displaying the physiologically important stiffness of the conduit arteries. However, this measurement approach has several disadvantages, and a local PWV-measurement of CCA-stiffness has been proposed as an alternative in the past. In the presented pilot study, laser Doppler vibrometry (LDV) is used to measure PWV locally in the CCA (PWVLDV) in 48 patients aged between 48 and 70, with known atherosclerotic arterial disease: stabilized coronary artery disease (CAD), cerebro-vascular disease (CVD) or peripheral artery disease (PAD). Additionally, cfPWV, CCA distensibility coefficient (DC), CCA intima-media thickness (IMT), blood pressure (BP) and age were evaluated. LDV is a valid method for local PWV-measurement. The method is potentially easy to use, and causes no discomfort to the patient. PWVLDV correlates with age (R = 0.432; p = 0.002) as reported in related studies using other techniques, and measured values lay between 2.5 and 5.8 m s(-1), which is well in line with literature measures of local PWV in the CCA. In conclusion, PWVLDV potentially is a marker for arterial health, but more research in a larger and more homogeneous patient population is mandatory. In future studies, blood velocity measurements should be incorporated, as well as a reference method such as pulse wave imaging (PWI) or magnetic resonance imaging (MRI).
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Affiliation(s)
- Adriaan Campo
- Laboratory of Biomedical Physics, Faculty of Science, University of Antwerp, Groenenborgerlaan 171 B-2020 Antwerp, Belgium. Ultrasound Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, 630 West 168th Street, NY 10032, USA
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29
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Tokitsu T, Yamamoto E, Hirata Y, Kusaka H, Fujisue K, Sueta D, Sugamura K, Sakamoto K, Tsujita K, Kaikita K, Hokimoto S, Sugiyama S, Ogawa H. Clinical significance of pulse pressure in patients with heart failure with preserved left ventricular ejection fraction. Eur J Heart Fail 2016; 18:1353-1361. [PMID: 27197000 DOI: 10.1002/ejhf.559] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 01/22/2016] [Accepted: 03/24/2016] [Indexed: 11/08/2022] Open
Abstract
AIMS Although pulse pressure (PP) is a recognized risk factor for various cardiovascular diseases, its association with cardiovascular outcomes in patients with heart failure with preserved ejection fraction (HFpEF) is uncertain. METHODS AND RESULTS We enrolled 512 of 951 consecutive HFpEF patients admitted to the Kumamoto University Hospital between 2007 and 2013 and divided them into five groups according to PP quintiles. Blood pressure and pulse wave velocity (PWV) were measured by an ankle-brachial index device. The PP values in HFpEF were significantly and positively correlated with PWV and LV stroke volume index, and were negatively correlated with estimated glomerular filtration rate and haemoglobin levels. Furthermore, plasma B-type natriuretic peptide levels in HFpEF patients with the lowest (<45 mmHg) and highest PP (≥75 mmHg) were significantly higher than those with other PP (45-74 mmHg). The percentage of total cardiovascular and heart failure (HF)-related events by PP category resulted in U- and J-shaped curves. The higher frequency of coronary-related events was nearly linear. In the Kaplan-Meier analysis, HFpEF patients with the lowest and highest PP quintiles had a significantly higher risk of cardiovascular and HF-related events than those with other PPs (45-74 mmHg) (log-rank test, both P < 0.01). Conversely, the frequency of coronary-related events in the highest PP group, but not in the lowest PP group, was significantly higher than in other PP groups. CONCLUSION Pulse pressure lower than 45 mmHg and higher than 75 mmHg was closely associated with HFpEF prognosis, indicating the clinical significance of PP for risk stratification of HFpEF.
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Affiliation(s)
- Takanori Tokitsu
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Yoshihiro Hirata
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hiroaki Kusaka
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Koichi Sugamura
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seiji Hokimoto
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Seigo Sugiyama
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.,Diabetes Care Centre, Jinnouchi Hospital, Kumamoto, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Pressure-independent relationship of aortic characteristic impedance with left ventricular mass and geometry in untreated hypertension. J Hypertens 2016; 33:153-60. [PMID: 25269017 DOI: 10.1097/hjh.0000000000000354] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
METHOD We investigated whether aortic characteristic impedance (Zc), that is, the ratio between the pulsatile change in pressure and flow in the proximal aorta, is related to left ventricular hypertrophy and geometry independently of blood pressure (BP). A total of 438 never-treated hypertensive individuals (men 62%, age 48 ± 11 years, BP 147/90 ± 16/10 mm Hg) underwent echocardiography and 24 h BP monitoring. Aortic pressure waveform was obtained from radial tonometry with a generalized transfer function (SphygmoCor). Using a validated aortic blood flow model based on higher order Windkessel theory (ARCSolver), aortic Zc, forward (Pf) and backward (Pb) wave amplitudes and their ratio (Pb/Pf = reflection magnitude) were calculated from central waveform. RESULTS After adjusting for age, BMI, and 24-h SBP, aortic Zc was higher in individuals with left ventricular hypertrophy (0.230 ± 0.09 vs. 0.205 ± 0.07 arbitrary units, P = 0.04 in women; 0.232 ± 0.07 vs. 0.214 ± 0.06 arbitrary units, P < 0.05 in men). Women with left ventricular concentric remodeling had higher adjusted Zc (0.225 ± 0.08 vs. 0.203 ± 0.07 arbitrary units, P = 0.04), whereas men did not differ (0.218 ± 0.07 vs. 0.218 ± 0.07 arbitrary units, P = 0.64). After controlling for age, BMI, 24 h SBP, and other relevant variables, aortic Zc independently predicted left ventricular mass (β = 0.14, P < 0.05) and relative wall thickness (β = 0.21, P < 0.01) in women, and left ventricular mass in men (β = 0.11, P < 0.05), whereas other arterial function parameters had no independent relation with left ventricular mass or geometry. CONCLUSION Aortic Zc has a significant association with left ventricular mass and a sex-specific one with left ventricular concentric geometry in hypertension. These effects are independent from, and additional to, those of 24 h SBP.
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Chen SC, Lee WH, Hsu PC, Lin MY, Lee CS, Lin TH, Voon WC, Lai WT, Sheu SH, Su HM. Association of Brachial-Ankle Pulse Wave Velocity With Cardiovascular Events in Atrial Fibrillation. Am J Hypertens 2016; 29:348-56. [PMID: 26271108 DOI: 10.1093/ajh/hpv124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/03/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) and increased arterial stiffness share several risk factors and the 2 diseases often coexist. However, the prognostic value of increased arterial stiffness remains uncertain in the AF population. We evaluated whether brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, can predict cardiovascular events, and determined that the baPWV is a more favorable prognostic marker compared with conventional clinical and echocardiographic markers in patients with AF. METHODS We enrolled 167 patients with persistent AF. Arterial stiffness was assessed using baPWV. Cardiovascular events were defined as cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, and hospitalization for heart failure. The relative risk of cardiovascular events was analyzed using Cox regression models. An improvement in model prediction was determined using the -2 log likelihood ratio statistic. RESULTS During a median 26-month follow-up, 42 (24.9%) cardiovascular events were observed. The baPWV emerged as an independent predictor of cardiovascular events (adjusted hazard ratio: 1.152; 95% confidence interval: 1.054-1.259; P = 0.002) in the multivariate analysis. Furthermore, the addition of baPWV to a Cox model comprising standard clinical, biochemical, and echocardiographic parameters improved the prediction of adverse cardiovascular events (P < 0.001). CONCLUSIONS In patients with AF, a high baPWV is associated with increased cardiovascular events and improve the prediction of adverse cardiovascular events. Hence, baPWV might be included when examining patients with AF for prediction of adverse cardiovascular outcomes.
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Affiliation(s)
- Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsien Lee
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Chao Hsu
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chee-Siong Lee
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chol Voon
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Ter Lai
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hsiung Sheu
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Bell V, Sigurdsson S, Westenberg JJM, Gotal JD, Torjesen AA, Aspelund T, Launer LJ, Harris TB, Gudnason V, de Roos A, Mitchell GF. Relations between aortic stiffness and left ventricular structure and function in older participants in the Age, Gene/Environment Susceptibility--Reykjavik Study. Circ Cardiovasc Imaging 2015; 8:e003039. [PMID: 25795761 DOI: 10.1161/circimaging.114.003039] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Left ventricular (LV) contraction displaces the aortic annulus and produces a force that stretches the ascending aorta. We hypothesized that aortic stiffening increases this previously ignored component of LV load and may contribute to hypertrophy. Conversely, aortic stretch-related work represents stored energy that may facilitate early diastolic filling. METHODS AND RESULTS We performed MRI of the aorta and LV in 347 participants (72-91 years old, 189 women) in the Age, Gene/Environment Susceptibility-Reykjavik Study to examine relations of aortic stretch with LV structure and function. Aortic stiffness was evaluated as the product of Young's modulus and aortic wall thickness. Force was computed from Young's modulus and longitudinal aortic strain; work was the integrated product of force and annulus displacement during systole. LV mass and dynamic volume were measured using the area-length method. Filling was assessed from time-resolved LV volume curves. In multivariable models that adjusted for age, sex, height, weight, end-diastolic LV volume, augmentation index, end-systolic pressure, and cardiovascular disease risk factors, higher aortic stiffness was associated with increased LV mass (β=3.0±0.8% per SD, P<0.001; sex interaction, P=0.8). Greater stretch-related aortic work was associated with enhanced early filling in men (β=4.0±0.8 mL/SD; P<0.001), but not in women (β=-0.4±0.7 mL/SD; P=0.6). CONCLUSIONS Higher aortic stiffness was associated with higher LV mass, independently of pressure. Higher stretch-related work was associated with greater early diastolic filling in men only. Impaired diastolic recovery of energy stored by systolic proximal aortic stretch may contribute to increased susceptibility to diastolic dysfunction in women.
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Affiliation(s)
- Vanessa Bell
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Sigurdur Sigurdsson
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Jos J M Westenberg
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - John D Gotal
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Alyssa A Torjesen
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Thor Aspelund
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Lenore J Launer
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Tamara B Harris
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Vilmundur Gudnason
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Albert de Roos
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.)
| | - Gary F Mitchell
- From Cardiovascular Engineering, Inc, Norwood, MA (V.B., J.D.G., A.A.T., G.F.M.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
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Weberruß H, Pirzer R, Böhm B, Elmenhorst J, Pozza RD, Netz H, Oberhoffer R. Increased intima-media thickness is not associated with stiffer arteries in children. Atherosclerosis 2015; 242:48-55. [PMID: 26177274 DOI: 10.1016/j.atherosclerosis.2015.06.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/29/2015] [Accepted: 06/22/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Subclinical atherosclerosis can be assessed via sonographic measurement of intima-media thickness and carotid artery distensibility, both may already be pathologically altered in childhood. Therefore, the purpose of this study was to provide reference percentiles and investigate possible associations between alterations of intima-media thickness and distensibility. METHODS Carotid intima-media thickness and distensibility was measured via B- and M-mode ultrasound. Distensibility was defined by arterial compliance, elastic modulus, stiffness parameter β, and local pulse wave velocity β. Age- and height-dependent reference values were calculated separately for boys and girls among 690 (intima-media thickness) and 870 (distensibility) non-obese children aged 7-17 years. RESULTS Intima-media thickness and distensibility did not increase significantly with age or differ between boys and girls. Systolic blood pressure and body mass index were independent predictors of intima-media thickness, while an increased systolic blood pressure or pulse pressure was associated with stiffer arteries. Increased intima-media thickness was accompanied by higher arterial compliance and lower stiffness. CONCLUSION Using this healthy cohort, we describe a functional and non-pathological arterial adaptation wherein an increase in intima-media thickness is not associated with stiffer arteries.
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Affiliation(s)
- Heidi Weberruß
- Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany.
| | - Raphael Pirzer
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Birgit Böhm
- Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Julia Elmenhorst
- Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Robert Dalla Pozza
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Heinrich Netz
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Renate Oberhoffer
- Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Abstract
Pathophysiological studies have extensively investigated the structural factor in hypertension, including large and small artery remodeling and functional changes. Here, we review the recent literature on the alterations in small and large arteries in hypertension. We discuss the possible mechanisms underlying these abnormalities and we explain how they accompany and often precede hypertension. Finally, we propose an integrated pathophysiological approach to better understand how the cross-talk between large and small artery changes interacts in pressure wave transmission, exaggerates cardiac, brain and kidney damage, and lead to cardiovascular and renal complications. We focus on patients with essential hypertension because this is the most prevalent form of hypertension, and describe other forms of hypertension only for contrasting their characteristics with those of uncomplicated essential hypertension.
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Affiliation(s)
- Stéphane Laurent
- From the Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (S.L., P.B.); Université Paris-Descartes, Paris, France (S.L., P.B.); and INSERM U 970, Paris, France (S.L., P.B.).
| | - Pierre Boutouyrie
- From the Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France (S.L., P.B.); Université Paris-Descartes, Paris, France (S.L., P.B.); and INSERM U 970, Paris, France (S.L., P.B.)
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Mikola H, Pahkala K, Rönnemaa T, Viikari JS, Niinikoski H, Jokinen E, Salo P, Simell O, Juonala M, Raitakari OT. Distensibility of the Aorta and Carotid Artery and Left Ventricular Mass From Childhood to Early Adulthood. Hypertension 2015; 65:146-52. [DOI: 10.1161/hypertensionaha.114.03316] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abstract—
In adults, arterial distensibility decreases with age and relates to changes in cardiac left ventricular mass. Longitudinal data on changes in arterial distensibility from childhood to adulthood are lacking. Our aim was to study the effect of age and sex, and low-saturated fat dietary counseling on arterial distensibility from childhood to early adulthood. In addition, we assessed the association of arterial distensibility with left ventricular mass. Distensibility of the abdominal aorta and common carotid artery was measured repeatedly at ages 11, 13, 15, 17, and 19 years (n=395–472) in an atherosclerosis prevention trial (Special Turku Coronary Risk Factor Intervention Project [STRIP]). Aortic and carotid distensibility decreased with age (both
P
<0.0001). In boys, distensibility values were generally lower (
P
<0.0001) and showed steeper decrease by age (age and sex interaction: both
P
<0.01). The low-saturated fat dietary counseling given in STRIP was not significantly associated with arterial distensibility. Left ventricular mass increased with age (
P
<0.0001), and it was greater in boys (
P
<0.0001). In conclusion, a marked age-related decrease in vascular distensibility was found already at this young age, and this decrease was more pronounced in boys than girls. The longitudinal progression of aortic and carotid distensibility was related with changes in left ventricular mass.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00223600.
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Affiliation(s)
- Hanna Mikola
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Katja Pahkala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Tapani Rönnemaa
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Jorma S.A. Viikari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Harri Niinikoski
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Eero Jokinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Pia Salo
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Olli Simell
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Markus Juonala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
| | - Olli T. Raitakari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., P.S., O.S., M.J., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Medicine (T.R., J.S.A.V.), and Department of Clinical Physiology and Nuclear Medicine (OT.R.), University of Turku, Turku, Finland; Division of Medicine (T.R., J.S.A.V., M.J.), Department of Clinical Physiology and Nuclear Medicine (OT.R.), and Department of
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Schillaci G, Battista F, Settimi L, Anastasio F, Pucci G. Cardio-ankle vascular index and subclinical heart disease. Hypertens Res 2014; 38:68-73. [PMID: 25231254 DOI: 10.1038/hr.2014.138] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/13/2014] [Accepted: 08/03/2014] [Indexed: 12/20/2022]
Abstract
The relationship between arterial stiffness, measured as pulse wave velocity (PWV), and the left ventricle is confounded by the effects of blood pressure. We evaluated the relationship between carotid-femoral PWV and cardio-ankle vascular index (CAVI), a less pressure-dependent measurement of the stiffness constant (β) of the aorta and the iliac, femoral and tibial arteries, and obtained prognostically relevant measurements of left ventricular structure and systolic function. CAVI, carotid-femoral PWV and echocardiographic left ventricular mass and systolic function were determined in 133 subjects with either hypertension or high-normal blood pressure (33% treated; 56 ± 16 years, blood pressure 145/89 ± 21/12 mm Hg). Carotid-femoral PWV exhibited a direct relationship with systolic and diastolic blood pressure (r = 0.33/0.26, P < 0.001/0.014), whereas CAVI demonstrated no such relationship (r = 0.12/-0.05, both P > 0.1). Both CAVI and PWV correlated significantly with left ventricular mass index (r = 0.31, P<0.001; r = 0.21, P = 0.014). Subjects with inappropriately high left ventricular masses for a given cardiac workload (n = 44) had higher CAVI values (9.1 ± 2.0 vs. 7.9 ± 1.6, P < 0.001), but not higher PWV values (8.5 ± 2.5 vs. 8.7 ± 2.4, P>0.1). In a multivariate regression model, CAVI was independently associated with inappropriate left ventricular mass (β = 0.40, P < 0.001), along with body mass index. CAVI also demonstrated a negative relationship with left ventricular midwall fractional shortening (r = -0.41, P = 0.001) that was independent of age, sex, blood pressure and left ventricular mass in a multivariate analysis. In conclusion, a high CAVI is associated with inappropriately high left ventricular mass and low midwall systolic function. As a marker of arterial diastolic-to-systolic stiffening, CAVI may have a relationship with left ventricular structure and function that is independent of blood pressure levels.
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Affiliation(s)
- Giuseppe Schillaci
- 1] Dipartimento di Medicina, Università di Perugia, Perugia, Italy [2] Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Francesca Battista
- 1] Dipartimento di Medicina, Università di Perugia, Perugia, Italy [2] Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Laura Settimi
- Dipartimento di Medicina, Università di Perugia, Perugia, Italy
| | - Fabio Anastasio
- 1] Dipartimento di Medicina, Università di Perugia, Perugia, Italy [2] Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Giacomo Pucci
- 1] Dipartimento di Medicina, Università di Perugia, Perugia, Italy [2] Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
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Markers of inflammation, endothelial activation, and arterial stiffness in hypertensive heart disease and the effects of treatment: results from the SILVHIA study. J Cardiovasc Pharmacol 2014; 62:559-66. [PMID: 24084214 DOI: 10.1097/fjc.0000000000000017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We assessed the contribution of blood pressure (BP), inflammation, and endothelial activation to the development of structural vascular and cardiac changes in hypertension. Furthermore, the effects of antihypertensive therapy were studied. We studied 114 patients with hypertension and left ventricular hypertrophy and 38 matched hypertensive subjects without cardiac hypertrophy and 38 normotensive subjects. The group with hypertension and cardiac hypertrophy were randomized to treatment with an angiotensin receptor blocker (irbesartan) or a beta-adrenergic receptor blocker (atenolol) for 48 weeks. Markers of inflammation (high-sensitive C-reactive protein, interleukin-6, leukocyte counts), vascular function (ambulatory aortic stiffness index, arterial compliance, and pulse pressure), and endothelial activation (E-selectin, intracellular adhesion molecule-1, vascular adhesion molecule-1) were assessed. Markers of inflammation and arterial stiffness were lowest in the normotensive group and highest in patients with hypertensive heart disease; endothelial markers were similar between groups. Inflammation was independently related to BP. Markers of arterial stiffness were independently related to BP and to a lesser extent to left ventricular mass. Antihypertensive treatment improved arterial compliance; inflammatory and endothelial markers remained unchanged. In conclusion, markers of inflammation and arterial stiffness are independently related to BP. Antihypertensive therapy seems to improve arterial stiffness, but effects on markers of inflammation and endothelial activation are small.
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Tennant IA, Barnett AT, Thompson DS, Kips J, Boyne MS, Chung EE, Chung AP, Osmond C, Hanson MA, Gluckman PD, Segers P, Cruickshank JK, Forrester TE. Impaired cardiovascular structure and function in adult survivors of severe acute malnutrition. Hypertension 2014; 64:664-71. [PMID: 24980666 DOI: 10.1161/hypertensionaha.114.03230] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age/sex/body mass index-matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8±7.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16; P<0.001), stroke volume 0.44 (0.17; P=0.009), cardiac output 0.5 (0.16; P=0.001), and pulse wave velocity 0.32 (0.15; P=0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2-7.3 mm Hg; P=0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8-8.4 mm Hg min/L; P<0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity.
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Affiliation(s)
- Ingrid A Tennant
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Alan T Barnett
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Debbie S Thompson
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Jan Kips
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Michael S Boyne
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Edward E Chung
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Andrene P Chung
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Clive Osmond
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Mark A Hanson
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Peter D Gluckman
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Patrick Segers
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - J Kennedy Cruickshank
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Terrence E Forrester
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.).
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Ghista DN, Kabinejadian F. Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review. Biomed Eng Online 2013; 12:129. [PMID: 24330653 PMCID: PMC3867628 DOI: 10.1186/1475-925x-12-129] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/10/2013] [Indexed: 12/24/2022] Open
Abstract
In this paper, coronary arterial bypass grafting hemodynamics and anastomosis designs are reviewed. The paper specifically addresses the biomechanical factors for enhancement of the patency of coronary artery bypass grafts (CABGs). Stenosis of distal anastomosis, caused by thrombosis and intimal hyperplasia (IH), is the major cause of failure of CABGs. Strong correlations have been established between the hemodynamics and vessel wall biomechanical factors and the initiation and development of IH and thrombus formation. Accordingly, several investigations have been conducted and numerous anastomotic geometries and devices have been designed to better regulate the blood flow fields and distribution of hemodynamic parameters and biomechanical factors at the distal anastomosis, in order to enhance the patency of CABGs. Enhancement of longevity and patency rate of CABGs can eliminate the need for re-operation and can significantly lower morbidity, and thereby reduces medical costs for patients suffering from coronary stenosis. This invited review focuses on various endeavors made thus far to design a patency-enhancing optimized anastomotic configuration for the distal junction of CABGs.
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Affiliation(s)
| | - Foad Kabinejadian
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, Block EA #03-12, Singapore 117576, Singapore.
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Mori T, Watanabe K, Iwasaki A, Kimura C, Matsushita H, Shinohara K, Wakatsuki A. Differences in vascular reactivity between pregnant women with chronic hypertension and preeclampsia. Hypertens Res 2013; 37:145-50. [PMID: 24067892 DOI: 10.1038/hr.2013.131] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/26/2013] [Accepted: 08/25/2013] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to evaluate the distinct pathogenic mechanisms underlying chronic hypertension in pregnancy and preeclampsia in terms of oxidative stress and vascular reactivity. A total of 17 women with uncomplicated pregnancies, 30 women with preeclampsia and 17 women with chronic hypertension were evaluated. We measured serum derivatives of reactive oxygen metabolites (d-ROMs; marker of oxygen free radicals), flow-mediated vasodilation (FMD; marker of endothelial function) and intima-media thickness in the carotid artery (IMT; marker of atherogenesis) during pregnancy and 1 month after delivery. Serum d-ROM concentrations were significantly higher in women with chronic hypertension and severe preeclampsia than in the control group during pregnancy. d-ROM concentrations in all groups significantly decreased to similar levels 1 month after delivery. FMD was significantly lower during pregnancy in preeclamptic and chronic hypertension groups compared with the control group. FMD in preeclamptic groups significantly increased and normalized to control levels after delivery. Similarly, FMD in the chronic hypertension group significantly increased after delivery but was still lower. IMT in the chronic hypertension group was significantly higher than that in control and preeclamptic groups. These findings suggest that endothelial dysfunction induced by enhanced oxidative stress is reversible in women with preeclampsia, whereas impaired vascular reactivity may be associated with atherosclerotic changes in women with chronic hypertension.
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Affiliation(s)
- Toshitaka Mori
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kazushi Watanabe
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Ai Iwasaki
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Chiharu Kimura
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Hiroshi Matsushita
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Koichi Shinohara
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, School of Medicine, Aichi Medical University, Nagakute, Japan
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Gosse P, Cremer A, Papaioannou G, Yeim S. Arterial Stiffness From Monitoring of Timing of Korotkoff Sounds Predicts the Occurrence of Cardiovascular Events Independently of Left Ventricular Mass in Hypertensive Patients. Hypertension 2013; 62:161-7. [DOI: 10.1161/hypertensionaha.113.01039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philippe Gosse
- From the Department of Cardiology and Hypertension, University Hospital of Bordeaux, Bordeaux, France
| | - Antoine Cremer
- From the Department of Cardiology and Hypertension, University Hospital of Bordeaux, Bordeaux, France
| | - Georgios Papaioannou
- From the Department of Cardiology and Hypertension, University Hospital of Bordeaux, Bordeaux, France
| | - Sunthareth Yeim
- From the Department of Cardiology and Hypertension, University Hospital of Bordeaux, Bordeaux, France
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Turanlahti MI, Taskinen M, Saarinen-Pihkala U, Jokinen EV. Time-related arterial changes after allogeneic hematopoietic stem cell transplantation in children. Pediatr Res 2013; 73:777-82. [PMID: 23493165 DOI: 10.1038/pr.2013.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Metabolic syndrome is a frequent late effect in young adults after hematopoietic stem cell transplantation (HSCT) performed in childhood. METHODS To further study the signs of cardiovascular changes in HSCT patients, we performed noninvasive vascular ultrasonic measurements of arterial stiffness and endothelial function in 25 children (median age: 11.2 y) and in 22 healthy matched controls. RESULTS The distensibility of the common carotid artery (CCA) was significantly lower in the patients than in the controls (mean = 0.48, SD = 0.19 vs. mean = 0.64 mm Hg(-1) × 10(-2), SD = 0.28; P = 0.024). The distensibility decreased with time passed after HSCT (P = 0.009). The compliance of the CCA was decreased (mean = 0.10, SD = 0.04 vs. mean = 0.13 mm(2) × mm Hg(-1), SD = 0.05; P = 0.041), and the incremental elastic modulus (E inc) was higher in the patients than in the controls (mean = 2.05, SD = 0.7 vs. mean = 1.6 mm × 10(3), SD = 0.6; P = 0.019). E inc was associated with time passed after HSCT (P = 0.036). The size of the brachial artery and flow-mediated dilation did not differ between the groups. CONCLUSION Early mechanical changes of the arterial wall were found at young age after HSCT. Ultrasonography may offer a noninvasive method to find early alterations of the vascular bed and to optimize prevention of atherosclerosis in HSCT patients.
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Affiliation(s)
- Maila I Turanlahti
- Department of Pediatric Cardiology, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
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Levisianou D, Foussas S, Skopelitis E, Adamopoulou E, Xenopoulou T, Destounis A, Koukoulis G, Skoularigis I, Melidonis A, Triposkiadis F. Arterial stiffness predicts risk for long-term recurrence in patients with type 2 diabetes admitted for acute coronary event. Diabetes Res Clin Pract 2013; 99:315-20. [PMID: 23260851 DOI: 10.1016/j.diabres.2012.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 11/12/2012] [Accepted: 11/23/2012] [Indexed: 01/19/2023]
Abstract
OBJECTIVES to investigate the predictive value of arterial stiffness (AS) estimation for long-term recurrences in patients with type 2 diabetes (DM2) following acute coronary event. PATIENTS AND METHODS prospective observational study involving 119 DM2 patients without history of coronary heart disease admitted with ST-segment elevation myocardial infarction (STEMI). Medical history, anthropometrics, smoking, HbA1c, lipid profile, troponine-I levels, and left ventricular ejection fraction (LVEF) were recorded. Carotid-femoral pulse wave velocity (cf-PWV) was measured 1 month after discharge. Patients were followed up for 36 months or to reach an end-point: cardiovascular death, acute coronary event, angioplasty or hospitalization for acute heart failure. To facilitate analysis, patients were divided into two groups according to cf-PWV, using the accepted cut-off value of 12m/s. RESULTS overall, 34 patients had a recurrence. In Kaplan-Meier analysis patients with cf-PWV>12m/s had mean time-to-event 353±43 days compared to 505±115 days for patients with cf-PWV≤12m/s, log rank=0.0252. In multivariate analysis factors independently associated with recurrence were age (66.53±6.87 vs. 61.54±10.77 years, p=0.015), LVEF (41.66±8.21 vs. 47.58±8.11%, p=0.001) and cf-PWV (13.94±2.91 vs. 12.35±2.77m/s, p=0.008). CONCLUSIONS AS estimation in patients with DM2 after STEMI discriminate patients at higher risk for 3-year recurrence, and maybe valuable for distinguishing patients likely to require a more rigorous therapeutic intervention.
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Affiliation(s)
- Dimitrios Levisianou
- 2nd Department of Internal Medicine, Nikea General Hospital, 3 D.Mantouvalou str, Nikea, Greece.
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Pereira T, Vaz P, Oliveira T, Santos I, Pereira HC, Almeida V, Correia C, Cardoso J. Empirical mode decomposition for self-mixing Doppler signals of hemodynamic optical probes. Physiol Meas 2013; 34:377-90. [PMID: 23442889 DOI: 10.1088/0967-3334/34/3/377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A new type of optical probe based on laser Doppler self-mixing technology, for a truly non-contact measurement in a single location, and extraction of the temporal features of the distension wave in the arterial wall, was developed. The monitoring of temporal features allows the assessment of cardiovascular function when measurement is carried out at the carotid artery. An algorithm based on the short-time Fourier transform and empirical mode decomposition was applied to the test setup self-mixing signals for the determination of waveform features, with an accuracy of a few milliseconds and a root mean square error less than 3 ms. In vivo testing signals show great consistency in the measured pulse pressure waveform.
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Affiliation(s)
- Tânia Pereira
- Instrumentation Centre, Physics Department, University of Coimbra, Portugal.
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Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int 2012; 82:388-400. [DOI: 10.1038/ki.2012.131] [Citation(s) in RCA: 256] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. J Hypertens 2012; 30:396-402. [DOI: 10.1097/hjh.0b013e32834e4b75] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Larsson M, Kremer F, Claus P, Kuznetsova T, Brodin LA, D'hooge J. Ultrasound-based radial and longitudinal strain estimation of the carotid artery: a feasibility study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2011; 58:2244-2251. [PMID: 21989888 DOI: 10.1109/tuffc.2011.2074] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ultrasound-based estimation of arterial wall elasticity is commonly used to assess arterial stiffness. However, previous elastography studies have mostly addressed radial strain measurements, and the longitudinal strain has been more or less ignored. This study shows the feasibility of a speckle-tracking-based algorithm for simultaneous estimation of radial and longitudinal strain in the carotid artery in silico. Additionally, these results were preliminarily confirmed in vivo.
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Vriz O, Bossone E, Bettio M, Pavan D, Carerj S, Antonini-Canterin F. Carotid Artery Stiffness and Diastolic Function in Subjects without Known Cardiovascular Disease. J Am Soc Echocardiogr 2011; 24:915-21. [DOI: 10.1016/j.echo.2011.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Indexed: 11/24/2022]
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